What do systematic reviews say?

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

Oral-health-education interventions significantly reduced net increment in DMFS (SMD -1.05); no significant subgroup difference vs other interventions (P=0.74).

• 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) · Intervention type: oral health education
  SMD -1.05 [-2.03, -0.08]
  3 studies
  GRADE not reported
• 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) · WHO health-promoting-schools framework
  SMD -0.57 [-1.56, 0.42]
  2 studies
  GRADE not reported
• 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) · Non-WHO-framework interventions
  SMD -1.88 [-3.15, -0.60]
  Studies not reported
  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 the prevalence of dental caries (RR 0.70, 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)
  RR 0.70 [0.53, 0.94]
  4 studies · 2968 participants
  Very low
• Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes

  <2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration <2 years
  RR 0.95 [0.75, 1.21]
  2 studies
  GRADE not reported
• Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes

  >=2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration >=2 years
  RR 0.58 [0.40, 0.84]
  2 studies
  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

Among children aged 5-8 years, net increment in DMFT was not significantly reduced (SMD -0.36); no significant subgroup difference by age.

• 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) · Age 5-8 years
  SMD -0.36 [-0.76, 0.04]
  5 studies
  GRADE not reported
• 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 -0.34 [-0.69, 0.02]
  5 studies · 5492 participants
  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) · Age 9-12 years
  SMD -0.20 [-0.44, 0.04]
  1 study
  GRADE not reported

Single full-coverage metal-ceramic crown over composite core and post vs Direct adhesive composite restoration with post (conventional filling, no crown)

The review found no eligible studies for this question.

• Single crowns versus conventional fillings for the restoration of root‐filled teeth 2015 · Cochrane All outcomes
  No data were reported nor measured by the study. The abstract confirms no evidence was available for any secondary outcome.
  Studies not reported
  No studies found

Resin composite restorations containing antibacterial agents vs Non-antibacterial containing composite restorations

The review found no eligible studies for this question.

• Antibacterial agents in composite restorations for the prevention of dental caries 2013 · Cochrane All outcomes
  No studies were included in this review, as we were unable to find any trials directly comparing antibacterial containing composites to other active interventions or controls.
  0 studies
  No studies found

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

It is very uncertain whether package of oral health education/promotion including oral hygiene… changes caries presence in primary teeth compared with standard care (very low certainty).

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes

  Children assessed at 1-6 yrs
  RR 0.73 [0.50, 1.07]
  5 studies · 1326 participants
  Very low

Dietary advice on how to achieve a healthy diet for infants (tailored advice focused on a diet low in saturated fat and cholesterol intake) vs usual care

The review found no eligible studies for this question.

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  dmfs was listed in the SoF table but not assessed (not reported for this comparison).
  0 studies
  No studies found
• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  dmft was listed in the SoF table but not assessed (not reported for this comparison).
  0 studies
  No studies found

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Oral health education/promotion (oral hygiene advice plus diet and… showed no clear difference in mother microbiological presence (high-level mutans streptococci /… compared with standard care; GRADE not reported.

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  RR 0.53 [0.28, 1.03]
  1 study · 50 participants
  GRADE not reported

Consumption of xylitol chewing gum by women (mothers) vs Consumption of CHX/xylitol gum by women, or CHX varnish applied to women's dentition

It is very uncertain whether consumption of xylitol chewing gum by women (mothers) changes caries presence in primary teeth compared with consumption of CHX/xylitol gum by women, or CHX varnish applied to… (very low certainty).

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes

  Children assessed at 4 yrs
  RR 0.62 [0.27, 1.39]
  1 study · 96 participants
  Very low

Prophylaxis (teeth cleaning) and CHX or iodine-NaF solution application in the dentition of women (mothers) vs placebo

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  Narrative (Dasanayake 1993; Dasanayake 2002): significant reductions in MS and other bacteria immediately post-treatment; chlorhexidine varnish significantly reduced maternal S. mutans over ~12 months.
  2 studies
  GRADE not reported

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

It is very uncertain whether package of oral health education/promotion including oral hygiene… changes caries presence in top front four teeth compared with standard care (very low certainty).

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes

  Children assessed at 3 yrs · Higher-protein diet trial
  RR 0.68 [0.42, 1.10]
  1 study · 226 participants
  Very low

Advice about a healthy diet (including breastfeeding promotion and sugar avoidance) and feeding practices (e.g. relating to bottle-feeding and sleep) for infants and young children vs usual care

Advice about a healthy diet (including breastfeeding promotion and… showed no clear difference in dmfs index score (decayed, missing, filled primary surfaces; range… compared with standard care (low certainty).

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes

  Children assessed at 1-3 yrs
  MD -0.29 [-0.58, 0]
  2 studies · 757 participants
  Low

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Package of oral health education/promotion including oral hygiene… showed no clear difference in dmfs index score compared with standard care (low certainty).

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes

  Children assessed at 3 yrs
  MD -0.87 [-2.18, 0.43]
  2 studies · 657 participants
  Low
• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes

  Children assessed at 6 yrs
  MD -0.30 [-0.96, 0.36]
  1 study · 187 participants
  Low

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  Two trials (Batliner 2018; Plutzer 2008) provided information on changes in mother oral health behaviours (other data): some benefit in favour of the intervention.
  2 studies
  GRADE not reported

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes

  Birth to 6 yrs
  Plutzer 2008 reported dental attendance as cumulative child-visit categories (other data): intervention children more likely to have 1-2 visits, no difference for 3-4 visits, less likely for >=5 visits.
  1 study
  GRADE not reported

Advice about a healthy diet (including breastfeeding promotion and sugar avoidance) and feeding practices (e.g. relating to bottle-feeding and sleep) for infants and young children vs usual care

Advice about a healthy diet (including breastfeeding promotion and… probably leads to lower caries presence in primary teeth compared with standard care (moderate certainty).

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes

  Children assessed at 3-5 yrs
  RR 0.85 [0.75, 0.97]
  3 studies · 782 participants
  Moderate

Consumption of xylitol chewing gum by women (mothers) vs Consumption of CHX/xylitol gum by women, or CHX varnish applied to women's dentition

Consumption of xylitol chewing gum by women (mothers) led to lower child microbiological presence (any mutans streptococci colonisation) compared with consumption of CHX/xylitol gum by women, or CHX varnish applied to…; GRADE not reported.

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  RR 0.60 [0.45, 0.81]
  2 studies
  GRADE not reported

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  Three trials (Muhoozi 2017; Pereira 2021; Yu 2021) reported changes in child oral health behaviours (other data): some benefit in favour of the intervention.
  3 studies
  GRADE not reported

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

The review found no eligible studies for this question.

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  dmfs was listed in the SoF table but not assessed (not reported for this comparison).
  0 studies
  No studies found
• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes

  Children assessed at 18 months
  The mean dmft index score was 0.52 (standard care) versus 0 (advice + treatment group); relative effect not estimable; 50 participants (1 study); very low-certainty evidence.
  1 study · 50 participants
  Very low

High-dose vitamin D3 supplementation during pregnancy (2400 IU/day from pregnancy week 24 to 1 week postpartum, in addition to the recommended 400 IU/day) vs Low-dose (standard) vitamin D supplementation as recommended in national pregnancy guidelines

It is very uncertain whether high-dose vitamin D3 supplementation during pregnancy (2400 IU/day… changes caries presence in primary teeth compared with low-dose (standard) vitamin D supplementation as recommended in… (very low certainty).

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes

  Children assessed at 6 yrs
  RR 0.99 [0.70, 1.41]
  1 study · 496 participants
  Very low