Title : Caries prevention in children: what determines practice ?
Supervisors : Pierre Farge / Marc Chanelière / Béatrice Thivichon-Prince
Jury :
Mme BACCHETTA Justine
Mme DELFOSSE Caroline
M. FARGE Pierre
M. GOCKO Xavier
Mme HAESEBAERT Julie
Mme TARDIEU Corinne
Abstract :
Affecting 40% of children under 6 in France, caries is the most prevalent non-communicable disease of childhood. It is therefore a daily problem for all primary care practitioners involved in children's oral health care (dentists, general practitioners and paediatricians). Today, all international recommendations stress the importance of individual prevention as a strategy in the fight against caries. However, it seems difficult for health professionals to implement this strategy, and they claim to devote little time to it. The classic reasons given for this situation are lack of time, training and financial recognition. But are these factors alone capable of influencing the behavior of healthcare professionals in terms of oral health prevention? In other words, what factors determine whether healthcare professionals carry out individual caries prevention? To answer these questions, we carried out a number of studies. First, a systematic review of the literature was carried out. The aim of this review was to identify and classify the factors perceived by healthcare professionals as being obstacles or levers to caries prevention in children. In addition to a lack of time and financial recognition, the results of this study highlight numerous systemic obstacles affecting all levels of our healthcare system, from public policy to the perceptions of healthcare professionals (perception of the patient, perception of illness, professional identity, etc.).
professional identity). In a second phase, particular attention was paid to identifying unconscious obstacles related to the psychology of healthcare professionals. Through a qualitative study, we explored the perceptions and attitudes of healthcare professionals towards children with polycaries and their parents. Preliminary results reveal that dentists associate negative stereotypes with the parents of these children. For some professionals, these negative representations are associated with discriminatory practices (less patient-centred approach, impaired communication and restricted access to care). Beyond discrimination, this qualitative study shows the importance of working on the representations held by healthcare professionals. These representations and their influence on practice must continue to be studied. To this end, we have begun a study on the perception of caries disease, by adapting and translating the Illness Perception Questionnaire for Health Professionals.
