‘Feeling more like a mechanic’ – A qualitative study on experiences of caries prevention to patients with recurrent cavities among experienced dentists
DOI:
https://doi.org/10.2340/aos.v83.42271Keywords:
Caries, clinical practice, oral health, dentistry, patient-centered dental careAbstract
Objective: To explore experiences of caries prevention in adult patients with recurrent cavities among experienced dentists.
Method: Five focus group discussions consisting of seven men and nine women, 38–61 years of age, and with working experience as dentists between 5 and 35 years, were conducted. The participants represented Public Dental Health Service clinics and private practitioners. Qualitative content analysis was used to analyze data.
Results: The participants emphasized the importance of effective communication and patient engagement in caries prevention. They described their experiences as an endless trail, making fillings. They expressed their inability to take necessary responsibility and being stuck in the dental care system due to various circumstances. The understanding of caries was contradictory, and an inadequate mandate to control time to fulfill their preventive work was evident. They felt responsible to do the best for their patients, but how to share responsibility with colleagues and patients and having enough time for this seemed difficult and unclear. These problems did not motivate to further education in cariology.
Conclusion: The findings underscore the urgent need for improvement in preventive caries treatment and the necessity of allocating sufficient time for dentists to engage in this crucial aspect of their work.
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Kastenbom L, Falsen A, Larsson P, Sunnegårdh-Grönberg K, Davidson T. Costs and health-related quality of life in relation to caries. BMC Oral Health. 2019;19(1):187. https://doi.org/10.1186/s12903-019-0874-6
Vujicic M, Listl S. An Economic perspective of the global burden of dental caries. 2021. Available from: https://www.acffglobal.org/wp-content/uploads/2021/03/An-economic-perspective-on-the-burden-of-dental-caries.pdf
Adiatman M, Banerjee A, Braga MM, Carter N, Chaves, Eaton K, et al. Time to put your money where your mouth is: addressing inequalities in oral health. 2024. European Federation of Periodontology; 2024. Available from: https://www.efp.org/fileadmin/uploads/efp/Documents/Other_publications/EIxEFP_-_Oral_Health_white_paper_FINAL.pdf
Peres MA, Macpherson LMD, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge [Review]. Lancet. 2019;394(10194):249–60. https://doi.org/10.1016/S0140-6736(19)31146-8
Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of untreated caries: a systematic review and metaregression. J Dent Res. 2015;94(5):650–8. https://doi.org/10.1177/0022034515573272
Schwendicke F, Splieth CH, Bottenberg P, Breschi L, Campus G, Domejean S, et al. How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement. Clin Oral Investig. 2020;24(9):3315–21. https://doi.org/10.1007/s00784-020-03431-0
Schwendicke F, Domejean S, Ricketts D, Peters M. Managing caries: the need to close the gap between the evidence base and current practice. Br Dent J. 2015;219(9):433–8. https://doi.org/10.1038/sj.bdj.2015.842
Pitts NB, Mayne C. Making cavities history: a global policy consensus for achieving a dental cavity-free future. JDR Clin Trans Res. 2021;6:264–67. https://doi.org/10.1177/23800844211020298
Jordan RA, Krois J, Schiffner U, Micheelis W, Schwendicke F. Trends in caries experience in the permanent dentition in Germany 1997–2014, and projection to 2030: morbidity shifts in an aging society. Sci Rep. 2019;9(1):1–7. https://doi.org/10.1038/s41598-019-41207-z
Rødseth SC, Høvik H, Schuller AA, Bjertness E, Skudutyte-Rysstad R. Dental caries in a Norwegian adult population, the HUNT4 oral health study; prevalence, distribution and 45-year trends. Acta Odontol Scand. 2022;80:202–10. https://doi.org/10.1080/00016357.2022.2117735
Annual report – 2022 – The Swedish Quality Registry for caries and periodontal disease (SKaPa), in swedish. 2023. Available from: http://www.skapareg.se/ [cited June 2023]
Huysmans MC, Fontana M, Lussi A, Jablonski-Momeni A, Banerjee A, Ricketts D, et al. ORCA-EFCD consensus report on clinical recommendations for caries diagnosis. Paper III: caries diagnosis at the individual level. Caries Res. 2024;58: 521–532. https://doi.org/10.1159/000539427
