Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

390 questions · 476 findings · 30 reviews · All outcomes

No studies found 40 · 8.4%GRADE not reported 290 · 60.9%Very low 82 · 17.2%Low 47 · 9.9%Moderate 17 · 3.6%High 0 · 0%

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected Significant Caries (SiC) index · Alaska Native children (below age 18)

A simulation projected a 50% drop in the Significant Caries index for children (12.3 to 6.1) under the PDHA model (certainty not graded).

2 findings from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected proportion of caries-free children (5-18 years) · Alaska Native children (below age 18)

A simulation projected 0% of children aged 5-18 would be caries-free under the baseline scenario (certainty not graded).

3 findings from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected receipt of school-based prevention services · Alaska Native children (below age 18)

A simulation projected that over 90% of children would receive school-based prevention services under the PDHA model, up from 53% (certainty not graded).

1 finding from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected dental care utilisation · Alaska Native children (below age 18)

A simulation projected that the PDHA program would raise dental care utilisation from 75% to 90% (certainty not graded).

1 finding from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected mean DMFT (children below 5 years) · Alaska Native children (below age 18)

A simulation projected mean DMFT in children under 5 would fall from 7.4 to 4.9 under the PDHA model (certainty not graded).

1 finding from 1 review

CBT vs alternative treatment

Reduction in pain intensity · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in pain intensity at treatment completion compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

Relaxation vs Occlusal (oral) appliance

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Relaxation showed no clear difference in pain intensity compared with occlusal (oral) appliance; GRADE not reported.

1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Treatment completion · Adolescents (12-19 years)
    Not pooled. Wahlund 2015: MD 3.70 (95% CI -1.21 to 8.61), n=57 (relaxation 28, appliance 29); Wahlund 2003: MD not reported, n=83 (relaxation 41, appliance 42). Both studies were in adolescents; the occlusal appliance…
    2 studies · 140 participants
    GRADE not reported

Hope-based intervention vs Pain education

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Hope-based intervention showed no clear difference in pain intensity compared with pain education; GRADE not reported.

1 finding from 1 review

Mindfulness plus medication vs Medication alone

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Reduction in pain intensity · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) may leads to lower pain intensity at follow-up (12 months) compared with usual care, waiting list or no treatment (control) (low certainty).

2 findings from 1 review

Hypnosis vs relaxation

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Hypnosis showed no clear difference in pain intensity compared with relaxation; GRADE not reported.

1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Treatment completion
    Not pooled (clinical heterogeneity). Abrahamsen 2011: MD -1.00 (95% CI -2.27 to 0.27), n=38 (hypnosis 19, relaxation 19); Stam 1984: MD not reported, n=27 (hypnosis 12, relaxation 15).
    2 studies · 65 participants
    GRADE not reported

Habit reversal vs waiting list control

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Habit reversal treatment led to lower pain intensity compared with waiting-list control; GRADE not reported.

1 finding from 1 review

Education vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review

CBT plus hypnosis (combined package) vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

CBT plus hypnosis (combined package) led to lower pain intensity compared with usual care; GRADE not reported.

1 finding from 1 review

Responsive complementary feeding (RCF) / other caregivers' feeding practices vs Other models of complementary feeding (traditional/non-responsive CF)

Hypertension (later in life) · Healthy, term-born, normal-birth-weight infants aged 4-24 months (breastfed and/or formula-fed) in Western industrialized countries

No eligible studies examined the influence of complementary feeding practices on later hypertension; this is an evidence gap.

1 finding from 1 review

Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)

Postoperative pain intensity in the immediate postobturation period (up to 72 hours), continuous (VAS) · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without internal resorption

Single-visit root canal treatment showed no clear difference in postoperative pain intensity in the immediate postobturation period… compared with multiple-visit root canal treatment (two or more visits) (low certainty).

1 finding from 1 review

In-office laser therapy (all types combined) vs Placebo (placebo laser or placebo agent) or no treatment

Changes in intensity of pain (VAS 0 to 10) tested through air blast stimuli · Patients aged above 12 years with self-reported tooth hypersensitivity confirmed on clinical evaluation

It is very uncertain whether in-office laser therapy (all types combined) changes changes in intensity of pain (VAS 0 to 10) tested through air blast… compared with placebo (placebo laser or placebo agent) or no treatment (very low certainty).

3 findings from 1 review

Vibrational appliance with fixed appliances vs Fixed appliances

Harms (discomfort, pain intensity, analgesia use) · Children or adolescents (aged 16 years old or under) receiving orthodontic treatment to prevent or correct crowded teeth
1 finding from 1 review
  • Orthodontic treatment for crowded teeth in children 2021 · Cochrane All outcomes
    first week
    No clear difference in discomfort/pain intensity or analgesia consumption between vibrational appliance and control (Miles 2012, Miles 2016, Woodhouse 2015; 100 mm VAS). Narrative; no pooled estimate.
    2 studies
    GRADE not reported