Dental caries prevention in children and adolescents: a systematic quality assessment of clinical practice guidelines

Clin Oral Investig. 2018 Dec;22(9):3129-3141. doi: 10.1007/s00784-018-2405-2. Epub 2018 Mar 9.

Abstract

Objectives: To evaluate the quality of clinical practice guidelines (CPGs) for dental caries prevention in children and adolescents MATERIALS AND METHODS: We performed a systematic search of CPGs on caries preventive measures between 2005 and 2016. We searched MEDLINE, EMBASE, LILACS, TripDatabase, websites of CPG developers, compilers of CPGs, scientific societies and ministries of health. We included CPGs with recommendations on sealants, fluorides and oral hygiene. Three reviewers independently assessed the included CPGs using the AGREE II instrument. We calculated the standardised scores for the six domains and made a final recommendation about each CPG. Also, we calculated the overall agreement among calibrated reviewers with the intraclass correlation coefficient (ICC).

Results: Twenty-two CPGs published were selected from a total of 637 references. Thirteen were in English and nine in Spanish. The overall agreement between reviewers was very good (ICC = 0.90; 95%CI 0.89-0.92). The mean score for each domain was the following: Scope and purpose 89.6 ± 12%; Stakeholder involvement 55.0 ± 15.6%; Rigour of development 64.9 ± 21.2%; Clarity of presentation 84.8 ± 14.1%; Applicability 30.6 ± 31.5% and Editorial independence 59.3 ± 25.5%. Thirteen CPGs (59.1%) were assessed as "recommended", eight (36.4%) "recommended with modifications" and one (4.5%) "not recommended".

Conclusions: The overall quality of CPGs in caries prevention was moderate. The domains with greater deficiencies were Applicability, Stakeholder involvement and Editorial independence.

Clinical relevance: Clinicians should use the best available CPGs in dental caries prevention to provide optimal oral health care to patients.

Keywords: Adolescents; Child; Dental caries; Guideline.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Child
  • Dental Care for Children / standards*
  • Dental Caries / prevention & control*
  • Fluorides, Topical / administration & dosage
  • Humans
  • Oral Hygiene
  • Pit and Fissure Sealants
  • Practice Guidelines as Topic*

Substances

  • Fluorides, Topical
  • Pit and Fissure Sealants