Service d'Odontologie, Hospices Civils de Lyon, 6/8 Place Deperet, 69007, Lyon, France.
Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France.
BMC Oral Health. 2023 Oct 19;23(1):767. doi: 10.1186/s12903-023-03458-1.
Considered the most prevalent noncommunicable disease in childhood, dental caries is both an individual and a collective burden. While international guidelines highlight prevention as a major strategy for caries management in children, health professionals still struggle to implement prevention into their clinical practice. Further research is needed to understand the gap between the theoretical significance of dental prevention and its lack of implementation in the clinical setting. This systematic review aims to identify and classify factors perceived by health professionals to be barriers or facilitators to caries prevention in children.
A systematic literature search was conducted in three electronic databases (Medline, Web of Science and Cairn). Two researchers independently screened titles, abstracts and texts. To be selected, studies had to focus on barriers or facilitators to caries prevention in children and include health professionals as study participants. Qualitative and quantitative studies were selected. The factors influencing caries prevention in children were sorted into 3 main categories (clinician-related factors, patient-related factors, and organizational-related factors) and then classified according to the 14 domains of the theoretical domains framework (TDF).
A total of 1771 references were found by combining manual and database searches. Among them, 26 studies met the inclusion criteria, of which half were qualitative and half were quantitative studies. Dentists (n = 12), pediatricians (n = 11), nurses (n = 9), and physicians (n = 5) were the most frequently interviewed health professionals in our analysis. Barriers and facilitators to caries prevention in children were categorized into 12 TDF domains. The most frequently reported domains were Environmental Context and Resources, Knowledge and Professional Role and Identity.
This systematic review found that a wide range of factors influence caries prevention in children. Our analysis showed that barriers to pediatric oral health promotion affect all stages of the health care system. By highlighting the incompatibility between the health care system's organization and the implementation of caries prevention, this study aims to help researchers and policy-makers design new interventions to improve children's access to caries prevention.
PROSPERO CRD42022304545.
龋齿被认为是儿童中最常见的非传染性疾病，它既是个人的负担，也是集体的负担。虽然国际指南强调预防是儿童龋齿管理的主要策略，但卫生专业人员仍难以将预防措施纳入其临床实践。需要进一步研究以了解龋齿预防的理论意义与其在临床环境中实施不足之间的差距。本系统评价旨在确定并分类卫生专业人员认为是儿童龋齿预防的障碍或促进因素的因素。
在三个电子数据库（Medline、Web of Science 和 Cairn）中进行了系统文献检索。两名研究人员独立筛选标题、摘要和文本。为了被选中，研究必须侧重于儿童龋齿预防的障碍或促进因素，并将卫生专业人员作为研究参与者。选择了定性和定量研究。影响儿童龋齿预防的因素分为 3 个主要类别（临床医生相关因素、患者相关因素和组织相关因素），然后根据理论领域框架（TDF）的 14 个领域进行分类。
通过组合手动和数据库搜索，共发现 1771 条参考文献。其中，有 26 项研究符合纳入标准，其中一半是定性研究，一半是定量研究。在我们的分析中，被采访的卫生专业人员中牙医（n=12）、儿科医生（n=11）、护士（n=9）和医生（n=5）最为常见。儿童龋齿预防的障碍和促进因素分为 12 个 TDF 领域。报告最多的领域是环境背景和资源、知识和专业角色与身份。
本系统评价发现，影响儿童龋齿预防的因素很多。我们的分析表明，影响儿科口腔健康促进的障碍影响整个医疗保健系统的各个阶段。通过强调医疗保健系统的组织与龋齿预防实施之间的不兼容性，本研究旨在帮助研究人员和政策制定者设计新的干预措施，以改善儿童获得龋齿预防的机会。
PROSPERO CRD42022304545。
