Findings

What do systematic reviews say?

9 questions · 24 findings · 2 reviews · Oral Health

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No studies found 0 · 0%GRADE not reported 17 · 70.8%Very low 7 · 29.2%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Dental caries prevalence measured by dmft or DMFT/S score greater than one · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce the prevalence of dental caries (RR 0.70, favouring intervention), but the certainty of evidence is very low.

3 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
RR 0.70 [0.53, 0.94]
4 studies · 2968 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
<2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration <2 years
RR 0.95 [0.75, 1.21]
2 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
>=2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration >=2 years
RR 0.58 [0.40, 0.84]
2 studies
GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Plaque index (PI) / oral hygiene · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

School-based interventions may reduce dental plaque scores (SMD -0.32, favouring intervention), but the certainty of evidence is very low.

1 finding from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.32 [-0.46, -0.18]
7 studies · 3339 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Oral hygiene measured by mean gingival scores · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

The effect of school-based interventions on gingival scores is uncertain and not statistically significant (SMD 0.12; very low certainty).

1 finding from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD 0.12 [-0.32, 0.55]
3 studies · 1573 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Dental caries · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 6-8 years, DMFT scores were significantly reduced (SMD -0.11); subgroup not separately GRADE-rated.

8 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 6-8 years
SMD -0.11 [-0.17, -0.04]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · <=3 intervention activities
SMD -0.58 [-1.62, 0.45]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
<2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration <2 years
SMD 0.01 [-0.16, 0.18]
3 studies
GRADE not reported

Show 5 more findings

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 8-15 years
SMD -0.41 [-0.50, -0.32]
Studies not reported
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
>=2 years · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention duration >=2 years
SMD -0.49 [-0.79, -0.19]
4 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.33 [-0.56, -0.10]
7 studies · 6766 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.26 [-0.70, 0.18]
5 studies · 3506 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · >3 intervention activities
SMD 0.02 [-0.13, 0.17]
Studies not reported
GRADE not reported

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Annual increment in DMFS (D3) · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Oral-health-education interventions significantly reduced net increment in DMFS (SMD -1.05); no significant subgroup difference vs other interventions (P=0.74).

5 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention type: oral health education
SMD -1.05 [-2.03, -0.08]
3 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · WHO health-promoting-schools framework
SMD -0.57 [-1.56, 0.42]
2 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Non-WHO-framework interventions
SMD -1.88 [-3.15, -0.60]
Studies not reported
GRADE not reported

Show 2 more findings

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Intervention type: other (daily tooth brushing)
SMD -1.23 [-1.46, -1.00]
1 study
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -1.09 [-1.91, -0.27]
4 studies · 3755 participants
Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

Caries increment, tooth index D(M)FT · Primary school children (aged 3-16 years) attending primary school in low- and middle-income countries (LMICs)

Among children aged 5-8 years, net increment in DMFT was not significantly reduced (SMD -0.36); no significant subgroup difference by age.

3 findings from 1 review

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 5-8 years
SMD -0.36 [-0.76, 0.04]
5 studies
GRADE not reported
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
SMD -0.34 [-0.69, 0.02]
5 studies · 5492 participants
Very low
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes
Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean) · Age 9-12 years
SMD -0.20 [-0.44, 0.04]
1 study
GRADE not reported

Selective carious tissue removal (selective excavation, SE) vs Non-selective or complete carious tissue removal

Pulp exposure during caries removal · Children with dentine caries in primary and permanent teeth

Partial caries removal was reported to reduce pulp-exposure risk by 77% versus complete caries removal (RR 0.23; ungraded).

1 finding from 1 review

Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review. 2022 All outcomes
12 months · Primary and permanent teeth combined (2 studies)
RR 0.23 [0.08, 0.69]
2 studies
GRADE not reported

Selective carious tissue removal (selective excavation, SE) vs Non-selective or complete carious tissue removal

Pulp exposure during caries removal · Children (3-11 years) with symptomless, vital dentine caries in primary molars

Partial caries removal reduced the reported risk of pulp exposure versus complete caries removal in primary teeth (RR 0.24; ungraded).

1 finding from 1 review

Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review. 2022 All outcomes
12 months · Primary teeth
RR 0.24 [0.06, 0.90]
262 participants
GRADE not reported

Selective carious tissue removal (selective excavation, SE) vs Non-selective or complete carious tissue removal

Pulpal disease (signs/symptoms of pulp necrosis) · Children with dentine caries in primary and permanent teeth

The reported estimate did not show a clear difference in pulpal disease after partial versus complete caries removal (ungraded).

1 finding from 1 review

Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review. 2022 All outcomes
12 months · 3 studies (primary and permanent teeth)
RR 0.27 [0.05, 1.60]
3 studies
GRADE not reported