Table 2.

Summaries of included studies

First author, year, country	Aims	Study design	Study population	EPOC categories [intervention(s)]	Comparator group	Outcome
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)