The Association Between Wisconsin Dentists’ Use Of Silver Diamine Fluoride (Sdf) And The Theory Of Planned Behavior (Tpb)

Abstract

Objectives: Silver diamine fluoride (SDF) is a topical product used to arrest caries. While particularly effective when traditional care is improbable, such as among children with special needs or the elderly, SDF is underutilized in the U.S. To identify current beliefs regarding SDF with its clinical use, this study identified the association between SDF use among Wisconsin dentists and the Theory of Planned Behavior (TPB) constructs of attitudes, subjective norms, and perceived behavioral control. Methods: This mixed-methods, cross sectional study invited 816 Wisconsin dentists to participate via electronic survey. A TPB index quantified the three constructs with higher scores indicating greater positivity toward SDF. Data were analyzed using t-tests or one-way ANOVAs for continuous data and Chi-square tests for categorical data. Qualitative responses were coded by TPB construct with new codes generated for responses outside of the TPB framework. Results: The response rate for the study was 10% (n=80) with 55% reporting SDF use. Mean total TPB index and sub-scores were higher in SDF-users versus non-users. Most respondents (74%) provided qualitative responses. Triangulation of qualitative and quantitative results strengthened the finding that higher TPB index scores correlated with SDF-use. One additional qualitative code revealed interest in continuing education about SDF among non-users. Conclusions: More than half of study participants reported SDF use. Results support the TPB as attitudes, subjective norms, and perceived behavioral control sub-scores were higher among SDF users. Non-users with higher TPB index scores expressed interest in SDF and supported the need for continuing education on SDF.