Clinical practice guidelines and consensus statements for antenatal oral healthcare: An assessment of their methodological quality and content of recommendations

• Published in: PloS one Vol. 17; no. 2; p. e0263444
• Main Authors: Wilson, Annika, Hoang, Ha, Bridgman, Heather, Crocombe, Leonard, Bettiol, Silvana
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 03.02.2022; Public Library of Science (PLoS)
• Subjects: Biology and Life Sciences; Clinical medicine; Clinical practice guidelines; Community involvement; Community participation; Consensus; Databases, Factual; Delivery of Health Care; Dental Care - standards; Dental caries; Developed countries; Documentation; Documents; Education; Female; Guidelines; Gynecology; Health aspects; Health care; Health Facilities; Health risks; Humans; Industrialized nations; Informed consent (Medical law); Management; Medicine; Medicine and Health Sciences; Nausea; Oral health; Oral Health - standards; Oral hygiene; Practice guidelines (Medicine); Practice Guidelines as Topic; Pregnancy; Prenatal care; Prenatal Care - standards; Professionals; Risk analysis; Risk Factors; Search engines; Search strategies; Systematic review; Vomiting; Womens health; Australia; Tasmania Australia
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0263444

To review the content of recommendations within antenatal oral healthcare guidance documents and appraise the quality of their methodology to inform areas of development, clinical practice, and research focus. A systematic search of five electronic databases, Google search engine, and databases from relevant professional and guideline development groups published in English, developed countries, and between 2010 and 2020 was undertaken to identify guidance documents related to antenatal oral healthcare. Quality of documents was appraised using the Appraisal of Guidelines Research and Evaluation II tool, and a 3-step quality cut-off value was used. Inductive thematic analysis was employed to categories discreet recommendations into themes. Six guidelines and one consensus statement were analysed. Two documents developed within Australia scored ≥60% across five of the six domains of the quality appraisal tool and were recommended for use. Four documents (developed in the United States and Canada) were recommended for use with modifications, whilst one document (developed in Europe) was not recommended. A total of 98 discreet recommendations were identified and demonstrated considerable unanimity but differed in scope and level of information. The main content and number of recommendations were inductively categorised within the following clinical practice points: risk factor assessments (n = 2), screening and assessment (n = 10), pre-pregnancy care (referral, n = 1), antenatal care (health education and advice, n = 14; management of nausea and vomiting, n = 7; referral, n = 2), postnatal care (health education and advice, n = 1; anticipatory guidance, n = 6), documentation (n = 4), coordinated care (n = 4), capacity building (n = 6), and community engagement (n = 1). The methodological rigour of included guidance documents revealed areas of strengths and limitations and posit areas for improvement. Further research could centre on adapting antenatal oral healthcare guidelines and consensus statements to local contexts. More high-quality studies examining interventions within antenatal oral healthcare are needed to support the development of recommendations.