Influences on dentists' decisions to refer paediatric patients to dental hygienists and therapists for fissure sealants: a qualitative approach.

Objectives: Little is known about the delegation of care within skill mix in dentistry, therefore this study aimed to explore dentists' and dental care professionals' (DCPs') perceptions of factors that might influence the referral of paediatric patients to dental hygienists and therapists for fissure sealants.

Method: Qualitative semi-structured interviews were conducted with 10 dentists and 10 DCPs. Qualitative content analysis of the interview transcripts was used to identify themes in the data.

Results: A predominant view was that there were no characteristics that systematically influenced the referral of patients to DCPs to place fissure sealants. However, idiosyncratic factors were said to occasionally play a role. Structural factors included use of resources, payment and contracting systems and practice characteristics. Individual patient-related factors were parents' and patients' attitudes and patient characteristics. Dentist-related factors included dentists' preferences, perceptions of DCPs, their perceived role of DCPs and providing a service to patients.

Conclusion: This study has identified a variety of factors that may influence a dental practitioner's decision to refer child patients to DCPs for fissure sealant placement. However, these factors do not appear to be systematic.