Application of the extended theory of planned behavior to predict dentist intention and behavior in providing caries preventive care for preschool children

Background: Various studies show a gap between evidence-based recommendations and the preventive practice of dentists. This study aimed to create and assess an extended Theory of Planned Behavior (TPB) model on dentists' intentions to do caries preventive measures and related barriers experienced by dentists. Methods: A total of 362 general dentists from 34 Indonesian provinces were included in this study. A self-administered online questionnaire consisted of three sections: dentist characteristics and practice pattern, TPB questionnaire, and dentist perceived behavior regarding preventive care for pediatric patients. The questionnaire was distributed and the data was analyzed through structural equation modeling. Results: TPB's extended version is a fit and relevant model, explaining 55.3% of dentists' intentions to undertake preventive procedures and 17.8% of preventive practices. Perceived behavioral control was the most powerful predictor of intention (44.2%) and practice (8.8%), while parental barriers were the most significant barrier to provide preventive care (18.9%). Conclusion: Extending the TPB by taking barriers from multiple stakeholders as a consideration has a higher predictive level for preventive practices. Each barrier should be addressed through oral health programs and policies, and dentists must be taught to overcome these barriers (through formal or continuing education) in order to maximize caries prevention strategies.