Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

38 questions · 40 findings · 3 reviews · Dental public health and special care

No studies found 8 · 20%GRADE not reported 13 · 32.5%Very low 7 · 17.5%Low 11 · 27.5%Moderate 1 · 2.5%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

Oral health-related quality of life · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

The review found no eligible studies for this question.

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

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

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

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

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

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

Special manual 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

Special manual toothbrush (self, carer or carer-assisted brushing) showed no clear difference in gingival inflammation (short term) compared with conventional manual toothbrush (self, carer or carer-assisted… (low certainty).

1 finding from 1 review

Special manual 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

It is very uncertain whether special manual toothbrush (self, carer or carer-assisted brushing) changes gingival inflammation (medium term) compared with conventional manual toothbrush (self, carer or carer-assisted… (very 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

Quality of life changes or long-term, patient-centred outcomes (e.g. tooth retention) · 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

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

Calculus · 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 calculus (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (low certainty).

1 finding from 1 review

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

Denture-induced stomatitis · Residents of institutions for elderly people (nursing staff and residents took part in the education programme)
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

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

Oral health-related behaviour (denture cleaning habits) · Residents of institutions for elderly people (nursing staff and residents took part in the education programme)
1 finding from 1 review