Cochrane · intervention · CD004625
Routine scale and polish for periodontal health in adults
Lamont, T, Worthington, HV, Clarkson, JE, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.
Questions
25
current version
GRADE rated
14
No studies
11
Included studies
2
as reported
No studies 11 · 44%Ungraded 0 · 0%Very low 3 · 12%Low 3 · 12%Moderate 0 · 0%High 8 · 32%
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 | We included studies involving dentate adults regularly attending for dental care in primary care settings. We excluded trials where participants were described as having severe periodontal disease (e.g. alveolar bone loss involving most teeth, or people requiring referral for specialist (surgical) periodontal treatment). We also excluded trials where participants had previously undergone specialist periodontal treatment and were in the post-treatment 'maintenance phase'. | The two included studies were conducted in general dental practice settings in the UK and involved regularly attending adults without severe periodontitis. Ramsay 2018 included 1406 participants and Jones 2011 included 305 participants in the analyses, giving a total of 1711 participants in this review. Participants were adults aged 18 to 92 years in Ramsay 2018 and aged 18 to 73 years in Jones 2011. |
| Intervention | We included trials where routine S&P treatments with or without oral hygiene instruction were provided by a dentist, dental hygienist or therapist. | Scale and polish at 6-monthly intervals (n=2); Scale and polish at 12-monthly intervals (n=2) |
| Comparison | S&P treatment at a planned, regular interval (e.g. every six months, every 12 months) versus no scheduled S&P treatment for the duration of the trial/S&P treatment at a planned, regular interval (e.g. every six months) versus S&P treatment at a different planned, regular interval (e.g. every 12 months)/S&P treatment provided by a dentist at a planned, regular interval (e.g. every six months) versus S&P treatment provided by a dental hygienist or dental therapist at the same planned, regular interval | No scale and polish (n=2) |
| Outcomes | Periodontal disease, assessed by gingivitis indices (both inflammatory and bleeding on probing). Secondary outcomes: Calculus and plaque indices; Changes in probing depths; Changes in attachment level; Periodontal indices; Tooth loss; Adverse events; Halitosis; Participant satisfaction; Oral-health related quality of life; Costs of S&P. | Gingivitis indices (n=2); Calculus indices (n=2); Plaque indices (n=1); Probing depth (n=1); Quality of life (n=1); Participant satisfaction outcomes (n=1); Cost (n=1) |
| Study designs | We included randomised controlled trials (RCTs) with at least six months' follow-up. We excluded split-mouth studies as this design does not reflect the manner in which a routine S&P is delivered in practice. | NR |
| Timing | At least six months' follow-up | One study measured outcomes at 24 months and one study measured outcomes at 36 months |
Search date: 2018-01-10. Databases: Cochrane Oral Health's Trials Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid; Embase Ovid
Questions and results
Show all 5 versionsPlanned, regular routine scale and polish (6-monthly; 12-monthly parallel) vs No scheduled scale and polish treatment
Population: Dentate adults without severe periodontitis, regularly attending for dental care in primary care (UK general dental practice)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Participant satisfaction (perceived oral cleanliness) 36 months · 6-monthly (12-monthly parallel) | RR 1.83 [1.28, 2.63] 30 per 100 vs 52 per 100 | 1 study · 205 participants | Low Downgraded: risk of bias |
Gingivitis 24 to 36 months · 6-monthly (12-monthly parallel) | SMD -0.01 [-0.13, 0.11] | 2 studies · 1087 participants | High |
Halitosis | no estimate extracted | 0 studies | No studies |
Probing depth 36 months · 6-monthly (12-monthly parallel) | MD 0.00 [-0.04, 0.04] | 1 study · 880 participants | High |
Costs (NHS perspective, GBP) 6-monthly (12-monthly parallel) | MD 0.52 [-18.10, 19.14] | 1 study · 554 participants | Very low Downgraded: imprecision, indirectness |
Adverse events | no estimate extracted | 0 studies | No studies |
Plaque 24 months · 6-monthly (12-monthly parallel) | MD -0.04 [-0.13, 0.05] | 1 study · 207 participants | Low Downgraded: risk of bias, indirectness |
Attachment change | no estimate extracted | 0 studies | No studies |
Calculus 24 to 36 months · 6-monthly (12-monthly parallel) | SMD -0.32 [-0.44, -0.20] | 2 studies · 1086 participants | High |
Oral health-related quality of life (OHIP-14) 36 months · 6-monthly (12-monthly parallel) | MD -0.30 [-1.24, 0.64] | 1 study · 795 participants | High |
Tooth loss | no estimate extracted | 0 studies | No studies |
Routine scale and polish every 6 months vs Routine scale and polish every 12 months
Population: Dentate adults without severe periodontitis, regularly attending for dental care in primary care (UK general dental practice)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Oral health-related quality of life (OHIP-14) 36 months | MD -0.40 [-1.34, 0.54] | 1 study · 786 participants | High |
Costs (NHS perspective, GBP) | MD -7.62 [-28.39, 13.15] | 1 study · 556 participants | Very low Downgraded: imprecision, indirectness |
Plaque 24 months | MD -0.04 [-0.13, 0.05] | 1 study · 207 participants | Low Downgraded: risk of bias, indirectness |
Calculus 24 to 36 months | SMD -0.13 [-0.25, -0.01] | 2 studies · 1086 participants | High |
Probing depth 36 months | MD 0.00 [-0.04, 0.04] | 1 study · 882 participants | High |
Gingivitis 24 to 36 months | SMD 0.03 [-0.09, 0.15] | 2 studies · 1090 participants | High |
Participant satisfaction (perceived oral cleanliness) 36 months | RR 1.11 [0.85, 1.47] 47 per 100 vs 52 per 100 | 1 study · 207 participants | Very low Downgraded: risk of bias, imprecision |
Routine scale and polish provided by a dentist vs Routine scale and polish provided by a dental care professional (dental therapist or hygienist)
Population: Dentate adults without severe periodontitis, regularly attending for dental care in primary care (UK general dental practice)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Plaque | no estimate extracted | 0 studies | No studies |
Calculus | no estimate extracted | 0 studies | No studies |
Oral health-related quality of life | no estimate extracted | 0 studies | No studies |
Probing depth | no estimate extracted | 0 studies | No studies |
Gingivitis | no estimate extracted | 0 studies | No studies |
Participant satisfaction | no estimate extracted | 0 studies | No studies |
Costs (NHS perspective) | no estimate extracted | 0 studies | No studies |