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dc.contributor.authorMarshman, Zoe
dc.contributor.authorKettle, Jennifer E.
dc.contributor.authorHolmes, Richard D.
dc.contributor.authorCunningham, Kathryn B.
dc.contributor.authorFreeman, Ruth
dc.contributor.authorGibson, Barry J.
dc.contributor.authorMcColl, Elaine
dc.contributor.authorMaguire, Anne
dc.contributor.authorDouglas, Gail V. A.
dc.contributor.authorClarkson, Janet E.
dc.contributor.authorInnes, Nicola P. T.
dc.identifier.citationMarshman , Z , Kettle , J E , Holmes , R D , Cunningham , K B , Freeman , R , Gibson , B J , McColl , E , Maguire , A , Douglas , G V A , Clarkson , J E & Innes , N P T 2020 , ' Dental professionals’ experiences of managing children with carious lesions in their primary teeth – a qualitative study within the FiCTION randomised controlled trial ' , BMC Oral Health , vol. 20 , 64 .
dc.identifier.otherPURE: 266865553
dc.identifier.otherPURE UUID: 8b209082-57e9-4be9-8113-f991306413c0
dc.identifier.otherRIS: urn:72ADC5B12E3BF526B2C4EF94F406F3F6
dc.identifier.otherRIS: Marshman2020
dc.identifier.otherORCID: /0000-0002-3300-7220/work/70619100
dc.identifier.otherScopus: 85081305591
dc.identifier.otherWOS: 000520528100001
dc.descriptionFunding: National Institute for Health Research Health Technology Assessment program (project number 07/44/03).en
dc.description.abstractBackground The lack of evidence for the effective management of carious lesions in children’s primary teeth has caused uncertainty for the dental profession and patients. Possible approaches include conventional and biological management alongside best practice prevention, and best practice prevention alone. The FiCTION trial assessed the effectiveness of these options, and included a qualitative study exploring dental professionals’ (DPs) experiences of delivering the different treatment arms. This paper reports on how DPs managed children with carious lesions within FiCTION and how this related to their everyday experiences of doing dentistry. Methods Overall, 31 DPs from FiCTION-trained dental surgeries in four regions of the UK participated in semi-structured interviews about their experiences of the three treatment arms (conventional management of carious lesions and prevention (C + P), biological management of carious lesions and prevention (B + P) or prevention alone (PA)). A theoretical framework, drawing on social practice theory (SPT), was developed for analysis. Results Participants discussed perceived effectiveness of, and familiarity with, the three techniques. The C + P arm was familiar, but some participants questioned the effectiveness of conventional restorations. Attitudes towards the B + P arm varied in terms of familiarity, but once DPs were introduced to the techniques, this was seen as effective. While prevention was familiar, PA was described as ineffective. DPs manage children with carious lesions day-to-day, drawing on previous experience and knowledge of the child to provide what they view as the most appropriate treatment in the best interests of each child. Randomisation undermined these normal choices. Several DPs reported deviating from the trial arms in order to treat a patient in a particular way. Participants valued evidence-based dentistry, and expect to use the results of FiCTION to inform future practice. They anticipate continuing to use the full range of treatment options, and to personally select appropriate strategies for individual children. Conclusions RCTs take place in the context of day-to-day practices of doing dentistry. DPs employ experiential and interpersonal knowledge to act in the best interests of their patients. Randomisation within a clinical trial can present a source of tension for DPs, which has implications for assuring individual equipoise in future trials.
dc.relation.ispartofBMC Oral Healthen
dc.rightsCopyright © The Author(s). 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
dc.subjectDental cariesen
dc.subjectCarious lesionsen
dc.subjectPaediatric dentistryen
dc.subjectPrimary careen
dc.subjectRandomised controlled trialen
dc.subjectQualitative researchen
dc.subjectDental professionalsen
dc.subjectRJ Pediatricsen
dc.subjectRK Dentistryen
dc.titleDental professionals’ experiences of managing children with carious lesions in their primary teeth – a qualitative study within the FiCTION randomised controlled trialen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews.School of Medicineen
dc.contributor.institutionUniversity of St Andrews.Population and Behavioural Science Divisionen
dc.description.statusPeer revieweden

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