Abstract

Applying fluoride varnish prevents dental caries in primary and permanent teeth. This study explores what is needed to support dental professionals to make full use of this quick, easy and, most importantly, effective intervention.

Within Scotland there is a network of Childsmile dental practices within primary dental care that are currently offered remuneration for applying fluoride varnish at least twice each year to the teeth of all children from 2 years old. However, evidence from monitoring data identified that only about 8% of children attending Childsmile practices meet this target. This suggests providing additional funding for applying fluoride varnish does not alone encourage its use. This study aimed to understand further the factors that may act to influence general dental practitioners (GDPs) in Scotland to apply fluoride varnish to children's teeth. To do this, Gnich and co-authors developed a questionnaire using the Theoretical Domains Framework. This approach explores factors that may influence the behaviour of health professionals when it comes to implementing current evidence and professional guidelines. A questionnaire was posted to all GDPs working within the NHS in Scotland in 2011. In total, 1090 dentists responded (54% response rate). There was an equal distribution of dentists who worked in a Childsmile practice and those who did not. Analysis revealed that the four main perceived drivers for increased fluoride varnish applications were within the domains/categories of: knowledge; social influences; positive emotional reinforcement; and professional role. Interestingly, GDPs' perception of whether parents wanted their child to have fluoride varnish applications was considered strongly important. Therefore, to influence GDPs' compliance with guidelines for fluoride varnish application, the study suggests that an intervention is needed that will target both GDPs' knowledge of guidelines and beliefs regarding professional responsibility, but also raise parental expectations that fluoride varnish is a routine part of all children's current dental care.