Barriers and facilitators in utilisation of dental health services across low- and middle-income countries: a scoping review

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OBJECTIVES: This scoping review aims to systematically identify and theoretically categorise barriers and facilitators affecting access to dental care in LMICs. METHODS: This scoping review employed the Theoretical Domains Framework (TDF) to synthesise the findings thematically. A comprehensive search of literature published up to May 2025 in MEDLINE (PubMed), Embase, Scopus, and Web of Science, as well as grey literature sources, was conducted to identify relevant articles. Screening was performed using Rayyan, and data were extracted and categorised into the TDF domains. RESULTS: From the 15,140 initial hits, 214 articles were found eligible for final analysis. The maximum number of studies was published in India, Brazil, Nigeria and Iran. Eleven TDF domains were identified, and 'environmental context and resources' (n = 452, 41.5%) emerged as the most frequent domain, followed by 'beliefs about consequences' (n = 251, 23.1%) and 'knowledge' (n = 144, 13.2%). Barriers were more frequently reported than facilitators across all domains. Distinct domain patterns were observed across population subgroups and income categories, with structural barriers dominating in all contexts. CONCLUSION: Findings from this review underscore the need for integrated, context-sensitive interventions that combine system-level reforms with behaviour change strategies to improve dental care utilisation and reduce inequalities in oral health access across LMICs. There is also a need for more research on this health issue in low-income countries.

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