Findings

What do systematic reviews say?

2,890 questions · 3,917 findings · 272 reviews · Oral Health

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No studies found 429 · 11%GRADE not reported 2,657 · 67.8%Very low 512 · 13.1%Low 219 · 5.6%Moderate 80 · 2%High 20 · 0.5%

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health attitudes (1-7 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health attitude (SMD 9.32; low certainty); the very large effect warrants cautious interpretation.

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up immediately after to 6 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 9.32 [7.08, 11.55]
3 studies · 2370 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health-related quality of life · school‐age children and adolescents

Theory-based interventions significantly improved oral health-related quality of life (SMD 7.38; low certainty), with very high heterogeneity.

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 0.5 to 12 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 7.38 [5.57, 9.19]
4 studies · 4751 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Mean DMFT (decayed, missing, filled permanent teeth) · school‐age children and adolescents

Theory-based interventions showed no significant effect on DMFT scores (SMD -0.11; low certainty).

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 3 to 12 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD -0.11 [-0.27, 0.04]
4 studies · 2556 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Periodontal health status · school‐age children and adolescents

Theory-based interventions significantly improved periodontal health (SMD -1.18; moderate certainty).

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 2 weeks to 6 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD -1.18 [-1.83, -0.53]
4 studies · 3342 participants
Moderate

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health behaviour (1-9 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health behavior (SMD 2.58; low certainty), with very high heterogeneity.

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 0.5 to 24 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 2.58 [2.03, 3.12]
6 studies · 13973 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health knowledge (1-9 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health knowledge (SMD 1.09; low certainty).

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up immediately after to 24 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 1.09 [0.80, 1.39]
7 studies · 10904 participants
Low

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Plaque index (PI) / oral hygiene · school‐age children and adolescents

Theory-based interventions significantly reduced dental plaque (SMD -1.92; moderate certainty).

1 finding from 1 review

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 1 to 24 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD -1.92 [-2.42, -1.42]
9 studies · 12562 participants
Moderate

No dentinal caries removal (caries sealed under a preformed metal crown or restoration without removing dentinal caries) vs Complete caries removal

Restoration failure · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

No dentinal caries removal (caries sealed under a preformed metal… probably leads to lower failure of restorations compared with complete caries removal (moderate certainty).

1 finding from 1 review

Operative caries management in adults and children 2013 · Cochrane All outcomes
1 year (2-year and 5-year data also available for Innes 2007)
RR 0.08 [0.02, 0.26]
1 study · 132 participants
Moderate

No dentinal caries removal (caries sealed under a preformed metal crown or restoration without removing dentinal caries) vs Complete caries removal

Signs or symptoms of pulpal disease · Patients with carious teeth, affecting any tooth surface(s), in unrestored primary and permanent teeth

No dentinal caries removal (caries sealed under a preformed metal… showed no clear difference in signs or symptoms of pulpal disease compared with complete caries removal (moderate certainty).

1 finding from 1 review

Operative caries management in adults and children 2013 · Cochrane All outcomes
1 year
RR 0.20 [0.02, 1.72]
1 study · 132 participants
Moderate

Medical interventions (systemic: analgesics, antidepressants, antiepileptics, steroids; topical: analgesics, anaesthetics) vs Another intervention, or no intervention

Outcome not reported · Patients of any age in any setting requiring intervention for iatrogenic injury to the inferior alveolar or lingual nerve

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for iatrogenic inferior alveolar and lingual nerve injury 2014 · Cochrane All outcomes
Results: 'No studies evaluated medical ... interventions.' No eligible RCT of medical interventions (analgesics, antidepressants, antiepileptics, steroids, topical anaesthetics).
0 studies
No studies found

One-to-one dietary intervention aimed at preventing tooth erosion (e.g., reducing consumption of acidic/carbonated drinks) vs No dietary advice, or different dietary advice

Dental erosion / tooth wear (tooth wear indices) · Participants of any age receiving one-to-one dietary advice in a dental setting

The review found no eligible studies for this question.

1 finding from 1 review

One‐to‐one dietary interventions undertaken in a dental setting to change dietary behaviour 2012 · Cochrane All outcomes
There were no studies concerned with dietary change aimed at preventing tooth erosion.
0 studies
No studies found

Gene sequencing (GS) applied to diagnose/manage oral conditions (predominantly 16S rRNA next-generation sequencing of the oral microbiome; also genome-wide/whole-genome sequencing) vs Negligible ('abysmal') effect of gene sequencing; no separate comparator arm (within-sample event contrast in the forest plots)

Noticeable impact of gene sequencing on diagnosing/managing oral conditions · Human patients (any age) with oral-cavity related disorders (e.g. dental caries, periodontitis, gingivitis, peri-implant mucositis,…

Pooled across 8 clinical trials, gene sequencing had a statistically significant impact on diagnosing/managing oral-cavity disorders (RR 0.50, 95% CI 0.46-0.54); certainty not GRADE-rated.

