Acceptability of oral health care: a scoping review of reviews to inform framework development

Canada launched the Canadian Dental Care Plan (CDCP) in 2023 to improve access by reducing cost barriers. Data from September 2025 indicate that only about half of enrollees had accessed services, highlighting that addressing affordability alone may not be sufficient to facilitate uptake. Among the multiple dimensions of access, acceptability has been the least explored in oral health, despite its influence on whether patients seek care and providers deliver it. This review synthesized acceptability-related barriers and facilitators from patient and provider perspectives to assess their influence on access to and utilization of oral health care.

A scoping review of reviews was conducted. Four databases (MEDLINE, Embase, Scopus, PsycINFO) and targeted grey literature from oral health and governmental organizations were searched for English or French language sources explicitly addressing acceptability or proxy concepts in oral health. Extracted findings were analyzed thematically using an abductive approach within a constructivist/interpretivist paradigm.

Sixty-four sources (47 peer-reviewed reviews, 17 grey literature) met inclusion. Key patient-level barriers included anxiety, fear, cultural beliefs, and provider attributes; facilitators included behavioural or psychological support, provider's cultural competency, and shared decision making. Key provider-level barriers centered on inadequate reimbursement and gaps in clinical preparedness; facilitators included structural support and targeted training. Identified themes informed the development of the acceptability of oral health care framework.

Acceptability is context-dependent and influenced by both patient and provider perspectives. Applying this lens can bridge gaps between coverage, reach, and utilization by ensuring that care is not only about being affordable and available, but also aligned with patient and provider needs and expectations. Integrating acceptability into oral health care policy and program planning is critical to maximizing uptake and equity.