Caries preventive measures in orthodontic practice: the development of a clinical practice guideline

• Published in: Orthodontics & craniofacial research Vol. 19; no. 1; pp. 36 - 45
• Main Authors: Oosterkamp, B. C. M., van der Sanden, W. J. M., Frencken, J. E. F. M., Kuijpers-Jagtman, A. M.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.02.2016; Wiley Subscription Services, Inc
• Subjects: Clinical medicine; Delphi; Dental Caries - etiology; Dental Caries - prevention & control; Dentistry; evidence-based practice; Humans; Orthodontics; preventive measures; tooth demineralization; preventive measures; evidence-based practice; orthodontics; Delphi; tooth demineralization
• ISSN: 1601-6335; 1601-6343
• DOI: 10.1111/ocr.12107

Structured Objectives White spot lesions (WSLs) are a side effect of orthodontic treatment, causing esthetic problems and a risk of deeper enamel and dentine lesions. Many strategies have been developed for preventing WSLs, but great variability exists in preventive measures between orthodontists. This study developed statements on which a clinical practice guideline (CPG) can be developed in order to help orthodontists select preventive measures based on the best available evidence. Materials and methods A nominal group technique (RAND‐e modified Delphi procedure) was used. A multidisciplinary expert panel rated 264 practice‐ and evidence‐based statements related to the management of WSLs. To provide panel members with the same knowledge, a total of six articles obtained from a systematic review of the literature were read by the panel in preparation of three consensus rounds. According to the technique, a threshold of 75% of all ratings within any 3‐point section of the 9‐point scale regarding a specific statement was accepted as consensus. Results After the first and second consensus rounds, consensus was reached on 37.5 and 31.1% of statements, respectively. For the remaining 31.4% of statements, consensus was reached during a 4‐h consensus meeting. Conclusions Statements on the management of WSLs derived from a systematic literature review combined with expert opinion were formally integrated toward consensus through a nominal group technique. These statements formed the basis for developing a CPG on the management of WSLs before and during orthodontic treatment.