2 findings from 1 review

Gene sequencing applications to combat oral-cavity related disorders: a systematic review with meta-analysis. 2024 All outcomes
Various countries; clinical trials of the oral microbiome/genetics · Overall
RR 0.50 [0.46, 0.54]
8 studies · 2211 participants
GRADE not reported
Gene sequencing applications to combat oral-cavity related disorders: a systematic review with meta-analysis. 2024 All outcomes
Various countries; clinical trials of the oral microbiome/genetics · Overall
OR 0.30 [0.26, 0.33]
8 studies · 2211 participants
GRADE not reported

Gene sequencing (GS) applied to diagnose/manage oral conditions (predominantly 16S rRNA next-generation sequencing of the oral microbiome; also genome-wide/whole-genome sequencing) vs Negligible ('abysmal') effect of gene sequencing; no separate comparator arm (within-sample event contrast in the forest plots)

Reduction in occurrence of oral conditions · Human patients (any age) with oral-cavity related disorders (e.g. dental caries, periodontitis, gingivitis, peri-implant mucositis,…

Pooled across 8 clinical trials, gene sequencing was associated with a statistically significant risk difference for impact on oral-cavity disorders (RD -0.29, 95% CI -0.32 to -0.26); certainty not GRADE-rated.

1 finding from 1 review

Gene sequencing applications to combat oral-cavity related disorders: a systematic review with meta-analysis. 2024 All outcomes
Various countries; clinical trials of the oral microbiome/genetics · Overall
RD -0.29 [-0.32, -0.26]
8 studies · 2211 participants
GRADE not reported

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

Comprehensive interventions produced a small, statistically significant reduction in surface-level caries (dmfs SMD -0.14, 95% CI -0.26 to -0.02; 10 studies; not GRADE-rated).

1 finding from 1 review

The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes
Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.) · Comprehensive intervention (vs oral health education only)
SMD -0.14 [-0.26, -0.02]
10 studies
GRADE not reported

Comprehensive oral health intervention (oral health education plus additional support: motivational interviewing, toothbrush/toothpaste provision, community engagement, and/or fluoride varnish/sealant application) delivered by non-dental health workers vs control (no intervention/usual care/isotonic exercise)

Caries experience · Children (mean age newborn to ~5.2 years) and their parents/carers

Comprehensive interventions produced a statistically significant reduction in tooth-level caries (dmft SMD -0.47, 95% CI -0.84 to -0.10; 4 studies; not GRADE-rated), though heterogeneity was very high.

1 finding from 1 review

The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes
Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.) · Comprehensive intervention (vs oral health education only)
SMD -0.47 [-0.84, -0.10]
4 studies
GRADE not reported

A permanent restorative material or technique (e.g. amalgam; glass ionomer (type I-IV); composite resin (macrofilled, microfilled, hybrid, nanofilled); resin-modified glass ionomer (compomer, giomer); cement/cermet; stainless steel or nickel-chrome crown; pre-fabricated resin/porcelain veneer facing; microabrasion) vs A different permanent restorative material or technique

Outcome not reported · Children and adolescents under 18 years with amelogenesis imperfecta requiring restorative care of anterior teeth, irrespective of…

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for the restorative care of amelogenesis imperfecta in children and adolescents 2013 · Cochrane All outcomes
Main results: No studies met the inclusion criteria for this review. Effects of interventions: No studies met the inclusion criteria.
0 studies
No studies found

A permanent restorative material or technique (e.g. amalgam; glass ionomer (type I-IV); composite resin (macrofilled, microfilled, hybrid, nanofilled); resin-modified glass ionomer (compomer, giomer); cement/cermet; stainless steel or nickel-chrome crown; pre-fabricated resin/porcelain veneer facing; microabrasion) vs A different permanent restorative material or technique

Outcome not reported · Children and adolescents under 18 years with amelogenesis imperfecta requiring restorative care of posterior teeth, irrespective of…

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for the restorative care of amelogenesis imperfecta in children and adolescents 2013 · Cochrane All outcomes
Main results: No studies met the inclusion criteria for this review. Effects of interventions: No studies met the inclusion criteria.
0 studies
No studies found

Intervention not reported

Composite: Preference for replacement over repair - Scenario 8: disruption of occlusal integrity

The intervention led to lower composite: Preference for replacement over repair - Scenario 8:…; GRADE not reported.

1 finding from 1 review

Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational… 2025 All outcomes
HDI: Low
RR 0.27 [0.22, 0.34]
2 studies
GRADE not reported

Intervention not reported

Composite: Preference for replacement over repair - Scenario 2: loss of dental hard substance adjacent to the restoration

The intervention showed no clear difference in composite: Preference for replacement over repair - Scenario 2: loss…; GRADE not reported.

1 finding from 1 review

Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational… 2025 All outcomes
Continent: South America
RR 0.91 [0.54, 1.54]
2 studies
GRADE not reported

Intervention not reported

Amalgam: Preference for replacement over repair - Scenario 2: loss of dental hard substance adjacent to the restoration

The intervention showed no clear difference in amalgam: Preference for replacement over repair - Scenario 2: loss…; GRADE not reported.

1 finding from 1 review

Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational… 2025 All outcomes
HDI: Medium
RR 2.42 [0.37, 15.80]
2 studies
GRADE not reported