Quality and Credibility of Japanese Dental Clinical Practice Guidelines: A Cross-Sectional Appraisal

Although clinical practice guidelines (CPGs) aim to translate high-quality evidence into clinical practice, their use in Japanese dentistry remains limited. This study evaluated the methodological quality and credibility of Japanese dental CPGs.

A cross-sectional assessment was conducted using 32 CPGs registered with the Japanese Association for Dental Science Guidelines Library. Methodological rigor and recommendation quality were independently appraised by 3 calibrated reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) and the Appraisal of Guidelines for Research and Evaluation-Recommendation Excellence (AGREE-REX). Domain scores were standardized and interpreted individually, without composite scoring, and the normality of each domain was assessed using the Shapiro-Wilk test. Interrater reliability was examined using intraclass correlation coefficients, and cross-instrument domain correlations and temporal trends were analyzed.

For AGREE II, Scope and Purpose and Clarity of Presentation scored the highest, whereas Applicability was consistently the lowest. For AGREE-REX, Values and Preferences scored the lowest, indicating limited incorporation of patient values and preferences into the development of recommendations. Rigor of Development (AGREE II) was correlated with Clinical Applicability (AGREE-REX), Stakeholder Involvement (AGREE II), and Values and Preferences (AGREE-REX). Among all domains, only Editorial Independence showed significant improvement over time, with no corresponding gains in the AGREE-REX domains.

Japanese dental CPGs demonstrate strong methodological rigor across several domains but remain limited in translating evidence into patient-centered, implementable recommendations. Strengthening stakeholder involvement and evidence-to-decision processes may be essential to enhance guideline uptake in clinical practice.Knowledge Transfer Statement:This study evaluated the methodological quality and recommendation credibility of Japanese dental clinical practice guidelines using the AGREE II and AGREE-REX instruments. These findings highlight the gaps between guideline rigor and patient-centered implementability and provide clinicians, guideline developers, and policymakers with actionable insights to improve evidence-to-decision processes and guideline uptake in dental practice.