Key Points
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Suggests it is internationally recognised that dentists should take a more proactive approach to caries, using both preventive and restorative treatments.
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Reports that the application of fissure sealants is an evidence-based preventive treatment known to be globally underutilised in primary dental care.
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Stresses that for dentistry to progress via the preventive paradigm it is important to understand why it is underutilised.
Abstract
International and UK professional organisations, Cochrane systematic reviews, and international and UK guidance documents all support the application of preventive fissure sealants (PFSs) as an effective treatment for reducing caries. However, PFSs are well known to be underutilised in primary care. This paper collates data from PFS-relevant studies in Scotland, which has a large population of children at caries risk, to identify the beliefs and factors dentists perceive as influencing their decision not to provide this treatment. This information provides a platform to suggest how to increase the application of PFSs in this region (a standardised audit incorporating evidence-based behaviour change techniques, supplemental guidance on how to implement gold-standard recommendations in practice, training). This may also be relevant outside of Scotland, as well as to the implementation of other evidence-based behaviours in practice.
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Acknowledgements
The list of colleagues who should be acknowledged for their significant contribution and expertise to the research described in this paper would be longer than the paper itself, so I hope they forgive a general thank you. I would also like to thank participating dentists who took part in this research, and the grant providers (the Medical Research Council, the Chief Scientist Office, the Scottish Higher Education Funding Council and NHS National Education for Scotland) who funded these studies. The views expressed in this paper are those of the author and may not be shared by others.
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Bonetti, D. Evidence not practised: The underutilisation of preventive fissure sealants. Br Dent J 216, 409–413 (2014). https://doi.org/10.1038/sj.bdj.2014.248
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DOI: https://doi.org/10.1038/sj.bdj.2014.248
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