Abstract
OBJECTIVE: The objectives of the present systematic review were to (1) identify facilitators and barriers to oral health behaviours (OHBs) among adolescents and (2) map identified factors to the Theoretical Domains Framework (TDF) and the Capability, Opportunity, and Motivation-Behaviour (COM-B) model. METHODS: Studies directly investigating self-reported factors influencing oral health behaviours among adolescents (aged 10-19) using qualitative, quantitative, or mixed research methods were included. A comprehensive search was conducted on 4 databases (PubMed, Embase, APA PsycINFO, and Web of Science) on September 17, 2024. Data regarding study design, basic information, and findings were extracted. The Mixed-Methods Appraisal Tool (MMAT) was used to appraise the methodological quality of the included studies. The facilitators and barriers to OHBs were matched to domains in the TDF and COM-B model using the framework analysis method. Thematic analysis was employed to categorize related facilitators and barriers into different descriptive themes within each TDF domain. RESULTS: Out of the 2898 publications initially identified in database searches, 22 studies were finally included. Most studies appeared to have moderately high quality. Facilitators and barriers relevant to adolescents' OHBs were found across 13 TDF domains (13 out of 14) and all COM-B model components. The more commonly identified TDF domains included 'social influences', 'goals', 'environmental context and resources', and 'beliefs about consequences'. Factors related to the domain of 'social professional role and identity' were not identified. Tooth brushing had the largest number of investigated studies and identified influencing factors compared to other oral health behaviours. CONCLUSION: This review identified a wide range of facilitators and barriers influencing different OHBs (ie, tooth brushing, flossing, sugar consumption, smoking, and alcohol drinking) among adolescents. These identified facilitators and barriers have been successfully mapped across almost all TDF domains and all COM-B components. PROSPERO registration number, CRD42024601202.