Findings

What do systematic reviews say?

336 questions · 427 findings · 28 reviews · Dental caries

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No studies found 48 · 11.2%GRADE not reported 284 · 66.5%Very low 46 · 10.8%Low 25 · 5.9%Moderate 24 · 5.6%High 0 · 0%

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Plaque · Children aged 4 to 12 years attending primary school

Primary school-based behavioural intervention (both oral hygiene and… showed no clear difference in plaque indices (permanent and deciduous teeth) compared with no intervention or delayed intervention (non-intervention control;… (low certainty).

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
3 to 15 months
SoF (Plaque indices, follow-up 3 to 15 months): 'All 3 RCTs showed a reduction in plaque in the intervention group compared to control group'; 827 participants (3 RCTs); GRADE low; comment 'Data not suitable for…
3 studies · 827 participants
Low

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Caries increment on tooth surfaces (dmfs/DMFS) (prevented fraction) · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
15 months
PF 0.65 [0.12, 1.18]
1 study · 60 participants
Low

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Change in oral health knowledge and skills · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
Worthington 2001 reported changes in oral health knowledge and skills: improvement was apparent in both intervention and control groups at the 4-month follow-up (phase one) but greater in the intervention group (34%…
1 study
GRADE not reported

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Changes in dental attendance · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
Worthington 2001 found no change in reported dental visits over the course of the programmes, with 97% of children at baseline reporting visiting the dentist every 2 years.
1 study
GRADE not reported

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Behavioural outcomes (reported and/or other measures, e.g. data tracking toothbrushes and collecting food wrappers) · Children aged 4 to 12 years attending primary school

The review found no eligible studies for this question.

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
No other behavioural outcomes (e.g. objective toothbrush tracking or food-wrapper collection) were measured by the four included studies.
0 studies
No studies found

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Adverse events · Children aged 4 to 12 years attending primary school

The review found no eligible studies for this question.

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
No study reported any adverse events.
0 studies
No studies found

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Caries increment, tooth index D(M)FT · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
2 years
PF 0.49
1 study
GRADE not reported

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Frequency of cariogenic food and drink consumption · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
Worthington 2001: few children had problems identifying foods containing sugar; only 15% of intervention and 19% of control participants reported routinely consuming sugary snacks on arriving home from school; snacking…
1 study
GRADE not reported

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

Frequency of toothbrushing · Children aged 4 to 12 years attending primary school

1 finding from 1 review

Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
Worthington 2001 reported children's brushing frequency: almost all children (99%) at baseline reported twice daily brushing, and this level was maintained across all groups throughout the intervention (in baseline…
1 study
GRADE not reported

Ozone applied to the carious lesion (10 or 40 seconds), with a fluoride reductant and oral hygiene/preventive advice vs No ozone, with a fluoride reductant and oral hygiene/preventive advice (as in the intervention group)

Time to intervention · People of any age with caries (including demineralisation in non-cavitated carious lesions); the caries may affect any single tooth…

The review found no eligible studies for this question.

1 finding from 1 review

Ozone therapy for the treatment of dental caries 2004 · Cochrane All outcomes
No data were provided in any of the included trials on time to intervention.
Studies not reported
No studies found

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

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 4 weeks to 12 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 1.49 [0.99, 2.00]
10 studies · 4513 participants
Low

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

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up immediately after to 6 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 9.32 [7.08, 11.55]
3 studies · 2370 participants
Low

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

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 0.5 to 12 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 7.38 [5.57, 9.19]
4 studies · 4751 participants
Low

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

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 3 to 12 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD -0.11 [-0.27, 0.04]
4 studies · 2556 participants
Low

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

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 2 weeks to 6 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD -1.18 [-1.83, -0.53]
4 studies · 3342 participants
Moderate

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

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 0.5 to 24 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 2.58 [2.03, 3.12]
6 studies · 13973 participants
Low

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

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up immediately after to 24 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD 1.09 [0.80, 1.39]
7 studies · 10904 participants
Low

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

Health promotion theory-based educational interventions for improving oral health in children and adolescents: a… 2025 All outcomes
Post-intervention (follow-up 1 to 24 months, varies by study) · School-based and community settings; multiple countries (predominantly Iran; also Pakistan, Hong Kong, Lithuania, Thailand) · Overall
SMD -1.92 [-2.42, -1.42]
9 studies · 12562 participants
Moderate

Health service and/or policy intervention designed to modify access to oral health information or services for pregnant women, new mothers or other primary caregivers vs Standard care (or any comparator)

Outcome not reported · For interventions, pregnant women, mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years…

The review found no eligible studies for this question.

1 finding from 1 review

Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
No trials evaluated policy or health service interventions designed to modify access to oral health information or services.
0 studies
No studies found

Behaviour change / oral health promotion interventions delivered by non-dental professionals and health workers (nurses, midwives, health visitors, community health workers) vs control (no intervention/usual care/isotonic exercise)

Caries experience at the surface level (dmfs/defs) · Children (mean age newborn to ~5.2 years) and their parents/carers

Behaviour change interventions delivered by non-dental health workers produced a small, statistically significant reduction in caries experience at the surface level (dmfs SMD -0.15, 95% CI -0.25 to -0.04; 12 studies); the review judged the overall evidence to be of low quality (not GRADE-rated).

1 finding from 1 review

The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children's… 2022 All outcomes
Primary care and community settings; interventions delivered by non-dental health workers (multiple countries: Australia, Brazil, Canada, India, UK, USA, etc.)
SMD -0.15 [-0.25, -0.04]
12 studies
GRADE not reported