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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
288 questions in 13 reviews · Dental public health and special care
current versionsNo studies 73 · 25.3%Ungraded 90 · 31.3%Very low 90 · 31.3%Low 29 · 10.1%Moderate 6 · 2.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Oral hygiene care training of carers vs No training (or a placebo training session) of carers Behaviour, attitude and self-efficacy of carers (medium term) · People with mixed levels of ID (age range unclear); setting residential · Medium term (6 weeks to 12 months) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | MD 0.15 [-0.80, 1.10] | 2 studies · 189 participants | Very low |
Special manual toothbrush (self, carer or carer-assisted brushing) vs Conventional manual toothbrush (self, carer or carer-assisted brushing) Plaque (short term) · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified · Short term (<6 weeks) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | MD 0.20 [-0.45, 0.85] | 1 study · 25 participants | Very low |
Special manual toothbrush (self, carer or carer-assisted brushing) vs Conventional manual toothbrush (self, carer or carer-assisted brushing) Gingival inflammation (short term) · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified · Short term (<6 weeks) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | MD -0.10 [-0.77, 0.57] | 1 study · 25 participants | Low |
Special manual toothbrush (self, carer or carer-assisted brushing) vs Conventional manual toothbrush (self, carer or carer-assisted brushing) Plaque (medium term) · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified · Medium term (6 weeks to 12 months) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | MD -0.44 [-0.93, 0.05] | 1 study · 18 participants | Very low |
Oral hygiene care training of carers vs No training (or a placebo training session) of carers Oral health knowledge of carers (medium term) · People with mixed levels of ID (age range unclear); setting residential · Medium term (6 weeks to 12 months) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | MD 0.69 [0.31, 1.06] | 2 studies · 189 participants | Low |
Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush (self, carer or carer-assisted brushing) Plaque (short term) · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified · Short term (<6 weeks) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | Assorted plaque indices scale 0-5, 1-4 weeks; 247 participants (4 RCTs); Very Low. Uncertain effect on plaque short term: 2 studies (69 participants) favoured the electric toothbrush; 2 studies (178 participants)… | 4 studies · 247 participants | Very low |
Oral hygiene training (toothbrushing routine) of people with ID vs No oral hygiene training of people with ID Gingival inflammation (short term) · Children and adults with mild to profound ID; setting residential or school · Short term (<6 weeks) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | MD -0.28 [-0.90, 0.34] | 1 study · 10 participants | Very low |
Individualised oral care plan based on a multidisciplinary assessment vs Usual care (regular oral hygiene care following the institution's standard guidelines) Plaque (medium term) · Adults aged 22 to 57 years with mixed levels of ID; setting residential · Medium term (6 weeks to 12 months) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | Individualised oral care plan vs usual care. Subjective Oral Hygiene Rating scale 1-5 and Improvement Differential, mean 12 months; SOHR 2.97 (intervention) vs 3.10 (control); improvement differential 38% vs 5%; 79… | 1 study · 79 participants | Very low |
Oral hygiene care training of carers vs No training (or a placebo training session) of carers Gingival inflammation (medium term) · People with mixed levels of ID (age range unclear); setting residential · Medium term (6 weeks to 12 months) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | MD -0.09 [-0.63, 0.45] | 2 studies · 99 participants | Low |
Daily toothbrushing by a dental student vs Twice-weekly or once-weekly toothbrushing by a dental student Gingival inflammation (short term) · People aged 15 to 30 years with mixed levels of ID; setting residential · Short term (<6 weeks) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | Daily vs twice-weekly or once-weekly toothbrushing by dental students. Buccal and labial Loe & Silness index, mean 21 days; 80 participants (1 RCT); Low. Brushing daily most likely reduced gingival inflammation more… | 1 study · 80 participants | Low |
Special manual toothbrush (self, carer or carer-assisted brushing) vs Conventional manual toothbrush (self, carer or carer-assisted brushing) Gingival inflammation (medium term) · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified · Medium term (6 weeks to 12 months) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | MD -12.40 [-24.31, -0.49] | 1 study · 18 participants | Very low |
