Personal oral hygiene and dental caries: A systematic review of randomised controlled trials

Philippe Pierre Hujoel, Margaux Louise A. Hujoel, Georgios A. Kotsakis

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


Objective: To conduct a systematic review of randomised trials assessing the association between personal oral hygiene and dental caries in the absence of the confounding effects of fluoride. Background: Dental caries continues to affect close to 100% of the global population. There is a century-old conflict on whether dental caries is caused by poor oral hygiene or poorly formed teeth (ie, teeth with dental defects). Resolving this conflict is of significant public health importance as these two hypotheses on dental caries aetiology can lead to different prevention strategies. Methods: A systematic search for randomised trials was conducted using predefined criteria in 3 databases. The impact of personal oral hygiene interventions on coronal dental caries incidence was evaluated using random-effects models. Results: Three randomised studies involving a total of 743 participants were included. Personal oral hygiene interventions failed to influence the incidence of dental caries (Δ Decayed, Missing and Filled Surfaces (DFMS) = −0.11; 95% confidence interval: (−0.91, 0.69; P-value <.79)) despite meticulous deplaquing of teeth. There was no significant heterogeneity in the trial results (heterogeneity chi-squared = 1.88, P =.39). The findings were robust to sensitivity analyses, including consideration of the results of nonrandomised studies. Conclusion: Personal oral hygiene in the absence of fluorides has failed to show a benefit in terms of reducing the incidence of dental caries.

Original languageEnglish (US)
Pages (from-to)282-289
Number of pages8
Issue number4
StatePublished - Dec 2018
Externally publishedYes


  • dental caries
  • epidemiology
  • oral hygiene
  • systematic reviews

ASJC Scopus subject areas

  • Dentistry(all)
  • Geriatrics and Gerontology


Dive into the research topics of 'Personal oral hygiene and dental caries: A systematic review of randomised controlled trials'. Together they form a unique fingerprint.

Cite this