A systematic scoping review of oral health models

Purpose: The purpose of this systematic scoping review was to identify, analyze, and compare existing generic oral health models in English scientific dental literature. Methods: We conducted a literature search in five databases, Ovid Medline, Embase, PsycINFO, Cochrane, and Web of Science, using pre-determined inclusion and exclusion criteria and calculated the interrater agreement coefficient “prevalence-adjusted bias-adjusted kappa” (PABAK). We identified, reviewed, and displayed the generic oral health models in review tables. Results: Of the 3498 references identified, 13 oral health models from seven countries met the inclusion criteria. The interrater agreement coefficient resulted in a ‘‘substantial agreement’’ (PABAK = 0.80). Ten of the 13 (77%) generic oral health models were developed in English-speaking countries. All models were multidimensional and contained from two to 12 dimensions. Four models presented linear conception, and we observed non-linear conception in six models. Authors presented the unidirectional or reciprocal relations between dimensions in six models, and five models, respectively. Two models did not show models’ relation or conception. Researchers used only experts (N = 1), literature (N = 2), dental patients (N = 2), or general population subjects (N = 3), or a combination of these sources (N = 5) for development of their generic oral health models. Statistical analyses supported the majority of the models (N = 8). Conclusions: The identified 13 oral health models vary substantially in their characteristics. This systematic scoping review of generic oral health models provides a toolbox, from which dental researchers can choose the theoretical model they consider fit best their oral health concept they want to investigate. Ideally, the international dental community will come soon to an agreement of accepting one oral health model, and this will provide an opportunity for comparison of outcomes across studies and populations and thus elevate dentistry to a higher evidence-based level.