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Evidence found and GRADE certainty

8 questions · 8 findings · 2 reviews

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No studies found 0 · 0%GRADE not reported 8 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Bleaching vs No bleaching (untreated control)

Caries susceptibility, enamel demineralisation, erosion, or microhardness · Permanent teeth or extracted human teeth with artificial lesions

The laboratory studies did not find increased susceptibility to caries or enamel demineralisation, but no firm conclusions can be drawn because of high risk of bias.

1 finding from 1 review

Tooth bleaching (combined in-office and home bleaching) vs No bleaching (untreated control)

Patient satisfaction (measured by patient satisfaction or aesthetic scales) · Patients with post-orthodontic white spot lesions and permanent dentition

In the single RCT, all bleached patients were satisfied with the aesthetic outcome, though the trial was at high risk of bias (ungraded).

1 finding from 1 review

Tooth bleaching (carbamide or hydrogen peroxide; home and/or in-office) vs No bleaching (untreated or pH-cycling control)

Caries susceptibility, enamel demineralisation, erosion, or microhardness · Permanent teeth / enamel specimens (in vitro)

Low-quality in vitro evidence suggests that bleaching of permanent teeth does not increase susceptibility to caries, demineralisation or erosion (ungraded); the clinical question could not be answered because only in vitro studies were available.

1 finding from 1 review

Tooth bleaching (carbamide or hydrogen peroxide; home and/or in-office) vs No bleaching (untreated control)

Colour change / camouflage of white spot lesions (reduction of colour disparity between carious and sound enamel) · Permanent teeth with post-orthodontic white spot lesions (orthodontic patients and in vitro enamel specimens)

Bleaching may diminish colour disparities and camouflage post-orthodontic white spot lesions, but the certainty of the evidence is very low; the findings could neither support nor refute bleaching.

1 finding from 1 review

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Access to oral healthcare (referral pathways, documentation processes, operating efficiencies, staffing, visits for oral health issues, uptake of fluoride varnish/other preventive treatment, and visits to an oral health professional) · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most strategies to integrate oral health into primary care were associated with improved access to oral healthcare (19 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Access to oral healthcare was the primary outcome most studied (n=19). Most studies reported results favouring the integration strategy, including improvements in referral pathways, documentation processes, operating…
    19 studies
    GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Knowledge, attitudes and perceptions of staff and patients regarding oral health · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Integration strategies were generally associated with positive oral health knowledge, attitudes and perceptions among staff and patients (16 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Knowledge/attitudes/perceptions of staff and patients was the second most studied outcome (n=16). Patient and staff perceptions on various aspects of the integration strategy were usually reported as positive.…
    16 studies
    GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Barriers and facilitators to implementation of the integration strategy (qualitative) · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Key barriers to implementing integration strategies were time/staff/resource constraints and lack of organisational support, while facilitators were professionals' knowledge and attitudes and supportive governance/leadership (qualitative; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    The most commonly studied qualitative outcomes were barriers and facilitators related to the strategy implementation process. Reported barriers were time and staff constraints, resource limitations and lack of…
    15 studies
    GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Oral disease outcomes, including dental caries estimates · People of all ages and abilities served through primary care and related settings (children, pregnant women, older adults in…

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 studies, narrative synthesis; ungraded).

1 finding from 1 review
  • Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
    Primary care, community, school, and aged-care/residential/nursing-home settings
    Nine studies reported oral disease outcomes, seven of which measured change in dental caries estimates. Eight of the nine studies reported improved oral disease outcomes; one (Vichayanrat 2012) reported no change in…
    9 studies
    GRADE not reported