No evidence to support or refute the benefits of school dental screening

Abstract

Medline, Embase, The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register, Web of Science ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. Randomised controlled trials (RCTs) of school-based dental screening versus no screening for oral health, conducted on children aged three to 18 years were considered. Two reviewers independently selected studies and abstracted data with study quality being assessed using the Cochrane risk of bias tool. Narrative and quantitative syntheses of included studies' findings were performed. Risk ratios were calculated for binary outcomes, and standardised mean differences were planned for continuous outcomes. Five cluster RCTs involving 28,442 children were included, with the type of screening intervention varying across the studies. Follow-up periods varied from two to four months. Four studies measured dental attendance and one measured changes in prevalence and mean number of deciduous and permanent teeth with active caries as its primary outcomes. There was no statistically significant difference in dental attendance between children who received dental screening and those who did not. The studies were considered to be at high or unclear risk of bias. There is currently no evidence to support or refute the clinical benefits or harms of dental screening. Routine dental screening does not have an effect on dental attendance of school children, but there is a lot of uncertainty in this finding because of the quality of evidence. Given the potential benefits and costs of screening, there is a need to conduct an RCT with low risk of bias, adequate sample size and follow-up to identify differences in clinical outcomes.