3.3.18

A systematic review of the effects of supervised toothbrushing on caries incidence in children and adolescents.

Dos Santos APP, de Oliveira BH, Nadanovsky P.
Int J Paediatr Dent. 2018 Jan;28(1):3-11. doi: 10.1111/ipd.12334. Epub 2017 Sep21.
BACKGROUND: The anticaries effect of supervised toothbrushing, irrespective of
the effect of fluoride toothpaste, has not been clearly determined yet.
AIM: To assess the effects of supervised toothbrushing on caries incidence in
children and adolescents.
DESIGN: A systematic review of controlled trials was performed (CRD42014013879). 
Electronic and hand searches retrieved 2046 records, 112 of which were read in
full and independently assessed by two reviewers, who collected data regarding
characteristics of participants, interventions, outcomes, length of follow-up and
risk of bias.
RESULTS: Four trials were included and none of them had low risk of bias. They
were all carried out in schools, but there was great variation regarding
children's age, fluoride content of the toothpaste, baseline caries levels and
the way caries incidence was reported. Among the four trials, two found
statistically significant differences favouring supervised toothbrushing, but
information about the magnitude and/or the precision of the effect estimate was
lacking and in one trial clustering effect was not taken into consideration. No
meta-analysis was performed due to the clinical heterogeneity among the included 
studies and differences in the reporting of data.
CONCLUSIONS: There is no conclusive evidence regarding the effectiveness of
supervised toothbrushing on caries incidence.