Summary of findings 4. Summary of findings ‐ oral hygiene education combined with diet and feeding practice advice versus standard care.
| Oral hygiene education combined with diet and feeding practice advice for infants and young children compared with standard care for preventing caries in young children | ||||||
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Population: for interventions, pregnant women and mothers or other caregivers of infants in the first year of life; for outcomes, children up to 6 years of age Settings: Australia (1 RCT), Canada (Cree communities, 1 RCT) Intervention: package of oral health education and promotion measures including oral hygiene advice for pregnant women, mothers infants and young children, and dietary and feeding practice advice focused on infants and young children Comparison: standard care | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Standard care | Oral hygiene, dietary and feeding advice | |||||
|
Caries presence in primary teeth (children 0 to 6 yrs) |
537 per 1000 |
489 per 1000 (403 to 591) |
RR 0.91 (0.75 to 1.10) | 365 (2 studies) | ⊕⊕⊝⊝ low1 | |
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dmfs index score (range 0 to 80) (children assessed at 6 yrs) |
The mean dmfs index score in the standard care group was 2.45 | The mean dmfs index score in the intervention group was 0.99 lower (2.45 lower to 0.47 higher) | 187 (1 study) |
⊕⊝⊝⊝ very low2 | The dmfs index expresses the total number of decayed missing or filled surfaces in primary dentition (five per posterior tooth and four per anterior tooth) as a score (range 0 to 80 surfaces, lower is better) | |
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dmft index score (range 0 to 20) (children assessed at 6 yrs) |
The mean dmft index score in the standard care group was 1.29 | The mean dmft index score in the intervention group was 0.30 lower (0.96 lower to 0.36 higher) | 187 (1 study) |
⊕⊝⊝⊝ very low2 | The dmft index expresses the total number of decayed, missing or filled primary teeth as a score (range 0 to 20 teeth, lower is better) | |
| The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval;; dmfs: decayed, missing and filled surfaces (in primary teeth of children); dmft: decayed, missing and filled teeth (primary, of children); RR: risk ratio; yrs: years | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
1ROB (‐1): downgraded for unclear risk of selection bias and unclear implications associated with loss of data. Imprecision (‐1): downgraded for confidence interval passing through line of no effect (signals uncertainty about direction of the intervention effect)
2 ROB (‐1): downgraded for unclear risk of selection bias, and uncertain risk of bias implications associated with attrition (not downgraded for lack of blinding due to objective outcome); Imprecision (‐2): downgraded for line passing through line of no effect and only one study in analysis