Exploring dentists’ perceptions, practices and potential stigma surrounding severe dental caries in children: A qualitative study

Abstract Background : Despite recommendations emphasizing individualized prevention and patient-centered communication, studies show that preventive care is often under-delivered in routine dental practice. Parents are sometimes identified by dentists as a major barrier to caries prevention, due to perceived lack of parenting skills. Existing literature suggests that negative stereotypes may influence the quality of care provided to these families. This study aims to explore health professionals’ perceptions of children with early childhood caries (ECC) and how these perceptions may shape clinical practice. Method : This qualitative study was based on semi-structured interviews conducted with French general dental practitioners, with thematic analysis of the data. Results : Interviews were conducted with a mixed sample of 15 general dental practitioners, (varying in age, gender, geographic location, practice setting, and the number of children treated per week). Thematic analysis identified four main themes: 1/ Parents portrayed as guilty of neglecting their child’s oral health 2/ Ambivalent emotional perceptions of the child with severe dental caries 3/ Behavior change perceived as a major challenge 4/ Caries prevention perceived as a public health issue with systemic causes. Conclusion : The findings of this qualitative study suggest that children with severe dental caries and their parents may be exposed to a dual form of stigma. On one hand, children are perceived as too difficult or unpleasant to treat; on the other, their oral condition is often associated with stereotypes of parental neglect and exclusive responsibility for illness. These perceptions may undermine the quality of the patient–provider relationship and act as a barrier to accessing care. Trial registration number : NCT05284279, registered on 2022-03-17