Effectiveness of Supervised Toothbrushing in Preschool Children: Systematic Review and Meta-Analysis

Abstract

Objective: This study aimed to determine the effectiveness of a supervised toothbrushing program in preventing the progression of dental caries among preschool children through a systematic review and meta-analysis. Material and Methods: Eligible studies published until 2024 from four databases: Cochrane, PubMed, Web of Science, and SCOPUS were included. The studies aimed to establish the effect of supervised toothbrushing compared to control groups for dental caries among preschool children who were included as eligible for the studies. The type of studies included were randomized controlled trials (RCTs) and interventional studies. The primary outcome was regarded as dental caries. The Cochrane Handbook was used as a guideline for the systematic review, meta-analysis, and risk of bias assessment with specific domains for the included studies. Results: A total of eight studies were included in the review, and a meta-analysis was conducted on five of these eight studies. The results showed significant prevention of caries by favoring the supervised toothbrushing intervention over the control group with an effect size of risk ratio (RR)=0.91 [0.83, 1.00] (p-value=0.05) for RCT studies and 0.77 [0.71, 0.83] (p-value<0.05) for non-RCT studies. Conclusion: The evidence suggests supervised toothbrushing probably reduces the caries development risk in preschool children, but certainty remains moderate to low due to methodological limitations. Supervised toothbrushing should be encouraged among preschool children by considering which scheme is effective.