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Evidence found and GRADE certainty

85 questions · 138 findings · 22 reviews · Dental caries

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No studies found 1 · 0.7%GRADE not reported 115 · 83.3%Very low 11 · 8%Low 8 · 5.8%Moderate 3 · 2.2%High 0 · 0%

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Mean DMFT (decayed, missing, filled permanent teeth) · school‐age children and adolescents

Theory-based interventions showed no significant effect on DMFT scores (SMD -0.11; low certainty).

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Periodontal health status · school‐age children and adolescents

Theory-based interventions significantly improved periodontal health (SMD -1.18; moderate certainty).

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health behaviour (1-9 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health behavior (SMD 2.58; low certainty), with very high heterogeneity.

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health knowledge (1-9 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health knowledge (SMD 1.09; low certainty).

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Plaque index (PI) / oral hygiene · school‐age children and adolescents

Theory-based interventions significantly reduced dental plaque (SMD -1.92; moderate certainty).

1 finding from 1 review

Higher parental education (tertiary) vs Lower parental education (reference)

Early childhood caries (ECC) · Children aged 0-5 years in North Africa

Paternal tertiary education was associated with lower odds of ECC (OR 0.381).

3 findings from 1 review

Higher parental / maternal education vs Lower parental education (reference)

Oral health-related quality of life · Adolescents (10-19 years)

Higher parental education is associated with better OHRQoL in adolescents (narrative synthesis; no pooled estimate or GRADE rating).

1 finding from 1 review
  • Oral-health-related quality of life in adolescents: umbrella review. 2023 All outcomes
    Community/school/clinic settings; adolescents 10-19 years; included reviews conducted in multiple countries
    Adolescents from families with higher incomes and higher levels of maternal education have better OHRQoL scores [34]. Children from families with high income, parental education and family economy had better OHRQoL [42].
    Studies not reported
    GRADE not reported

1.23% APF gel + oral health education vs Oral health education

Arrest or reversal of noncavitated facial/lingual carious lesions · Children and adults with noncavitated carious lesions on facial/lingual surfaces (primary and permanent teeth)

1.23% APF gel + oral health education was probably more effective than Oral health education for arrest or reversal of facial/lingual carious lesions (RR 2.47, 95% CI 1.95 to 3.13; moderate certainty).

1 finding from 1 review

Lower parental (maternal/paternal) education vs Higher parental education

Dental caries · Healthy children and adolescents in the United Arab Emirates

The association between parental education and caries was inconsistent; father's (but not consistently mother's) education was inversely associated with caries in some studies (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Low maternal education (<=6 years of schooling) vs Higher maternal education (>6 years)

Poor oral health-related quality of life (OHRQoL) · Children aged 3-12 years

Lower maternal education was associated with poor OHRQoL (OR 1.12, 95% CI 1.00-1.23; 4 studies; high heterogeneity; CI lower bound at the null; ungraded).

1 finding from 1 review

Resin-modified glass ionomer fissure sealant plus oral health education vs Fluoride varnish plus oral health education

Change in DMF increment on occlusal surfaces of first permanent molars · Children and adolescents (general population, aged under 20 years)

Resin-modified glass ionomer fissure sealant plus oral health… showed no clear difference in change in DMF increment on occlusal surfaces of first permanent molars compared with fluoride varnish plus oral health education; GRADE not reported.

2 findings from 1 review

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Adherence to oral hygiene routines by people with ID or their carers · Children or adolescents

Gamified interventions appear to increase children's engagement and adherence to oral hygiene routines, but the evidence is narrative and ungraded.

1 finding from 1 review
  • The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
    Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
    The regular use rate was significantly higher (72.4%) in the gamified mobile health app group than in the nongamified intervention group (48.3%) [Zolfaghari 2021]; quiz-based challenges in mobile apps encouraged higher…
    Studies not reported
    GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Plaque index (PI) / oral hygiene · Children or adolescents

Gamified interventions appear to improve plaque control and oral hygiene status in children versus conventional methods, but the evidence is narrative and ungraded (individual-study P values only).

1 finding from 1 review
  • The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
    Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
    In the gamified mobile health app group, plaque control was superior (P<.05) compared with the conventional method group [Zolfaghari 2021]; a gamified/reminder sticker-book group showed a significant improvement in…
    Studies not reported
    GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Oral health knowledge (1-9 scale) · Children or adolescents

Gamified interventions appear to improve children's oral health knowledge compared with conventional education, but the evidence is narrative and ungraded.

1 finding from 1 review
  • The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
    Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
    The effectiveness of digital-based interventions was generally positive, with 38% (9/24) of the experimental studies reporting improvements in oral health knowledge and behaviors; game-based teaching significantly…
    9 studies
    GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Oral hygiene behavior (brushing habits, preventive dental visits, dietary choices) · Children or adolescents

Gamified interventions appear to improve oral hygiene behaviors (brushing habits, preventive dental visits) in children, but the evidence is narrative and ungraded.

1 finding from 1 review
  • The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
    Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
    A gesture-based motion-capture game enhanced brushing independence and skill retention (P<.001) [Kang 2021]; 58.8% of caregivers reported their children brushed more often when using gamified applications [France…
    Studies not reported
    GRADE not reported

Sociodemographic and behavioural factors (older age, lower education, lower income, poor oral hygiene/brushing, smoking, disadvantaged/slum residence, sex) vs Referent groups (younger, higher education/income, better oral hygiene, non-slum residence)

Determinants of oral diseases · Adult residents of slums and non-slum urban settings of LMICs

Age, education, income, oral-hygiene behaviour, dental-visit pattern and slum/disadvantaged residence are associated with oral disease; gender effects are disease-specific; ungraded.

1 finding from 1 review

38% SDF plus oral health education vs oral health instruction plus water

new root-surface carious lesions or restorations · community-dwelling older adults with root caries

SDF plus oral health education had a 33% preventative fraction at 24 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

Populations with a lower proportion of university-educated people (<33.78% with university level) vs Not applicable

Dental caries · Adult participants in 25 meta-regression studies

The Model 1 adjusted meta-regression coefficient for lower university education was -4.132903.

2 findings from 1 review

Community and caregiver oral health education plus media campaign vs Pre-intervention BBTD rate

Baby bottle tooth decay prevalence · Alaska Native and American Indian Head Start children

High-intensity community education was associated with a 33% reduction in BBTD prevalence, without a GRADE rating.

3 findings from 1 review

Community and caregiver oral health education plus media campaign vs Pre-intervention BBTD rate

Baby bottle tooth decay prevalence · Alaska Native Head Start children

The Alaska Native site had a 20% increase in BBTD prevalence, without a GRADE rating.

1 finding from 1 review