Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

64 questions · 125 findings · 15 reviews

No studies found 0 · 0%GRADE not reported 125 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Partial pulpotomy with permanent restoration after 7-14 days vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Permanent restoration after 7-14 days was associated with a pooled success rate of 73.6%.

1 finding from 1 review

Partial pulpotomy with tri-calcium silicate material (MTA or Biodentine) vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Partial pulpotomy with MTA or Biodentine had a pooled success rate of 86.8%.

1 finding from 1 review

Partial pulpotomy with one additional day before permanent restoration vs Partial pulpotomy with one fewer day before permanent restoration

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Each additional day before permanent restoration was associated with a 0.088% decrease in success in meta-regression.

1 finding from 1 review

Partial pulpotomy with permanent restoration after more than 14 days vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Permanent restoration after more than 14 days was associated with a pooled success rate of 23.2%.

1 finding from 1 review

High periodontal-disease prevalence vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

No statistically significant difference in OHRQoL was reported by periodontal-disease prevalence.

1 finding from 1 review

Partial pulpotomy (PP) with calcium hydroxide vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Partial pulpotomy with calcium hydroxide had a pooled success rate of 34.3%.

1 finding from 1 review

Partial pulpotomy with one-unit longer follow-up vs Partial pulpotomy with one-unit shorter follow-up

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

In the high-risk-study-excluded sensitivity meta-regression, longer follow-up was associated with lower success.

1 finding from 1 review

Unemployment rate vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

No statistically significant difference in OHRQoL was reported by unemployment rate.

1 finding from 1 review

Health expenditure per capita vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

No statistically significant difference in OHRQoL was reported by health expenditure per capita.

1 finding from 1 review

Partial pulpotomy with immediate (same-visit) permanent restoration vs No comparator

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Immediate permanent restoration was associated with a pooled success rate of 89.9%.

1 finding from 1 review

Low periodontal-disease prevalence vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

No statistically significant difference in OHRQoL was reported by periodontal-disease prevalence.

1 finding from 1 review

Partial pulpotomy with tri-calcium silicate material (MTA or Biodentine) vs Partial pulpotomy with calcium hydroxide

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Tri-calcium silicate use was associated with a 37% increase in partial-pulpotomy success in meta-regression.

1 finding from 1 review

High dental-caries prevalence vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

The review reported higher OHRQoL in the low than high dental-caries-prevalence category.

1 finding from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Access to oral healthcare (referral pathways, documentation processes, operating efficiencies, staffing, visits for oral health issues, uptake of fluoride varnish/other preventive treatment, and visits to an oral health professional) · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most strategies to integrate oral health into primary care were associated with improved access to oral healthcare (19 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Access to oral healthcare was the primary outcome most studied (n=19). Most studies reported results favouring the integration strategy, including improvements in referral pathways, documentation processes, operating…
    19 studies
    GRADE not reported

Multivariable caries prediction model vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance for root caries increment (negative likelihood ratio, LR-) · Older adults (aged 52-95; mean 52-73) at risk of root caries increment

The single root-caries validation study (Hayes 2017) showed LR- of 0.34-0.41, above the useful rule-out threshold; no pooled estimate; ungraded.

2 findings from 1 review

Multivariable caries prediction model vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance for root caries increment (positive likelihood ratio, LR+) · Older adults (aged 52-95; mean 52-73) at risk of root caries increment

Developmental root-caries prediction models were generally modest, except Sanchez-Garcia 2011 (LR+ 7.09) which reached the useful threshold; no pooled estimate; ungraded.

2 findings from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Knowledge, attitudes and perceptions of staff and patients regarding oral health · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Integration strategies were generally associated with positive oral health knowledge, attitudes and perceptions among staff and patients (16 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Knowledge/attitudes/perceptions of staff and patients was the second most studied outcome (n=16). Patient and staff perceptions on various aspects of the integration strategy were usually reported as positive.…
    16 studies
    GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Barriers and facilitators to implementation of the integration strategy (qualitative) · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Key barriers to implementing integration strategies were time/staff/resource constraints and lack of organisational support, while facilitators were professionals' knowledge and attitudes and supportive governance/leadership (qualitative; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    The most commonly studied qualitative outcomes were barriers and facilitators related to the strategy implementation process. Reported barriers were time and staff constraints, resource limitations and lack of…
    15 studies
    GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Oral disease outcomes, including dental caries estimates · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Nine studies reported oral disease outcomes, seven of which measured change in dental caries estimates. Eight of the nine studies reported improved oral disease outcomes; one (Vichayanrat 2012) reported no change in…
    9 studies
    GRADE not reported

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

Cost‐effectiveness · Children aged 6 years and older (healthy except for dental caries)

In children aged 6 years and older, the cost-effectiveness estimate was extremely imprecise and not significant (OR 0.00, 95% CI 0.00 to 48704.6; ungraded).

1 finding from 1 review