Oral hygiene interventions (mechanical plaque removal): knowledge-based, behavioural, or skills training for people with ID or their carers vs Usual care, no care, or a similar alternative intervention Quality of life changes or long-term, patient-centred outcomes (e.g. tooth retention) · People with intellectual disabilities (ID), living at home, in day care, in hospital or in a residential care setting;… Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | No studies measured quality of life changes or long-term, patient-centred outcomes as formal outcomes; some studies commented on quality of life only in the discussion or conclusion sections. | 0 studies | No studies |
Discussion of individual clinical photographs (plaque highlighted by a disclosing agent) as an oral hygiene motivator, plus oral hygiene instruction vs No discussion of clinical photographs, but received the same oral hygiene instruction Plaque (medium term) · People with ID (level of ID and age unclear); setting day centre · Medium term (6 weeks to 12 months) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | MD -0.10 [-0.85, 0.65] | 1 study · 29 participants | Very low |
Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush (self, carer or carer-assisted brushing) Calculus (medium term) · Children and adults with mixed levels of ID; setting home, residential, day care, school, mixed or not specified · Medium term (6 weeks to 12 months) Oral hygiene interventions for people with intellectual disabilities (2019) · Cochrane | SMD -0.04 [-0.40, 0.32] | 2 studies · 120 participants | Low |
Personalised one-to-one OHA vs Routine one-to-one OHA Patient-reported changes in knowledge, attitudes and quality of life · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Jonsson 2009 (OHQoL-UK oral health-related quality of life) and Ramsay 2018 (dental quality of life, oral hygiene self-efficacy); measured, not synthesised or GRADE-rated. | 2 studies | Ungraded |
Any form of one-to-one oral hygiene advice (OHA) vs No OHA Probing depth · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Hetland 1982 reported pocket depths > 4 mm; measured but not synthesised or GRADE-rated (no usable pooled estimate). | 1 study | Ungraded |
Any form of one-to-one oral hygiene advice (OHA) vs No OHA Dental caries · Children or adults (fit and healthy, or with a well-defined medical condition) · 4 to 12 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | SoF: 1 study in adults reported only 'small and statistically insignificant changes' but no usable data; the other study on infants provided evidence of a benefit for OHA at 8 and 12 months but not at 4 months.… | 2 studies · 244 participants | Very low |
Self-management (self-administered/self-monitored OHA) vs Professional OHA Periodontal health: gingivitis · Children or adults (fit and healthy, or with a well-defined medical condition) · 2 to 6 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | SoF: 2 studies reported no significant differences but no usable data; 1 study showed little or no difference at 3 months; 1 study in adults with hyposalivation gave weak evidence of a benefit in gingivitis for… | 4 studies · 181 participants | Very low |
Any form of one-to-one oral hygiene advice (OHA) vs No OHA Periodontal health: gingivitis · Children or adults (fit and healthy, or with a well-defined medical condition) · 3 to 36 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | SoF: 1 small study in adults had contradictory results at 3 and 6 months; the other study in adults showed evidence of a benefit for OHA at all time points (12, 24, 36 months). Results: Hetland 1982 MD 0.25 (0.05 to… | 2 studies · 235 participants | Very low |
Personalised one-to-one OHA vs Routine one-to-one OHA Probing depth · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Jonsson 2009 and Ramsay 2018 reported probing depths; measured but not synthesised or GRADE-rated. | 2 studies | Ungraded |
Personalised one-to-one OHA vs Routine one-to-one OHA Patient-reported behaviour changes and health indices · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Ramsay 2018 (oral health behaviour) and Jonsson 2009 (patient-reported health indices: GOHAI and self-rated oral health); measured, not synthesised or GRADE-rated. | 2 studies | Ungraded |
Enhanced one-to-one OHA vs One-to-one OHA (standard) Probing depth · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Bali 1999 (probing depths) and Soderholm 1982 (pocket depths > 5 mm); measured but not synthesised or GRADE-rated. | 2 studies | Ungraded |
Self-management (self-administered/self-monitored OHA) vs Professional OHA Probing depth · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Jonsson 2006 (probing depth) and Lopez-Jornet 2014 (CPITN score); measured but not synthesised or GRADE-rated. | 2 studies | Ungraded |
