What do systematic reviews say?

Individually designed, patient-centred preventive programme: dietary counselling (snacking timing, regular meals, fermentable carbohydrates) plus toothbrushing counselling, delivered by trained dental hygienists (a multi-intervention) vs Basic prevention offered as standard in public dental clinics

• One‐to‐one dietary interventions undertaken in a dental setting to change dietary behaviour 2012 · Cochrane All outcomes

  4 years
  Mean (95% CI) DMFS increment after 4 years: intervention 2.56 (2.07 to 3.05) versus control 4.60 (3.99 to 5.21); significant difference favouring the intervention (P<0.0001; non-overlapping CIs). No between-group point…
  1 study · 497 participants
  GRADE not reported
• One‐to‐one dietary interventions undertaken in a dental setting to change dietary behaviour 2012 · Cochrane All outcomes

  2 years
  Mean (95% CI) DMFS increment after 2 years: intervention 1.86 (1.50 to 2.21) versus control 2.44 (2.12 to 2.77); significant difference favouring the intervention (P<0.05, comparing intervention and control). No…
  1 study · 497 participants
  GRADE not reported

Clinical examination with 24-month recall vs Clinical examination with 12-month recall

It is very uncertain whether clinical examination with 24-month recall changes dental caries: dmfs increment (primary teeth) compared with clinical examination with 12-month recall (very low certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  2 years · 3-5 year olds (primary teeth)
  MD 0.90 [-0.16, 1.96]
  1 study · 58 participants
  Very low

Clinical examination with 24-month recall vs Clinical examination with 12-month recall

It is very uncertain whether clinical examination with 24-month recall changes dental caries: DMFS increment (permanent teeth) compared with clinical examination with 12-month recall (very low certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  2 years · 16-20 year olds (permanent teeth)
  MD 0.86 [-0.03, 1.75]
  1 study · 127 participants
  Very low

Initiation of water fluoridation (artificial or natural) vs Low/non-fluoridated water (0.4 ppm fluoride or less)

The review found no eligible studies for this question.

• Water fluoridation for the prevention of dental caries 2015 · Cochrane All outcomes

  Adults
  No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review's inclusion criteria. There are no data to determine the effect of water fluoridation on caries…
  0 studies
  No studies found

Clinical examination with 24-month recall vs Clinical examination with 6-month recall

Clinical examination with 24-month recall showed no clear difference in dental caries: number of tooth surfaces with any caries (ICDAS 1-6) compared with clinical examination with 6-month recall (moderate certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD -0.60 [-2.54, 1.34]
  1 study · 271 participants
  Moderate

Clinical examination with risk-based recall vs Clinical examination with 6-month recall

Clinical examination with risk-based recall showed no clear difference in dental caries: prevalence of root caries compared with clinical examination with 6-month recall; GRADE not reported.

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  RR 0.93 [0.76, 1.13]
  1 study · 1306 participants
  GRADE not reported

Clinical examination with 24-month recall vs Clinical examination with 6-month recall

Clinical examination with 24-month recall showed no clear difference in dental caries: prevalence of moderate to extensive caries (ICDAS 3-6) compared with clinical examination with 6-month recall (low certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  RR 1.05 [0.92, 1.20]
  1 study · 271 participants
  Low

Clinical examination with risk-based recall vs Clinical examination with 6-month recall

Clinical examination with risk-based recall showed no clear difference in dental caries: prevalence of moderate to extensive caries (ICDAS 3-6) compared with clinical examination with 6-month recall (moderate certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  RR 1.04 [0.99, 1.09]
  1 study · 1478 participants
  Moderate

Clinical examination with risk-based recall vs Clinical examination with 6-month recall

Clinical examination with risk-based recall showed no clear difference in dental caries: number of tooth surfaces with any caries (ICDAS 1-6) compared with clinical examination with 6-month recall (high certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD 0.15 [-0.77, 1.08]
  1 study · 1478 participants
  High

Clinical examination with risk-based recall vs Clinical examination with 24-month recall

Clinical examination with risk-based recall showed no clear difference in dental caries: prevalence of root caries compared with clinical examination with 24-month recall; GRADE not reported.

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  RR 1.21 [0.72, 2.03]
  1 study · 247 participants
  GRADE not reported

Clinical examination with 24-month recall vs Clinical examination with 6-month recall

Clinical examination with 24-month recall showed no clear difference in dental caries: prevalence of root caries compared with clinical examination with 6-month recall; GRADE not reported.

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  RR 1.17 [0.65, 2.11]
  1 study · 238 participants
  GRADE not reported

Clinical examination with risk-based recall vs Clinical examination with 24-month recall

Clinical examination with risk-based recall showed no clear difference in dental caries: prevalence of moderate to extensive caries (ICDAS 3-6) compared with clinical examination with 24-month recall (moderate certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  RR 1.06 [0.95, 1.19]
  1 study · 279 participants
  Moderate

Clinical examination with risk-based recall vs Clinical examination with 24-month recall

Clinical examination with risk-based recall showed no clear difference in dental caries: number of tooth surfaces with any caries (ICDAS 1-6) compared with clinical examination with 24-month recall (moderate certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD 1.40 [-0.69, 3.49]
  1 study · 279 participants
  Moderate

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

• School dental screening programmes for oral health 2022 · Cochrane All outcomes
  Milsom 2006 measured prevalence of dental caries as mean number of teeth with active caries in primary teeth (dt) and permanent teeth (DT); post-intervention changes from baseline were not significant, and the authors…
  1 study · 16684 participants
  GRADE not reported

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

It is very uncertain whether any form of one-to-one oral hygiene advice (OHA) changes dental caries compared with no OHA (very low certainty).

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes

  4 to 12 months
  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

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

  2 months
  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

Self-management (self-administered/self-monitored OHA) vs Professional OHA

The review found no eligible studies for this question.

• One‐to‐one oral hygiene advice provided in a dental setting for oral health 2018 · Cochrane All outcomes
  No studies were found that looked at dental caries.
  0 studies
  No studies found

Enhanced 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

  12 months
  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

Fluoridated milk vs Non-fluoridated milk

The review found no eligible studies for this question.

• Fluoridated milk for preventing dental caries 2015 · Cochrane All outcomes
  No evidence found. (No information was reported by the included study.)
  0 studies
  No studies found

Referral letter based on the common-sense model (CSM) plus dental information guide (DIG) vs Referral letter based on the common-sense model (CSM) alone

It is very uncertain whether referral letter based on the common-sense model (CSM) plus dental… changes proportion of children with treated/untreated caries (receipt of… compared with referral letter based on the common-sense model (CSM) alone (very low certainty).

• School dental screening programmes for oral health 2022 · Cochrane All outcomes

  mean 8 months
  OR 1.30 [0.85, 1.99]
  1 study · 411 participants
  Very low