Preventive oral health services and caries risk assessment of young children by non-dental healthcare providers: a scoping review
Bibliographic record
Abstract
Abstract Background Early childhood caries (ECC) remains a significant global public health concern, disproportionately affecting vulnerable and underserved populations. Integrating oral health services into primary care particularly through non-dental primary care providers (NDPCPs) offers a promising strategy for early identification and prevention. However, the extent and characteristics of such integration across global health systems remain unclear. Objectives This scoping review aimed to map the available evidence on preventive oral health services (POHS) and caries risk assessment (CRA) delivered to children under six years of age by NDPCPs. Specifically, it addressed (1) the types and characteristics of POHS and CRA provided, and (2) how commonly these services are implemented in pediatric primary care settings. Methods The review followed the Joanna Briggs Institute (JBI) Scoping Review Framework. A comprehensive search of four databases, MEDLINE, EMBASE, CINAHL, and Web of Science was conducted for English-language studies published between 2009 and 2024. Eligible studies included primary research on CRA, fluoride varnish application, dental referrals, or oral health promotion delivered by NDPCPs (e.g., physicians, nurses, dietitians) to children under six. A total of 54 studies met the inclusion criteria and were charted, summarized, and analyzed narratively. Results Most studies (83%) were conducted in the United States, with additional representation from Australia, the United Kingdom, Europe, and limited low– and middle-income countries (LMIC) settings. Interventions were delivered by a wide range of NDPCPs including physicians, nurse practitioners, and health visitors, often during well-child visits. Common interventions included oral health education, CRA using structured tools, fluoride varnish application, and dental referrals. Several studies reported improved service uptake following provider training, electronic medical record (EMR) integration, or Medicaid reimbursement policies. Despite evidence of effectiveness and feasibility, no eligible studies were identified from e.g. Canada, highlighting a critical implementation gap. Conclusions NDPCPs play an important and increasingly well-supported role in the delivery of POHS to young children. This review underscores the need for policy frameworks such as reimbursement mechanisms and interprofessional training to support oral health integration into primary care. Canada may benefit from adopting system-level policies to enable and evaluate CRA and POHS in primary care, especially for underserved and Indigenous populations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.062 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.006 |
| Bibliometrics | 0.019 | 0.020 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".