The Older Adults’ Intention to Use Silver Diamine Fluoride for Dental Caries Treatment

Figures & data

Table 1 Sociodemographic Characteristics and Comparisons of Different Intentions to Use SDF Among Different Characteristics

	Total		Intention to use SDF		No-intention to use SDF		P-value
	Frequency	Percentage	Frequency	Percentage	Frequency	Percentage
	588	100	486	82.7	102	17.4
Age (years)
Mean (SD) = 65.30 (5.53); min, max = 60, 90			Mean (SD) = 65.33 (5.93)		Mean (SD) = 65.29 (5.44)		0.943^b
60–70	506	86.1	413	85.0	93	91.0	0.011^a
71–80	67	11.4	63	13.0	4	4.0
81–90	15	2.6	10	2.0	5	5.0
Gender							0.194^a
Male	278	47.3	223	45.9	55	53.9
Female	310	52.7	263	54.1	47	46.1
Occupation							0.325^a
Government officer/Employee	16	2.7	16	3.3	0	0
Business owner	112	19.0	89	18.3	23	22.5
Work for hire	81	13.8	68	14.0	13	12.7
Retired	199	33.8	162	33.3	37	36.3
Unemployed/Others	180	30.6	151	31.1	29	28.4
Residence							0.119^a
House-with-family	475	80.8	394	81.0	81	13.9
House alone	113	19.2	92	19.0	21	3.6
Highest education							0.058^a
Lower than Grade 6	373	63.4	318	65.4	55	53.9
Upper than Grade 6	215	36.5	168	34.6	47	46.1
Family income per month (10,000 Baht ≈ 300 US $)							<0.001^a
Less than 10,000 Baht	370	62.9	328	67.5	42	41.2
More than 10,000 Baht	218	37	158	32.5	60	58.2
Underlying disease							<0.001^a
No underlying disease	214	36.4	203	41.8	11	10.8
Having underlying disease	588	63.6	283	58.2	91	89.2
Have you ever had dental problems?							<0.001^a
Yes	474	80.6	378	77.8	96	94.1
No	114	19.4	108	22.2	6	5.9
Fear of seeing a dentist							<0.001^a
Yes	470	79.9	372	76.6	98	96.1
No	118	20.0	114	23.4	4	3.9

Notes: ^aChi-square test; ^bIndependent t-test.

Table 2 Score Distribution and Descriptive Statistics of Each TRA Question (Direct Measurement)

	Score^a				Mean	SD	Median	Mode
	1	2	3	4
Intention
23. I intend to do the SDF treatment if I have cavities.	15	87	451	35	2.86	0.539	3.00	3
Attitudes
17. Using the dental caries-stopping agent in the anterior teeth is acceptable	7	116	409	56	2.87	0.570	3.00	3
18. Using the dental caries-stopping agent in the posterior teeth is acceptable	26	98	407	57	2.84	0.645	3.00	3
19. I feel unacceptable with the black staining from the SDF treatment.	23	209	310	46	2.64	0.682	3.00	3
Subjective norms
20. People who are important to me do not believe that SDF treatment can stop tooth decay.	39	136	382	31	2.69	0.673	3.00	3
21. People who are important to me think that fillings are better than the SDF treatment.	35	135	386	32	2.71	0.661	3.00	3
22. Someone who is important to me believes that the SDF is not a safe option	60	131	371	26	2.62	0.728	3.00	3

Notes: ^aScore: 1= Strongly Disagree; 2= Disagree; 3= Agree; 4= Strongly Agree.

Table 3 Score Distribution and Descriptive Statistics of Each TRA Question (Indirect Measurement)

Statements	Score^a				Mean	SD	Median	Mode
	1	2	3	4
Intention
23. I intend to do the SDF treatment if I have cavities.	15	87	451	35	2.86	0.539	3.00	3
Behavioral belief
1. SDF treatment can help stop tooth decay.	8	86	403	91	2.98	0.596	3.00	3
2. SDF treatment can help avoid the complications of dental procedures	25	70	396	97	2.96	0.673	3.00	3
3. Using SDF treatment can help save on dental expenses.	12	88	387	101	2.98	0.635	3.00	3
4. SDF treatment can help save time for dental treatment.	20	78	361	129	3.02	0.699	3.00	3
5. SDF treatment is safe.	27	80	391	90	2.93	0.684	3.00	3
6. SDF treatment can reduce the chances of toothache.	27	67	419	75	2.92	0.648	3.00	3
Evaluation outcome
7. The benefit of SDF treatment is that it can stop tooth decay.	16	81	439	52	2.90	0.570	3.00	3
8. SDF treatment has the advantage of avoiding complicated dental procedures	12	79	445	52	2.91	0.545	3.00	3
9. An advantage of SDF treatment is that it can assist in lowering dental costs.	23	72	423	70	2.92	0.626	3.00	3
10. Using SDF treatment to avoid complicated dental procedures is a good idea.	19	79	429	61	2.90	0.599	3.00	3
11. The benefit of SDF treatment is that it is safe.	24	70	427	67	2.91	0.624	3.00	3
12. SDF is an effective treatment for stopping tooth decay.	22	75	449	42	2.87	0.576	3.00	3
Normative beliefs
13. People who are important to me do not want me to do the SDF treatment if I have cavities.	21	155	382	30	2.72	0.614	3.00	3
14. People who are important to me do not want me to do the SDF treatment due to the black staining.	39	132	388	29	2.69	0.667	3.00	3
Motivation to comply
15. I will not do the SDF treatment when I have cavities if people who are important to me do not want me to do it.	69	309	204	6	2.25	0.666	2.00	2
16. I will not do the SDF treatment when I have dental caries if people who are important to me do not want me to do it due to the black staining.	84	305	194	5	2.20	0.683	2.00	2

