Method: A Cochrane Effective Practice and Organisation of Care (EPOC) systematic review. The types of studies considered inclusion were: randomised controlled trials (RCTs); non-randomised controlled trials (non-RCTs); controlled before and after studies; interrupted time series.
The electronic databases searched included: The Cochrane Central Register of Controlled Trials; Medline, EMBASE, CINAHL; EPOC Specialised Register; PubMed; Cochrane Oral Health Group; NHS Economic Evaluations Database (NHS EED) Health Economics Electronic Database (HEED) and grey literature databases. Additional information was retrieved by handsearching high yield journals and searching reference lists of key publications. Assessment of risk of bias of included studies used the EPOC group risk of bias tool.
Result: Five studies were included for analysis (4 RCTs and 1 non-RCT): 2 compared survival rates of the atraumatic restorative technique (ART) (1 RCT and 1 non-RCT) and 3 RCTs compared survival rates of fissure sealants (FS). All 5 studies were methodologically and statistically heterogeneous and were either of unclear or high risk of bias. One study reported better FS survival rates for a dentist. There was no difference in survival rates of ART or fissure sealants between dentists and DAs in all other studies.
Conclusion: Within the limitations of the included studies, dentists and DAs appear to be equally effective in providing ART and placing fissure sealants in 4 out of 5 of the studies. Overall the quality of studies comparing dentists and DAs was low.