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.