ArticleResearch square2025
Identifying Gaps in Caries Prevention and Management: A Multi-Institutional Mixed-Methods Study.
Article in Research square, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
Corrections and comments
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Authors and funding
23 authors.
Funding
Abstract
Background: Despite established evidence-based guidelines, the prevention and management of dental caries varies across clinical settings. This study aimed to identify and understand quality gaps in caries prevention and management across four dental institutions. Methods: A mixed-methods study was conducted across four large dental institutions. Three data sources were integrated: (1) structured chart reviews (n = 2,000) using six validated dental quality measures; (2) semi-structured interviews (n = 102) with patients, caregivers, staff, and dental providers; and (3) ethnographic observations of clinical care (n = 64) using the AEIOU framework. Data were triangulated using thematic coding and root cause analysis. Quality gaps were categorized as quantitative and qualitative gaps, and system-level challenges. Results: Three categories of gaps emerged. (1) Quantitative gaps included low sealant placement (33.7%-54.6% in ages 6-9; 17.5%-43.0% in ages 10-14), inconsistent caries risk documentation (50.4%-99.6%), and high rates of untreated (23.1%-56.4%) and no new decay rates (65.9%-80.6%). (2) Qualitative gaps included limited documentation of preventive therapies, oral hygiene instruction, and nutritional counseling. Providers cited time constraints, unclear CRA protocols, and EHR usability issues. Interviews revealed unclear team roles and limited patient awareness of preventive options. (3) System-level challenges included workflow inefficiencies, fragmented responsibilities, and poor integration of CRA and preventive codes into clinical routines. Observations confirmed misalignments between documented and delivered care and missed opportunities for risk communication and same-day preventive interventions. Conclusions: Substantial quality gaps persist in caries prevention and management despite institutional protocols. These gaps result from a complex interplay of systems, providers, and patient-level factors. Findings emphasize the need for coordinated data-informed strategies to improve the consistency and effectiveness of preventive care. This study highlights the value of integrating multiple data sources and user-centered methods to inform quality improvement in dental settings.
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Registered trials
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