ArticleGerodontology2026
Implementing Clinical Practice Guidelines for Oral Care for (Frail) Older Patients: Facilitators, Barriers, and Recommendations.
Article in Gerodontology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe Dutch organisation for the development of clinical practice guidelines (CPGs) in oral care known as the Kennisinstituut Mondzorg (KIMO) developed three CPGs to support professionals in oral care for (frail) older patients: (1) treatment of root caries, (2) xerostomia and hyposalivation related to medication and polypharmacy, and (3) oral care for homebound frail older adults. However, actual CPG use in practice is not guaranteed. This study aims to assess adherence to these CPGs among Dutch dentists, identify opportunities and barriers for implementation, and formulate recommendations for an effective implementation strategy.
methodsA modified two-round Delphi study investigated current practices and opinions of dentists; 260 dentists were invited to participate. For round one, an online survey was developed based on the KIMO CPG recommendations. Round two, informed by round one results, explored perceived facilitators, barriers, suggestions for adapting less-followed recommendations, and preferences regarding CPG information and accessibility.
resultsIn round one 41 dentists responded and in round two 44 responded. While the value of CPGs was acknowledged, adherence to several recommendations was limited due to practical barriers, such as time, equipment, training, and reimbursement. Further, communication with other healthcare providers was infrequent. Dentists preferred e-mail notifications and on-demand webinars. Digital availability via a website or app was favoured, though half still appreciate paper versions.
conclusionPractical barriers hinder the use of CPG recommendations in oral care for (frail) older patients. Involving clinicians in guideline development is essential to improve feasibility and implementation.
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