Cochrane · intervention · CD004346
Recall intervals for oral health in primary care patients
Fee, PA, Riley, P, Worthington, HV, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
44
current version
GRADE rated
17
No studies
4
Included studies
2
as reported
No studies 4 · 9.1%Ungraded 23 · 52.3%Very low 2 · 4.5%Low 1 · 2.3%Moderate 7 · 15.9%High 7 · 15.9%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | All children and adults receiving dental check-ups in primary care settings, irrespective of their level of risk for oral disease | Dentate adults (>=18 years) who had visited their dentist within the previous two years, receiving NHS dental care at 51 UK general dental practices - INTERVAL 2020 (n=1); regular-attending patients aged 3, 16 or 18 years at entry in a Norwegian public dental clinic - Wang 1992 (n=1) |
| Intervention | Recall intervals for: clinical examination only; clinical examination plus scale and polish; clinical examination plus preventive advice; clinical examination plus scale and polish plus preventive advice; no recall interval/patient-driven attendance; clinician risk-based recall intervals | Clinical examination with 24-month recall (n=2); clinical examination with risk-based recall (n=1) |
| Comparison | A different fixed recall interval; the same check-up type at a different fixed interval; a clinician risk-based recall interval; no recall interval/patient-driven attendance | Clinical examination with 12-month recall (n=1); clinical examination with 6-month recall (n=1); clinical examination with 24-month recall (n=1) |
| Outcomes | Dental caries (mean dmft/DMFT, dmfs/DMFS, caries increment, decayed/missing/filled/sound surfaces, white spot lesions, root caries); Periodontal disease (plaque and calculus, gingivitis, periodontitis, pocket depth, attachment level, bleeding on probing); Oral mucosa (mucosal/potentially malignant/cancerous lesions; size and stage at diagnosis); Dento-facial development; Psychosocial (patient/parent satisfaction with provider/care received/appearance, oral comfort, oral-health-related quality of life); Economic costs (patient out-of-pocket and time/opportunity costs; provider and health-system costs and resource use); Other (oral health knowledge and attitudes, harms such as fluorosis/overtreatment, dietary and behavioural change) | Caries dmfs/DMFS increment (n=1); prevalence of moderate to extensive caries ICDAS 3-6 (n=1); number of tooth surfaces with any caries ICDAS 1-6 (n=1); prevalence of root caries (n=1); gingival bleeding % of sites (n=1); probing pocket depth mm (n=1); oral-health-related quality of life OHIP-14 (n=1); patient satisfaction (n=1); total time minutes (n=1); patient and health-system costs GBP (n=1); oral health knowledge, attitudes and behaviour (n=1) |
| Study designs | Randomised controlled trials | RCT (n=2) |
| Timing | Not specified | 2 years (Wang 1992, n=1); 4 years (INTERVAL 2020, n=1) |
Search date: 2020-01. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid; ClinicalTrials.gov; WHO International Clinical Trials Registry Platform
Questions and results
Show all 5 versionsClinical examination with 24-month recall vs Clinical examination with 12-month recall
Population: Regular-attending primary-care dental patients aged 3, 16 or 18 years at entry (aged up to 20; low caries risk)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries: dmfs increment (primary teeth) 2 years · 3-5 year olds (primary teeth) | MD 0.90 [-0.16, 1.96] 0.90 [-0.16, 1.96] dmfs surfaces | 1 study · 58 participants | Very low Downgraded: risk of bias, imprecision |
Oral-health-related quality of life 2 years | Summary of findings 1 lists 'Oral-health-related quality of life: Not reported' for the 24-month versus 12-month comparison (Wang 1992 did not measure it). | 0 studies | No studies |
