Defining Consensus-Based Components for Integrating Dietitians Into Primary Dental Care for Paediatric Populations: A Delphi Study.

چکیده اصلی

BACKGROUND: Diet is a modifiable risk factor linking oral and systemic health, contributing to dental caries and weight-related outcomes (including underweight, overweight and obesity) in the paediatric population. However, dietary advice provided by dental professionals in primary dental care is often brief and sugar-focused, representing a missed opportunity to address shared risk factors. Integrating dietitians into primary dental care may support more holistic paediatric preventative care. OBJECTIVE: To develop expert consensus on the components required to integrate dietitians into primary dental care to address diet as a common risk factor in paediatric oral health and weight-related outcomes. METHODS: A three-round online Delphi study was conducted with dietitians and dental professionals, followed by patient and public involvement (PPI) consultation with caregivers and children and young people. Round 1 open-text responses were thematically analysed and synthesised into 158 statements. In Rounds 2 and 3, experts rated statements using a 7-point Likert scale. Consensus agreement was defined a priori as ≥ 70% agreement (ratings of 6 or 7) and < 15% disagreement (ratings of 1 or 2) across the panel and within both professional groups. Results were summarised using descriptive statistics. RESULTS: Thirty-six, twenty-eight, and twenty-five experts completed Delphi Rounds 1, 2 and 3, respectively. Round 1 generated 158 statements, of which 90 achieved full consensus agreement by Round 3. Full consensus agreement was reached on safeguards for discussing weight-related outcomes sensitively, referral criteria for oral-health dietary support, training and skill development, organisational structures for collaboration, communication pathways and role clarification. No single approach to identifying weight-related outcomes met the predefined agreement threshold and remained exploratory. CONCLUSION: This study identified consensus-based components for integrating dietitians into primary dental care, providing a practical foundation to inform the design and piloting of integrated dietetic-dental care models with potential to improve oral health and broader child health outcomes.

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