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Evidence found and GRADE certainty

94 questions · 161 findings · 18 reviews · Dental caries

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No studies found 19 · 11.8%GRADE not reported 133 · 82.6%Very low 7 · 4.3%Low 2 · 1.2%Moderate 0 · 0%High 0 · 0%

Partial pulpotomy with tri-calcium silicate material (MTA or Biodentine) vs Partial pulpotomy with calcium hydroxide

Overall success (composite of clinical and radiographic success) · Adults aged 18 years or older with mature permanent teeth and carious pulp exposure

Tri-calcium silicate use was associated with a 37% increase in partial-pulpotomy success in meta-regression.

1 finding from 1 review

High dental-caries prevalence vs Not applicable

Oral health-related quality of life · people aged 60 years and older living in the community

The review reported higher OHRQoL in the low than high dental-caries-prevalence category.

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

Multivariable caries prediction model vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance for root caries increment (negative likelihood ratio, LR-) · Older adults (aged 52-95; mean 52-73) at risk of root caries increment

The single root-caries validation study (Hayes 2017) showed LR- of 0.34-0.41, above the useful rule-out threshold; no pooled estimate; ungraded.

2 findings from 1 review

Multivariable caries prediction model vs Alternative prediction model(s) within the same study, or no formal comparator (models compared descriptively; no between-model statistical test)

Predictive performance for root caries increment (positive likelihood ratio, LR+) · Older adults (aged 52-95; mean 52-73) at risk of root caries increment

Developmental root-caries prediction models were generally modest, except Sanchez-Garcia 2011 (LR+ 7.09) which reached the useful threshold; no pooled estimate; ungraded.

2 findings 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)

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

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

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)

Oral disease outcomes, including dental caries estimates · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 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
    Nine studies reported oral disease outcomes, seven of which measured change in dental caries estimates. Eight of the nine studies reported improved oral disease outcomes; one (Vichayanrat 2012) reported no change in…
    9 studies
    GRADE not reported

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

Cost‐effectiveness · Children aged 6 years and older (healthy except for dental caries)

In children aged 6 years and older, the cost-effectiveness estimate was extremely imprecise and not significant (OR 0.00, 95% CI 0.00 to 48704.6; ungraded).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 6 years and older (healthy except for dental caries)

In children aged 6 years and older, OHPPs showed no significant effect on DMFT/S (OR 0.29, 95% CI 0.08 to 1.01; ungraded).

1 finding from 1 review

Low income vs High income

Prevalence of untreated decay (% DT > 0) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In Australia, low versus high income differed by 11.90 percentage points in prevalence of untreated decay.

5 findings from 1 review
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Bilateral extraction of compromised mandibular first permanent molars vs Age- and gender-matched non-extraction controls

Lower incisor inclination (lingual tipping and retrusion) · Children (approximately 11 years or older) with compromised mandibular first permanent molars

Bilateral lower first permanent molar extraction was associated with lingual tipping and retrusion of the lower incisors in one case-control study; ungraded.

1 finding from 1 review

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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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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Post-secondary education vs University education

Mean number of decayed teeth (mean DT) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In Canada, post-secondary versus university education differed by 0.2 decayed teeth in mean number of decayed teeth.

4 findings from 1 review
Show 1 more finding

Primary education vs University education

Prevalence of untreated decay (% DT > 0) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In Australia, primary versus university education differed by 18.40 percentage points in prevalence of untreated decay.

5 findings from 1 review
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Medium income vs High income

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, medium versus high income differed by 8.3 percentage points in prevalence of fair/poor self-rated oral health.

4 findings from 1 review
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Medium income vs High income

Prevalence of untreated decay (% DT > 0) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In Australia, medium versus high income differed by 6.8 percentage points in prevalence of untreated decay.

4 findings from 1 review
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Low income vs High income

Mean number of decayed teeth (mean DT) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

Across four countries, low versus high income differed by 0.44 decayed teeth in mean number of decayed teeth (random-effects meta-analysis; I2=76.4%).

5 findings from 1 review
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Secondary education vs University education

Mean number of decayed teeth (mean DT) · Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States

In Canada, secondary versus university education differed by 0.7 decayed teeth in mean number of decayed teeth.

4 findings from 1 review
Show 1 more finding