Clinical practice guideline adaptation for risk-based caries management in 18- 55 years old Iranian adults

Abstract

Purpose: To adapt an evidence based clinical practice guideline (CPG) for risk-based management of caries in 18-55 years old Iranian adults.Methods: A multidisciplinary adaptation team reviewed evidence-based guidelines such as NICE, SIGN, and ADA according to the defined clinical questions. In addition, databases such as PubMed and google scholar were searched and CPGs were screened and appraised employing AGREE II (Appraisal of Guidelines for Research & Evaluation II) tool. Clinical scenarios were developed and their level of evidence, clinical advantage and adaptability was assessed. Following a two-round of ranking by experts, final recommendations were selected using RAND-UCLA appropriateness method.Results: Of 17 guides, 5 CPGs were selected as source adaptation guidelines. For assessing risk of caries in adult population, reduced Cariogram (without saliva tests) and CAMBRA were selected. In addition, adaptation team recommended 53 risk-based recommendations on preventive measures, operative intervention threshold and follow up intervals for Iranian adults.Conclusions: Our study demonstrated an adapted guide for risk-based management of tooth decay in Iranian adults. This helps local dentists in decision making and promoting oral health of adults. Further research on the feasibility of the adapted guideline in Iranian population is needed.