Notes: ^aScore: 1= Strongly Disagree; 2= Disagree; 3= Agree; 4= Strongly Agree.

Figure 1 The proportion of responses to each statement among participants with different intentions for SDF treatment (Direct measurement); (a) Statements about attitudes towards SDF treatment; (b) Statements about subjective norms related to SDF treatment; *Chi-square test; p-value<0.05.

Figure 2 The proportion of responses to each statement among participants with varying intentions towards SDF treatment (Indirect measurement); (a) Statements about behavioral beliefs related to SDF treatment; (b) Statements about evaluation of the behavioral outcome of SDF treatment; (c) Statements of normative beliefs related to SDF treatment; (d) Statements about the motivation to comply with SDF treatment; *Chi-square test; p-value<0.05.

Table 4 Multiple Logistic Regression Models of Intention to Use SDF for Dental Caries Treatment by Sociodemographic and TRA Variables

Model	4			3			2			1
Variables	B	P-value	ORadj	B	P-value	ORadj	B	P-value	ORadj	B	P-value	ORadj
Age
60–70 years^a		0.803			0.778			0.489			0.066
71–80 years	4.304	0.557	73.959	4.351	0.535	77.569	0.858	0.328	2.357	1.202	0.029	3.326
81–90 years	3.109	0.753	22.403	3.059	0.726	21.316	−0.599	0.52	0.549	−0.457	0.475	0.633
Income
More than 10,000 Bht/mth^a
Less than 10,000 Bht/mth	0.404	0.51	1.497	0.492	0.417	1.636	0.768	0.024	2.155	1.459	<0.001	4.303
Fears of seeing dentist
Yes^a
No	0.723	0.437	2.061	0.84	0.352	2.316	1.606	0.025	4.985	1.654	0.003	5.23
Have ever had dental problems
No^a
Yes	0.019	0.979	1.019	0.036	0.959	1.037	−0.4378	0.453	0.645	−1.374	0.003	0.253
Having underlying disease
No underlying disease^a
Have underlying disease	0.426	0.558	1.531	0.339	0.635	1.404	−1.1754	0.007	0.309	−1.635	<0.001	0.195
Behavioral belief^b	2.614	0.036	13.653	2.436	0.022	11.426
Evaluation of behavioral outcome^c	5.729	<0.001	307.797	6.018	<0.001	410.616
Normative beliefs^d	−0.182	0.741	0.834	−0.125	0.9812	0.882
Motivation to comply^e	−0.05	0.958	0.952	−1.008	0.129	0.365
Attitudes^f	0.117	0.693	1.194				1.688	<0.001	5.410
Subjective norms^g	−0.455	0.127	0.634				−0.578	<0.001	0.561
Constant	−19.741	<0.001	0	−19.822	<0.001	0	−6.27	<0.001	0.002	2.921	<0.001	18.569
−2 Log likelihood^h	96.99			99.21			249.77			430.67
Cox & Snell R Square	0.531			0.53			0.392			0.173
Nagelkerke R Square	0.882			0.879			0.651			0.288
Overall percentage of correct prediction	96.9			96.8			92.0			84.4

Notes: Variables: ^aReferences category. ^bBehavioral belief=MEAN (Statement 1–6); ^cEvaluation of behavioral outcome= MEAN (Statement 7–12); ^dNormative belief= MEAN (Reverse scores of statement 13–14); ^eMotivation to comply= MEAN (Reverse scores of statement 15–16); ^fAttitudes= MEAN (Statement 17–18, reverse scores of statement 19); ^gSubjective norms= MEAN (reverse scores of statement 20–22). ^hEstimation terminated at iteration number 10 because parameter estimates changed by less than 0.001.

Abbreviations: Bht/mth, Baht/month; OR_adj, odds ratio adjusted for the other predictors in the model.

Table 5 Reasons for Not Intending to Use SDF. (Only Participants Who Did Not Intend to Use SDF)

Reasons (N =103)	Frequency	Percentage
SDF is not aesthetically pleasing	17	16.7
Lack of knowledge about SDF	38	37.3
Concerns about the safety of SDF	40	39.2
Belief that SDF cannot effectively stop tooth decay	55	53.9
Other reasons	20	19.6