Table 2 Summaries of included studies

Afuakwah, C., 2015, Scotland

Improve documentation of caries risk assessments (CRA)

Pretest-posttest quasi-experimental study

Four dentists working at a general dental practice in a Scottish Index of Multiple Deprivation One area

Multifaceted intervention:

⦁ Reminders [CRA pro forma, aide memoire]

⦁ Education (NFS) [staff training]

N/A

Adherence improved from 52.5% pre-intervention to 100% post-intervention

Amemori, M., 2013, Finland

Develop and evaluate two interventions intended to increase the implementation of tobacco use prevention and cessation counselling

Cluster randomised controlled trial

75 dentists and dental hygienists employed at 34 clinics within two municipal health care regions in Finland

⦁ Education (meetings) [lectures, interactive sessions, multimedia demonstrations and role play session (n = 21)]

⦁ Multifaceted intervention (n = 27):

 o Education (meetings) [as above]

 o Pay for performance [fee for service]

No intervention (n = 25)

⦁ No effect on prevention counselling for any group

⦁ Cessation counselling 6 months post-intervention was higher for intervention groups (effect size = 0.52, p = 0.007), despite a relapse after 2 months

Bahrami, M., 2004, Scotland

Evaluate the effectiveness of different implementation strategies for clinical guidelines relating to the management of impacted and unerupted third molar teeth

Pragmatic, 2 × 2 factorial cluster randomised controlled trial

51 general dental practices in Scotland who had been given the opportunity to attend a postgraduate course regarding the guidelines

⦁ Reminders [computer-aided learning with decision support (n = 13)]

⦁ Audit and feedback [audit and feedback (n = 13)]

⦁ Multifaceted intervention (n = 13):

 o Reminders [as above]

⦁ Audit and feedback [as above]

No intervention (n = 12)

No significant difference in guideline adherence was seen between intervention and control groups

Chopra, R., 2014, UK

To audit dentists’ antimicrobial prescription and evaluate the effectiveness of education on their adherence to antimicrobial prescribing guidelines

Pretest-posttest quasi-experimental study

Two audit cycles each including 60 patients in the dental department of a hospital in London

Education (meetings) [extensive training and education of staff and students]

N/A

A 50% increase in appropriate prescriptions was seen post intervention, as was a 38% increase in practitioners recording a diagnosis

Elouafkaoui, P., 2016, Scotland

Compare the impact of individualised audit and feedback interventions on dentists’ antibiotic prescribing rates

Cluster randomised controlled trial

2566 dentists from 795 general dental practices

⦁ Audit and feedback [audit and feedback (n = 1999)]

Current practice (n = 567)

⦁ A 5.7% greater decrease in antibiotic prescription (p = 0.01) was seen among the intervention groups

⦁ Defined daily dose rate reduced by 6.6% more in the intervention group (p = 0.03)

Friction, J., 2011, USA

Compare the impact of two reminder approaches on access of guidelines for patients with medically complex conditions

Randomised clinical trial

109 dentists from 15 dental clinics

⦁ Reminders [computer alerts to providers (n = 32)]

⦁ Patient-mediated interventions [notifications to patients (n = 38)]

Usual care (n = 39)

Both interventions increased guideline website use by 19% for the first 6 months (p < 0.05); however, this was not sustained to 12 months

Gnich, W., 2018, Scotland

Explore the effect of a financial incentive on frequency of fluoride varnish application(FVA) and underlying mechanisms

Non-equivalent groups quasi-experimental study

709 dentists who had submitted payment claims for dental services to the NHS primary care dental contract

Pay for performance [novel fee-for-service (n = 343)]

Continuous fee-for-service (n = 350)

FVA rates increased among both groups; however, a greater increase was seen among the intervention group (β = 0.82, 95% CI = 0.72–0.92)

Isaacson Tilliss, T., 2006, USA

To determine the effect of a multifaceted implementation strategy on oral cancer screening examinations and discussions of tobacco use

Cluster randomised controlled trial

31 dental care providers at 6 dental practices in Colorado

Multifaceted intervention (n = 18):

⦁ Local consensus process [local consensus process]

⦁ Reminders [multi-modal reminders for practitioners]

⦁ Patient-mediated interventions [multi-modal reminders for patients]

