What do systematic reviews say?

Monitoring (any means of observation, supervision, keeping under review, measuring or testing at intervals) vs No monitoring

The review found no eligible studies for this question.

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  No study reported useable data
  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 usual care

The review found no eligible studies for this question.

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  No study reported useable data
  0 studies
  No studies found

Motivational interview plus oral health education vs Oral health education

The review found no eligible studies for this question.

• Oral health education (advice and training) for people with serious mental illness 2016 · Cochrane All outcomes
  No study reported useable data
  0 studies
  No studies found

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… may leads to lower calculus (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 -2.00 [-2.64, -1.36]
  1 study · 304 participants
  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 plaque (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 0.29 [-0.07, 0.65]
  2 studies · 120 participants
  Low
• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  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

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

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

  Long term (>12 months)
  Comparison 2.8 (reported; not GRADE-rated). One NRS (Bratel 1991, 23 participants), self-efficacy at 16 months: 10/12 people with ID using the electric toothbrush reported a preference for it, finding it easier to use…
  1 study · 23 participants
  GRADE not reported

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

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

  Short term (<6 weeks)
  Electric vs manual toothbrush. Assorted gingival indices scale 0-4, 2-4 weeks; 252 participants (4 RCTs); Low. Four studies showed no significant differences for gingival inflammation short term; data could not be…
  4 studies · 252 participants
  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 dental caries levels. One RCT (Shaw 1991, Comparison 5) assessed DMFT at baseline only and did not report caries at any later time point.
  0 studies
  No studies found

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… may leads to lower gingival pocketing (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 -0.60 [-0.97, -0.23]
  1 study · 304 participants
  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… may leads to lower plaque (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 -0.70 [-1.28, -0.12]
  1 study · 304 participants
  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

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
  Adverse/unintended effects addressed narratively: 10 of 34 studies investigated or reported negative unintended or adverse effects (e.g. difficulty with the electric or 3-headed toothbrushes, being frightened by the…
  10 studies
  GRADE not reported

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

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

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

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

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