Objectives: to use conventional systematic review methods and more recent advances in methods for interpretive synthesis to produce a synthesis of theory and logic model of how SE differences in regular dental attendance are generated.
Methods: Seminal papers were identified by 3 topic experts (n=33) and used to develop an electronic search of 8 databases, identifying 8,950 titles and abstracts, which were screened to identify 83 papers. Paper screening was undertaken by 2 reviewers and 28 papers excluded. A further 24 papers were added from citation snowballing and contact with experts, giving a total of 79 included papers. Data extraction involved capturing concepts in each study and translating these concepts into each other, sometimes generating synthetic constructs.
Results: A logic model explaining micro-level (individual) preventive dental utilisation behaviour was produced, along with concepts and linkages at the meso-sociological and macro-sociological level. In the micro-level model, three main concepts (Importance of obtaining care, Emotional Response and Perceived Behaviour Control) feed into a balancing of Competing Demands (time, stress, finance) against Mental Resources (self-esteem, sense of coherence). The resulting motivation can be tempered by service accessibility factors with feedback loops from the care experience itself. Meso-level factors such as social cohesion, social attribution and professional norms are theorised as having an impact at a number of points.
Conclusion: The logic model identifies several points where interventions to reduce SE inequalities in regular dental visiting could be tried at the individual, meso and dental care systems levels.