What do systematic reviews say?

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Electric toothbrush (self, carer or carer-assisted brushing) showed no clear difference in gingival inflammation (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (moderate certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  MD 0.02 [-0.06, 0.09]
  2 studies · 120 participants
  Moderate

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  Comparison 1.5 (graded in the Effects of interventions text; not tabulated in the SoF). Single-use suction toothbrush vs standard manual toothbrush (both with a chemical agent), 90 days, Ferozali 2007: Total Oral…
  1 study · 22 participants
  Very low

Oral hygiene training (toothbrushing routine) of people with ID vs No oral hygiene training of people with ID

It is very uncertain whether oral hygiene training (toothbrushing routine) of people with ID changes plaque (short term) compared with no oral hygiene training of people with ID (very low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  MD -0.47 [-0.92, -0.02]
  1 study · 10 participants
  Very low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… showed no clear difference in gingival bleeding (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.20 [-0.86, 0.46]
  1 study · 304 participants
  Low

Oral hygiene training (toothbrushing routine) of people with ID vs No oral hygiene training of people with ID

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  Behaviour, attitude and self-efficacy (steps achieved in a toothbrushing routine), 100 days to 19 months; 59 participants (4 NRS); Very Low. Results not in a format for meta-analysis: 3 NRS (56 participants) reported…
  4 studies · 59 participants
  Very low

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  Comparison 1.6 (graded in the Effects of interventions text; not tabulated in the SoF). Bildt 2010, Superbrush vs conventional, 4 months, 18 participants (1 RCT): carer handling of toothbrush MD 0.50 (95% CI -0.35 to…
  1 study · 18 participants
  Very low

Oral hygiene care training of carers vs No training (or a placebo training session) of carers

It is very uncertain whether oral hygiene care training of carers changes behaviour, attitude and self-efficacy of carers (medium term) compared with no training (or a placebo training session) of carers (very low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  MD 0.15 [-0.80, 1.10]
  2 studies · 189 participants
  Very low

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

It is very uncertain whether special manual toothbrush (self, carer or carer-assisted brushing) changes plaque (short term) compared with conventional manual toothbrush (self, carer or carer-assisted… (very low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  MD 0.20 [-0.45, 0.85]
  1 study · 25 participants
  Very low
• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  MD -0.44 [-0.93, 0.05]
  1 study · 18 participants
  Very low

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Special manual toothbrush (self, carer or carer-assisted brushing) showed no clear difference in gingival inflammation (short term) compared with conventional manual toothbrush (self, carer or carer-assisted… (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  MD -0.10 [-0.77, 0.57]
  1 study · 25 participants
  Low

Oral hygiene care training of carers vs No training (or a placebo training session) of carers

Oral hygiene care training of carers may leads to higher oral health knowledge of carers (medium term) compared with no training (or a placebo training session) of carers (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  MD 0.69 [0.31, 1.06]
  2 studies · 189 participants
  Low

Oral hygiene training (toothbrushing routine) of people with ID vs No oral hygiene training of people with ID

It is very uncertain whether oral hygiene training (toothbrushing routine) of people with ID changes gingival inflammation (short term) compared with no oral hygiene training of people with ID (very low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  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

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  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

Oral hygiene care training of carers showed no clear difference in gingival inflammation (medium term) compared with no training (or a placebo training session) of carers (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  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

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  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 Manual toothbrush

It is very uncertain whether special manual toothbrush (self, carer or carer-assisted brushing) changes gingival inflammation (medium term) compared with conventional manual toothbrush (self, carer or carer-assisted… (very low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  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

The review found no eligible studies for this question.

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
  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 found

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

It is very uncertain whether discussion of individual clinical photographs (plaque highlighted by… changes plaque (medium term) compared with no discussion of clinical photographs, but received the same oral… (very low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  MD -0.10 [-0.85, 0.65]
  1 study · 29 participants
  Very low

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Electric toothbrush (self, carer or carer-assisted brushing) showed no clear difference in calculus (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  SMD -0.04 [-0.40, 0.32]
  2 studies · 120 participants
  Low

Personalised one-to-one OHA vs Routine one-to-one OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  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
  GRADE not reported

Any form of one-to-one oral hygiene advice (OHA) vs No OHA

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  Hetland 1982 reported pocket depths > 4 mm; measured but not synthesised or GRADE-rated (no usable pooled estimate).
  1 study
  GRADE not reported