General and paediatric dentists’ knowledge, attitude and practises regarding the use of Silver Diammine Fluoride for the management of dental caries: a national survey in the Netherlands

Background: Silver Diammine Fluoride (SDF) is a topical medication used to arrest cavitated carious lesions non-invasively. The primary aim was to investigate, and analyse the relationships between; knowledge, attitudes and practises (including barriers and facilitators) for SDF use in the management of dental caries by general dental practitioners (GDPs) and paediatric dentists (PDs) in the Netherlands. A secondary aim was to explore any differences in these, between these groups. Methods: A randomly selected sample of 600 Dutch GDPs (out of 9,502 respectively) and all 57 registered Dutch PDs were invited to participate in this cross-sectional survey, consisting of four sections: (1) participant characteristics, (2) knowledge (through responses to summative questions), (3) attitudes (through statement agreement using 5-point Likert scale), and (4) practises, use, barriers and facilitators (through multiple choice questions). Results: The response rates were: GDPs 23% (n = 140) and PDs 47% (n = 27). Knowledge: out of 15 questions to test understanding of SDF, the mean number of correct answers were GDPs 6.7; standard deviation (SD) 2.6 and PDs 7.4, SD 2.2 with no significant difference. The mean overall attitude score showed positive attitudes towards SDF use for both groups. Compared to GDPs, PDs were more likely to use SDF (p < 0.001) and expected to increase their use (p = 0.037). The main barrier for users was parental acceptance (47%) and for non-users it was lack of knowledge (60%). The main facilitator for both users and non-users was gaining knowledge through courses and workshops, followed by written information leaflets about SDF for parents. Conclusion: Less than half of the knowledge questions about SDF were answered correctly. Despite low knowledge, attitude towards SDF use was positive. Practitioners believed that its use would be facilitated by professionals having more accessible information and training and by the availability of parent information leaflets. Furthermore, SDF is used more frequently by PDs than GDPs