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Perceived Barriers among Indonesian General Dentists in Providing Caries Preventive Care for Pediatric PatientsFunding This research was supported by grant from Universitas Indonesia
Objective This study aimed to investigate Indonesian dentists' perceived barriers in providing caries prevention for pediatric patients.
Materials and Methods A total of 362 general dentists were included in this cross-sectional study. The participants were asked to complete a self-administered online questionnaire of dentist characteristics and perceived barriers in multiple domains (children, parents, dentists, and healthcare system-related barriers). The frequency of responses to items of the questionnaire was presented. The Mann–Whitney U test was used to compare perceived barriers by gender, Kruskal–Wallis by practice sector, and Spearman analysis was used to assess the correlation between perceived barrier with age, years of practice experience, weekly practice hours, percentage of pediatric patients, percentage of pediatric preventive care, and percentage of insured patients. A multivariate analysis was conducted through structural equation modeling.
Results The highest perceived barrier was found to be healthcare system-related, followed by parents, children, and dentists themselves. Most participants thought parents have poor knowledge of pediatric caries prevention (n = 290; 80%), and dental care for young children emphasizes curative treatment over prevention (n = 257; 70%). The multivariate analysis showed that dentists' practice sector and age affect perceived barriers and pediatric preventive care the most.
Conclusions Factors and barriers identified in this study must be the main focus of oral health programs, and dentists, as service providers, need proper training to address these barriers to optimize caries prevention in Indonesia.
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of the Faculty of Dentistry, Universitas Indonesia (protocol No. 031101022; November 9th 2022)
Informed Consent Statement
Informed consent was obtained from all subjects involved in the study
Data Availability Statement
The raw data are not publicly available due to ethical restrictions but are available from the corresponding author to any author who wishes to collaborate with us.
R.R., D.A.M., F.S. supervised the study and contributed to the conception of the study. SK contributed to the acquisition of data. S.K., R.R., D.A.M., and F.S. contributed to the statistical analysis and data interpretation. S.K. drafted the manuscript and R.R., D.A.M., F.S. revised the manuscript critically. All authors contributed in finalizing the manuscript and give final approval of the article.
Article published online:
17 August 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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- 1 Pierce A, Singh S, Lee J, Grant C, Cruz de Jesus V, Schroth RJ. The burden of early childhood caries in Canadian children and associated risk factors. Front Public Health 2019; 7: 328
- 2 Chen J, Duangthip D, Gao SS. et al. Oral health policies to tackle the burden of early childhood caries: a review of 14 countries/regions. Front Oral Health 2021; 2: 670154
- 3 Lee GHM, McGrath C, Yiu CKY. Barriers to providing oral health care to pre-school children-differences between paediatric dentists' and general dental practitioners' beliefs. Community Dent Health 2015; 32 (01) 32-38
- 4 Xu M, Yuan C, Sun X, Cheng M, Xie Y, Si Y. Oral health service utilization patterns among preschool children in Beijing, China. BMC Oral Health 2018; 18 (01) 31
- 5 Al-Jaber AS, Al-Qatami HM, Abed Al Jawad FH. Knowledge, attitudes, and practices of parents on early childhood caries in Qatar-a questionnaire study. Eur J Dent 2022; 16 (03) 669-679
- 6 van Spreuwel PCJM, Jerković-Ćosić K, van Loveren C, van der Heijden GJMG. Parents' willingness to invest in primary oral health prevention for their preschool children. Int J Environ Res Public Health 2021; 18 (21) 11437
- 7 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 (01) 96-108
- 8 Elouafkaoui P, Bonetti D, Clarkson J, Stirling D, Young L, Cassie H. Is further intervention required to translate caries prevention and management recommendations into practice?. Br Dent J 2015; 218 (01) E1
- 9 Sveinsdottir EG, Wang NJ. Dentists' views on the effects of changing economic conditions on dental services provided for children and adolescents in Iceland. Community Dent Health 2014; 31 (04) 219-223
- 10 Rosing K, Leggett H, Csikar J. et al. Barriers and facilitators for prevention in Danish dental care. Acta Odontol Scand 2019; 77 (06) 439-451
- 11 Faizunisa H, Chaly PE, Junaid M, Vaishnavi S, Nijesh JE, Musthafa M. Road blocks perceived by the dentists toward the treatment of early childhood caries in Chennai city - a cross-sectional study. J Indian Soc Pedod Prev Dent 2017; 35 (04) 291-295
- 12 El Batawi HY, Fakhruddin KS. Impact of preventive care orientation on caries status among preschool children. Eur J Dent 2017; 11 (04) 475-479
