Barriers and Facilitators to Providing Preventive Dental Care for Young Children in Dental Settings.

Objectives: This qualitative study aimed to understand dental professionals' perspectives and practices regarding preventive dental care for very young children and preventive oral health services (POHS) provided outside of dental practices.

Methods: Semi-structured interviews were conducted on Zoom with a purposive sample of dental professionals in Massachusetts between December 12, 2022, and June 15, 2023, until theoretical saturation was reached. The Consolidated Framework for Implementation Research was the study's conceptual framework. Applying Charmaz's approach to grounded theory, transcripts were coded line-by-line in an iterative process, using memos and axial coding to identify themes.

Results: Twenty-eight interviews were conducted with general dentists (n = 18), pediatric dentists (n = 5), registered dental hygienists (n = 3), a dental assistant (n = 1), and a dental administrator (n = 1). Major themes included: (1) facilitators and barriers to providing preventive dental care for children under 3 years old; (2) perceptions of POHS delivery outside of dental practices and care coordination; (3) public policies potentially impacting the provision of preventive dental care for young children; and (4) potential levers for change to improve receipt of recommended preventive dental services. Sub-themes included training, concerns about the quality of care in non-dental sites, public insurance barriers, and increasing joint dental-medical curriculum programs.

Conclusions: Potentially modifiable barriers were identified at provider, practice, and policy levels. Further research is needed regarding the financial impacts of public insurance reimbursement rates, the potential role of bias in access to preventive dental services, and the effects of systematic accountability for performance on quality and equity measures related to preventive dental care.