Evidence map›Paper›PMID 40751088›Full record

SynthesisEvidence-based dentistry2025

Supervised toothbrushing programs: evaluating impact, barriers, and facilitators - a mixed-method umbrella review.

Chandrashekar Janakiram, Anju James, Sujay Vivek Vattiprolu, Nitika Monga, Monika Arora

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Evidence-based dentistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Chandrashekar JanakiramDepartment of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India. sekarcandra@gmail.com.ORCID http://orcid.org/0000-0003-1907-8708
Anju JamesDepartment of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Sujay Vivek VattiproluDepartment of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Nitika MongaIndian Council of Medical Research, New Delhi, India.
Monika AroraExecutive director, HRIDAY and Vice President (Research and Health Promotion), Public Health Foundation of India (PHFI), New Delhi, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the effectiveness of supervised toothbrushing programs in improving oral health outcomes among children and adolescents aged 3 to 18 years and to explore stakeholders' perceptions in implementing and sustaining tooth brushing programs.

methodsThis mixed-method umbrella review followed JBI methodology and PRISMA guidelines. A systematic search was conducted across databases including MEDLINE, Cochrane, Scopus, Web of Science, CINAHL, Epistemonikos, ProQuest, and Google Scholar. A total of 159 articles were identified, and after screening, three systematic reviews met the inclusion criteria. The quantitative and qualitative findings were synthesized using a convergent segregated approach. The Theoretical Domains Framework (TDF) was applied to map barriers and facilitators influencing program adoption and sustainability.

resultsThe quantitative synthesis included one systematic review with four included trials, two of which found statistically significant reductions in dental caries with supervised toothbrushing. The qualitative synthesis (two mixed-method systematic reviews) revealed key facilitators and barriers. The most prominent enablers and barriers identified across these reviews were knowledge about oral health/tooth brushing, social influences, and environmental context and resources. Specifically, the knowledge domain received 32 enabler responses and 25 barrier responses, underscoring the importance of understanding oral health practices to improve toothbrushing behavior. Social support garnered 35 enabler responses and 26 barrier responses, highlighting the role of a supportive environment in enhancing adherence to toothbrushing routines.

conclusionThis review highlights the effectiveness of supervised toothbrushing programs in reducing dental caries. The qualitative synthesis, guided by the Theoretical Domains Framework (TDF), identifies key barriers and facilitators, including knowledge gaps, environmental constraints, social influences, and behavioural regulation factors.

Indexed as

Oral HealthToothbrushingAdolescentChildChild, PreschoolDental CariesHumansProgram Evaluation

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.