Non-Cochrane · intervention · PM41275321
The effectiveness of school-based supervised tooth brushing intervention for preventing dental caries: a systematic review and meta-analysis.
Tavakoli Shaghayegh, Saadatfar Navid, Tiyuri Amir · BMC oral health · 2025 · PubMed · doi:10.1186/s12903-025-07299-y
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
2
current version
GRADE rated
0
No studies
0
Included studies
16
linked below
No studies 0 · 0%Ungraded 2 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
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 | Children in school or kindergarten settings | Children aged 3-14 years across seven countries (n=8 RCTs) |
| Intervention | School-based supervised toothbrushing (STB) as the sole intervention | School-based STB supervised by teachers, trained parents/mothers, dental assistants or research assistants; fluoride toothpaste 0-1450 ppm (n=8) |
| Comparison | No intervention (no-intervention control group) | No intervention (n=8) |
| Outcomes | Dental caries measured by DMFT/dmft or DMFS/dmfs indices | DMFS/dmfs (3 studies pooled: Rong, Jackson, Schwarz) and DMFT/dmft (2 studies pooled: Al-Jundi, Helderman); 5 of 8 RCTs entered the meta-analysis (n=5) |
| Study designs | Randomized controlled trials (RCTs) published in English | RCTs (n=8; 5 in meta-analysis) |
| Timing | Follow-up of at least 1 year | Follow-up 18 months to 4 years (n=8) |
Search date: February 2025. Databases: PubMed; Cochrane Library; Science Direct; Web of Science; Scopus; Google Scholar; clinical trial registers
Questions and results
School-based supervised toothbrushing (STB) vs No intervention
Population: Children in school or kindergarten settings (aged 3-14 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Dental caries increment, DMFS/dmfs (tooth-surface level) 2-3 years follow-up School-based supervised toothbrushing produces a small but statistically significant reduction in tooth-surface caries (DMFS/dmfs SMD -0.22, 95% CI -0.42 to -0.01; ungraded). Source: Abstract; Results 'DMFS/dmfs meta-analysis'; Fig. 2 · same question in other reviews | SMD -0.22 [-0.42, -0.01] | 3 studies · 1135 participants | Ungraded |
Dental caries increment, DMFT/dmft (whole-tooth level) 3-4 years follow-up School-based supervised toothbrushing has no statistically significant effect on whole-tooth caries (DMFT/dmft SMD 0.05, 95% CI -0.27 to 0.37; ungraded). Source: Abstract; Results 'DMFT/dmft meta-analysis'; Fig. 3 · same question in other reviews | SMD 0.05 [-0.27, 0.37] | 2 studies · 1239 participants | Ungraded |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | No | no |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | Yes | Yes | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: N/A · RCT: Yes | RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | NRSI: N/A · RCT: Yes | RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Low | yes |
Included primary studies 16
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| van Palenstein Helderman 1997 Effect evaluation of an oral health education programme in primary schools in Tanzania DOI:10.1111/j.1600-0528.1997.tb00943.x | 1 other review | Dental caries increment, DMFT/dmft (whole-tooth level) | not extracted yet | not extracted yet |
| Al-Jundi 2006 The efficacy of a school‐based caries preventive program: a 4‐year study DOI:10.1111/j.1601-5037.2006.00156.x | this review only | Dental caries increment, DMFT/dmft (whole-tooth level) | not extracted yet | not extracted yet |
| Al-Jundi 2006 matched by author and year (probable) | this review only | Dental caries increment, DMFT/dmft (whole-tooth level) | not extracted yet | not extracted yet |
| Curnow 2002 A Randomised Controlled Trial of the Efficacy of Supervised Toothbrushing in High-Caries-Risk Children DOI:10.1159/000063925 | this review only | not stated | not extracted yet | not extracted yet |
| Curnow 2002 matched by author and year (probable) | this review only | Dental caries increment, DMFS/dmfs (tooth-surface level) | not extracted yet | not extracted yet |
| Frazao 2011 Effectiveness of the bucco-lingual technique within a school-based supervised toothbrushing program on preventing caries: a randomized… PMID:21426572 | this review only | not stated | not extracted yet | not extracted yet |
| Frazão 2011 matched by author and year (probable) | this review only | Dental caries increment, DMFT/dmft (whole-tooth level) | not extracted yet | not extracted yet |
| Helderman 1997 matched by author and year (probable) | this review only | Dental caries increment, DMFT/dmft (whole-tooth level) | not extracted yet | not extracted yet |
| Jackson 2005 The Effects of a Supervised Toothbrushing Programme on the Caries Increment of Primary School Children, Initially Aged 5–6 Years DOI:10.1159/000083155 | this review only | Dental caries increment, DMFS/dmfs (tooth-surface level) | not extracted yet | not extracted yet |
| Jackson 2005 matched by author and year (probable) | this review only | Dental caries increment, DMFS/dmfs (tooth-surface level) | not extracted yet | not extracted yet |
| Rong 2003 Effectiveness of an oral health education and caries prevention program in kindergartens in China DOI:10.1046/j.1600-0528.2003.00040.x | this review only | Dental caries increment, DMFS/dmfs (tooth-surface level) | not extracted yet | not extracted yet |
| Rong 2003 matched by author and year (probable) | this review only | Dental caries increment, DMFS/dmfs (tooth-surface level) | not extracted yet | not extracted yet |
| Schwarz 1998 Prevention of Early Childhood Caries—Results of a Fluoride Toothpaste Demonstration Trial on Chinese Preschool Children after Three Years DOI:10.1111/j.1752-7325.1998.tb02985.x | this review only | Dental caries increment, DMFS/dmfs (tooth-surface level) | not extracted yet | not extracted yet |
| Schwarz 1998 matched by author and year (probable) | this review only | Dental caries increment, DMFS/dmfs (tooth-surface level) | not extracted yet | not extracted yet |
| Winter 2017 Effect of supervised brushing with fluoride gel during primary school, taking into account the group prevention schedule in kindergarten DOI:10.1007/s00784-016-2000-3 | this review only | not stated | not extracted yet | not extracted yet |
| Winter 2017 matched by author and year (probable) | this review only | Dental caries increment, DMFT/dmft (whole-tooth level) | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income countries: a systematic… (2022) | 1 | 0.01 |