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Evidence found and GRADE certainty

129 questions · 201 findings · 16 reviews

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No studies found 1 · 0.5%GRADE not reported 181 · 90%Very low 7 · 3.5%Low 7 · 3.5%Moderate 5 · 2.5%High 0 · 0%

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

No intervention (single-arm cohort estimates) vs No comparator

First dentine caries incidence rate per person-year at risk (D3) · Caries-free children and adolescents with permanent dentition

Sánchez-Pérez et al. 2010 reported an incidence rate of 0.07 per person-year at risk.

16 findings from 1 review
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Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual decline in percentage of caries-free participants (permanent dentition, D3) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

For low baseline caries experience, the annual decline in caries-free participants ranged 4.3% to 10.2% (9 studies; ungraded).

4 findings from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: low
    4.3% to 10.2%
    9 studies · 4811 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations)
    0.8% to 10.2%
    18 studies · 12017 participants
    GRADE not reported
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: high
    0.8% to 2.2%
    2 studies · 5029 participants
    GRADE not reported
Show 1 more finding
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Annual (studies with >=3 y follow-up) · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: moderate
    3.7% to 8.3%
    4 studies · 928 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual increment in DMFT (permanent dentition) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the annual DMFT increment ranged from 0.06 to 0.73 across 14 studies, and was higher where baseline caries experience was higher (descriptive range; ungraded).

4 findings from 1 review
Show 1 more finding
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per year of follow-up · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: moderate
    0.24 to 0.73
    6 studies · 16705 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Caries development in permanent teeth · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the annual DMFS increment ranged from 0.07 to 1.77 across 26 studies, and was higher where baseline caries experience was higher (descriptive range; ungraded).

4 findings from 1 review
Show 1 more finding
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per year of follow-up · Western Europe, North America, Australia, New Zealand (or comparable Western populations) · Baseline caries experience: low
    0.07 to 0.53
    8 studies · 3735 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Dental caries: dmfs increment (primary teeth) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmfs increment ranged from -1.0 to 1.0 across 7 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual decline in percentage of caries-free children (primary dentition, d3) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual decline in the percentage of caries-free children ranged from 3.8% to 12.2% across 6 studies (descriptive range, no pooled estimate; ungraded).

1 finding from 1 review

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Caries incidence rate (first D3 lesion) per person-year at risk (permanent dentition) · Children and adolescents (permanent dentition, D3, up to 21 y), Western or comparable populations

In the permanent dentition, the pooled caries incidence rate was 0.11 per person-year at risk (95% CI 0.09 to 0.13; random-effects meta-analysis of 15 studies), i.e., about 11 of every 100 caries-free persons develop dentine caries each year (ungraded).

1 finding from 1 review
  • Caries Progression Rates Revisited: A Systematic Review. 2019 All outcomes
    Per person-year at risk · Western Europe, North America, Australia, New Zealand (or comparable Western populations)
    Incidence rate (per person-year at risk) 0.11 [0.09, 0.13]
    15 studies · 10768 participants
    GRADE not reported

Longitudinal follow-up over time (natural caries progression; no assigned intervention) vs Within-cohort change from baseline to follow-up (>=3 y)

Annual increment in dmft (primary dentition) · Children (primary dentition, d3), Western or comparable populations

In the primary dentition, the annual dmft increment ranged from -0.3 to 0.3 across 4 studies; values were inconsistent because of tooth exfoliation and could not be pooled (ungraded).

1 finding from 1 review

Farzanegan 2021 = Transbond XT + 1% chitosan + 1% TiO2 (co-intervention); Mollabashi 2022 = TiO2-only composite (1 wt%) vs Conventional/control orthodontic adhesive (e.g., Transbond XT) or negative control

Enamel demineralization / white spot lesion prevention (DIAGNOdent, enamel mineral content) · Patients undergoing fixed orthodontic (fixed appliance) treatment (adolescents and adults, ages 12 to 35)

Two small RCTs gave inconsistent results for TiO2-modified adhesives/composites on enamel demineralization (one favorable on DIAGNOdent, one no difference in mineral content); ungraded.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Chlorhexidine mouthrinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

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

8 findings from 1 review
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Salvadora persica (miswak) mouthrinse vs Chlorhexidine 0.2% mouthrinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

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

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

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

1 finding from 1 review

Fluoride-releasing resin-based sealant vs Non-invasive measures (fluoride varnish; no intervention)

Radiographic proximal caries lesion progression · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)

Pooling 2 trials, resin-based sealants reduced radiographic proximal caries progression versus non-invasive measures (OR 0.24; ungraded subgroup).

1 finding from 1 review

School-based supervised toothbrushing (STB) vs no intervention

Caries increment on tooth surfaces (dmfs/DMFS) (prevented fraction) · Children in school or kindergarten settings (aged 3-14 years)

School-based supervised toothbrushing produces a small but statistically significant reduction in tooth-surface caries (DMFS/dmfs SMD -0.22, 95% CI -0.42 to -0.01; ungraded).

1 finding from 1 review

School-based supervised toothbrushing (STB) vs no intervention

Dental caries increment, DMFT/dmft (whole-tooth level) · Children in school or kindergarten settings (aged 3-14 years)

School-based supervised toothbrushing has no statistically significant effect on whole-tooth caries (DMFT/dmft SMD 0.05, 95% CI -0.27 to 0.37; ungraded).

1 finding from 1 review

Microinvasive technique (proximal sealing) vs no intervention

Radiographic proximal caries lesion progression · Children with lesions in both primary and permanent teeth (ages 8-10)

In one trial including both primary and permanent teeth, proximal sealing reduced radiographic caries progression versus no intervention (OR 0.16; ungraded subgroup).

1 finding from 1 review

Oral health education only (verbal, written, or audio-visual education) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Oral-health-education-only interventions showed at most a marginal effect on tooth-level caries (dmft SMD -0.11, 95% CI -0.21 to -0.00; 2 studies; not GRADE-rated).

1 finding from 1 review