Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

75 questions · 125 findings · 17 reviews · Dental caries

No studies found 1 · 0.8%GRADE not reported 102 · 81.6%Very low 11 · 8.8%Low 8 · 6.4%Moderate 3 · 2.4%High 0 · 0%

Primary education vs University education

Prevalence of fair/poor self-rated oral health · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In New Zealand, primary versus university education differed by 17.59 percentage points in prevalence of fair/poor self-rated oral health.

5 findings from 1 review
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Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Adherence to oral hygiene routines by people with ID or their carers · Children or adolescents

Gamified interventions appear to increase children's engagement and adherence to oral hygiene routines, but the evidence is narrative and ungraded.

1 finding from 1 review
  • The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
    Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
    The regular use rate was significantly higher (72.4%) in the gamified mobile health app group than in the nongamified intervention group (48.3%) [Zolfaghari 2021]; quiz-based challenges in mobile apps encouraged higher…
    Studies not reported
    GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Plaque index (PI) / oral hygiene · Children or adolescents

Gamified interventions appear to improve plaque control and oral hygiene status in children versus conventional methods, but the evidence is narrative and ungraded (individual-study P values only).

1 finding from 1 review
  • The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
    Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
    In the gamified mobile health app group, plaque control was superior (P<.05) compared with the conventional method group [Zolfaghari 2021]; a gamified/reminder sticker-book group showed a significant improvement in…
    Studies not reported
    GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Oral hygiene behavior (brushing habits, preventive dental visits, dietary choices) · Children or adolescents

Gamified interventions appear to improve oral hygiene behaviors (brushing habits, preventive dental visits) in children, but the evidence is narrative and ungraded.

1 finding from 1 review
  • The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
    Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
    A gesture-based motion-capture game enhanced brushing independence and skill retention (P<.001) [Kang 2021]; 58.8% of caregivers reported their children brushed more often when using gamified applications [France…
    Studies not reported
    GRADE not reported

Secondary education vs University education

Prevalence of fair/poor self-rated oral health · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In United States, secondary versus university education differed by 27.5 percentage points in prevalence of fair/poor self-rated oral health.

4 findings from 1 review
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Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Caries presence in primary teeth · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

It is very uncertain whether package of oral health education/promotion including oral hygiene… changes caries presence in primary teeth compared with standard care (very low certainty).

1 finding from 1 review

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Caries presence in top front four teeth · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

It is very uncertain whether package of oral health education/promotion including oral hygiene… changes caries presence in top front four teeth compared with standard care (very low certainty).

1 finding from 1 review

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Dental caries · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

Package of oral health education/promotion including oral hygiene… showed no clear difference in dmfs index score compared with standard care (low certainty).

2 findings from 1 review

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Child dental attendance · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…
1 finding from 1 review

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Adverse events for mother or child · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…
1 finding from 1 review

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Child plaque (any plaque visible on any teeth) · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

Package of oral health education/promotion including oral hygiene… led to lower child plaque (any plaque visible on any teeth) compared with standard care; GRADE not reported.

1 finding from 1 review

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

d1-4 efs · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…
1 finding from 1 review

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Child microbiological presence (any mutans streptococci colonisation) · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

Package of oral health education/promotion including oral hygiene… showed no clear difference in child microbiological presence (mutans streptococci colonisation) compared with standard care; GRADE not reported.

1 finding from 1 review

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

SiC30 index score · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

Package of oral health education/promotion including oral hygiene… led to lower siC30 index score compared with standard care; GRADE not reported.

1 finding from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Mother microbiological presence (high-level mutans streptococci / lactobacilli) · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

Oral health education/promotion (oral hygiene advice plus diet and… showed no clear difference in mother microbiological presence (high-level mutans streptococci /… compared with standard care; GRADE not reported.

1 finding from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Dental caries · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

The review found no eligible studies for this question.

2 findings from 1 review

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

Caries presence in primary teeth · For interventions, pregnant women and mothers of infants in the first year of life; for outcomes, children up to 6 years of age

It is very uncertain whether oral health education/promotion (oral hygiene advice plus diet and… changes caries presence in primary teeth compared with standard care (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

Post-secondary education vs University education

Prevalence of fair/poor self-rated oral health · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In Canada, post-secondary versus university education differed by 2.4 percentage points in prevalence of fair/poor self-rated oral health.

4 findings from 1 review
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