U.S. Preventive Services Task Force: Lack of evidence for primary care oral health screening

The U.S. Preventive Services Task Force (USPSTF) concludes that the evidence is currently insufficient for recommending oral health screening and preventive interventions for children aged 5 to 17 and adults in primary care settings. These findings are presented in two draft recommendation statements published by the USPSTF.

Roger Chou, M.D., from Pacific Northwest Evidence-based Practice Center in Portland, Oregon, and colleagues conducted a systematic review to update the evidence of primary care screening and prevention of dental caries in children and adolescents aged 5 to 17 years; 23 studies and thee systematic reviews were included. The researchers found that supervised administration of fluoride supplements in schools and administration of fluoride gels, varnish, and sealant in dental or school settings improved caries outcomes. The effectiveness of these interventions needs to be determined in primary care settings. Based on these findings, the USPSTF concludes that for asymptomatic children and adolescents ages 5 to 17 years, the evidence is currently insufficient for assessing the balance of benefits and harms of routine screening and preventive interventions performed by primary care clinicians (I statements).

Chou and colleagues reviewed the evidence relating to primary care screening for and prevention of dental caries and periodontal disease in adults using data from 16 studies. The researchers found that the oral health preventive interventions examined were administered by dental professionals, with the applicability and feasibility in primary care unclear. A screening questionnaire had moderate pooled sensitivity and specificity for periodontal disease. The effectiveness of primary care oral health behavioral counseling versus no counseling and referral to a dental health provider versus no referral was not examined. Based on these findings, the USPSTF concludes that for asymptomatic adults age 18 years or older, the evidence is insufficient for the balance of benefits and harms of routine screening and preventive interventions performed by primary care clinicians (I statements).

These draft recommendation statements and evidence reviews are posted for public comment. Comments can be submitted from May 23 through June 20, 2023.