Acceptance of Non-Aesthetic Caries Treatment Approaches in Children: a Systematic Review

Objective: To evaluate the acceptance of non-aesthetic treatment approaches for dental caries in children as perceived by parents, children, and dental professionals. Materials and Methods: A systematic search was conducted across four databases: PubMed, Scopus, Web of Science, and Embase. The included studies comprised cross-sectional or cohort studies, and randomized controlled trials assessing the acceptance of non-aesthetic treatments for dental caries in children, as reported by parents, children, and dental professionals. The risk of bias was assessed using the ROB-2, ROBINS-I, and JBI tools, depending on the study design. Results: A total of 126 studies were included in this systematic review. The acceptance rate of Silver Diamine Fluoride (SDF) treatment for posterior primary molars in children ranged from 71.4% to 100% (median 93.2%). Among parents, it ranged from 3.2% to 91% (median 69.9%), and for dental professionals it ranged from 13.2% to 95% (median 61.6%). The acceptance rate for Stainless-Steel crowns (SSC) or Hall technique (HT) treatment in posterior primary molars for children, ranged from 32% to 100% (median 90%), for parents, it ranged from 14.5% to 100% (median 81.9%), and for dental professionals it ranged from 1% to 96% (median 44%). Parents had higher acceptance of SDF treatment for posterior teeth compared to anterior teeth. Conclusion: Non-aesthetic treatment options are generally accepted by children, parents, and, to a lesser extent, dental professionals, particularly for posterior teeth. However, most of the included studies presented a high risk of bias. The systematic review protocol was registered in OSF platform (doi: 10.17605/OSF.IO/P7CNY).