Findings

What do systematic reviews say?

2,227 questions · 2,562 findings · 156 reviews · All outcomes

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No studies found 297 · 11.6%GRADE not reported 1,616 · 63.1%Very low 405 · 15.8%Low 144 · 5.6%Moderate 81 · 3.2%High 19 · 0.7%

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Denture plaque · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

Educational intervention with information and practical components… showed no clear difference in denture plaque compared with (Optimised) usual care (low certainty).

1 finding from 1 review

Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
3 to 60 months
SMD -0.60 [-1.25, 0.05]
5 studies · 816 participants
Low

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Caries/root caries · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

1 finding from 1 review

Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
6 to 18 months
SoF: Caries/root caries (follow-up 6 to 18 months). No meta-analysis. 178 participants (2 RCTs); low quality. Comment: 2 studies at unclear (Frenkel 2001) or high risk of bias (Mojon 1998) showed no apparent…
2 studies · 178 participants
Low

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Nutritional status · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

Educational intervention with information and practical components… showed no clear difference in nutritional status compared with (Optimised) usual care; GRADE not reported.

1 finding from 1 review

Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
OR 1.0 [0.3, 3.1]
1 study
GRADE not reported

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Incidence of respiratory diseases and pneumonia · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

The review found no eligible studies for this question.

1 finding from 1 review

Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
None of the included studies assessed incidence of respiratory diseases or pneumonia.
0 studies
No studies found

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Adverse effects of the interventions · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

The review found no eligible studies for this question.

1 finding from 1 review

Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
None of the included studies assessed adverse effects of the intervention.
0 studies
No studies found

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Denture-induced stomatitis · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

1 finding from 1 review

Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
6 to 18 months
SoF: Denture-induced stomatitis (method of Budtz-Jorgensen; follow-up 6 to 18 months). No meta-analysis (data not comparable). 417 participants (2 RCTs); low quality. Comment: 2 studies at unclear (Frenkel 2001) or…
2 studies · 417 participants
Low

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Gingivitis · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

1 finding from 1 review

Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
3 to 6 months
SoF: Gingivitis (Gingival Bleeding Index and method of Suomi; follow-up 3 to 6 months). No meta-analysis (data not comparable). 245 participants (3 RCTs); low quality. Comment: 3 studies at unclear risk of bias showed…
3 studies · 245 participants
Low

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Plaque · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses)

Educational intervention with information and practical components… showed no clear difference in dental plaque compared with (Optimised) usual care (low certainty).

1 finding from 1 review

Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
3 to 60 months
MD -0.04 [-0.26, 0.17]
6 studies · 437 participants
Low

Behaviour change / oral health promotion interventions delivered by non-dental professionals and health workers (nurses, midwives, health visitors, community health workers) vs control (no intervention/usual care/isotonic exercise)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

Behaviour change interventions delivered by non-dental health workers produced a small, statistically significant reduction in caries experience at the surface level (dmfs SMD -0.15, 95% CI -0.25 to -0.04; 12 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

1 finding from 1 review

The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes
Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.)
SMD -0.15 [-0.25, -0.04]
12 studies
GRADE not reported

Behaviour change / oral health promotion interventions delivered by non-dental professionals and health workers (nurses, midwives, health visitors, community health workers) vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Behaviour change interventions delivered by non-dental health workers produced a small-to-moderate, statistically significant reduction in caries experience at the tooth level (dmft SMD -0.34, 95% CI -0.54 to -0.13; 6 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

1 finding from 1 review

The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes
Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.)
SMD -0.34 [-0.54, -0.13]
6 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

Dental caries · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 6-8 years, DMFT scores were significantly reduced (SMD -0.11); subgroup not separately GRADE-rated.

8 findings from 1 review

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 6-8 years
SMD -0.11 [-0.17, -0.04]
Studies not reported
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) · <=3 intervention activities
SMD -0.58 [-1.62, 0.45]
Studies not reported
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
SMD 0.01 [-0.16, 0.18]
3 studies
GRADE not reported

Show 5 more findings

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 8-15 years
SMD -0.41 [-0.50, -0.32]
Studies not reported
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
SMD -0.49 [-0.79, -0.19]
4 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 -0.33 [-0.56, -0.10]
7 studies · 6766 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)
SMD -0.26 [-0.70, 0.18]
5 studies · 3506 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) · >3 intervention activities
SMD 0.02 [-0.13, 0.17]
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

Annual increment in DMFS (D3) · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

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

5 findings from 1 review

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

Show 2 more findings

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: other (daily tooth brushing)
SMD -1.23 [-1.46, -1.00]
1 study
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 -1.09 [-1.91, -0.27]
4 studies · 3755 participants
Very low

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

Dental caries prevalence measured by dmft or DMFT/S score greater than one · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce the prevalence of dental caries (RR 0.70, favouring intervention), but the certainty of evidence is very low.

3 findings from 1 review

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

Caries increment, tooth index D(M)FT · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

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

3 findings from 1 review

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

Chloral hydrate vs placebo or no intervention

Good or better behaviour · Children and adolescents (0 to 16 years) needing dental treatment

It is very uncertain whether chloral hydrate changes good or better behaviour compared with placebo (including no intervention) (very low certainty).

1 finding from 1 review

Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
RR 1.33 [0.80, 2.22]
1 study · 60 participants
Very low

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

Comprehensive interventions produced a small, statistically significant reduction in surface-level caries (dmfs SMD -0.14, 95% CI -0.26 to -0.02; 10 studies; not GRADE-rated).

1 finding from 1 review

The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes
Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.) · Comprehensive intervention (vs oral health education only)
SMD -0.14 [-0.26, -0.02]
10 studies
GRADE not reported

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Comprehensive interventions produced a statistically significant reduction in tooth-level caries (dmft SMD -0.47, 95% CI -0.84 to -0.10; 4 studies; not GRADE-rated), though heterogeneity was very high.

1 finding from 1 review

The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes
Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.) · Comprehensive intervention (vs oral health education only)
SMD -0.47 [-0.84, -0.10]
4 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

Intervention not reported

Oral hygiene improvement

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Gamified group (reminder sticker book, rewards and visual aids)
Narrative (P value) Significant improvement in oral hygiene in gamified group (P<.001)
1 study
GRADE not reported

Intervention not reported

Oral health-related quality of life (OHRQoL sum score, transformed 0-100)

1 finding from 1 review

Association between oral health-related quality of life and structural determinants of health among elderly… 2025 All outcomes
Overall (pooled across all studies)
MEAN 77.0
45 studies
GRADE not reported