Dentists' choice of treatment for root caries – a qualitative study

Despite existing recommendations for root caries treatment, their implementation in clinical practice remains inconsistent. This qualitative study explores the factors influencing dentists' decision-making in selecting appropriate therapies for root caries. A structured interview guide was designed based on the Theoretical Domains Framework (TDF), and 15 semi-structured individual interviews were conducted with dentists (mean (min/max) professional experience: 14.8 (3/48) years). The interview transcripts were analysed using the TDF and the Capability-Opportunity-Motivation-Behaviour (COM-B) model to identify key motivations behind treatment choices for root caries. Data saturation was reached, and a total of 34 barriers, facilitators or conflicting themes were identified that aligned to all COM-B domains. Main barriers included limited awareness of current diagnostic and treatment guidelines, a lack of sufficient incentives for root caries therapy and the perception of root caries management as a frustrating task. Facilitators included viewing root caries management as a high-priority task and a strong interest in offering evidence-based management options. Root caries management is complex and often under-prioritized, despite clinicians’ motivation to provide quality care. Knowledge gaps, emotional strain, and systemic disincentives hinder effective treatment and need to be addressed to improve outcomes. Clinical Significance: This study identifies behavioural, emotional, and systemic barriers that contribute to continued invasive management of root caries despite evidence-based recommendations for non-invasive care of early lesions, particularly in older and care-dependent patients. Identifying these barriers may support more consistent adoption of evidence-based approaches in routine dental practice.