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

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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.

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Acknowledgements

Andrea Seiffert is a MSc candidate, Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile. Ma. José Martínez is funded by a Miguel Servet research contract from the Instituto de Salud Carlos III and European Social Fund (CP15/00116). We would like to acknowledge Ingrid Obrecht for her help in the English editing process.

Funding

This project was partially funded by a grant from Universidad de La Frontera, DIUFRO No. DI16-0087.

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Authors and Affiliations

  1. Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile

    Andrea Seiffert

  2. Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Manuel Montt #112, Temuco, Chile

    Carlos Zaror

  3. Centre for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile

    Carlos Zaror & Claudia Atala-Acevedo

  4. Faculty of Dentistry, Universidad de los Andes, Santiago, Chile

    Andrea Ormeño

  5. Iberoamerican Cochrane Centre, Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain

    María José Martínez-Zapata & Pablo Alonso-Coello

  6. CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

    María José Martínez-Zapata & Pablo Alonso-Coello

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  1. Andrea Seiffert
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Correspondence to Carlos Zaror.

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Seiffert, A., Zaror, C., Atala-Acevedo, C. et al. Dental caries prevention in children and adolescents: a systematic quality assessment of clinical practice guidelines. Clin Oral Invest 22, 3129–3141 (2018). https://doi.org/10.1007/s00784-018-2405-2

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