Aim: To understand barriers and facilitators for adopting an evidence-based non-surgical preventive approach to manage dental caries in private dental practice
Methods: This qualitative study used grounded theory; an established systematic methodology. Semi-structured interviews were conducted with 22 participants (10 dentists, 1 dental therapist/hygienist and 11 dental practice staff), who provided detailed explanations of their experience and work processes. Results: Two deeply-held assumptions which could limit the adoption of non-surgical preventive protocols were identified: 1) dentists and practice staff believed that some patients were too “unreliable” to benefit from prevention; 2) dentists and practice staff believed that patients thought that only tangible restorative treatment offered “value for money”. Dental professionals described factors that could hinder adopting a non-surgical preventive approach: in particular, having an historical restorative background and being focused on cutting cavities fast and well. On the positive side, a non-surgical preventive approach could be adopted if dentists were able to (1) adapt protocols to their established practice management systems, (2) could make prevention financially viable, and (3) had the appropriate technology, time, and a supportive dental team.
Conclusion: Despite dental professionals being accustomed to restorative care, there were very important facilitators for prevention, such as dentist leadership, clear communication and trust between dental team members. These findings illustrate a need to challenge deeply held and questionable assumptions in the dental profession to allow non-surgical preventive care to potentially benefit all patients.
Acknowledgement: University of Sydney PG Award, Oral Health Foundation, Dental Board NSW, ADRF, NHMRC 632715, GC Australia, Colgate.