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Evidence found and GRADE certainty

4,587 questions · 5,761 findings · 495 reviews

No studies found 1,011 · 17.5%GRADE not reported 1,797 · 31.2%Very low 1,100 · 19.1%Low 1,052 · 18.3%Moderate 649 · 11.3%High 152 · 2.6%

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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

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

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)

Barriers and facilitators to implementation of the integration strategy (qualitative) · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Key barriers to implementing integration strategies were time/staff/resource constraints and lack of organisational support, while facilitators were professionals' knowledge and attitudes and supportive governance/leadership (qualitative; ungraded).

1 finding from 1 review
  • 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
    The most commonly studied qualitative outcomes were barriers and facilitators related to the strategy implementation process. Reported barriers were time and staff constraints, resource limitations and lack of…
    15 studies
    GRADE not reported

Country-level periodontal disease prevalence (Global Burden of Disease) vs Low vs high periodontal disease prevalence

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly by country-level periodontal disease prevalence; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Country-level income (World Bank income classification) vs Higher- vs lower-income country categories

Oral health-related quality of life · people aged 60 years and older living in the community

Community-dwelling older adults in higher-income countries had better OHRQoL than those in lower-income countries (77.9, 95% CI 70.2 to 85.6 vs 66.9, 95% CI 56.7 to 77.0); the difference by income was statistically significant (ungraded).

2 findings from 1 review

Country-level income inequality (Gini index) vs Lower vs higher income inequality categories

Oral health-related quality of life · people aged 60 years and older living in the community

Older adults in countries with relative income equality (low Gini index) had markedly higher OHRQoL (91.3, 95% CI 90.0 to 92.6) than those in less equal countries; the difference by Gini index was statistically significant (ungraded).

4 findings from 1 review
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Human Development Index (HDI) vs Higher vs lower HDI categories

Oral health-related quality of life · people aged 60 years and older living in the community

Older adults in higher-HDI countries had better OHRQoL (high 79.9, 95% CI 74.4 to 85.5; very high 78.4, 95% CI 71.1 to 85.8) than those in medium-HDI countries (63.5, 95% CI 54.3 to 72.7); the difference by HDI was statistically significant (ungraded).

3 findings from 1 review

Country-level unemployment rate vs Higher vs lower unemployment-rate categories

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly across country-level unemployment-rate categories; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Health expenditure per capita vs Higher vs lower per-capita health expenditure categories

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly across per-capita health-expenditure categories; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Country-level edentulism prevalence (Global Burden of Disease) vs Low vs high edentulism prevalence

Oral health-related quality of life · people aged 60 years and older living in the community

OHRQoL did not differ significantly by country-level edentulism prevalence; no pooled estimate was reported in the text (ungraded).

1 finding from 1 review

Out-of-pocket health expenditure vs Lower vs higher out-of-pocket expenditure categories

Oral health-related quality of life · people aged 60 years and older living in the community

Lower out-of-pocket health expenditure was associated with better OHRQoL (83.9, 95% CI 75.2 to 92.6 vs 67.5, 95% CI 58.5 to 76.5); the difference was statistically significant (ungraded).

2 findings from 1 review

Country-level dental caries prevalence (Global Burden of Disease) vs Low vs high dental caries prevalence

Oral health-related quality of life · people aged 60 years and older living in the community

Lower country-level dental caries prevalence was associated with better OHRQoL (low-prevalence pooled mean 81.5, 95% CI 76.5 to 86.6, higher than high-prevalence countries); statistically significant (ungraded).

1 finding from 1 review

Disability (developmental, intellectual, or sensory) vs Persons without disabilities

Oral health-related quality of life · Persons with disabilities (children and adults with autism, Down syndrome, cerebral palsy, hearing impairment, or multiple disabilities)…

Persons with disabilities in Saudi Arabia report poorer overall oral health-related quality of life and greater oral-health impact than those without disabilities, synthesized narratively without a pooled estimate (ungraded).

1 finding from 1 review

Child has a disability (special needs) vs Parents/caregivers of children without disabilities

Parental concern / caregiver stress indices (parental perception and parenting stress about the child's oral health) · Parents/caregivers of children with disabilities (special needs; autism spectrum disorder or unspecified disability) in Saudi Arabia

Parents of children with disabilities in Saudi Arabia report significantly greater concern/stress about their child's oral health than parents of children without disabilities (pooled SMD 0.43, 95% CI 0.23 to 0.63; I2=0%; 3 studies); not GRADE-rated.

1 finding from 1 review

Slum / urban-disadvantaged setting vs Non-slum urban setting

Determinants of oral diseases · Adult residents of slums and non-slum urban settings of LMICs

Older age, lower education and income, poor oral hygiene, and disadvantaged residential setting were associated with oral diseases; directions varied across studies.

1 finding from 1 review