Methods: Qualitative cross-sectional study using semi-structured in-depth interviews and focus groups of a purposive snowball sample of adults.
Results: Three themes emerged from the data. The first two (Perceptions of the Nature of Dental Services and Anxiety of Dental Treatment) were related to dimensions of the other (Support for Skillmix). Perceptions of the nature of dental services ranged between seeing a service integral to the NHS and seeing a consumerist private service.
All participants, given the choice, preferred to be treated by a dentist. Reasons for preferring a dentist included: concerns about DCPs' competence; importance of familiarity and trust in the dentist; qualifications; and convenience. Support for the use of skill-mix appeared to be related to: a public service view of dentistry; hopes for greater access to care and low reported anxiety. Views on acceptability of DCPs treating children varied, with some stating they would refuse to allow them to do so.
Expectations of lower costs of NHS treatment from DCPs tended to be related to a private service view of dentistry. Expectations of other benefits (e.g. increased access) were widely held. Concerns about a two-tier service, with DCPs employed in areas of poorest access, tended to be associated with a public service view. The need for skill-mix to be “sold” at a national and practice level was emphasised.
Conclusions: Views of skill-mix in dentistry varied. Support was related to perceptions of the nature dental services and levels of anxiety of dental care. These factors will need to be considered to increase skill-mix's social acceptability.