Perceived Problems and Barriers in Implementing the Caries Management System

A system for non-invasive management of dental caries was introduced to dental students at The University of Sydney. This system focused mainly on the delivery of primary prevention and non-invasive secondary prevention services for dental caries.

Objectives: The purpose of this study was to identify problems and barriers to the implementation of this system in a university teaching clinic.

Methods: In addition to the researcher's observations and field note data, an open-ended question was used to evaluate students' perceived problems and barriers in implementing the Caries Management System. Interviews with senior clinical tutors and hospital staff were also conducted.

Results: A thematic analysis of 83 comments reported by 52 students was carried out. The main themes identified were clinic and patient related factors. The patient factors were motivation, adherence, and understanding. Clinic related factors were clinic policy, available clinical time, the complexity of applying non-invasive protocols, and related paper work.

The main themes extracted from 31 comments reported by staff were clinic related factors and students related factors. Clinic factors such as clinic policy, available clinical time, and complexity of the protocols and related paper work, in addition to administrative issues were reported. Students' motivation and students' perception of their patients' motivation were also considered as the main barriers.

The analysis of the researcher's field note data supported these findings and, in addition, identified constraints due to hospital treatment priorities and patient expectations.

Conclusion: More communication between teaching and clinical staff is needed to facilitate the implementation of the Caries Management System.

Acknowledgement: Australian Dental Research Foundation Grant No. 5/2005.