Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

59 questions · 106 findings · 15 reviews · Oral Health

No studies found 0 · 0%GRADE not reported 90 · 84.9%Very low 7 · 6.6%Low 6 · 5.7%Moderate 3 · 2.8%High 0 · 0%

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Self-efficacy related to oral health · school‐age children and adolescents

Theory-based educational interventions significantly improved oral health self-efficacy (SMD 1.49; low certainty), though between-study heterogeneity was very high.

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health attitudes (1-7 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health attitude (SMD 9.32; low certainty); the very large effect warrants cautious interpretation.

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health-related quality of life · school‐age children and adolescents

Theory-based interventions significantly improved oral health-related quality of life (SMD 7.38; low certainty), with very high heterogeneity.

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Periodontal health status · school‐age children and adolescents

Theory-based interventions significantly improved periodontal health (SMD -1.18; moderate certainty).

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health behaviour (1-9 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health behavior (SMD 2.58; low certainty), with very high heterogeneity.

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Oral health knowledge (1-9 scale) · school‐age children and adolescents

Theory-based interventions significantly improved oral health knowledge (SMD 1.09; low certainty).

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Mean DMFT (decayed, missing, filled permanent teeth) · school‐age children and adolescents

Theory-based interventions showed no significant effect on DMFT scores (SMD -0.11; low certainty).

1 finding from 1 review

Theory-based oral health education/promotion interventions (HBM, TPB, SCT, HAPA, TTM, PMT, SOC, PRECEDE-PROCEED, MI) vs Control (waitlist, routine/standard oral health education, or minimal intervention)

Plaque index (PI) / oral hygiene · school‐age children and adolescents

Theory-based interventions significantly reduced dental plaque (SMD -1.92; moderate certainty).

1 finding from 1 review

1.23% APF gel + oral health education vs Oral health education

Arrest or reversal of noncavitated facial/lingual carious lesions · Children and adults with noncavitated carious lesions on facial/lingual surfaces (primary and permanent teeth)

1.23% APF gel + oral health education was probably more effective than Oral health education for arrest or reversal of facial/lingual carious lesions (RR 2.47, 95% CI 1.95 to 3.13; moderate certainty).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

Incremental cost‐effectiveness · Children younger than 6 years (healthy except for dental caries)

In children younger than 6 years, OHPPs were associated with lower cost per DMFT/S (OR 0.07, 95% CI 0.02 to 0.32; ungraded).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children with dental caries

Oral-health promotion programs were associated with markedly lower odds of DMFT/S in children (OR 0.19, 95% CI 0.10 to 0.39; ungraded, very high heterogeneity I2=98.5%).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

Cost‐effectiveness · Children aged 6 years and older (healthy except for dental caries)

In children aged 6 years and older, the cost-effectiveness estimate was extremely imprecise and not significant (OR 0.00, 95% CI 0.00 to 48704.6; ungraded).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 6 years and older (healthy except for dental caries)

In children aged 6 years and older, OHPPs showed no significant effect on DMFT/S (OR 0.29, 95% CI 0.08 to 1.01; ungraded).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

Incremental cost‐effectiveness · Children with dental caries

OHPPs were associated with a lower program cost per DMFT/S in about 97 of 100 programs (OR 0.03, 95% CI 0.01 to 0.11; ungraded, very high heterogeneity I2=99%).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children younger than 6 years (healthy except for dental caries)

In children younger than 6 years, OHPPs were associated with lower odds of DMFT/S (OR 0.14, 95% CI 0.05 to 0.39; ungraded).

1 finding from 1 review

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Conventional or traditional oral health education, or non-gamified interventions (comparator varied; several studies were single-arm/uncontrolled)

Oral health knowledge (1-9 scale) · Children or adolescents

Gamified interventions appear to improve children's oral health knowledge compared with conventional education, but the evidence is narrative and ungraded.

1 finding from 1 review
  • The Application of Gamification in Children's Oral Health Management: Systematic Review. 2025 All outcomes
    Post-intervention (predominantly short-term; long-term follow-up in a minority of studies) · School-based settings, specialized dental clinics, and home-based environments
    The effectiveness of digital-based interventions was generally positive, with 38% (9/24) of the experimental studies reporting improvements in oral health knowledge and behaviors; game-based teaching significantly…
    9 studies
    GRADE not reported

38% SDF plus oral health education vs oral health instruction plus water

new root-surface carious lesions or restorations · community-dwelling older adults with root caries

SDF plus oral health education had a 33% preventative fraction at 24 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in the United Kingdom

In UK studies, OHPPs were associated with lower DMFT/S (OR 0.04, 95% CI 0.00 to 0.58; ungraded).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in Ireland

The single Irish study showed lower DMFT/S with OHPP (OR 0.52, 95% CI 0.45 to 0.61; ungraded, single study).

1 finding from 1 review

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

DMFT/DMFS index (dental caries experience) · Children aged 0-12 years in Japan

The single Japanese study yielded a degenerate estimate of OR 0.00 (95% CI 0.00 to 0.00; ungraded, single study).

1 finding from 1 review