Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

3,703 questions · 3,824 findings · 858 reviews

No studies found 573 · 15%GRADE not reported 383 · 10%Very low 993 · 26%Low 1,062 · 27.8%Moderate 614 · 16.1%High 199 · 5.2%

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

Calculus · 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 calculus (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

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

Behaviour, attitude and self-efficacy (participant/carer preference) · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified
1 finding from 1 review
  • Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
    Long term (>12 months)
    Comparison 2.8 (reported; not GRADE-rated). One NRS (Bratel 1991, 23 participants), self-efficacy at 16 months: 10/12 people with ID using the electric toothbrush reported a preference for it, finding it easier to use…
    1 study · 23 participants
    GRADE not reported

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

Gingivitis · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified
1 finding from 1 review
  • Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
    Short term (<6 weeks)
    Electric vs manual toothbrush. Assorted gingival indices scale 0-4, 2-4 weeks; 252 participants (4 RCTs); Low. Four studies showed no significant differences for gingival inflammation short term; data could not be…
    4 studies · 252 participants
    Low

Oral hygiene interventions (mechanical plaque removal): knowledge-based, behavioural, or skills training for people with ID or their carers vs Usual care, no care, or a similar alternative intervention

Dental caries levels of people with ID · People with intellectual disabilities (ID), living at home, in day care, in hospital or in a residential care setting; all levels of ID as…

The review found no eligible studies for this question.

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

Gingival pocketing (long term) · 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 gingival pocketing (long term) compared with usual care (no specific treatment) (low certainty).

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

Oral hygiene interventions (mechanical plaque removal): knowledge-based, behavioural, or skills training for people with ID or their carers vs Usual care, no care, or a similar alternative intervention

Any unintended (positive or negative) effects of the interventions · People with intellectual disabilities (ID), living at home, in day care, in hospital or in a residential care setting; all levels of ID as…
1 finding from 1 review
  • Adverse/unintended effects addressed narratively: 10 of 34 studies investigated or reported negative unintended or adverse effects (e.g. difficulty with the electric or 3-headed toothbrushes, being frightened by the…
    10 studies
    GRADE not reported

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

Gingival inflammation (medium term) · 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 gingival inflammation (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (moderate certainty).

1 finding from 1 review

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

Oral health assessment and oral bacteria levels (medium term) · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified
1 finding from 1 review
  • Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
    Medium term (6 weeks to 12 months)
    Comparison 1.5 (graded in the Effects of interventions text; not tabulated in the SoF). Single-use suction toothbrush vs standard manual toothbrush (both with a chemical agent), 90 days, Ferozali 2007: Total Oral…
    1 study · 22 participants
    Very low

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

Gingival bleeding (various bleeding indices) · Adults (mean age 30.9 years), level of ID unclear; setting day centre

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… showed no clear difference in gingival bleeding (long term) compared with usual care (no specific treatment) (low certainty).

1 finding from 1 review

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

Behaviour, attitude and self-efficacy (carer experience) (medium term) · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified
1 finding from 1 review
  • Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
    Medium term (6 weeks to 12 months)
    Comparison 1.6 (graded in the Effects of interventions text; not tabulated in the SoF). Bildt 2010, Superbrush vs conventional, 4 months, 18 participants (1 RCT): carer handling of toothbrush MD 0.50 (95% CI -0.35 to…
    1 study · 18 participants
    Very low

Intervention not reported

Incidence of AAD · Children receiving antibiotic treatment between 4 and 28 days duration for a variety of infections

The intervention probably leads to lower incidence of AAD (moderate certainty).

1 finding from 1 review

Intervention not reported

Adverse events · Children receiving antibiotic treatment between 4 and 28 days duration for a variety of infections

The intervention showed no clear difference in adverse events (low certainty).

1 finding from 1 review

Comparison 2: any simplified antibiotic regimen vs 7 days injectable benzylpenicillin + injectable gentamicin

Neonatal mortality · neonates with possible serious bacterial infection

Comparison 2: any simplified antibiotic regimen showed no clear difference in neonatal mortality compared with the standard antibiotic regimen (7 days injectable benzylpenicillin… (moderate certainty).

1 finding from 1 review

Comparison 2: any simplified antibiotic regimen vs 7 days injectable benzylpenicillin + injectable gentamicin

Treatment failure · neonates with possible serious bacterial infection

Comparison 2: any simplified antibiotic regimen showed no clear difference in treatment failure compared with the standard antibiotic regimen (7 days injectable benzylpenicillin… (moderate certainty).

1 finding from 1 review