Findings

What do systematic reviews say?

4,534 questions · 5,247 findings · 456 reviews

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No studies found 1,142 · 21.8%GRADE not reported 1,503 · 28.6%Very low 1,040 · 19.8%Low 869 · 16.6%Moderate 554 · 10.6%High 139 · 2.6%

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Caries assessment at enamel threshold vs None (single-group incidence)

Dental caries prevalence · European adolescents aged 12 years

Pooled caries prevalence was 0.69 (I² = 100.0%).

1 finding from 1 review

Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. 2022 All outcomes
Europe · Exact age
Prevalence 0.69 [0.49, 0.90]
13 studies
GRADE not reported

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Gingival index (GI) · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… led to lower gingival index (GI) compared with no active intervention/usual care; GRADE not reported.

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
SMD -1.75 [-2.27, -1.24]
12 studies
GRADE not reported

CBT vs inactive control (usual care care, attention control, waitlist)

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer

1 finding from 1 review

Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
Only 1 study reported adverse events as an outcome (Litt 2010): it found worsening symptoms in 13 people treated with an oral splint (as part of standard treatment) and 4 people treated with CBT.
1 study · 101 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

Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without internal resorption

Single-visit root canal treatment showed no clear difference in postoperative pain in the immediate postobturation period (up to 72… compared with multiple-visit root canal treatment (two or more visits) (low certainty).

1 finding from 1 review

Single versus multiple visits for endodontic treatment of permanent teeth 2022 · Cochrane All outcomes
Up to 72 hours postobturation
RR 0.97 [0.81, 1.16]
12 studies · 1329 participants
Low

Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)

Tooth extraction due to endodontic problems · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without internal resorption

It is very uncertain whether single-visit root canal treatment changes tooth extraction due to endodontic problems compared with multiple-visit root canal treatment (two or more visits) (very low certainty).

1 finding from 1 review

Single versus multiple visits for endodontic treatment of permanent teeth 2022 · Cochrane All outcomes
RR 0.46 [0.09, 2.50]
2 studies · 402 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

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

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

HbA1c (glycated haemoglobin), change · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… probably leads to lower hbA1c (glycated haemoglobin), change compared with no active intervention/usual care (moderate certainty).

1 finding from 1 review

Treatment of periodontitis for glycaemic control in people with diabetes mellitus 2022 · Cochrane All outcomes
3-4 months
MD -0.43 [-0.59, -0.28]
30 studies · 2443 participants
Moderate

Caries distribution assessment (individual, tooth and surface levels) vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Caries distribution (individual/tooth/surface level) · European adolescents aged 12–19 years

Caries distribution was skewed at individual, tooth and surface levels and too heterogeneous to meta-analyze (narrative synthesis of 11 studies; not GRADE-rated).

1 finding from 1 review

Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. 2022 All outcomes
Europe (community, subnational and national dental surveys)
No meta-analysis possible; caries distribution reported narratively from 11 studies as skewed at individual, tooth and surface levels, changing with age at tooth and surface level (Results – Caries distribution).
11 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

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

Caries assessment at enamel threshold vs None (single-group incidence)

Caries experience · European adolescents aged 13 years

Pooled caries experience was 1.45.

1 finding from 1 review

Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. 2022 All outcomes
Europe · Exact age
Mean DMFS 1.45 [1.06, 1.98]
1 study
GRADE not reported

Caries assessment at enamel threshold vs None (single-group incidence)

Dental caries prevalence · European adolescents aged 17 years

Pooled caries prevalence was 0.83 (I² = 87.2%).

1 finding from 1 review

Dental caries at enamel and dentine level among European adolescents - a systematic review and meta-analysis. 2022 All outcomes
Europe · Exact age
Prevalence 0.83 [0.71, 0.94]
3 studies
GRADE not reported

Hope-based intervention vs Pain education

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Hope-based intervention showed no clear difference in pain intensity compared with pain education; GRADE not reported.

1 finding from 1 review

Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
Treatment completion
MD 0.10 [-13.52, 13.72]
1 study · 29 participants
GRADE not reported

Single-visit root canal treatment vs Multiple-visit root canal treatment (two or more visits)

Swelling or flare-up · People aged 10 years or above requiring root canal treatment; permanent teeth with completely formed apex and without internal resorption

It is very uncertain whether single-visit root canal treatment changes swelling or flare-up compared with multiple-visit root canal treatment (two or more visits) (very low certainty).

1 finding from 1 review

Single versus multiple visits for endodontic treatment of permanent teeth 2022 · Cochrane All outcomes
RR 0.56 [0.16, 1.92]
6 studies · 605 participants
Very low

Fluoride-releasing resin-based sealant vs No sealant (control/no treatment)

Mean caries increment (mean number of new cavitated occlusal lesions) · Children with caries-free or non-cavitated carious lesion primary molars, aged 3-7 years (paediatric department, dental hospital, France)

1 finding from 1 review

Sealants for preventing dental caries in primary teeth 2022 · Cochrane All outcomes
24 months
Mean number of new cavitated occlusal lesions 0.23 (SD 0.06) in sealed molars vs 0.29 (SD 0.06) in control molars (Wilcoxon matched-pairs signed-rank test P = 0.42)
1 study · 85 participants
GRADE not reported

Sociodemographic / socioeconomic factors (single-parent family, low parental education, family income, socioeconomic status) vs Absence of the factor / reference socioeconomic category

Caries increment in permanent teeth · School children and adolescents (6-18 years) followed from primary dentition (baseline examination before 72 months of age)

Evidence on the association between sociodemographic/socioeconomic factors and permanent-teeth caries is weak and inconsistent (3 studies; could not be pooled; not GRADE-rated).

1 finding from 1 review

Does Early Childhood Caries Increase Caries Development among School Children and Adolescents? A Systematic Review and… 2022 All outcomes
Cohort studies (Norway, China, Brazil)
Inconsistent findings across studies; meta-analysis could not be performed as data could not be extracted. Single-parent family and low parental education were significant in one study (Saethre-Sundli 2020); higher…
3 studies
GRADE not reported

High-viscosity glass-ionomer cement (HVGIC) restoration (conventional restorative approach) vs Compomer, composite resin, or another HVGIC

Treatment failure (annual failure rate) · Children with previously unrestored, vital carious lesions in primary teeth (no pulp therapy); aged 1.5-11 years

High-viscosity GIC had a wide annual failure rate (2.9-25.6%) and was outperformed by compomer/composite in some trials (3 RCTs); low quality of evidence (ungraded).

1 finding from 1 review

Clinical effectiveness of restorative materials for the restoration of carious primary teeth without pulp therapy: a… 2022 All outcomes
12-36 months · University and private-practice settings (Turkey, Israel)
Annual failure rate (%) 2.9-25.6%
3 studies
GRADE not reported

Hypnosis vs relaxation

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer

1 finding from 1 review

Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
Abrahamsen 2011: one participant who received hypnosis was admitted to a psychiatric hospital during the intervention; per study authors this was unrelated to the study treatment.
1 study
GRADE not reported

Traditional screening (referral card given if the inspecting dentist judges the child needs to see a dentist) vs No screening

Dental attendance · School children (aged 4 to 15 years), primary and secondary schools in the UK and India

1 finding from 1 review

School dental screening programmes for oral health 2022 · Cochrane All outcomes
3 to 4 months
Data not pooled; 6281 participants (4 RCTs); Very low. There was substantial heterogeneity, in part due to study design (3 cluster-RCTs and 1 individually randomised trial). We are unable to draw conclusions about this…
4 studies · 6281 participants
Very low