⦁ Education (meetings) [interactive educational workshop]

Usual care (n = 12)

No significant change was seen in patient reports of dental provider practice following the intervention, except a 22.1% (p = 0.015) increase in reporting “the dentist/hygienist told me that I was being screened for oral cancer”

Montini T., 2013, USA

To test the feasibility of using web-based computer-mediated clinical decision support system to improve dentists’ adherence to the Treating Tobacco Use and Dependence Clinical Practice Guidelines

Pretest-posttest quasi-experimental study

One general dental clinic located at the New York College of Dentistry

Reminders [computer decision support system]

N/A

⦁ Screening patients for tobacco use increased by 33.1% (p < 0.001)

⦁ Rates of advising, referring and prescribing nicotine replacement therapy for tobacco users increased by 58.9% (p < 0.001), 15.2% (p < 0.001) and 14.3% (p = 0.035) respectively

Rindal, D. B., 2013, USA

To determine the effect of a computer-assisted tobacco intervention tool on frequency of dentists’ adherence to tobacco guidelines

Cluster randomised controlled trial

548 patients from 15 HealthPartners Dental Group clinics in metropolitan Minnesota

Reminders [practitioners provided with computer decision support system]

Usual care

Rates of assessing interest in quitting (17%, p = 0.0006), discussing strategies (21%, p = 0.003) and referral (20%, p = 0.007) were significantly higher in the intervention group

Rosseel, J. P., 2012, The Netherlands

To examine the effect of patient-mediated feedback on adherence of dental practitioners to tobacco cessation guidelines

Pretest-posttest quasi-experimental study

23 primary care dental practices in the Netherlands, their professional personnel and patients

Patient-mediated interventions [patient-mediated feedback]

N/A

More patients reported receiving assessment of smoking status (25.3% increase, p < 0.01), information on smoking (21.3% increase, p < 0.01) and advice and support (26.5%, p < 0.01) 12 months post-intervention despite a 6.1% drop in reported provision of advice after 6 months

Shelley, D., 2011, USA

To evaluate the effect of a multicomponent intervention to implement tobacco use treatment guidelines in public health dental clinics

Pretest-posttest quasi-experimental study

14 comprehensive care general dentistry clinics at the New York College of Dentistry

Multifaceted intervention:

⦁ Reminders [chart system]

⦁ Education (meetings) [faculty and student training]

⦁ Environment [nicotine replacement therapy]

⦁ Referral systems [referral protocol]

⦁ Audit and feedback [referral feedback]

N/A

⦁ No significant difference in rates of screening for tobacco use

⦁ Rates of advising, assessing and referring or prescribing nicotine replacement therapy for tobacco users increased by 20.6% (p < 0.001), 12.1% (p = 0.01) and 9.1% (p = 0.01) respectively

Simons, D., 2013, UK

To determine the effects of an audit on the process and outcomes of clinical endodontic care

Pretest-posttest quasi-experimental study

20 clinicians within the Community Dental Service of the National Health Service

Audit and feedback [audit and feedback]

N/A

In general, there was increased adherence to various endodontic guidelines (0.7–42.9% increase), although this was not seen in all guidelines

Walsh, M. M., 2006, USA

To compare the effects of workshop training and mailed self-study training with and without reimbursement on tobacco-use-related attitudes and behaviours as reported by dentists and patients

Cluster randomised controlled trial with a 2 × 2 factorial design

265 dentists who participated in Delta Dental plans serving state employees in California, Pennsylvania and West Virginia

⦁ Education (materials) [self-study (n = 100)]

⦁ Education (meetings) [workshop (n = 99)]

No intervention (n = 66)

Although patient and self-reported adherence to tobacco guidelines was higher among both intervention groups, more dentists in the workshop group reported adherence than in the self-study group.

Due to a low claim rate, reimbursement had no further effect on this

Zahabiyoun, S., 2015, UK

To determine whether clinical audit can improve use of antibiotics in the dental service

Pretest-posttest quasi-experimental study

Two dental clinics in the northeast of England

Audit and feedback [clinical audit]

N/A

⦁ Compliance with metronidazole prescription guidelines increased by 15.3% (p = 0.012)

⦁ Compliance with amoxicillin prescription guidelines increased by 35.2% (p = 0.041)