Dentists identify UK healthcare system as barrier to children’s treatment

The provision of restorative care for young children has been the subject of considerable debate in the UK in recent years, with many deciduous teeth affected by caries being left untreated. Objectives: To identify whether there are potential barriers specific to UK dentists in relation to the UK healthcare system and compare the relative strength of dentists' opinions on whether these factors constitute barriers to care of the deciduous dentition. Methods: A questionnaire developed within an international study was sent to 525 UK dentists in general dental practice (GDP) selected at random from 7 health authorities. The areas chosen were selected to provide a wide range of dmft values and care indices at 5 years old. Three mailings were conducted to maximise response. 347 dentists completed the questionnaire comprising a 70% response rate, after allowing for redundant addresses. Results: Factor analysis identified six factors representing the following dentist-identified barriers: the importance of filling deciduous teeth; the ability of young children to accept dental care; how providing care affects dentists; the effects of parents' expectations; the healthcare system; dentists' self-efficacy, or confidence in their own ability to provide care. The factor relating to the healthcare system was identified as the strongest barrier, followed by how providing care to young children affects dentists. The importance of filling deciduous teeth was the lowest rated, suggesting that dentists do not see this as a barrier to treatment. A significant difference in male and female responses to the factor related to how providing care affects dentists, shows males on average are significantly more likely to identify this as a barrier (p=0.005). Conclusions: Factors relating to the healthcare system are perceived by GDPs as a main reason for not providing restorative care for young children in the UK. Supported by NIH Grant No. DE13703-02