Self-management (self-administered/self-monitored OHA) vs Professional OHA Patient-reported behaviour changes · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Baab 1986 (time spent brushing, number of oral hygiene aids), Aljafari 2017 (child's dietary habits, self-reported snacking and toothbrushing), Jonsson 2006 (oral self-care habits); measured, not synthesised or… | 3 studies | Ungraded |
Personalised one-to-one OHA vs Routine one-to-one OHA Periodontal health: gingivitis · Children or adults (fit and healthy, or with a well-defined medical condition) · 2 to 36 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | SoF: 1 large study showed little or no difference at 36 months; 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… | 4 studies · 1635 participants | Very low |
Personalised one-to-one OHA vs Routine one-to-one OHA Dental caries · Children or adults (fit and healthy, or with a well-defined medical condition) · 2 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | SoF: 1 study in children between the ages of 1 year and 6 years old reported 'statistically significant (P < 0.05) improvement' for personalised OHA but did not report usable data. Results: Lepore 2011 not estimable… | 1 study · 69 participants | Very low |
Any form of one-to-one oral hygiene advice (OHA) vs No OHA Patient-reported changes in knowledge, attitudes and quality of life · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Hoogstraten 1983 (dental knowledge, attitude, behaviour, fear of dental treatment) and Memarpour 2016 (parents' knowledge and performance regarding oral health); measured, not synthesised or GRADE-rated. | 2 studies | Ungraded |
Self-management (self-administered/self-monitored OHA) vs Professional OHA Patient satisfaction with advice provided · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Aljafari 2017 reported parent and child satisfaction with their educational intervention; measured, not synthesised or GRADE-rated. | 1 study | Ungraded |
Enhanced one-to-one OHA vs One-to-one OHA (standard) Periodontal health: gingivitis · Children or adults (fit and healthy, or with a well-defined medical condition) · 2 to 12 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | SoF: 2 studies did not report usable data; 1 study gave low-quality evidence of a benefit in gingivitis reduction at 5.5 months for enhanced OHA; 3 studies found little or no difference across all time points. Results:… | 5 studies · 430 participants | Very low |
Enhanced one-to-one OHA vs One-to-one OHA (standard) Patient-reported behaviour changes · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Tedesco 1992 reported self-reported brushing and flossing behaviours and self-efficacy (Oral Health Behavior Expectation Scale); measured, not synthesised or GRADE-rated. | 1 study | Ungraded |
Self-management (self-administered/self-monitored OHA) vs Professional OHA Dental caries · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | No studies were found that looked at dental caries. | 0 studies | No studies |
Enhanced one-to-one OHA vs One-to-one OHA (standard) Dental caries · Children or adults (fit and healthy, or with a well-defined medical condition) · 12 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | 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 One-to-one OHA (standard) Periodontal health: plaque levels · Children or adults (fit and healthy, or with a well-defined medical condition) · 2 to 12 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | 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 One-to-one OHA (standard) Patient-reported changes in knowledge, attitudes and quality of life · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | 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 | Ungraded |
Personalised one-to-one OHA vs Routine one-to-one OHA Economic net benefits (cost effectiveness) · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Ramsay 2018 reported economic net benefits of OHA; measured, not synthesised or GRADE-rated. | 1 study | Ungraded |
Personalised one-to-one OHA vs Routine one-to-one OHA Periodontal health: plaque levels · Children or adults (fit and healthy, or with a well-defined medical condition) · 2 to 12 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | 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 Adverse events · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | No adverse events due to OHA were reported in the included trials (review-wide; assessed across all 19 included studies). | NR | Ungraded |
