ปัจจัยที่สนับสนุนหรือเป็นอุปสรรคต่อการใช้ซิลเวอร์ไดเอมีนฟลูออไรด์ในการหยุดยั้งฟันผุในผู้สูงอายุในมุมของผู้ให้บริการ

Abstract

This study aimed to explain enabling factors and barriers to the use of silver diamine fluoride among the elderly by dental practitioners in northeastern Thailand. Data were initially gathered using a questionnaire-based pilot survey in Google form to identify dental practitioners who had used silver diamine fluoride. Then, in-depth interviews with eight dentists, six professors , five lecturers from Sirindhorn College of Public Health, two silver diamine fluoride experts, and four dental policy makers were conducted to understand the enabling conditions and impediments to the use of silver diamine fluoride adapted from “The concept of access” by Penchansky and Thomas 1981. The findings revealed that the enabling factors are the acceptance of caries arrested efficacy, simple procedures, less material and time, a small volume while applying, and prior experience with silver diamine fluoride in children. Teaching the topic of silver diamine fluoride in the undergraduate dentistry curriculum or other courses results in dental practitioners' perception of silver diamine fluoride. Furthermore, Covid – 19 pandemics caused the inability to do aerosolizing treatments, which impelled dental practitioners curious about employing silver diamine fluoride. Black staining following silver diamine fluoride application, flavor, and acerbity, as well as the lack of a silver diamine fluoride code in the systems, are barriers to use. At present, silver diamine fluoride is not listed in the benefit packages of Thailand’s Universal Health Coverage and has no policy explicitly encouraging its usage resulting in an ambiguous problem for entering the code after treatment. Possibly due to dental policy makers’ opinions, though that silver diamine fluoride is not a treatment option for everyone, we have to choose cases appropriately, and also, there is no substantial academic evidence-based information on the use of silver diamine fluoride among the elderly in Thailand.