Findings

What do systematic reviews say?

126 questions · 178 findings · 21 reviews · All outcomes

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No studies found 32 · 18%GRADE not reported 113 · 63.5%Very low 14 · 7.9%Low 13 · 7.3%Moderate 6 · 3.4%High 0 · 0%

Community and caregiver oral health education plus media campaign vs Pre-intervention BBTD rate

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

High-intensity community education was associated with a 33% reduction in BBTD prevalence, without a GRADE rating.

3 findings from 1 review

Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes
3 years · Alaska Native and American Indian Head Start sites · High-intensity training
Percent reduction in BBTD prevalence 33
1 study
GRADE not reported
Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes
3 years · Alaska Native and American Indian Head Start sites · Medium-intensity training
Percent reduction in BBTD prevalence 18
1 study
GRADE not reported
Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes
3 years · Alaska Native and American Indian Head Start sites · Low-intensity training
Percent reduction in BBTD prevalence 27
1 study
GRADE not reported

Community and caregiver oral health education plus media campaign vs Pre-intervention BBTD rate

Baby bottle tooth decay prevalence · Alaska Native Head Start children

The Alaska Native site had a 20% increase in BBTD prevalence, without a GRADE rating.

1 finding from 1 review

Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes
3 years · Alaska Native Head Start site · Alaska Native site
Percent increase in BBTD prevalence 20
1 study
GRADE not reported

Traditional screening with motivation (oral health education and offer of free treatment) vs Traditional screening

Dental attendance · School children, primary and secondary schools in India

It is very uncertain whether traditional screening with motivation (oral health education and… changes dental attendance compared with traditional screening alone (very low certainty).

1 finding from 1 review

School dental screening programmes for oral health 2022 · Cochrane All outcomes
mean 3 months
RR 3.08 [2.57, 3.71]
1 study · 2486 participants
Very low

Oral health education only (verbal, written, or audio-visual education) 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

Oral-health-education-only interventions showed at most a marginal effect on tooth-level caries (dmft SMD -0.11, 95% CI -0.21 to -0.00; 2 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.) · Oral health education only (vs comprehensive intervention)
SMD -0.11 [-0.21, 0.00]
2 studies
GRADE not reported

Oral health education only (verbal, written, or audio-visual education) 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

Oral-health-education-only interventions did not show a statistically significant effect on surface-level caries (dmfs SMD -0.20, 95% CI -0.43 to 0.03; 2 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.) · Oral health education only (vs comprehensive intervention)
SMD -0.20 [-0.43, 0.03]
2 studies
GRADE not reported

Community and caregiver oral health education plus media campaign vs Pre-intervention baseline (and sites that discontinued the prevention program)

Reduction in prevalence of baby bottle tooth decay (BBTD) · Alaska Native and American Indian Head Start children

Community and caregiver oral health education was associated with a significant ~25% overall reduction in baby bottle tooth decay among Head Start children (certainty not graded).

1 finding from 1 review

Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes
3 to 8 years · Head Start sites in Alaska (1) and the continental US (11); Alaska Native and American Indian communities
Percent reduction in BBTD prevalence 25
1 study
GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Plaque index (PI) / oral hygiene · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce dental plaque scores (SMD -0.32, favouring intervention), but the certainty of evidence is very low.

1 finding from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.32 [-0.46, -0.18]
7 studies · 3339 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Oral hygiene measured by mean gingival scores · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

The effect of school-based interventions on gingival scores is uncertain and not statistically significant (SMD 0.12; very low certainty).

1 finding from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD 0.12 [-0.32, 0.55]
3 studies · 1573 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Dental caries · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 6-8 years, DMFT scores were significantly reduced (SMD -0.11); subgroup not separately GRADE-rated.

8 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 6-8 years
SMD -0.11 [-0.17, -0.04]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · <=3 intervention activities
SMD -0.58 [-1.62, 0.45]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
<2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration <2 years
SMD 0.01 [-0.16, 0.18]
3 studies
GRADE not reported

Show 5 more findings

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 8-15 years
SMD -0.41 [-0.50, -0.32]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
>=2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration >=2 years
SMD -0.49 [-0.79, -0.19]
4 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.33 [-0.56, -0.10]
7 studies · 6766 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.26 [-0.70, 0.18]
5 studies · 3506 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · >3 intervention activities
SMD 0.02 [-0.13, 0.17]
Studies not reported
GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Annual increment in DMFS (D3) · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Oral-health-education interventions significantly reduced net increment in DMFS (SMD -1.05); no significant subgroup difference vs other interventions (P=0.74).