Periodontal disease 2 years | Summary of findings 1 lists 'Periodontal disease: Not reported' for the 24-month versus 12-month comparison (Wang 1992 did not measure it). | 0 studies | No studies |
Total time (examination plus treatment) (minutes) 2 years · 3-5 year olds (primary teeth) | MD -10 [-26.7, 6.7] -10 [-26.7, 6.7] minutes | 1 study · 58 participants | Ungraded |
Total time (examination plus treatment) (minutes) 2 years · 16-20 year olds (permanent teeth) | MD -23.7 [-43.28, -4.12] -23.7 [-43.28, -4.12] minutes | 1 study · 127 participants | Ungraded |
Dental caries: DMFS increment (permanent teeth) 2 years · 16-20 year olds (permanent teeth) | MD 0.86 [-0.03, 1.75] 0.86 [-0.03, 1.75] DMFS surfaces | 1 study · 127 participants | Very low Downgraded: risk of bias, imprecision |
One type of dental check-up (e.g. examination plus scale and polish) vs A different type of dental check-up (e.g. examination only) at the same fixed recall interval
Population: Children and adults receiving dental check-ups in primary care, irrespective of oral disease risk
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | No studies identified comparing different check-up types at the same fixed recall interval. | 0 studies | No studies |
Clinical examination with risk-based recall vs Clinical examination with 6-month recall
Population: Dentate adults (aged 18 years and older) receiving dental check-ups in UK general dental practices (regular attenders)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Periodontal disease: gingival bleeding (percentage of sites) 4 years | MD 0.78 [-1.17, 2.73] 0.78 [-1.17, 2.73] % of sites | 1 study · 1472 participants | High |
Cost (patient perspective): total cost per patient (GBP) 4 years | MD -9.49 [-23.05, 4.07] | 1 study · 1944 participants | Ungraded |
Periodontal disease: probing pocket depth (mm) 4 years | MD 0.03 [-0.01, 0.07] 0.03 [-0.01, 0.07] mm | 1 study · 1463 participants | High |
Oral health behaviour (1-9 scale) 4 years | MD 0.00 [-0.01, 0.01] | 1 study · 1608 participants | Ungraded |
Dental caries: prevalence of root caries 4 years | RR 0.93 [0.76, 1.13] 24% (154/643, 6-month) vs 22% (147/663, risk-based) | 1 study · 1306 participants | Ungraded |
Oral health attitudes (1-7 scale) 4 years | MD 0.04 [-0.04, 0.12] | 1 study · 1607 participants | Ungraded |
Cost (healthcare-system perspective): total cost per patient (GBP) 4 years | MD 13.77 [-1.56, 29.11] | 1 study · 2006 participants | Ungraded |
Patient satisfaction with actual care received (1-7 scale) 4 years | MD 0.03 [-0.03, 0.09] | 1 study · 1607 participants | Ungraded |
Dental caries: prevalence of moderate to extensive caries (ICDAS 3-6) 4 years | RR 1.04 [0.99, 1.09] 30 [-10, 70] per 1000 | 1 study · 1478 participants | Moderate Downgraded: imprecision |
Oral-health-related quality of life (OHIP-14) 4 years | MD -0.35 [-1.02, 0.32] -0.35 [-1.02, 0.32] OHIP-14 points | 1 study · 1551 participants | High |
Dental caries: number of tooth surfaces with any caries (ICDAS 1-6) 4 years | MD 0.15 [-0.77, 1.08] 0.15 [-0.77, 1.08] tooth surfaces | 1 study · 1478 participants | High |
Oral health knowledge (1-9 scale) 4 years | MD -0.01 [-0.03, 0.01] | 1 study · 1604 participants | Ungraded |
No recall interval / patient-driven attendance vs A fixed recall interval
Population: Children and adults receiving dental check-ups in primary care, irrespective of oral disease risk
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcome NR | No studies identified comparing no-recall/patient-driven attendance with a fixed recall interval. | 0 studies | No studies |
Clinical examination with 24-month recall vs Clinical examination with 6-month recall