Innes NP, Frencken JE, Bjørndal L, Maltz M, Manton DJ, Ricketts D, et al. Managing carious lesions: consensus recommendations on terminology. Adv Dent Res. 2016;28(2):49–57. https://doi.org/10.1177/0022034516639276
Pitts N, Ismail A, Martignon S, Ekstrand K, Douglas G, Longbottom C. ICCMS™ Guide for Practitioners and Educators: International Caries Classification and Management System (ICCMS™). 2014. Available from: https://www.iccms-web.com/uploads/asset/59284654c0a6f822230100.pdf
Ruiz B, Broadbent JM, Thomson WM, Ramrakha S, Moffitt TE, Caspi A, et al. Childhood caries is associated with poor health and a faster pace of aging by midlife. J Public Health Dent. 2023;83(4):381–8. https://doi.org/10.1111/jphd.12591
Ruiz B, Broadbent JM, Murray Thomson W, Ramrakha S, Boden J, Horwood J, et al. Is childhood oral health the ‘canary in the coal mine’ for poor adult general health? Findings from two New Zealand birth cohort studies. Community Dent Oral Epidemiol. 2023;51(5):838–46. https://doi.org/10.1111/cdoe.12772
Pitts NB, Grant J, Hinrichs-Krapels S, Mazevet ME, Boulding HF, Mayne C. Towards a cavity free future: how do we accelerate a policy shift towards increased resource allocation for caries prevention and control? The Policy Institute at King’s; 2017. Available from: https://www.kcl.ac.uk/policy-institute/assets/towards-a-cavity-free-future.pdf. 2017. [cited June 2017]
Spencer AJ. Skewed distributions – new outcome measures. Community Dent Oral Epidemiol. 1997;25(1):52–9. https://doi.org/10.1111/j.1600-0528.1997.tb00899.x
Flink H, Hedenbjörk-Lager A, Liljeström S, Nohlert E, Tegelberg Å. Identification of caries-active individuals in longitudinal data a methodological study using a national registry. Acta Odontol Scand. 2024;83:70–5. https://doi.org/10.1080/00016357.2023.2265474
Flink H, Hedenbjörk-Lager A, Liljeström S, Nohlert E, Tegelberg Å. Identification of Swedish caries active individuals aged 30–90 years using a life course perspective and SKaPa longitudinal national registry data over a 10-year period. Acta Odontol Scand. 2024;83:412–8. https://doi.org/10.2340/aos.v83.40955
Tonetti MS, Bottenberg P, Conrads G, Eickholz P, Heasman P, Huysmans M-C, et al. Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing – consensus report of group 4 of the joint EFP/ORCA workshop on the boundaries between caries and periodontal diseases. J Clin Periodontol. 2017;44(S18):S135–44. https://doi.org/10.1111/jcpe.12681
National Guidelines for Adult Dental Care (Nationella riktlinjer för vuxentandvård). Socialstyrelsen, Stockholm (In Swedish). 2011.
Nationel Guidelines for Dental Care. Socialstyrelsen (In Swedish). 2021. Available from: https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/nationella-riktlinjer/2021-9-7549.pdf [cited September 2021]
Söderström U, Johansson I, Sunnegårdh-Grönberg K. A retrospective analysis of caries treatment and development in relation to assessed caries risk in an adult population in Sweden. BMC Oral Health. 2014;14:126. https://doi.org/10.1186/1472-6831-14-126
Chiang HM, Tranaeus S, Sunnegårdh-Grönberg K. Caries as experienced by adult caries active patients: a qualitative study. Acta Odontol Scand. 2018;77(1):15–21. https://doi.org/10.1080/00016357.2018.1493218
Flink H, Tegelberg A, Arnetz JE, Birkhed D. Patient-reported negative experiences related to caries and its treatment among Swedish adult patients. BMC Oral Health. 2017;17(1):95. https://doi.org/10.1186/s12903-017-0384-3
Santamaría RM, Fontana M, Chalas R, Guzman-Armstrong S, Kolker JL, Krithikadatta J, et al. The core curriculum in cariology: fiction or reality? Challenges about implementation. Caries Res. 2024;58:153–161. https://doi.org/10.1159/000536637
Brinkmann S, Kvale S. Interviews – learning the craft of qualitative research interviewing. 3rd ed. Sage Publications Inc. Thousand Oaks 45: NPO Tandvård, Stockholm; 2014.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurs Educ Today. 2004;24(2):105–12. https://doi.org/10.1016/j.nedt.2003.10.001
Graneheim UH, Lindgren B-M, Lundman B. Methodological challenges in qualitative content analysis: a discussion paper. Nurse Educ Today. 2017;56:29–34. https://doi.org/10.1016/j.nedt.2017.06.002
Flink H, Tegelberg Å, Arnetz J, Birkhed D. Correlation between perceived experience of caries disease and recorded caries activity among adult patients at a Swedish public dental clinic: a longitudinal study. Acta Odontol Scand. 2013;71(6):1486–92.
