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Evidence found and GRADE certainty

20 questions · 22 findings · 5 reviews · Dental public health and special care

No studies found 1 · 4.5%GRADE not reported 3 · 13.6%Very low 12 · 54.5%Low 6 · 27.3%Moderate 0 · 0%High 0 · 0%

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Plaque · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

Educational intervention with information and practical components… showed no clear difference in dental plaque compared with (Optimised) usual care (low certainty).

1 finding from 1 review

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Denture plaque · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

Educational intervention with information and practical components… showed no clear difference in denture plaque compared with (Optimised) usual care (low certainty).

1 finding from 1 review

Educational intervention with information only (theoretical dental health education, no practical training) vs usual care

Denture plaque · Residents of institutions for elderly people (nursing staff and residents took part in the education programme)
1 finding from 1 review

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Plaque · Adults (mean age 30.9 years), level of ID unclear; setting day centre

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… may leads to lower plaque (long term) compared with usual care (no specific treatment) (low certainty).

1 finding from 1 review

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Plaque · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified

Electric toothbrush (self, carer or carer-assisted brushing) showed no clear difference in plaque (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (low certainty).

2 findings from 1 review

Toothpaste with a plaque-disclosing agent vs Conventional toothpaste

Plaque · Children aged 7 to 13 years with Down syndrome (mild to moderate ID); setting residential
1 finding from 1 review
  • Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
    Short term (<6 weeks)
    Simplified Green & Vermillion Oral Hygiene Index (plaque), mean 10 days; percent mean difference 65 (intervention) vs 15 (control), P<0.0001 favouring the disclosing-agent toothpaste; 40 participants (SoF states 80,…
    1 study · 40 participants
    Very low

Oral hygiene training (toothbrushing routine) of people with ID vs No oral hygiene training of people with ID

Plaque · Children and adults with mild to profound ID; setting residential or school

It is very uncertain whether oral hygiene training (toothbrushing routine) of people with ID changes plaque (short term) compared with no oral hygiene training of people with ID (very low certainty).

1 finding from 1 review

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Plaque · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified

It is very uncertain whether special manual toothbrush (self, carer or carer-assisted brushing) changes plaque (short term) compared with conventional manual toothbrush (self, carer or carer-assisted… (very low certainty).

2 findings from 1 review

Oral hygiene care training of carers vs No training (or a placebo training session) of carers

Plaque · People with mixed levels of ID (age range unclear); setting residential

Oral hygiene care training of carers showed no clear difference in plaque (medium term) compared with no training (or a placebo training session) of carers (low certainty).

1 finding from 1 review

Individualised oral care plan based on a multidisciplinary assessment vs usual care

Plaque · Adults aged 22 to 57 years with mixed levels of ID; setting residential
1 finding from 1 review
  • Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
    Medium term (6 weeks to 12 months)
    Individualised oral care plan vs usual care. Subjective Oral Hygiene Rating scale 1-5 and Improvement Differential, mean 12 months; SOHR 2.97 (intervention) vs 3.10 (control); improvement differential 38% vs 5%; 79…
    1 study · 79 participants
    Very low

Discussion of individual clinical photographs (plaque highlighted by a disclosing agent) as an oral hygiene motivator, plus oral hygiene instruction vs No discussion of clinical photographs, but received the same oral hygiene instruction

Plaque · People with ID (level of ID and age unclear); setting day centre

It is very uncertain whether discussion of individual clinical photographs (plaque highlighted by… changes plaque (medium term) compared with no discussion of clinical photographs, but received the same oral… (very low certainty).

1 finding from 1 review

Enhanced one-to-one OHA vs Routine one-to-one OHA

Plaque · Children or adults (fit and healthy, or with a well-defined medical condition)

It is very uncertain whether enhanced one-to-one OHA changes periodontal health: plaque levels compared with one-to-one OHA (standard) (very low certainty).

1 finding from 1 review

Personalised one-to-one OHA vs Routine one-to-one OHA

Plaque · Children or adults (fit and healthy, or with a well-defined medical condition)

It is very uncertain whether personalised one-to-one OHA changes periodontal health: plaque levels compared with routine one-to-one OHA (very low certainty).

1 finding from 1 review

Any form of one-to-one oral hygiene advice (OHA) vs No OHA

Plaque · Children or adults (fit and healthy, or with a well-defined medical condition)

Any form of one-to-one oral hygiene advice (OHA) showed no clear difference in periodontal health: plaque levels compared with no OHA (low certainty).

1 finding from 1 review

Self-management (self-administered/self-monitored OHA) vs Professional OHA

Plaque · Children or adults (fit and healthy, or with a well-defined medical condition)

It is very uncertain whether self-management (self-administered/self-monitored OHA) changes periodontal health: plaque levels compared with professional OHA (very low certainty).

1 finding from 1 review

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs placebo or usual care

Plaque index (PI) / oral hygiene · Critically ill patients (adults and children) receiving mechanical ventilation in ICU
1 finding from 1 review

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs usual care

Dental state: No clinically important change in plaque index · People with serious mental illness (all included participants had schizophrenia); majority aged 18 to 65 years per NIMH 1987, or with…

It is very uncertain whether oral health education (advice and training) changes dental state: No clinically important change in plaque index compared with standard care (oral health advice not specifically emphasised beyond… (very low certainty).

1 finding from 1 review

Motivational interview plus oral health education vs Oral health education

Dental state: No clinically important change in plaque index · People with serious mental illness (all included participants had schizophrenia); majority aged 18 to 65 years per NIMH 1987, or with…

It is very uncertain whether motivational interview plus oral health education changes dental state: No clinically important change in plaque index compared with oral health education (very low certainty).

1 finding from 1 review

Monitoring (any means of observation, supervision, keeping under review, measuring or testing at intervals) vs No monitoring

Dental state: No clinically important change in plaque index · People with serious mental illness (all included participants had schizophrenia); majority aged 18 to 65 years per NIMH 1987, or with…

The review found no eligible studies for this question.

1 finding from 1 review