Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

624 questions · 782 findings · 62 reviews

No studies found 13 · 1.7%GRADE not reported 657 · 84%Very low 76 · 9.7%Low 23 · 2.9%Moderate 13 · 1.7%High 0 · 0%

Low socioeconomic position and adverse behavioural factors vs Higher socioeconomic position and fewer adverse behaviours

Systemic inflammation (C-reactive protein) and periodontal disease progression · General-population adults (German cohort)

In one 5-year longitudinal study, accumulation of low socioeconomic and behavioural factors was associated with greater periodontal disease progression and higher C-reactive protein; not pooled (ungraded).

1 finding from 1 review

Dementia (any type or severity) vs Older people without dementia

Mean number of missing teeth in OC cases vs controls · Older people (aged 60 years or older) with dementia

Missing-teeth values varied across studies and were not meta-analyzed.

1 finding from 1 review

PDHA program with robust prevention vs PDHA program or PDHA program with intensive staffing

Tooth decay-free children · Alaska children aged 5 to 18 years

The robust prevention PDHA model was projected to yield more than 50% tooth decay-free children versus 8% with other PDHA models, without a GRADE rating.

1 finding from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected Significant Caries (SiC) index · Alaska Native children (below age 18)

A simulation projected a 50% drop in the Significant Caries index for children (12.3 to 6.1) under the PDHA model (certainty not graded).

2 findings from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected proportion of caries-free children (5-18 years) · Alaska Native children (below age 18)

A simulation projected 0% of children aged 5-18 would be caries-free under the baseline scenario (certainty not graded).

3 findings from 1 review

DHAT-delivered dental care vs Dentist-delivered dental care

Technical performance / deficient restorations (DHATs vs dentists) · Alaska Native dental patients (children aged 6-17 and adults) and their caregivers

DHATs had a lower amalgam restoration deficiency rate than dentists (12% vs 22%; certainty not graded).

3 findings from 1 review

DHAT-delivered dental care vs Not applicable (single-group prevalence)

Clinical care quality · Alaska dental health aide therapists

Four newly trained DHATs met stated clinical care standards in a qualitative evaluation, without a GRADE rating.

1 finding from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected receipt of school-based prevention services · Alaska Native children (below age 18)

A simulation projected that over 90% of children would receive school-based prevention services under the PDHA model, up from 53% (certainty not graded).

1 finding from 1 review

DHAT-delivered dental care vs Dentist-delivered dental care

Caregiver satisfaction · Caregivers of Alaska Native children aged 6 to 17 years

More than 90% of caregivers reported being usually or always satisfied with DHAT care, without a GRADE rating.

1 finding from 1 review

DHAT-delivered dental care vs Dentist-delivered dental care

Composite restoration deficiency · Alaska dental health aide therapists

Composite restoration deficiency was 15% for DHATs versus 12% for dentists, without a GRADE rating.

1 finding from 1 review

DHAT-delivered dental care vs Dentist-delivered dental care

Consistency of diagnosis and postoperative complications · Alaska dental health aide therapists

No significant difference was reported between DHATs and dentists in diagnosis consistency or postoperative complications, without a GRADE rating.

1 finding from 1 review

Ongoing BBTD Prevention Program vs BBTD Prevention Program discontinued in 1989

Baby bottle tooth decay prevalence · Alaska Native and American Indian Head Start children

Sites discontinuing the prevention program had a non-significant 15% reduction in tooth decay rate, without a GRADE rating.

2 findings from 1 review

DHAT-delivered dental care vs Dentist-delivered dental care

Stainless steel crown preparation and placement deficiency · Alaska dental health aide therapists

No stainless steel crown preparation deficiencies were reported; placement deficiency was 3% for DHATs versus 9% for dentists, without a GRADE rating.

1 finding from 1 review

Primary dental health aide (PDHA) service-delivery models (PDHA program; PDHA + intensive staffing; PDHA + robust prevention) vs Baseline pre-intervention service-delivery scenario

Projected dental care utilisation · Alaska Native children (below age 18)

A simulation projected that the PDHA program would raise dental care utilisation from 75% to 90% (certainty not graded).

1 finding from 1 review

DHAT-delivered dental care vs Dentist-delivered dental care

Quality of dental record keeping by DHATs · Alaska Native dental patients (children aged 6-17 and adults) and their caregivers

Dental record keeping by DHATs was high quality and met Indian Health Service guidelines (certainty not graded).

1 finding from 1 review