Intervalli di richiamo per il mantenimento della salute orale nei pazienti odontoiatrici: una revisione Cochrane

Translated title of the contribution: Recall intervals for oral health in primary care patients: a Cochrane review

Patrick A. Fee, Philip Riley, Helen V. Worthington, Janet E. Clarkson, Dwayne Boyers, Paul V. Beirne

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND There is ongoing debate about the frequency with which patients should attend for a dental check-up and the effects on oral health of the interval between check-ups. Recommendations regarding optimal recall intervals vary be-tween countries and dental healthcare systems, but 6-month dental check-ups have traditional-ly been advocated by general dental practitioners in many high-income countries. This review updates a version first published in 2005, and updated in 2007 and 2013. OBJECTIVES To determine the optimal recall interval of dental check-up for oral health in a primary care setting. SEARCH METHODS Cochrane Oral Health’s Information Specialist searched the fol-lowing databases (to 17 January 2020): Cochrane Oral Health’s Trials Register, the Cochrane Central Register of Controlled Trials (CEN-TRAL; in the Cochrane Library, 2019, Issue 12), MEDLINE Ovid, and Embase Ovid. We also searched the US National Insti-tutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. We placed no restrictions on the language or date of publication when searching. SELECTION CRITERIA Randomized controlled trials (RCTs) assessing the effects of different dental recall intervals in a primary care setting. MAIN RESULTS We included two studies with data from 1736 participants. One study was conducted in a public dental service clinic in Norway and involved participants under 20 years of age who were regular attenders at dental appointments. It compared 12-month with 24-month recall intervals and measured outcomes at two years. The other study was conducted in UK general dental practices and involved adults who were regular attenders, which was defined as having attended the dentist at least once in the previous two years. It compared the effects of 6-month, 24-month and risk-based recall intervals, and mea-sured outcomes at four years. The main outcomes we considered were dental caries, gingival bleeding and oral-health-related quality of life. Neither study measured other potential adverse effects. Due to the very low certainty of evidence from one trial, it is un-clear if there is an important difference in caries experience between assignment to a 24-month or a 12-month recall. For 3-to 5-year-olds with primary teeth, the mean difference (MD) in dmfs (decayed, missing, and filled tooth surfaces) increment was 0.90. For 16-to 20-year-olds with permanent teeth, the MD in DMFS increment was 0.86. The trial did not assess other clinical outcomes of relevance to this review. We found high-certainty evidence from one trial of adults that there is little to no difference between risk-based and 6-month recall intervals for the outcomes: number of tooth surfaces with any caries (ICDAS 1 to 6); proportion of sites with gingi-val bleeding; oral-health-related quality of life. There is probably little to no difference in the prevalence of moderate to extensive caries (IC-DAS 3 to 6) between the groups. We found moderate-certainty evidence from one trial of adults that there is probably little to no differ-ence between 24-month and 6-month recall intervals for the outcomes: number of tooth surfac-es with any caries; percentage of sites with gingival bleeding. There may be little to no difference between the groups in the prevalence of moderate to extensive caries. We found high-certainty evidence that there is little to no difference in oral-health-related quality of life between the groups. We found moderate-certainty evidence from one trial of adults that there is probably little to no difference between risk-based and 24-month recall intervals for the outcomes: prevalence of moderate to extensive caries; number of tooth surfaces with any caries. We found high-certainty evidence that there is no important difference between the groups in the percentage of sites with gingival bleeding; or in oral-health-related quality of life. AUTHORS’ CONCLUSIONS Whether adults see their dentist for a check-up every 6 months or at personalised intervals based on their dentist’s assessment of their risk of dental disease does not affect tooth decay, gum disease, or quality of life. Longer intervals (up to 24 months) between check-ups may not negatively affect these outcomes. Currently, there is not enough reliable evidence available about how often children and adolescents should see their dentist for a check-up. For adults attending dental check-ups in primary care settings, there is little to no difference between risk-based and 6-month recall intervals in the number of tooth surfaces with any caries, gingival bleeding and oral-health-related quality of life over a 4-year period (high certainty evi-dence). There is probably little to no difference between the recall strate-gies in the prevalence of moderate to extensive caries (moderate-cer-tainty evidence). When comparing 24-month with either 6-month or risk-based recall intervals for adults, there is moderate-to high-certainty evidence that there is little to no difference in the number of tooth surfaces with any caries, gingival bleeding and oral-health-related quality of life over a 4-year period. The available evidence on recall intervals between dental check-ups for children and adolescents is uncertain. The two trials we included in the review did not assess adverse effects of different recall strategies.

Translated title of the contributionRecall intervals for oral health in primary care patients: a Cochrane review
Original languageItalian
Article numberCD004346
Pages (from-to)22-33
Number of pages12
JournalDental Cadmos
Volume90
Issue number1
DOIs
Publication statusPublished - Jan 2022

Keywords

  • Caries
  • Dental diseases
  • Gingival bleeding
  • Prevention
  • Recall visit

ASJC Scopus subject areas

  • Orthodontics
  • Oral Surgery

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