General and Paediatric Dentists’ Knowledge, Attitude and Practices Regarding the use of Silver Diammine Fluoride for the Management of Dental Caries: A National Survey in the Netherlands
Abstract Background: Silver Diammine Fluoride (SDF) is a topical medication used to arrest cavitated carious lesions non-invasively. The primary aim of this research was to investigate, and analyse the relationships between; knowledge, attitudes and practices (including barriers and facilitators) as they relate to SDF use for the management of dental caries by general dental practitioners (GDPs) and paediatric dentists (PDs) in the Netherlands. A secondary aim was to explore any differences between these groups.Methods: A sample of 600 Dutch GDPs (random selection from 9,777 registered) and all 57 registered PDs were invited to participate in this cross-sectional survey, consisting of four sections: 1) participant characteristics, 2) knowledge (through responses to summative questions), 3) attitudes (through agreements using 5-point Likert scale), and 4) practices, use, barriers and facilitators (through multiple choice questions). Results: Response rates were: GDPs 23% (n=140) and PDs 47% (n=27). Knowledge: out of 15 questions testing understanding of SDF, the mean correct answers were GDPs 6.7; SD 2.6 and PDs 7.4, SD 2.2 (no statistically significant differences). Mean overall attitude score showed positivity towards SDF use in both groups. Compared to GDPs, PDs were more likely to use SDF (p<0.001) and expected this to increase (p=0.03). The main barrier for users was parental acceptance (47%) and for non-users it was lack of knowledge (60%). The main facilitator for both users and non-users was gaining knowledge through courses and workshops, followed by written information leaflets about SDF for parents.Conclusions: Less than half knowledge questions about SDF were answered correctly. Despite low knowledge, attitude towards its use was positive. Practitioners believed that its use would be facilitated by professionals having more accessible information and training and by the availability of parent information leaflets. SDF was used more frequently by PDs than GDPs.