Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

82 questions · 87 findings · 4 reviews · Dental public health and special care

No studies found 15 · 17.2%GRADE not reported 17 · 19.5%Very low 37 · 42.5%Low 17 · 19.5%Moderate 1 · 1.1%High 0 · 0%

High-volume evacuation (HVE) vs No HVE

Reduction in level of contamination in aerosols (CFU) during ultrasonic scaling and air polishing at more than 1 foot from oral cavity (RCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether high-volume evacuation (HVE) changes reduction in level of contamination in aerosols (CFU) during… compared with no HVE (very low certainty).

1 finding from 1 review

Antimicrobial coolant A (chlorhexidine) vs Distilled water coolant

Reduction in level of contamination in aerosols (CFU): chlorhexidine coolant vs distilled water during ultrasonic scaling · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether chlorhexidine coolant changes reduction in level of contamination in aerosols (CFU): chlorhexidine… compared with distilled water coolant (very low certainty).

1 finding from 1 review

Laminar air flow with HEPA filter vs Without laminar flow or filter

Reduction in level of contamination in aerosols (CFU per cubic feet/min/patient) using Reyniers slit sampler 30 inches (76 cm) from floor · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether laminar air flow with HEPA filter changes reduction in level of contamination in aerosols (CFU per cubic… compared with without laminar flow or filter (very low certainty).

1 finding from 1 review

Rubber dam vs No rubber dam

Reduction in level of contamination in aerosols (CFU) during restorative procedures at operator's left ear (RCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

Rubber dam showed no clear difference in reduction in level of contamination in aerosols (CFU) during… compared with no rubber dam; GRADE not reported.

1 finding from 1 review

Any method, procedure or policy to reduce contaminated aerosols in dental clinics vs Any other method, no treatment or combination of methods

Reduction in volume of contaminated aerosols in the operative environment · Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental laboratory staff, dental…

The review found no eligible studies for this question.

1 finding from 1 review

Laminar air flow with HEPA filter vs Without laminar flow or filter

Reduction in level of contamination in aerosols (CFU per cubic feet/min/patient) using Andersen cascade sampler 20-30 cm from mouth · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether laminar air flow with HEPA filter changes reduction in level of contamination in aerosols (CFU per cubic… compared with without laminar flow or filter (very low certainty).

1 finding from 1 review

Any method, procedure or policy to reduce contaminated aerosols in dental clinics vs Any other method, no treatment or combination of methods

Incidence of infection of dental staff or patients · Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental laboratory staff, dental…

The review found no eligible studies for this question.

1 finding from 1 review

Combination system (Isolite) vs Rubber dam + HVE

Reduction in level of contamination in aerosols (CFU) during water spray using high-speed handpiece · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether combination system (Isolite) changes reduction in level of contamination in aerosols (CFU) during water… compared with rubber dam + HVE (very low certainty).

1 finding from 1 review

High-volume evacuation (HVE) vs No HVE

Reduction in level of contamination in aerosols (CFU) during ultrasonic scaling and air polishing at less than 1 foot (~30 cm) from oral cavity (RCTs) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether high-volume evacuation (HVE) changes reduction in level of contamination in aerosols (CFU) during… compared with no HVE (very low certainty).

1 finding from 1 review

Rubber dam + HVE vs Cotton roll + HVE

Reduction in level of contamination in aerosols (CFU) during restorative procedures at dental unit light · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether rubber dam + HVE changes reduction in level of contamination in aerosols (CFU) during… compared with cotton roll + HVE (very low certainty).

1 finding from 1 review

Air cleaning system (ACS) vs No air cleaning system

Reduction in level of contamination in aerosols (CFU) during ultrasonic scaling · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether air cleaning system (ACS) changes reduction in level of contamination in aerosols (CFU) during… compared with no air cleaning system (very low certainty).

1 finding from 1 review

Combination system (Isolite) vs HVE

Reduction in level of contamination in aerosols (CFU) during water spray using high-speed handpiece · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether combination system (Isolite) changes reduction in level of contamination in aerosols (CFU) during water… compared with HVE (very low certainty).

1 finding from 1 review

Air cleaning system (ACS) vs No air cleaning system

Reduction in level of contamination in aerosols (CFU) during cavity preparation · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether air cleaning system (ACS) changes reduction in level of contamination in aerosols (CFU) during cavity… compared with no air cleaning system (very low certainty).

1 finding from 1 review

Rubber dam + HVE vs Cotton roll + HVE

Reduction in level of contamination in aerosols (CFU) during restorative procedures at participant's chest · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether rubber dam + HVE changes reduction in level of contamination in aerosols (CFU) during… compared with cotton roll + HVE (very low certainty).

1 finding from 1 review

High-volume evacuation (HVE) vs Conventional dental suction (low-volume evacuator / saliva ejector)

Reduction in level of contamination in aerosols (CFU) during ultrasonic scaling at 150 cm from mouth · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether high-volume evacuation (HVE) changes reduction in level of contamination in aerosols (CFU) during… compared with conventional dental suction (low-volume evacuator / saliva ejector) (very low certainty).

1 finding from 1 review

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

Calculus · Adults (mean age 30.9 years), level of ID unclear; setting day centre

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).

1 finding from 1 review

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Plaque · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified

Electric toothbrush (self, carer or carer-assisted brushing) showed no clear difference in plaque (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (low certainty).

2 findings from 1 review

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Behaviour, attitude and self-efficacy (participant/carer preference) · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified
1 finding from 1 review
  • Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
    Long term (>12 months)
    Comparison 2.8 (reported; not GRADE-rated). One NRS (Bratel 1991, 23 participants), self-efficacy at 16 months: 10/12 people with ID using the electric toothbrush reported a preference for it, finding it easier to use…
    1 study · 23 participants
    GRADE not reported

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Gingivitis · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified
1 finding from 1 review
  • Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
    Short term (<6 weeks)
    Electric vs manual toothbrush. Assorted gingival indices scale 0-4, 2-4 weeks; 252 participants (4 RCTs); Low. Four studies showed no significant differences for gingival inflammation short term; data could not be…
    4 studies · 252 participants
    Low