What do systematic reviews say?

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs usual care or no treatment

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes
  The impact of psychological interventions on clinical markers was assessed in three studies (Little 1997; Stewart 1991; Weinstein 1996). All three found that psychological interventions resulted in improved plaque…
  3 studies
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs attention control

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes
  Weinstein 1996 reported that the psychological intervention led to improvements in plaque score greater than that noted in the attention control group; however the sample size in each arm was very small (n=5) and the…
  2 studies
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs Educational intervention (oral hygiene education/instruction)

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes

  5 weeks (2 weeks post-intervention)
  Stewart 1991: while the educational intervention group and the cognitive behavioural intervention group both showed significant differences compared to the control group in plaque scores, the cognitive behavioural…
  1 study · 50 participants
  GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

School-based interventions may reduce dental plaque scores (SMD -0.32, favouring intervention), but the certainty of evidence is very low.

• Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes

  Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
  SMD -0.32 [-0.46, -0.18]
  7 studies · 3339 participants
  Very low

Salvadora persica (miswak) mouthrinse vs Chlorhexidine mouthrinse

When usual mechanical plaque control continued, Salvadora persica and chlorhexidine did not differ significantly for plaque; not GRADE-rated.

• The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes

  Post-intervention · In vivo clinical trial (human oral cavity) · Did not refrain from mechanical plaque control
  MD 0.17 [-0.08, 0.42]
  11 studies · 594 participants
  GRADE not reported
• The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes

  Post-intervention · In vivo clinical trial (human oral cavity) · Duration of mouthwash use: >=3 weeks
  MD 0.24 [-0.11, 0.60]
  7 studies · 420 participants
  GRADE not reported
• The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes

  Post-intervention · In vivo clinical trial (human oral cavity)
  MD 0.19 [0.01, 0.37]
  18 studies · 902 participants
  GRADE not reported

Salvadora persica (miswak) mouthrinse vs Chlorhexidine 0.2% mouthrinse

Salvadora persica was less effective than 0.2% chlorhexidine at reducing plaque (favours chlorhexidine); not GRADE-rated.

• The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes

  Post-intervention · In vivo clinical trial (human oral cavity) · Chlorhexidine concentration: 0.2%
  MD 0.12 [0.03, 0.21]
  12 studies · 566 participants
  GRADE not reported

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Salvadora persica rinse reduced plaque more than placebo (favours Salvadora persica); certainty not GRADE-rated (Shekelle grade Ia).

• The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes

  Post-intervention · In vivo clinical trial (human oral cavity)
  MD -0.59 [-0.82, -0.35]
  12 studies · 452 participants
  GRADE not reported

Brushing vs Effervescent tablets

• Interventions for cleaning dentures in adults 2009 · Cochrane All outcomes

  12 weeks
  Tarbet 1984 compared brushing with two types of effervescent tablets. No standard deviations were reported and therefore no data were entered for this outcome. Brushing was associated with significantly lower plaque…
  1 study · 75 participants
  GRADE not reported

Silicone surfactant cleanser vs Placebo / sham solution

Silicone surfactant cleanser led to lower visual plaque score compared with placebo / sham solution; GRADE not reported.

• Interventions for cleaning dentures in adults 2009 · Cochrane All outcomes

  14 days
  MD -0.88 [-1.00, -0.76]
  1 study
  GRADE not reported
• Interventions for cleaning dentures in adults 2009 · Cochrane All outcomes

  2 days
  MD -1.02 [-1.13, -0.91]
  1 study
  GRADE not reported

Enzyme cleanser vs Brushing

• Interventions for cleaning dentures in adults 2009 · Cochrane All outcomes
  Standard deviations were not reported for the relevant data so these were not included in the analysis. Reduction of plaque scores was associated with enzyme concentration (ANOVA, P < 0.001). Brushing alone and…
  1 study
  GRADE not reported

Enzyme cleanser vs Placebo / sham solution

• Interventions for cleaning dentures in adults 2009 · Cochrane All outcomes

  5 weeks; 3 months
  Both interventions reduced biofilm scores after 2 weeks. However, plaque scores were significantly lower for 'E' after 5 weeks (P < 0.05) and 3 months (P < 0.01), as assessed by Chi2 test. It was not possible to…
  1 study
  GRADE not reported