Peer-reviewed article

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

Hallewell L, Bescos R, Brookes Z, Witton R, Casas-Agustench P · 1 Aug 2026

Abstract

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.