Current practice, barriers and facilitators to caries management in children: a qualitative study in the Netherlands

BACKGROUND: Dental caries remains a global challenge and implementing preventive and minimally invasive treatments for primary teeth is difficult in everyday practice. Evidence on how these approaches are applied and perceived is limited. AIM: Objectives were to (1) describe the current practice in preventive and minimally invasive caries treatment for children; (2) evaluate their alignment with national guidelines; and (3) identify barriers and facilitators experienced by oral healthcare professionals (OHCPs) and parents in managing caries in Dutch children under 12 years. DESIGN: Semi-structured interviews were conducted with purposively sampled prevention assistants, dental hygienists, dentists, and parents. Data were analysed thematically using inductive and deductive approaches. RESULTS: Twenty-six OHCPs and ten parents participated. OHCPs emphasised primary prevention through brushing and healthy eating. Care focussed on caries stabilisation and treatment, partly in accordance with the national guidelines, though advanced lesions were often treated restoratively. Behavioural modification strategies were used, but mostly without structure or training, mainly relying on information provision. OHCPs struggled to share responsibility with parents, though parents viewed themselves as accountable. Reported barriers included reimbursement systems, time constraints, parental influence, and limited familiarity with guideline-recommended options. Facilitators included cooperation, material availability, and continuing education. CONCLUSION: OCHPs aim to deliver preventive and minimally invasive caries management, but alignment with the national guideline is limited.