Intention to use Silver Diamine Fluoride for dental caries treatment among the elders

Abstract Background: Tooth decay is a leading cause of tooth loss in older adults. Silver diamine fluoride (SDF) has been proven effective for caries prevention and arrest among children and older adults. However, the SDF treatment leaves black staining on the decayed area. While several studies have revealed the acceptance of the staining of SDF treatment in children, very few studies have been conducted on older adults. This study aimed to assess the intention of the elders to use SDF for dental caries treatment. Methods: The participants consisted of individuals aged 60-90 who can read and understand Thai language. After providing information about the SDF, a theory-guided interview based on the Theory of Reason Action (TRA) consisting of 23 questions covering seven constructs: behavioral belief, evaluation of behavioral outcome, normative belief, motivation to comply, attitude towards behavior, subjective norm, and intention. The participants were asked to rate their agreement with each question on a 4-point Likert scale ranging from 1 (Strongly agree) to 4 (Strongly disagree). Characteristics of the participants and score of each TRA question of participants with different intentions were compared using the Chi-square test and t-test. Multiple logistic regression was employed to determine the determinants of the intention to use SDF. Results: A total of 588 elders with a mean age of 65.3 years (SD= 5.53), 52.7% were women, 58.1% were unemployed/retired, 80.8% lived with family, 63.4% had less than sixth-grade education, 62.9% had a monthly family income of less than 10,000 baht, and 63.6% had underlying diseases. Four hundred eighty-six participants (82.7%) indicated an intention to use SDF for dental caries treatment. An average score (SD) of intention to use SDF to treat dental caries was 2.86 (0.54). Age, family income, underlying disease, dental health problems, and fear of the dentist significantly affected intention. The behavioral belief and the evaluation of behavioral outcomes significantly affect the intention to use SDF treatment. Conclusion: Most older adults intend to use SDF for dental caries treatment. The different intentions depend on beliefs and the SDF treatment’s outcome evaluation. Trial registration: Thai Clinical Trials Registry (TCTR), (TCTR20230308003) Retrospectively registered, Registered March 08, 2023 https://www.thaiclinicaltrials.org/show/TCTR20230308003