Any form of one-to-one oral hygiene advice (OHA) vs No OHA Periodontal health: plaque levels · Children or adults (fit and healthy, or with a well-defined medical condition) · 6 to 36 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | 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 Patient-reported changes in knowledge, attitudes and quality of life · Children or adults (fit and healthy, or with a well-defined medical condition) One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | Aljafari 2017 reported child's dietary knowledge; measured, not synthesised or GRADE-rated. | 1 study | Ungraded |
Self-management (self-administered/self-monitored OHA) vs Professional OHA Periodontal health: plaque levels · Children or adults (fit and healthy, or with a well-defined medical condition) · 2 to 6 months One‐to‐one oral hygiene advice provided in a dental setting for oral health (2018) · Cochrane | 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 |
Oral health education (advice and training) vs Standard care (oral health advice not specifically emphasised beyond usual care) Service use: Emergency medical/dental treatment · People with serious mental illness (all included participants had schizophrenia); majority aged 18 to 65 years per… Oral health education (advice and training) for people with serious mental illness (2016) · Cochrane | No study reported useable data | 0 studies | No studies |
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 Denture plaque · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses) · 3 to 60 months Oral health educational interventions for nursing home staff and residents (2016) · Cochrane | SMD -0.60 [-1.25, 0.05] | 5 studies · 816 participants | Low |
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 Caries/root caries · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses) · 6 to 18 months Oral health educational interventions for nursing home staff and residents (2016) · Cochrane | SoF: Caries/root caries (follow-up 6 to 18 months). No meta-analysis. 178 participants (2 RCTs); low quality. Comment: 2 studies at unclear (Frenkel 2001) or high risk of bias (Mojon 1998) showed no apparent… | 2 studies · 178 participants | Low |
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 Nutritional status · Nursing home residents (mean age 78.3 to 86.0 years; more than 66% women; 62.1% to 87.3% with dental prostheses) Oral health educational interventions for nursing home staff and residents (2016) · Cochrane | OR 1.0 [0.3, 3.1] | 1 study | Ungraded |
Monitoring (any means of observation, supervision, keeping under review, measuring or testing at intervals) vs No monitoring Oral health: Not brushing teeth twice a day · People with serious mental illness (all included participants had schizophrenia); majority aged 18 to 65 years per… Oral health education (advice and training) for people with serious mental illness (2016) · Cochrane | No study reported useable data | 0 studies | No studies |
Oral health education (advice and training) vs Standard care (oral health advice not specifically emphasised beyond usual care) Leaving the study early · People with serious mental illness (all included participants had schizophrenia); majority aged 18 to 65 years per… Oral health education (advice and training) for people with serious mental illness (2016) · Cochrane | RR 1.67 [0.45, 6.24] | 1 study · 50 participants | Moderate |
Oral health education (advice and training) vs Standard care (oral health advice not specifically emphasised beyond usual care) Dental state: No clinically important change in plaque index · People with serious mental illness (all included participants had schizophrenia); majority aged 18 to 65 years per… Oral health education (advice and training) for people with serious mental illness (2016) · Cochrane | MD -0.5 [-0.62, -0.38] | 1 study · 40 participants | Very low |
Oral health education (advice and training) vs Standard care (oral health advice not specifically emphasised beyond usual care) Oral health: Not brushing teeth twice a day · People with serious mental illness (all included participants had schizophrenia); majority aged 18 to 65 years per… Oral health education (advice and training) for people with serious mental illness (2016) · Cochrane | No study reported useable data | 0 studies | No studies |
Motivational interview plus oral health education vs Oral health education Quality of life: Chronic pain · People with serious mental illness (all included participants had schizophrenia); majority aged 18 to 65 years per… Oral health education (advice and training) for people with serious mental illness (2016) · Cochrane | No study reported useable data | 0 studies | No studies |
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-related attitude of nursing staff · Nursing home nursing staff (approximately 95% female in the two contributing studies) Oral health educational interventions for nursing home staff and residents (2016) · Cochrane | SMD 0.30 [-0.23, 0.83] | 2 studies · 459 participants | Ungraded |