What do systematic reviews say?

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs usual care or no treatment

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes
  Stewart 1996: the psychological intervention group demonstrated significantly higher change in self efficacy scores for flossing at post-intervention compared to the other two groups (control and educational). Flossing…
  1 study · 117 participants
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs attention control

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes
  Weinstein 1996 reported that the psychological intervention led to improvements in plaque score greater than that noted in the attention control group; however the sample size in each arm was very small (n=5) and the…
  2 studies
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs usual care or no treatment

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes

  4 months
  Little 1997: no change in pocket depth; there were no differences between the intervention and control groups in overall change in pocket depth. (Some analyses suggested greater change in the intervention group when…
  1 study · 107 participants
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs usual care or no treatment

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes

  4 months
  Little 1997 reported decreased gingival bleeding in the active intervention group: gingival bleeding present in 9% of the intervention group at baseline and 4% at 4-month follow up, versus 10% of the control group on…
  1 study · 107 participants
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs usual care or no treatment

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes

  4 months
  Little 1997: no change in attachment loss; no differences between the intervention and control groups in overall change in attachment (loss of attachment) markers.
  1 study · 107 participants
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs attention control

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes

  5 weeks (2 weeks post-intervention)
  Stewart 1991: there were no differences between the attention control group and the cognitive behavioural (psychological) intervention group for self reported flossing; it cannot be concluded that the cognitive…
  1 study · 50 participants
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs usual care or no treatment

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes

  4 months
  Little 1997 observed and rated participants on brushing skill; Analysis of Covariance found a significant difference favouring the intervention group (one of four measures on which significant differences were found…
  1 study · 107 participants
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs usual care or no treatment

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes
  Stewart 1996: for dental knowledge the control group showed no change pre- and post-intervention, whereas the psychological intervention group improved dental knowledge significantly (both intervention groups improved…
  1 study · 117 participants
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs usual care or no treatment

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes
  Stewart 1996: the psychological intervention had no discernible effect on self efficacy beliefs concerning tooth brushing; the data on perceived self efficacy for tooth brushing were not analysed due to ceiling effects…
  1 study · 117 participants
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs usual care or no treatment

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes
  Self assessed flossing was assessed in two studies (Little 1997; Stewart 1991); both reported improvements for the intervention groups. Little 1997: Analysis of Covariance found significant differences favouring the…
  2 studies
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs attention control

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes

  5 weeks (2 weeks post-intervention)
  Stewart 1991: for self reported brushing only the comparison of the control group with the cognitive behavioural intervention was significant; the cognitive behavioural (psychological) intervention conveyed no…
  1 study · 50 participants
  GRADE not reported

Psychological intervention based on a specified psychological model/theory (to increase adherence to oral hygiene instructions) vs usual care or no treatment

• Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases 2007 · Cochrane All outcomes
  Self assessed brushing was assessed in two studies (Little 1997; Stewart 1991); both found the intervention groups reported improved brushing. Little 1997: Analysis of Covariance found significant differences favouring…
  2 studies
  GRADE not reported

Oral hygiene interventions (mechanical plaque removal): knowledge-based, behavioural, or skills training for people with ID or their carers vs Usual care, no care, or a similar alternative intervention

The review found no eligible studies for this question.

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
  No studies measured dental caries levels. One RCT (Shaw 1991, Comparison 5) assessed DMFT at baseline only and did not report caries at any later time point.
  0 studies
  No studies found

Oral hygiene interventions (mechanical plaque removal): knowledge-based, behavioural, or skills training for people with ID or their carers vs Usual care, no care, or a similar alternative intervention

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
  Adverse/unintended effects addressed narratively: 10 of 34 studies investigated or reported negative unintended or adverse effects (e.g. difficulty with the electric or 3-headed toothbrushes, being frightened by the…
  10 studies
  GRADE not reported

Oral hygiene interventions (mechanical plaque removal): knowledge-based, behavioural, or skills training for people with ID or their carers vs Usual care, no care, or a similar alternative intervention

The review found no eligible studies for this question.

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
  No studies measured quality of life changes or long-term, patient-centred outcomes as formal outcomes; some studies commented on quality of life only in the discussion or conclusion sections.
  0 studies
  No studies found

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… may leads to lower calculus (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -2.00 [-2.64, -1.36]
  1 study · 304 participants
  Low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… may leads to lower gingival pocketing (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.60 [-0.97, -0.23]
  1 study · 304 participants
  Low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… may leads to lower plaque (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.70 [-1.28, -0.12]
  1 study · 304 participants
  Low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… showed no clear difference in gingival bleeding (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.20 [-0.86, 0.46]
  1 study · 304 participants
  Low

Community and caregiver oral health education plus media campaign vs Pre-intervention baseline (and sites that discontinued the prevention program)

Community and caregiver oral health education was associated with a significant ~25% overall reduction in baby bottle tooth decay among Head Start children (certainty not graded).

• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  3 to 8 years · Head Start sites in Alaska (1) and the continental US (11); Alaska Native and American Indian communities
  Percent reduction in BBTD prevalence 25
  1 study
  GRADE not reported