A systematic review of dental recall intervals and incidence of dental caries

Background. Dental recall interval protocols are used to prevent dental disease through regular maintenance evaluations and preventive procedures. In this systematic review, the authors examined the evidence for the rationale behind a "one-recall-interval-fits-all" protocol, such as a six-month recall interval on caries incidence. Methods. The authors searched the PubMed database and reviewed titles, abstracts and full reports. They also searched the references of each full report and used the "Related articles" feature. They used a checklist validated for randomized and nonrandomized studies to conduct a quality assessment for each article. Results. The authors found seven articles representing six studies that met their inclusion criteria. The results of a randomized controlled trial showed no significant differences in oral health between patients recalled every 12 months and those recalled every 24 months. The investigators of one nonrandomized controlled trial reported that a two- to three-month recall interval significantly reduced the incidence and recurrence of caries. The investigators of an additional longitudinal nonrandomized controlled study that compared three-, six- and 12-month recall intervals reported caries increments of 4.4, 4.0 and 4.9, respectively. The results of two retrospective studies showed that a specific recall interval did not alter caries incidence significantly. The results from a cross-sectional study suggested that a six-month recall interval was associated with more restored teeth but less active caries. Conclusions. The authors conclude that the evidence for using a one-recall-interval-fits-all protocol to reduce caries incidence was weak. Studies that addressed the impact of recall interval on caries incidence were methodologically weak. The evidence was not strong enough to support using any specific one-recall-interval-fits-all protocol for all patients. Clinical Implications. Using a one-recall-interval-fits-all protocol for caries prevention should be re-evaluated. On the basis of evidence from the randomized controlled trial, recall intervals could be extended to every two years. Evidence from the other studies revealed conflicting results for the efficacy of using any specific recall interval protocol. Because all of these studies had serious threats to validity, clinicians may wish to consider assigning recall intervals to patients on the basis of the patients' risk of developing caries. However, a discussion of a caries risk assessment is beyond the scope of this review.