What do systematic reviews say?

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

The review found no eligible studies for this question.

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  SoF row 'Oral health': Illustrative risks -, relative effect -, participants/studies -, quality -; Comment: Outcome not reported. Not measured in any included study.
  0 studies
  No studies found

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  One study (Bellomo 2005) assessed oral health-related behaviour of residents; 60 residents were interviewed about toothbrushing habits. Use of toothbrushes and the frequency of brushing during the study period were…
  1 study · 60 participants
  GRADE not reported

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

The review found no eligible studies for this question.

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  SoF row 'Oral health-related quality of life': Illustrative risks -, relative effect -, participants/studies -, quality -; Comment: Outcome not reported. Not measured in any included study.
  0 studies
  No studies found

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

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

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

• 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

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)

Most strategies to integrate oral health into primary care were associated with improved access to oral healthcare (19 studies, narrative synthesis; ungraded).

• 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

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)

Integration strategies were generally associated with positive oral health knowledge, attitudes and perceptions among staff and patients (16 studies, narrative synthesis; ungraded).

• 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)

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 studies, narrative synthesis; ungraded).

• 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

Systemic oral acyclovir vs placebo or no treatment

Systemic oral acyclovir led to lower number of individuals with oral lesions (8 days after… compared with placebo or no treatment; GRADE not reported.

• Acyclovir for treating primary herpetic gingivostomatitis 2008 · Cochrane All outcomes

  8 days after administration
  RR 0.10 [0.02, 0.38]
  1 study · 72 participants
  GRADE not reported

Systemic oral acyclovir vs placebo or no treatment

Systemic oral acyclovir led to lower number of individuals who developed new extraoral lesions after… compared with placebo or no treatment; GRADE not reported.

• Acyclovir for treating primary herpetic gingivostomatitis 2008 · Cochrane All outcomes

  After administration
  RR 0.04 [0.00, 0.65]
  1 study · 72 participants
  GRADE not reported

Dental caries (carious oral microbiome) vs Caries-free / healthy oral microbiome

A group of genera/species (notably Selenomonas, Aggregatibacter, Actinomyces, Treponema) was predictive of caries, whereas Streptococcus was not (ungraded).

• Meta-analysis of caries microbiome studies can improve upon disease prediction outcomes. 2022 All outcomes

  Oral cavity microbiome (saliva and supragingival plaque samples); pooled across 19 international studies
  Mean-decrease-accuracy discriminating taxa: Capnocytophaga HMT-338, Lactobacillus panis, Treponema HMT-230, Bifidobacterium longum, Delftia acidovorans, Staphylococcus schleiferi; higher log2FC in caries: Selenomonas HMT-146, Aggregatibacter actinomycetemcomitans, Actinomyces HMT-896, Treponema HMT-257; Streptococcus not predictive
  19 studies · 2016 participants
  GRADE not reported

Dental caries (carious oral microbiome) vs Caries-free / healthy oral microbiome

In adults, caries-vs-health alpha diversity differed for the Shannon index but not Chao1/Observed (ungraded).

• Meta-analysis of caries microbiome studies can improve upon disease prediction outcomes. 2022 All outcomes

  Oral cavity microbiome (saliva and supragingival plaque samples); pooled across 19 international studies · Adults
  In adults, there was no significant caries-vs-health difference in Chao1 or Observed diversity, whereas the Shannon index differed significantly (p < 0.001).
  Studies not reported
  GRADE not reported

Dental caries (carious oral microbiome) vs Caries-free / healthy oral microbiome

In children, caries-vs-health Shannon alpha diversity differed significantly (ungraded).

• Meta-analysis of caries microbiome studies can improve upon disease prediction outcomes. 2022 All outcomes

  Oral cavity microbiome (saliva and supragingival plaque samples); pooled across 19 international studies · Children
  In children, the Shannon alpha-diversity index differed significantly between caries and health (p < 0.001).
  Studies not reported
  GRADE not reported

Dental caries (carious oral microbiome) vs Caries-free / healthy oral microbiome

Microbiome-based random forest classifiers could not reliably discriminate caries from health across the combined cohort (best AUC approximately 0.75 in a disease-only KO subset; ungraded).

• Meta-analysis of caries microbiome studies can improve upon disease prediction outcomes. 2022 All outcomes

  Oral cavity microbiome (saliva and supragingival plaque samples); pooled across 19 international studies
  AUC 0.75
  19 studies · 2016 participants
  GRADE not reported

Prophylactic aciclovir (oral or intravenous) vs placebo

Prophylactic aciclovir (oral or intravenous) led to lower presence/absence of HSV oral lesions compared with placebo; GRADE not reported.

• Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer 2009 · Cochrane All outcomes
  RR 0.16 [0.08, 0.31]
  9 studies · 398 participants
  GRADE not reported

Intraoral device releasing Biotene Oral Balance gel vs Manually administered bolus of the same gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference between device and bolus in unstimulated whole saliva, oral microbial profile or generalised inflammation.
  1 study · 22 participants
  GRADE not reported

Professional oral care vs Usual oral care

• Oral care measures for preventing nursing home‐acquired pneumonia 2022 · Cochrane All outcomes

  8-30 months
  Incidence of NHAP, follow-up 8-30 months, 5018 (5 studies), Low. Not pooled (individual and cluster-randomised designs, varying effect measures and follow-up). Component estimates: Bourigault HR 0.65 (0.29 to 1.46;…
  5 studies · 5018 participants
  Low

Professional oral care vs Usual oral care

• Oral care measures for preventing nursing home‐acquired pneumonia 2022 · Cochrane All outcomes

  12-30 months
  All-cause mortality, follow-up 12-30 months, 3764 (3 studies), Very low. Not pooled. Adachi RR 0.80 (0.40 to 1.58; 88); Juthani-Mehta HR 1.16 (0.88 to 1.53; 834); Zimmerman adjusted IRR 0.83 (0.61 to 1.12; 1606).…
  3 studies · 3764 participants
  Very low

Professional oral care vs Usual oral care

Professional oral care may leads to lower mortality (pneumonia-associated) compared with usual oral care (low certainty).

• Oral care measures for preventing nursing home‐acquired pneumonia 2022 · Cochrane All outcomes

  24 months
  RR 0.43 [0.25, 0.76]
  2 studies · 454 participants
  Low

Professional oral care vs Usual oral care

Professional oral care led to lower incidence or prevalence of fever compared with usual oral care; GRADE not reported.

• Oral care measures for preventing nursing home‐acquired pneumonia 2022 · Cochrane All outcomes

  24 months
  RR 0.49 [0.33, 0.75]
  1 study · 366 participants
  GRADE not reported