What do systematic reviews say?

Enhanced one-to-one OHA vs Routine one-to-one OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes

  12 months
  SoF: 1 study in adults did not report usable data. Results: Bali 1999 (DMFT) not estimable (no usable data).
  1 study · 70 participants
  Very low

Enhanced one-to-one OHA vs Routine one-to-one OHA

It is very uncertain whether enhanced one-to-one OHA changes periodontal health: plaque levels compared with one-to-one OHA (standard) (very low certainty).

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes

  2 to 12 months
  SoF: 2 studies did not report usable data; 1 study gave low-quality evidence of a benefit in plaque reduction at 5.5 months for enhanced OHA; 3 studies found little or no difference; 1 study gave weak evidence of a…
  6 studies · 440 participants
  Very low

Enhanced one-to-one OHA vs Routine one-to-one OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  Hoogstraten 1983 (dental knowledge, attitude, behaviour, fear), Munster Halvari 2012 (multiple psychological measures: autonomy, motivation, perceived competence), Tedesco 1992 (theory of reasoned action variables);…
  3 studies
  GRADE not reported

Personalised one-to-one OHA vs Routine one-to-one OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  Ramsay 2018 reported economic net benefits of OHA; measured, not synthesised or GRADE-rated.
  1 study
  GRADE not reported

Personalised one-to-one OHA vs Routine one-to-one OHA

It is very uncertain whether personalised one-to-one OHA changes periodontal health: plaque levels compared with routine one-to-one OHA (very low certainty).

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes

  2 to 12 months
  SoF: 1 study showed a benefit for personalised OHA at 3 and 12 months; 1 study in children reported 'statistically significant (P < 0.05) improvement' but no usable data; 1 study showed little or no difference at 3…
  3 studies · 308 participants
  Very low

Any form of one-to-one oral hygiene advice (OHA) vs No OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  No adverse events due to OHA were reported in the included trials (review-wide; assessed across all 19 included studies).
  Studies not reported
  GRADE not reported

Any form of one-to-one oral hygiene advice (OHA) vs No OHA

Any form of one-to-one oral hygiene advice (OHA) showed no clear difference in periodontal health: plaque levels compared with no OHA (low certainty).

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes

  6 to 36 months
  SoF: Both studies at all time points consistently showed a benefit in plaque reduction for OHA. Results: Hetland 1982 MD -0.41 (-0.54 to -0.28) at 3mo, -0.44 (-0.56 to -0.32) at 6mo; Hugoson 2007 MD -13.00 (-19.89 to…
  2 studies · 235 participants
  Low

Self-management (self-administered/self-monitored OHA) vs Professional OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  Aljafari 2017 reported child's dietary knowledge; measured, not synthesised or GRADE-rated.
  1 study
  GRADE not reported

Self-management (self-administered/self-monitored OHA) vs Professional OHA

It is very uncertain whether self-management (self-administered/self-monitored OHA) changes periodontal health: plaque levels compared with professional OHA (very low certainty).

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes

  2 to 6 months
  SoF: 2 studies reported no significant differences but no usable data; 1 study gave weak evidence of a benefit in plaque reduction at 3 months for self-management; 1 study in adults with hyposalivation gave very weak…
  4 studies · 181 participants
  Very low

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged)

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in… showed no clear difference in supragingival calculus formation (various calculus indices) compared with placebo/control mouthrinse, or no mouthrinse (mechanical oral…; GRADE not reported.

• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  4 to 6 weeks
  SMD 0.02 [-0.09, 0.14]
  2 studies · 102 participants
  GRADE not reported
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  7 to 12 weeks
  SMD 0.32 [-0.04, 0.69]
  6 studies · 425 participants
  GRADE not reported
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  6 months
  SMD 0.80 [0.33, 1.26]
  4 studies · 323 participants
  GRADE not reported

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged)

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in… leads to lower gingivitis (gingival inflammation) measured by Gingival Index of Loe… compared with placebo/control mouthrinse, or no mouthrinse (mechanical oral… (high certainty).

• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  4 to 6 weeks
  MD -0.21 [-0.31, -0.11]
  10 studies · 805 participants
  High
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  6 months
  MD -0.20 [-0.30, -0.11]
  13 studies · 2616 participants
  High

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged)

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in… led to lower gingival bleeding (various bleeding indices) compared with placebo/control mouthrinse, or no mouthrinse (mechanical oral…; GRADE not reported.

• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  4 to 6 weeks
  SMD -0.56 [-0.79, -0.33]
  8 studies · 649 participants
  GRADE not reported
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  6 months
  SMD -0.72 [-1.02, -0.42]
  8 studies · 1132 participants
  GRADE not reported

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged)

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in… leads to lower dental plaque (various plaque indices) compared with placebo/control mouthrinse, or no mouthrinse (mechanical oral… (high certainty).

• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  6 months
  SMD -1.43 [-1.76, -1.10]
  11 studies · 2075 participants
  High
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  4 to 6 weeks
  SMD -1.45 [-1.90, -1.00]
  12 studies · 950 participants
  High

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

Selective may leads to lower severe perineal/vaginal trauma compared with routine episiotomy: all vaginal births where operative vaginal… (low certainty).

• Selective versus routine use of episiotomy for vaginal birth 2017 · Cochrane Headline outcomes only
  RR 0.7 [0.52, 0.94]
  8 studies · 5375 participants
  Low

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

• Selective versus routine use of episiotomy for vaginal birth 2017 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 336 participants
  Very low

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

• Selective versus routine use of episiotomy for vaginal birth 2017 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 501 participants
  Moderate

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

Selective showed no clear difference in perineal infection compared with routine episiotomy: all vaginal births where operative vaginal… (low certainty).

• Selective versus routine use of episiotomy for vaginal birth 2017 · Cochrane Headline outcomes only
  RR 0.9 [0.45, 1.82]
  3 studies · 1467 participants
  Low

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

It is very uncertain whether selective changes women with moderate or severe pain (measured by visual analogue scale) compared with routine episiotomy: all vaginal births where operative vaginal… (very low certainty).

• Selective versus routine use of episiotomy for vaginal birth 2017 · Cochrane Headline outcomes only
  RR 0.71 [0.48, 1.05]
  1 study · 165 participants
  Very low

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

Selective showed no clear difference in women with long‐term dyspareunia (≥ 6 months) compared with routine episiotomy: all vaginal births where operative vaginal… (moderate certainty).

• Selective versus routine use of episiotomy for vaginal birth 2017 · Cochrane Headline outcomes only
  RR 1.14 [0.84, 1.53]
  3 studies · 1107 participants
  Moderate

Selective vs routine episiotomy: all vaginal births where operative vaginal delivery was not anticipated

Selective showed no clear difference in women with long‐term urinary incontinence (≥ 6 months) compared with routine episiotomy: all vaginal births where operative vaginal… (low certainty).

• Selective versus routine use of episiotomy for vaginal birth 2017 · Cochrane Headline outcomes only
  RR 0.98 [0.67, 1.44]
  3 studies · 1107 participants
  Low