Attitudes, knowledge and utilization of fissure sealants among Greek dentists: a national survey.

AIM: This was to evaluate the attitudes and knowledge of Greek Dentists concerning fissure sealants (FS) and other preventive measurements, together with the extent and the reasons for using or not using FS in their clinical practice.

METHODS: 1,221 general dental practitioners (GDPs) including 50 Paediatric Dentists (PD) were randomly selected from 35 local dental societies of Greece and asked to answer a telephone questionnaire regarding their attitudes to prevention, use of FS and variables influencing their placement. Non parametric Pearson's Chi square test and multifactorial logistic regression models were used for analysing the data.

RESULTS: Although 87.6% of all Greek dentists believe and apply prevention, only 35.8% are using them routinely. Factors highly correlated with FS usage for all dentists were using fluoride regimens (p<0.001), being in practice for 5-14 years (p=0.004) and practicing in urban areas (p<0.001). By contrast, all PD were using FS, regardless of any parameter (p>0.01). Concerning the type of surfaces sealed, 45.6% of GDP used FS on intact surfaces and 41.1% on questionable, while only 15% of them sealed incipient caries. Overall, fewer GDPs compared with PD sealed premolars, primary teeth, questionable surfaces, incipient enamel caries and molars in high risk patients (p<0.001), while fewer PD sealed intact surfaces (p<0.001). The reasons mentioned for not using FS were: 76.3% that parents were unwilling to pay, 61.9% did not know how to use them, while 43.0% believed that oral hygiene was sufficient in order to reduce caries.

CONCLUSIONS: Insufficient knowledge and lack of clinical practice guidelines for the use of FS by GDPs in Greece, leads to low usage rates. Appropriate professional and scientific authorities should join efforts to improve knowledge of GDP and instil confidence in using FS.