Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

18 questions · 18 findings · 5 reviews · Dental public health and special care · All outcomes

No studies found 6 · 33.3%GRADE not reported 4 · 22.2%Very low 2 · 11.1%Low 6 · 33.3%Moderate 0 · 0%High 0 · 0%

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to the patient or HCW before and/or after an AGP vs No treatment or saline or water

Other adverse events (allergy, irritation/burning of nasal, oral or oropharyngeal mucosa, long-term staining of mucous membranes or teeth, accidental ingestion) · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the healthcare workers…

The review found no eligible studies for this question.

1 finding from 1 review

Antimicrobial mouthwash and/or nasal spray (alone or in combination), any concentration, frequency or dosage vs No treatment or saline or water

Other adverse events (allergy, irritation/burning of nasal, oral or oropharyngeal mucosa, long-term staining of mucous membranes or teeth, accidental ingestion) · Patients with suspected or confirmed COVID-19 infection

The review found no eligible studies for this question.

1 finding from 1 review

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to healthcare workers, with or without the same intervention given to the patients with COVID-19 vs No treatment or saline or water

Other adverse events (allergy, irritation/burning of nasal, oral or oropharyngeal mucosa, long-term staining of mucous membranes or teeth, accidental ingestion) · Healthcare workers (HCWs) treating patients with suspected or confirmed COVID-19 infection

The review found no eligible studies for this question.

1 finding from 1 review

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

Calculus · Adults (mean age 30.9 years), level of ID unclear; setting day centre

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).

1 finding from 1 review

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

Gingival pocketing (long term) · Adults (mean age 30.9 years), level of ID unclear; setting day centre

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).

1 finding from 1 review

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

Plaque · Adults (mean age 30.9 years), level of ID unclear; setting day centre

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).

1 finding from 1 review

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

Gingival bleeding (various bleeding indices) · Adults (mean age 30.9 years), level of ID unclear; setting day centre

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).

1 finding from 1 review

Oral hygiene training (toothbrushing routine) of people with ID vs No oral hygiene training of people with ID

Behaviour, attitude and self-efficacy (toothbrushing behaviour) (medium and long term) · Children and adults with mild to profound ID; setting residential or school
1 finding from 1 review
  • Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
    Long term (>12 months)
    Behaviour, attitude and self-efficacy (steps achieved in a toothbrushing routine), 100 days to 19 months; 59 participants (4 NRS); Very Low. Results not in a format for meta-analysis: 3 NRS (56 participants) reported…
    4 studies · 59 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

Quality of life changes or long-term, patient-centred outcomes (e.g. tooth retention) · People with intellectual disabilities (ID), living at home, in day care, in hospital or in a residential care setting; all levels of ID as…

The review found no eligible studies for this question.

1 finding from 1 review

Oral care vs No oral care

Outcome not reported · Residents of nursing homes and other long-term care facilities

The review found no eligible studies for this question.

1 finding from 1 review

Professional oral care vs Usual oral care

Incidence of NHAP · Residents of nursing homes and other long-term care facilities
1 finding from 1 review
  • Incidence of NHAP, follow-up 8-30 months, 5018 (5 studies), Low. Not pooled (individual and cluster-randomised designs, varying effect measures and follow-up). Component estimates: Bourigault HR 0.65 (0.29 to 1.46;…
    5 studies · 5018 participants
    Low

Professional oral care vs Usual oral care

Mortality (all‐cause) · Residents of nursing homes and other long-term care facilities
1 finding from 1 review
  • All-cause mortality, follow-up 12-30 months, 3764 (3 studies), Very low. Not pooled. Adachi RR 0.80 (0.40 to 1.58; 88); Juthani-Mehta HR 1.16 (0.88 to 1.53; 834); Zimmerman adjusted IRR 0.83 (0.61 to 1.12; 1606).…
    3 studies · 3764 participants
    Very low