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Evidence found and GRADE certainty

624 questions · 782 findings · 62 reviews

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No studies found 13 · 1.7%GRADE not reported 657 · 84%Very low 76 · 9.7%Low 23 · 2.9%Moderate 13 · 1.7%High 0 · 0%

Autism spectrum disorder vs Healthy school-aged children (for some measures)

Oral health status and oral-care challenges · Children with autism spectrum disorder in Dubai

Two studies found high caries (77%) and gingivitis and considerable oral-care challenges among children with autism spectrum disorder, with low restorative indices (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Prison-nursery setting / incarcerated-mother household (oral health status) vs Counterparts (community children)

Oral health status (caries, oral hygiene, treatment indices) · Preschool children of incarcerated mothers in UAE prison nurseries

One study found high caries (89.8%) and poor oral hygiene with low restorative care among preschool children of incarcerated mothers (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Special health care needs vs None (descriptive; compared across disability types)

Oral health status and treatment needs · Arab children with special health care needs in Ras Al Khaimah

One study found very high caries (85.2%) and high unmet treatment needs among children with special healthcare needs, varying by disability type (narrative synthesis; not GRADE-rated).

1 finding from 1 review

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

Plaque index (PI) / oral hygiene · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce dental plaque scores (SMD -0.32, favouring intervention), but the certainty of evidence is very low.

1 finding from 1 review

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 hygiene measured by mean gingival scores · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

The effect of school-based interventions on gingival scores is uncertain and not statistically significant (SMD 0.12; very low certainty).

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

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)

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

Dental caries (carious oral microbiome) vs Caries-free / healthy oral microbiome

Differential microbial abundance / taxa predictive of caries · Individuals providing oral (saliva/supragingival plaque) 16S rRNA microbiome samples; 2016 samples from 19 studies (mixed children and…

A group of genera/species (notably Selenomonas, Aggregatibacter, Actinomyces, Treponema) was predictive of caries, whereas Streptococcus was not (ungraded).

1 finding from 1 review
  • Meta-analysis of caries microbiome studies can improve upon disease prediction outcomes. 2022 All outcomes
    Oral cavity microbiome (saliva and supragingival plaque samples); pooled across 19 international studies
    Mean-decrease-accuracy discriminating taxa: Capnocytophaga HMT-338, Lactobacillus panis, Treponema HMT-230, Bifidobacterium longum, Delftia acidovorans, Staphylococcus schleiferi; higher log2FC in caries: Selenomonas HMT-146, Aggregatibacter actinomycetemcomitans, Actinomyces HMT-896, Treponema HMT-257; Streptococcus not predictive
    19 studies · 2016 participants
    GRADE not reported

Dental caries (carious oral microbiome) vs Caries-free / healthy oral microbiome

Alpha diversity (Chao1, Observed, Shannon) · Adults providing oral (saliva/supragingival plaque) 16S rRNA microbiome samples

In adults, caries-vs-health alpha diversity differed for the Shannon index but not Chao1/Observed (ungraded).

1 finding from 1 review

Dental caries (carious oral microbiome) vs Caries-free / healthy oral microbiome

Alpha diversity (Shannon) · Children providing oral (saliva/supragingival plaque) 16S rRNA microbiome samples

In children, caries-vs-health Shannon alpha diversity differed significantly (ungraded).

1 finding from 1 review

Dental caries (carious oral microbiome) vs Caries-free / healthy oral microbiome

Discrimination of caries vs health (random forest ROC-AUC) · Individuals providing oral (saliva/supragingival plaque) 16S rRNA microbiome samples; 2016 samples from 19 studies (mixed children and…

Microbiome-based random forest classifiers could not reliably discriminate caries from health across the combined cohort (best AUC approximately 0.75 in a disease-only KO subset; ungraded).

1 finding from 1 review

Oral cancer patients (cases) vs Healthy controls

Periodontal parameters (all measures pooled) in OC cases vs controls · Adults in case-control studies (oral cancer patients vs healthy controls)

Pooling all periodontal measures, oral cancer patients had worse periodontal status than controls (SMD 0.95, 95% CI 0.41-1.49; very high heterogeneity, I2=96.8%); ungraded. Note this pools clinically different measures.

1 finding from 1 review

Oral cancer patients (cases) vs Healthy controls

Probing pocket depth · Adults in case-control studies (oral cancer patients vs healthy controls)

Periodontal pocket depth did not differ significantly between oral cancer patients and controls (SMD 1.64, 95% CI -0.20 to 3.47; very high heterogeneity); ungraded.

1 finding from 1 review

Oral cancer patients (cases) vs Healthy controls

Alveolar bone loss · Adults in case-control studies (oral cancer patients vs healthy controls)

Alveolar bone loss did not differ significantly between oral cancer patients and controls (SMD 0.18, 95% CI -2.34 to 2.69; extreme heterogeneity); ungraded.

1 finding from 1 review

Oral cancer patients (cases) vs Healthy controls

Dental caries · Adults in case-control studies (oral cancer patients vs healthy controls)

The DMFT index was significantly higher in oral cancer patients than controls (SMD 0.65, 95% CI 0.12-1.18); ungraded.

1 finding from 1 review

Oral cancer patients (cases) vs Healthy controls

Mean number of missing teeth in OC cases vs controls · Adults in case-control studies (oral cancer patients vs healthy controls)

The mean number of missing teeth did not differ significantly between oral cancer patients and controls (SMD 0.59, 95% CI -0.04 to 1.22); ungraded.

1 finding from 1 review

Oral cancer patients (cases) vs Healthy controls

Periodontitis (clinical attachment loss) · Adults in case-control studies (oral cancer patients vs healthy controls)

Clinical attachment loss was significantly greater in oral cancer patients than controls (SMD 1.94, 95% CI 0.22-3.66), though heterogeneity was very high (I2=96.7%); ungraded.

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)

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