Systematic review and meta-analysis of randomised controlled trials on the effectiveness of school-based dental screening versus no screening on improving oral health in children

Abstract

ObjectivesThe current study aimed to evaluate the effectiveness of school-based dental screening versus no screening on improving oral health in children aged 3–18 years by a systematic review and meta-analysis of randomised controlled trials. Sources and study selectionThree sets of independent reviewers searched MEDLINE, EMBASE, Web of Science and other sources through April 2016 to identify published and nonpublished studies without language restrictions and extracted data. DataPrimary outcomes included prevalence and mean number of teeth with caries, incidence of dental attendance and harms of screening. Cochrane’s criteria for risk of bias assessment were used. ResultsA total of five cluster RCTs (of unclear or high risk of bias), including 28,442 children, were meta-analysed. For an intracluster correlation coefficient of 0.030, there was no statistically significant difference in dental attendance between children who received dental screening and those who did not receive dental screening (RR 1.11, 95% 0.97, 1.27). The Chi-square test for heterogeneity and the Higgin’s I2 value indicated a substantial heterogeneity. Only one study reported the prevalence and mean number of deciduous and permanent teeth with dental caries and found no significant differences between the screening and no screening groups. ConclusionsThere is currently no evidence to support or refute the clinical benefits or harms of dental screening. Routine dental screening may not increase the dental attendance of school children, but there is a lot of uncertainty in this finding because of the quality of evidence. Clinical significanceEvidence from the reviewed trials suggests no clinical benefit from school-based screening in improving children’s oral health. However, there is a lot of uncertainty in this finding because of the quality of evidence. There is a need to conduct a well-designed trial with an intensive follow-up arm and cost-effectiveness analysis. Systematic review registration numberCRD42016038828 (PROSPERO database).