Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

821 questions · 993 findings · 80 reviews · Dental caries

No studies found 60 · 6%GRADE not reported 749 · 75.4%Very low 109 · 11%Low 41 · 4.1%Moderate 34 · 3.4%High 0 · 0%

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

Oral health-related quality of life · Adolescents (10-19 years)

Oral health promotion programs have a positive effect on OHRQoL in adolescents (narrative synthesis; low methodological quality of included evidence; no pooled estimate or GRADE rating).

2 findings from 1 review

Gamified oral health interventions (mobile apps, serious games, augmented reality, game-based education) vs Non-digital gamified oral health interventions (card/board games, storytelling, printed aids)

Long-term behavior change and overall oral health outcomes · Children or adolescents

Digital gamified interventions appear more effective than non-digital alternatives for long-term behavior change and oral health outcomes, 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
    Long-term follow-up (sustained behavior change) · Schools, dental clinics, and mobile-app user-testing environments
    Digital-based interventions were more effective in fostering long-term behavior change compared with nondigital alternatives and consistently outperformed nondigital alternatives in improving oral health outcomes;…
    Studies not reported
    GRADE not reported

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)

Adherence to oral hygiene routines by people with ID or their carers · Children or adolescents

Gamified interventions appear to increase children's engagement and adherence to oral hygiene routines, 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 regular use rate was significantly higher (72.4%) in the gamified mobile health app group than in the nongamified intervention group (48.3%) [Zolfaghari 2021]; quiz-based challenges in mobile apps encouraged higher…
    Studies not reported
    GRADE not reported

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)

Plaque index (PI) / oral hygiene · Children or adolescents

Gamified interventions appear to improve plaque control and oral hygiene status in children versus conventional methods, but the evidence is narrative and ungraded (individual-study P values only).

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
    In the gamified mobile health app group, plaque control was superior (P<.05) compared with the conventional method group [Zolfaghari 2021]; a gamified/reminder sticker-book group showed a significant improvement in…
    Studies not reported
    GRADE not reported

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

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 hygiene behavior (brushing habits, preventive dental visits, dietary choices) · Children or adolescents

Gamified interventions appear to improve oral hygiene behaviors (brushing habits, preventive dental visits) in children, 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
    A gesture-based motion-capture game enhanced brushing independence and skill retention (P<.001) [Kang 2021]; 58.8% of caregivers reported their children brushed more often when using gamified applications [France…
    Studies not reported
    GRADE not reported

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)

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

Sociodemographic and behavioural factors (older age, lower education, lower income, poor oral hygiene/brushing, smoking, disadvantaged/slum residence, sex) vs Referent groups (younger, higher education/income, better oral hygiene, non-slum residence)

Determinants of oral diseases · Adult residents of slums and non-slum urban settings of LMICs

Age, education, income, oral-hygiene behaviour, dental-visit pattern and slum/disadvantaged residence are associated with oral disease; gender effects are disease-specific; ungraded.

1 finding from 1 review

Gene sequencing (GS) applied to diagnose/manage oral conditions (predominantly 16S rRNA next-generation sequencing of the oral microbiome; also genome-wide/whole-genome sequencing) vs Negligible ('abysmal') effect of gene sequencing; no separate comparator arm (within-sample event contrast in the forest plots)

Noticeable impact of gene sequencing on diagnosing/managing oral conditions · Human patients (any age) with oral-cavity related disorders (e.g. dental caries, periodontitis, gingivitis, peri-implant mucositis,…

Pooled across 8 clinical trials, gene sequencing had a statistically significant impact on diagnosing/managing oral-cavity disorders (RR 0.50, 95% CI 0.46-0.54); certainty not GRADE-rated.

2 findings from 1 review

Gene sequencing (GS) applied to diagnose/manage oral conditions (predominantly 16S rRNA next-generation sequencing of the oral microbiome; also genome-wide/whole-genome sequencing) vs Negligible ('abysmal') effect of gene sequencing; no separate comparator arm (within-sample event contrast in the forest plots)

Reduction in occurrence of oral conditions · Human patients (any age) with oral-cavity related disorders (e.g. dental caries, periodontitis, gingivitis, peri-implant mucositis,…

Pooled across 8 clinical trials, gene sequencing was associated with a statistically significant risk difference for impact on oral-cavity disorders (RD -0.29, 95% CI -0.32 to -0.26); certainty not GRADE-rated.

1 finding from 1 review

Leukemia (oral health status) vs None (descriptive; compared by treatment location)

Oral health problems (mucositis, caries, candidiasis) · Children with leukemia in the United Arab Emirates

One study found oral problems in 60% of children with leukemia, most common during maintenance therapy and among those treated locally (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Down syndrome (oral health status) vs Healthy controls

Oral health status (caries, DMFT, calculus, erosion, malocclusion, treatment indices) · Children with Down syndrome in Dubai

One study found children with Down syndrome had similar caries prevalence but higher DMFT, calculus, erosion and malocclusion than controls, with better restorative-care access (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Cerebral palsy (oral health status) vs Healthy controls

Oral health status (caries, gingivitis, calculus, treatment indices) · Children with cerebral palsy in Dubai

One study found children with cerebral palsy had caries and gingivitis similar to matched controls but more calculus and anomalies, with lower restorative care despite greater need (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Beta-thalassemia major vs Healthy Emirati children

Oral health status (caries, calculus, gingivitis) · Children with beta-thalassemia major in Dubai

One study found higher caries and calculus but lower gingivitis and restorative care in children with beta-thalassemia major compared with healthy Emirati children (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Oral hygiene knowledge and practices assessment vs None (descriptive prevalence review; subgroup analyses by urban/rural status, country and year)

Oral hygiene knowledge and practices · Children and adolescents in the United Arab Emirates

Oral hygiene knowledge and practices among UAE children and adolescents were generally suboptimal and variable across studies, with better practices among females (narrative synthesis; not GRADE-rated).

1 finding from 1 review

Visual examination (VE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

Specificity for detection of oral cavity cancer/OPMD · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance programme, or screened…
1 finding from 1 review