5 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention type: oral health education
SMD -1.05 [-2.03, -0.08]
3 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · WHO health-promoting-schools framework
SMD -0.57 [-1.56, 0.42]
2 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Non-WHO-framework interventions
SMD -1.88 [-3.15, -0.60]
Studies not reported
GRADE not reported

Show 2 more findings

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention type: other (daily tooth brushing)
SMD -1.23 [-1.46, -1.00]
1 study
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -1.09 [-1.91, -0.27]
4 studies · 3755 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Dental caries prevalence measured by dmft or DMFT/S score greater than one · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce the prevalence of dental caries (RR 0.70, favouring intervention), but the certainty of evidence is very low.

3 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
RR 0.70 [0.53, 0.94]
4 studies · 2968 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
<2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration <2 years
RR 0.95 [0.75, 1.21]
2 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
>=2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration >=2 years
RR 0.58 [0.40, 0.84]
2 studies
GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Caries increment, tooth index D(M)FT · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 5-8 years, net increment in DMFT was not significantly reduced (SMD -0.36); no significant subgroup difference by age.

3 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 5-8 years
SMD -0.36 [-0.76, 0.04]
5 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.34 [-0.69, 0.02]
5 studies · 5492 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 9-12 years
SMD -0.20 [-0.44, 0.04]
1 study
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

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

Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. 2018 All outcomes
2009 · New Zealand · New Zealand
AD 17.59 [7.09, 28.09]
1 study · 2041 participants
GRADE not reported
Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. 2018 All outcomes
2003-2009 · Australia; Canada; New Zealand; United States · Overall random-effects meta-analysis
AD 20.49 [4.95, 36.04]
4 studies · 14960 participants
GRADE not reported
Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. 2018 All outcomes
2003-2004 · United States · United States
AD 40.35 [35.19, 45.51]
1 study · 4568 participants
GRADE not reported

Show 2 more findings

Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. 2018 All outcomes
2007-2009 · Canada · Canada
AD 12.98 [6.23, 19.73]
1 study · 3278 participants
GRADE not reported
Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. 2018 All outcomes
2004-2006 · Australia · Australia
AD 10.88 [8.42, 13.33]
1 study · 5073 participants
GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Adherence to oral hygiene routines by people with ID or their carers · Children or adolescents

Gamified interventions appear to increase children's engagement and adherence to oral hygiene routines, but the evidence is narrative and ungraded.

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
The regular use rate was significantly higher (72.4%) in the gamified mobile health app group than in the nongamified intervention group (48.3%) [Zolfaghari 2021]; quiz-based challenges in mobile apps encouraged higher…
Studies not reported
GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Plaque index (PI) / oral hygiene · Children or adolescents

Gamified interventions appear to improve plaque control and oral hygiene status in children versus conventional methods, but the evidence is narrative and ungraded (individual-study P values only).

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
In the gamified mobile health app group, plaque control was superior (P<.05) compared with the conventional method group [Zolfaghari 2021]; a gamified/reminder sticker-book group showed a significant improvement in…
Studies not reported
GRADE not reported

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Oral hygiene behavior (brushing habits, preventive dental visits, dietary choices) · Children or adolescents

Gamified interventions appear to improve oral hygiene behaviors (brushing habits, preventive dental visits) in children, but the evidence is narrative and ungraded.

1 finding from 1 review

The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
A gesture-based motion-capture game enhanced brushing independence and skill retention (P<.001) [Kang 2021]; 58.8% of caregivers reported their children brushed more often when using gamified applications [France…
Studies not reported
GRADE not reported

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

Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. 2018 All outcomes
2003-2004 · United States · United States
AD 27.5 [22.6, 32.5]
1 study · 4568 participants
GRADE not reported
Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. 2018 All outcomes
2007-2009 · Canada · Canada
AD 13.8 [7.3, 20.4]
1 study · 3278 participants
GRADE not reported
Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. 2018 All outcomes
2004-2006 · Australia · Australia
AD 2.7 [-0.4, 5.7]
1 study · 5073 participants
GRADE not reported

Show 1 more finding

Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. 2018 All outcomes
2009 · New Zealand · New Zealand
AD 6.7 [-1.3, 14.7]
1 study · 2041 participants
GRADE not reported

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

Caries presence in primary teeth · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

It is very uncertain whether package of oral health education/promotion including oral hygiene… changes caries presence in primary teeth compared with standard care (very low certainty).

1 finding from 1 review

Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
Children assessed at 1-6 yrs
RR 0.73 [0.50, 1.07]
5 studies · 1326 participants
Very low