Implementing Oral Hygiene Guidelines in Brazilian Primary Healthcare: Dentists’ and Managers’ Perspectives Study

To evaluate dentists’ and oral health managers’ perceptions of the knowledge and influential components in implementing clinical practice guidelines (CPGs) for managing dental caries in Brazil’s primary health care (PHC).

A mixed-methods study was conducted in five municipalities in Mato Grosso do Sul, Brazil, combining qualitative interviews with eight key informants to explore perceptions about barriers and facilitators in the implementation of CPGs for the management of dental caries, analyzed based on the Consolidated Framework for Implementation Research (CFIR). The quantitative component included a questionnaire for 104 dentists in Primary Health Care (PHC) to identify determinant variables in implementing CPGs using the CFIR domains. In addition, it allowed her to explore her perceptions about oral hygiene guidelines in childhood. Multivariate regression analyses, performed in STATA 14.2 (College Station, TX, USA), were used to explore the association between sociodemographic characteristics of dentists and knowledge and adoption of CPGs.

Limited knowledge and resistance to innovation, especially among older professionals, were the main barriers, while effective communication, recognition of the need for change, and the use of opinion leaders emerged as significant enablers, partially corroborating the initial hypothesis. Most actors supported minimal interventions for dental caries and the adoption of CPGs in PHC, with 82.6% emphasizing the importance of scientific evidence. In addition, 87.6% of respondents believed that individual knowledge impacts the perception of CPG application, and half recognized the role of opinion leaders in disseminating and implementing the guidelines.

Stakeholders recognize the benefits of minimal intervention in treating dental caries and advocate for using CPGs in PHC. The identified barriers and facilitators are critical in shaping the implementation of CPGs. Integrating these factors into implementation strategies is vital for improving health outcomes.