Broadbent JM, Thomson WM, Poulton R. Trajectory patterns of dental caries experience in the permanent dentition to the fourth decade of life. J Dent Res. 2008;87(1):69–72. https://doi.org/10.1177/154405910808700112
Broadbent JM, Foster Page LA, Thomson WM, Poulton R. Permanent dentition caries through the first half of life. Br Dent J. 2013;215(7):E12. https://doi.org/10.1038/sj.bdj.2013.991
Alm A. On dental caries and caries-related factors in children and teenagers. Swed Dent J Suppl. 2008;195:7–63.
Isaksson H, Alm A, Koch G, Birkhed D, Wendt LK. Caries prevalence in Swedish 20-year-olds in relation to their previous caries experience. Caries Res. 2013;47(3):234–42. https://doi.org/10.1159/000346131
Hall-Scullin E, Whitehead H, Milsom K, Tickle M, Su TL, Walsh T. Longitudinal study of caries development from childhood to adolescence. J Dent Res. 2017;96(7):762–7. https://doi.org/10.1177/0022034517696457
Leggett H, Csikar J, Vinall-Collier K, Douglas GVA. Whose responsibility is it anyway exploring barriers to prevention of oral diseases across Europe. JDR Clin Trans Res. 2021;6(1):96–108. https://doi.org/10.1177/2380084420926972
Leggett H, Vinall-Collier K, Csikar J, Veronica Ann Douglas G. Barriers to prevention in oral health care for english NHS dental patients: a qualitative study of views from key stakeholders. BMC Oral Health. 2023;23(1):332. https://doi.org/10.1186/s12903-023-03030-x
Schwendicke F, Foster Page LA, Smith LA, Fontana M, Thomson WM, Baker SR. To fill or not to fill: a qualitative cross-country study on dentists’ decisions in managing non-cavitated proximal caries lesions. Implement Sci. 2018;13(1):54. https://doi.org/10.1186/s13012-018-0744-7
Frantsve-Hawley J, Abt E, Carrasco-Labra A, Dawson T, Michaels M, Pahlke S, et al. Strategies for developing evidence-based clinical practice guidelines to foster implementation into dental practice. J Am Dent Assoc. 2022;153(11):1041–52. https://doi.org/10.1016/j.adaj.2022.07.012
Shmarina E, Ericson D, Götrick B, Franzén C. Dental professionals’ perception of their role in the practice of oral health promotion: a qualitative interview study. BMC Oral Health. 2023;23(1):43. https://doi.org/10.1186/s12903-023-02756-y
Birch S, Bridgman C, Brocklehurst P, Ellwood R, Gomez J, Helgeson M, et al. Prevention in practice – a summary [Review]. BMC Oral Health. 2015;15 Suppl 1:S12. https://doi.org/10.1186/1472-6831-15-S1-S12
Proctor E, Turner C, Pirozzo S, Wood P. Attitudes and beliefs of oral health professionals regarding their role in health promotion. Health Promot J Austr. 2003;14(1):19–24. https://doi.org/10.1071/HE03019
Rosing K, Leggett H, Csikar J, Vinall-Collier K, Christensen LB, Whelton H, et al. Barriers and facilitators for prevention in Danish dental care. Acta Odontol Scand. 2019;77: 439-451. https://doi.org/10.1080/00016357.2019.1587503
Sunnegårdh-Grönberg K, Hänsel Petersson G, Bergström E-K, Flink H. Behandling av okontrollerad kariessjukdom – rapport nationell arbetsgrupp (NAG) (in Swedish-Treatment of uncontrolled caries disease – a national report). Nationellt Programområde (NPO) för Tandvård; 2020.
McEvoy P. Interviewing colleagues: addressing the issues of perspective, inquiry and representation. Nurse Res. 2001;9(2):49–59. https://doi.org/10.7748/nr2002.01.9.2.49.c6182
Krippendorff K. Content analysis: an introduction to its methodology. Thousand Oaks, CA: 2019. Available from: https://methods.sagepub.com/book/content-analysis-4e [cited May 2018]
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Copyright (c) 2024 Karin Sunnegårdh-Grönberg , Jenny Molin , Håkan Flink , Britt- Marie Lindgren
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Acta Odontologica Scandinavica publishes original research papers as well as critical reviews relevant to the diagnosis, epidemiology, health service, prevention, aetiology, pathogenesis, pathology, physiology, microbiology, development and treatment of diseases affecting tissues of the oral cavity and associated structures including papers on cause and effect or explanatory/associative relationships for experimental or observational studies.
