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Barriers to and facilitators for attending dental care appointments among adults in low- and middle-income countries: a scoping review

Evidence-Based Dentistry volume 26, pages 150–151 (2025)Cite this article

Subjects

Abstract

Background

Oral diseases are a major public health concern in Low and Middle Income Countries (LMICs), where effective treatment requires multiple appointments. Despite its importance, limited research has explored appointment adherence among adults in these settings. This scoping review identifies the barriers and facilitators to attending dental care appointments in LMICs.

Methods

The current review followed JBI Scoping Review Methodology. The Databases of Dentistry, Oral Sciences Source (EBSCO), MEDLINE (Ovid), Embase (Ovid), Cochrane CENTRAL, Scopus and grey literature sources were searched systematically from inception till November 2024. Two independent reviewers performed data extraction using a customized JBI data extraction form. The Theoretical Domains Framework categorized barriers and facilitators of dental appointment keeping. Findings were tabulated and synthesized narratively with recommendations to improve dental attendance.

Results

Ten articles met the inclusion criteria after being screened through 5571 titles, abstracts, and 210 full texts. Knowledge, social and professional roles and identity, beliefs about capabilities, consequences, memory, attention, decision-making processes, environmental context and resources, social influence, and emotion are the main domains under which barriers and facilitators were identified. Environmental context and resource constraints were the most common barriers, while social influence was the main facilitator. The dental appointment adherence issues were determined to be comparable in public practice and university settings.

Conclusion

It is necessary to acknowledge the barriers and facilitators to dental appointment keeping to improve the effectiveness of the dental health system, ensure continuity of care, and encourage better patient-doctor relationships. Tailored interventions are required in the dental setting to effectively manage and reduce disparities in patient care.

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Fig. 1
Fig. 2: Geographic location of studies.

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Data availability

The data used in this systematic review were obtained from publicly available sources, including published research articles and reports. All data sources are appropriately cited in the reference section of this review. No additional datasets or proprietary information were used in this study. Researchers interested in accessing the primary data used in the included studies should refer to the original publications and contact the respective authors or institutions for any specific data requests or inquiries.

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Acknowledgements

LearnByResearch, Pune, supported the study.

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Authors and Affiliations

  1. Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Vineetha Karuveettil & Gurleen Kaur Anand

  2. Amrita Centre for Evidence Based Oral Health: A JBI Centre of Excellence, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Vineetha Karuveettil

  3. Learn By Research, Pune, India

    Swati Sapna

  4. Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Nitte (Deemed to be University), Mangalore, Karnataka, India

    Praneetha Jain

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  1. Vineetha Karuveettil
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  2. Swati Sapna
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Contributions

VK was responsible for conceptualization, search strategy, screening, data extraction, analysis, and manuscript preparation. SS contributed to screening, data extraction, and report writing. PJ participated in screening, data extraction, and report writing. GA was involved in search updates, screening, data extraction, analysis, and report writing.

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Correspondence to Vineetha Karuveettil.

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Karuveettil, V., Sapna, S., Jain, P. et al. Barriers to and facilitators for attending dental care appointments among adults in low- and middle-income countries: a scoping review. Evid Based Dent 26, 150–151 (2025). https://doi.org/10.1038/s41432-025-01148-1

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