Population: Dentate adults (aged 18 years and older) receiving dental check-ups in UK general dental practices (regular attenders)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Periodontal disease: gingival bleeding (percentage of sites) 4 years | MD -0.91 [-5.02, 3.20] -0.91 [-5.02, 3.20] % of sites | 1 study · 271 participants | Moderate Downgraded: imprecision |
Cost (healthcare-system perspective): total cost per patient (GBP) 4 years | MD -16.00 [-51.76, 19.76] | 1 study · 404 participants | Ungraded |
Dental caries: prevalence of moderate to extensive caries (ICDAS 3-6) 4 years | RR 1.05 [0.92, 1.20] 40 [-60, 140] per 1000 | 1 study · 271 participants | Low Downgraded: imprecision |
Oral health behaviour (1-9 scale) 4 years | MD 0.00 [-0.03, 0.03] | 1 study · 308 participants | Ungraded |
Oral health attitudes (1-7 scale) 4 years | MD 0.17 [-0.01, 0.35] | 1 study · 308 participants | Ungraded |
Dental caries: number of tooth surfaces with any caries (ICDAS 1-6) 4 years | MD -0.60 [-2.54, 1.34] -0.60 [-2.54, 1.34] tooth surfaces | 1 study · 271 participants | Moderate Downgraded: imprecision |
Periodontal disease: probing pocket depth (mm) 4 years | MD -0.03 [-0.12, 0.06] -0.03 [-0.12, 0.06] mm | 1 study · 270 participants | Moderate Downgraded: imprecision |
Oral-health-related quality of life (OHIP-14) 4 years | MD -0.24 [-1.55, 1.07] -0.24 [-1.55, 1.07] OHIP-14 points | 1 study · 305 participants | High |
Patient satisfaction with actual care received (1-7 scale) 4 years | MD -0.11 [-0.26, 0.04] | 1 study · 308 participants | Ungraded |
Cost (patient perspective): total cost per patient (GBP) 4 years | MD -53.00 [-76.91, -29.09] | 1 study · 375 participants | Ungraded |
Dental caries: prevalence of root caries 4 years | RR 1.17 [0.65, 2.11] 15% (17/116, 6-month) vs 17% (21/122, 24-month) | 1 study · 238 participants | Ungraded |
Oral health knowledge (1-9 scale) 4 years | MD -0.01 [-0.05, 0.03] | 1 study · 308 participants | Ungraded |
Clinical examination with risk-based recall vs Clinical examination with 24-month recall
Population: Dentate adults (aged 18 years and older) receiving dental check-ups in UK general dental practices (regular attenders)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Oral health knowledge (1-9 scale) 4 years | MD -0.01 [-0.05, 0.03] | 1 study · 303 participants | Ungraded |
Oral-health-related quality of life (OHIP-14) 4 years | MD -0.37 [-1.69, 0.95] -0.37 [-1.69, 0.95] OHIP-14 points | 1 study · 298 participants | High |
Periodontal disease: probing pocket depth (mm) 4 years | MD 0.10 [0.01, 0.19] 0.10 [0.01, 0.19] mm | 1 study · 279 participants | Moderate Downgraded: imprecision |
Periodontal disease: gingival bleeding (percentage of sites) 4 years | MD -0.07 [-4.10, 3.96] -0.07 [-4.10, 3.96] % of sites | 1 study · 279 participants | High |
Oral health attitudes (1-7 scale) 4 years | MD -0.02 [-0.20, 0.16] | 1 study · 304 participants | Ungraded |
Oral health behaviour (1-9 scale) 4 years | MD 0.01 [-0.02, 0.04] | 1 study · 304 participants | Ungraded |
Cost (healthcare-system perspective): total cost per patient (GBP) 4 years | MD 17.00 [-14.34, 48.34] | 1 study · 404 participants | Ungraded |
Patient satisfaction with actual care received (1-7 scale) 4 years | MD 0.16 [0.01, 0.31] | 1 study · 304 participants | Ungraded |
Dental caries: prevalence of root caries 4 years | RR 1.21 [0.72, 2.03] 17% (21/122, 24-month) vs 21% (26/125, risk-based) | 1 study · 247 participants | Ungraded |
Dental caries: prevalence of moderate to extensive caries (ICDAS 3-6) 4 years | RR 1.06 [0.95, 1.19] 47 [-40, 140] per 1000 | 1 study · 279 participants | Moderate Downgraded: imprecision |
Dental caries: number of tooth surfaces with any caries (ICDAS 1-6) 4 years | MD 1.40 [-0.69, 3.49] 1.40 [-0.69, 3.49] tooth surfaces | 1 study · 279 participants | Moderate Downgraded: imprecision |
Cost (patient perspective): total cost per patient (GBP) 4 years | MD 34.00 [9.78, 58.22] | 1 study · 375 participants | Ungraded |