Influences on dentists' adoption of nonsurgical caries management techniques: A qualitative study.
Nonsurgical
adoption
caries management
decision making
qualitative
Journal
Journal of the American Dental Association (1939)
ISSN: 1943-4723
Titre abrégé: J Am Dent Assoc
Pays: England
ID NLM: 7503060
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
09
07
2020
revised:
27
09
2020
accepted:
04
10
2020
pubmed:
20
1
2021
medline:
29
6
2021
entrez:
19
1
2021
Statut:
ppublish
Résumé
Nonsurgical caries management techniques (NSCMT) offer a simple, conservative approach to treating caries. Despite evidence supporting and potential advantages of NSCMT, dentists can be reluctant to adopt these techniques. To better understand this phenomenon, the authors interviewed dentists who primarily treat children regarding their thoughts, attitudes, and adoption of 3 NSCMT. The 3 NSCMT were fluoride varnish, silver diamine fluoride, and Hall stainless steel crowns. The authors interviewed dentists in North Carolina whose practices were restricted mostly to children. A nonprobabilistic maximum-variation design was used in the sampling. Using a semistructured interview guide, the authors recorded the interviews digitally and analyzed them thematically. The authors stratified the analysis according to years of practice, geographic location, and type of practice. Reporting was based on emerging and recurring themes and insightful quotes. Factors most likely to promote the adoption of NSCMT were related to clinical practice, family preference, patient safety, and provider philosophy. Barriers to adoption included previous practitioner negative experiences using the techniques, high-risk caries population, and perceived likelihood of negative outcomes. Characteristics of the practice environment, patient population, communication with families, and financial considerations were influential in the clinician's determination as to whether to use these techniques. These findings provide valuable insight into practitioners' influences, motivations, and clinical decision making in the adoption and use of management and treatment approaches for carious lesions in the pediatric population. The primary factors and barriers identified in this study are possible targets for education and quality improvement programs aimed at increasing NSCMT use.
Sections du résumé
BACKGROUND
BACKGROUND
Nonsurgical caries management techniques (NSCMT) offer a simple, conservative approach to treating caries. Despite evidence supporting and potential advantages of NSCMT, dentists can be reluctant to adopt these techniques. To better understand this phenomenon, the authors interviewed dentists who primarily treat children regarding their thoughts, attitudes, and adoption of 3 NSCMT.
METHODS
METHODS
The 3 NSCMT were fluoride varnish, silver diamine fluoride, and Hall stainless steel crowns. The authors interviewed dentists in North Carolina whose practices were restricted mostly to children. A nonprobabilistic maximum-variation design was used in the sampling. Using a semistructured interview guide, the authors recorded the interviews digitally and analyzed them thematically. The authors stratified the analysis according to years of practice, geographic location, and type of practice. Reporting was based on emerging and recurring themes and insightful quotes.
RESULTS
RESULTS
Factors most likely to promote the adoption of NSCMT were related to clinical practice, family preference, patient safety, and provider philosophy. Barriers to adoption included previous practitioner negative experiences using the techniques, high-risk caries population, and perceived likelihood of negative outcomes. Characteristics of the practice environment, patient population, communication with families, and financial considerations were influential in the clinician's determination as to whether to use these techniques.
CONCLUSIONS
CONCLUSIONS
These findings provide valuable insight into practitioners' influences, motivations, and clinical decision making in the adoption and use of management and treatment approaches for carious lesions in the pediatric population.
PRACTICE IMPLICATIONS
CONCLUSIONS
The primary factors and barriers identified in this study are possible targets for education and quality improvement programs aimed at increasing NSCMT use.
Identifiants
pubmed: 33461729
pii: S0002-8177(20)30730-3
doi: 10.1016/j.adaj.2020.10.001
pii:
doi:
Substances chimiques
Fluorides
Q80VPU408O
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
463-470Informations de copyright
Copyright © 2021 American Dental Association. Published by Elsevier Inc. All rights reserved.