- 13 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 (01) 54
- 14 Shah AH, Sheddi FM, Alharqan MS. et al. Knowledge and attitude among general dental practitioners towards minimally invasive dentistry in Riyadh and AlKharj. J Clin Diagn Res 2016; 10 (07) ZC90-ZC94
- 15 Yusuf H, Tsakos G, Ntouva A. et al. Differences by age and sex in general dental practitioners' knowledge, attitudes and behaviours in delivering prevention. Br Dent J 2015; 219 (06) E7-E7
- 16 Templeton AR, Young L, Bish A. et al; PMC study team. Patient-, organization-, and system-level barriers and facilitators to preventive oral health care: a convergent mixed-methods study in primary dental care. Implement Sci 2016; 11: 5
- 17 Suga USG, Terada RSS, Ubaldini ALM. et al. Factors that drive dentists towards or away from dental caries preventive measures: systematic review and metasummary. PLoS One 2014; 9 (10) e107831
- 18 Nagarajappa R, Sanadhya S, Batra M, Daryani H, Ramesh G, Aapaliya P. Perceived barriers to the provision of preventive care among dentists of Udaipur, India. J Clin Exp Dent 2015; 7 (01) e74-e79
- 19 Goodwin M, Pretty IA, Sanders C. A study of the provision of hospital based dental General Anaesthetic services for children in the North West of England: Part 2–the views and experience of families and dentists regarding service needs, treatment and prevention. BMC Oral Health 2015; 15: 47
- 20 P BJ. Dental subscale of children's fear survey schedule and dental caries prevalence. Eur J Dent 2013; 7 (02) 181-185
- 21 Arheiam A, Masoud I, Bernabé E. Perceived barriers to preventive dental care among Libyan dentists. Libyan J Med 2014; 9 (01) 24340
- 22 Baâdoudi F, van Exel JNA, Ali FM, Maskrey N, van der Heijden GJMG, Duijster D. Perspectives of general dental practitioners on preventive, patient-centred, and evidence-based oral healthcare-a Q-methodology study. PLoS One 2019; 14 (08) e0219931
- 23 Kang H. Sample size determination and power analysis using the G*Power software. J Educ Eval Health Prof 2021; 18: 17
- 24 Tiwari J, Pattanshetti K, Doifode D, Sankalecha S, Kothari HP, Sadhu R. Assessment of knowledge, attitude, and practice among private dental practitioners toward preventive measures of pediatric patients in Durg-Bhilai city. Int J Clin Pediatr Dent 2020; 13 (Suppl. 01) S78-S81
- 25 Althubaiti A. Information bias in health research: definition, pitfalls, and adjustment methods. J Multidiscip Healthc 2016; 9: 211-217
- 26 Gjersing L, Caplehorn JR, Clausen T. Cross-cultural adaptation of research instruments: language, setting, time and statistical considerations. BMC Med Res Methodol 2010; 10 (01) 13 DOI: 10.1186/1471-2288-10-13.
- 27 Hair, Joe, G. Tomas M.Hult, Christian M.Ringle, Marko Sarstedt. A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM). 3rd ed.. Thousand Oaks, CA: SAGE Publications; 2022
- 28 Hair JF, Hult GTM, Ringle CM, Sarstedt M, Danks NP, Ray S. Partial Least Squares Structural Equation Modeling (PLS-SEM) Using R: A Workbook. Springer International Publishing; Cham, Switzerland: 2021
- 29 Patil RU, Sahu A, Kambalimath HV, Panchakshari BK, Jain M. Knowledge, attitude and practice among dental practitioners pertaining to preventive measures in paediatric patients. J Clin Diagn Res 2016; 10 (12) ZC71-ZC75
- 30 Brega AG, Jiang L, Johnson RL, Wilson AR, Schmiege SJ, Albino J. Health literacy and parental oral health knowledge, beliefs, behavior, and status among parents of American Indian newborns. J Racial Ethn Health Disparities 2020; 7 (04) 598-608
- 31 Kathariya MD, Prabir A, Sahasrabudhe SR, Reddy AK, Azad S, Nambiar V. Knowledge, attitude, practice towards primary prevention of dental diseases among oral health professionals in India. J Res Dent. 2017; 4 (05) 150
- 32 Mayfitriana Z, Suwargiani AA, Setiawan AS. Growth stunting prevention in Indonesia: dentist knowledge and perception. Eur J Dent 2022
- 33 Basu S, Andrews J, Kishore S, Panjabi R, Stuckler D. Comparative performance of private and public healthcare systems in low- and middle-income countries: a systematic review. PLoS Med 2012; 9 (06) e1001244
- 34 Provost S, Pineault R, Levesque JF. et al. Does receiving clinical preventive services vary across different types of primary healthcare organizations? Evidence from a population-based survey. Healthc Policy 2010; 6 (02) 67-84
- 35 Emrani R, Sargeran K, Grytten J, Hessari H. A survey of common payment methods and their determinants in dental clinics, in Tehran, 2018. Eur J Dent 2019; 13 (04) 535-539
- 36 Gofur NRP, Aghasy AZZ, Gofur ARP. Spatial distribution analysis of dentists, dental technicians, and dental therapists in Indonesia. F1000 Res 2021; 10: 220
- 37 Kodama T, Ida Y, Miura H. A nationwide survey on working hours and working environment among hospital dentists in Japan. Int J Environ Res Public Health 2020; 17 (23) 9048
- 38 Garla BK, Satish G, Divya KT. Dental insurance: a systematic review. J Int Soc Prev Community Dent 2014; 4 (5, Suppl 2): S73-S77
- 39 Fry D, Zask A. Applying the Ottawa Charter to inform health promotion programme design. Health Promot Int 2017; 32 (05) 901-912