Freitas‐Fernandes 2002

Methods	Study design: controlled before‐and‐after study Conducted in: Brazil Unit of randomisation: not applicable Unit of analysis: individual Setting: children living in a Santo Antonio orphanage in the city of Niteroi, located 14 km from the city of Rio de Janeiro, Brazil Funded by: "This study was financed by CAPES, Brazil. Partial support for the study was provided by Unigranrio (Duque de Caxias, Rio de Janeiro)" Duration of the study: 6 months
Participants	Inclusion criteria: children with all first molars erupted, children living at the orphanage Exclusion criteria: not stated Age at baseline: 7 to 11 years N (controls baseline): 14 N (controls follow‐up): 12 N (interventions baseline): 28 N (interventions follow‐up): 25 Recruitment: from an orphanage Gender: 100% female
Interventions	Intervention: professional teeth cleaning, oral hygiene instructions and prophylaxis programme. Children received education on the origin and prevention of gingivitis, instructions on how to brush their teeth, demonstrations on oral hygiene practice and individual instructions Control: not reported Duration of intervention: 6 months
Outcomes	Plaque index and gingival index
Implementation related factors	Theoretical basis: social determinants of health, socio‐ecological model and health promotion Resources for implementation: oral hygiene instruction, prophylaxis, rubber cups and abrasive paste, dental floss and toothbrushes, education and disclosing solution Who delivered the intervention: nuns at the orphanage PROGRESS categories assessed at baseline: not reported PROGRESS categories analysed at outcome: not reported Outcomes related to harms/unintended effects: not reported Intervention included strategies to address diversity or disadvantage: not reported Economic evaluation: not reported
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	High risk	42 children with all first molars erupted were selected from 80. They were stratified by age and were divided into 2 groups: 14 children serving as controls, and 28 as an experimental group
Allocation concealment (selection bias)	Unclear risk	Unclear
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Unclear
Selective reporting (reporting bias)	Unclear risk	Unclear
Other bias	Unclear risk	Unclear
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Unclear
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Unclear