Assessing preventive dental care in Urumqi: insights from a KAP survey of dentists regarding children's oral health

Assessing preventive dental care in Urumqi: insights from a KAP survey of dentists regarding children's oral health | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessing preventive dental care in Urumqi: insights from a KAP survey of dentists regarding children's oral health Wusimanjiang Aierken, Abulajiang Anayeti, tao Guo, Gulinuer Shawuti, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8524531/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background Dental caries pose a severe public health threat to Chinese children. According to the Fourth National Oral Health Epidemiological Survey, the prevalence of dental caries is 71.9% among 5-year-olds (deciduous teeth) and 34.5% among 12-year-olds (permanent teeth), with a significant urban‒rural disparity. Effective preventive care is crucial to curb this trend, yet its integration into routine practice faces multifaceted barriers. In Urumqi, while previous research has highlighted gaps in emergency dental trauma management among nonprofessionals, the knowledge, practices, and perceived barriers of dentists—the key providers of preventive care—remain unexplored. This study aimed to assess these aspects among dentists in Urumqi, focusing on sociodemographic correlates and the impact of national Public Health Initiatives (PHI). Methods A cross-sectional online survey was conducted among dentists practicing in Urumqi from Apr to Oct 2025. A structured questionnaire adapted from international knowledge, attitudes, and practices (KAP) surveys and refined for the local context was distributed via dental associations and professional networks. It assessed 1) sociodemographics, 2) knowledge of preventive care and dental trauma, 3) beliefs regarding professional roles, 4) self-reported preventive practices, and 5) perceived barriers. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression. Results Of the 450 invited dentists, 332 valid responses were collected (response rate: 73.8%), with 1 incomplete questionnaire excluded—slightly below the calculated minimum sample size of 333. The sample was 63.5% female, with the largest age group being 31–45 years (42.2%). Only 58.1% were fully aware of the national "Children's Pit and Fissure Sealant Program." Knowledge scores were significantly higher among younger dentists (< 45 years) and those working in urban cores (p < 0.05). While 78.4% agreed that prevention is more important than treatment, only 45.3% reported "always" applying sealants when indicated. Key barriers included low parental awareness/acceptance (71.7%), low financial incentive (67.2%), and lack of time (59.1%). Dentists in suburban/rural areas reported significantly greater challenges in coordinating school-based PHI (p = 0.01). Formal training in prevention was the strongest predictor of both higher knowledge (OR = 3.1, 95% CI 1.8–5.2) and frequent preventive practice (OR = 2.8, 95% CI 1.6–4.7). Conclusions Significant gaps exist in the knowledge and practice of preventive care among dentists in Urumqi, influenced by age, practice location, and training. The urban-suburban/rural disparity in dentist preparedness mirrors the national trend of higher caries prevalence in rural child populations. Despite positive attitudes, substantial systemic and perceptual barriers hinder implementation. The findings underscore an urgent need for targeted continuing education, enhanced policy support for public health program implementation, and strategies tailored to urban-suburban disparities to optimize preventive oral healthcare for children and address the high caries burden identified in the national survey. Preventive dental care Knowledge attitudes and practices (KAP) Dentists Children Dental caries Public health initiatives Urumqi Introduction The global burden of dental caries in children remains a significant public health challenge, with profound implications for quality of life, nutrition, and socioeconomic costs [1, 2]. In China, the situation is particularly pressing. The Fourth National Oral Health Epidemiological Survey reveals alarming rates: 71.9% of 5-year-old children have caries in their deciduous teeth, with an average of 4.24 decayed teeth per affected child [3, 4]. This prevalence is significantly higher in rural areas than in urban areas. Among 12-year-olds, the permanent tooth caries rate is 34.5%, representing an increase of approximately 5 percentage points over the past decade [5]. These figures underscore that dental caries is the most prevalent chronic disease threatening children's oral health in China, necessitating urgent, science-based preventive strategies and early intervention. The efficacy of evidence-based preventive interventions, such as fluoride application and pit and fissure sealants, is well established [6, 7]. However, a persistent gap exists between this evidence and its translation into routine clinical practice, often attributed to a historically curative-centric model of dental care [8–10]. Dentists are the primary gatekeepers for delivering clinical preventive care. Their knowledge, beliefs, and practices directly influence patient outcomes [8]. KAP surveys have been widely used to understand healthcare providers' adoption of preventive measures, revealing that factors such as age, gender, practice setting, and financial incentives significantly influence behavior [11–13]. For instance, a recent study found that younger dentists had superior knowledge but faced greater time constraints, while gender influenced perceptions of remuneration for preventive services [12]. In the context of Northwest China, specifically the Xinjiang Uygur Autonomous Region and its capital Urumqi, oral health research has been limited. A previous study in Urumqi revealed critical knowledge gaps among schoolteachers and parents regarding the emergency management of dental trauma in children, highlighting a need for improved frontline response [14]. However, the preparedness of the professional dental workforce—who is responsible for providing the cornerstone of clinical prevention (e.g., sealants, fluoride) and managing complex cases—remains unassessed. This assessment is crucial following the launch of the 2024 national "Children's Pit and Fissure Sealant Program," which aims to provide free preventive care. The program’s success hinges on dentist engagement, knowledge, and ability to overcome local implementation barriers. Urumqi, as a major multiethnic urban center with distinct urban core, suburban, and rural districts, presents a unique microcosm to study how geography and resource distribution affect professional practice. This is especially relevant given the national survey's finding of higher caries rates in rural child populations. No study has yet examined the KAP of dentists in this region regarding integrated preventive care for children. Therefore, this study aimed to (1) evaluate the knowledge, beliefs, practices, and perceived barriers of dentists in Urumqi regarding preventive dental care for children; (2) analyze the associations between these factors and sociodemographic variables, particularly practice location; and (3) assess awareness and perceived challenges related to national oral health PHI. The findings will inform the development of targeted interventions to strengthen the preventive care capacity of the dental workforce in Urumqi and similar regions, contributing to the national goal of reducing the high burden of childhood caries. Methods Study Design and Population A cross-sectional survey was conducted among dentists actively practicing in Urumqi between Apr and Oct 2025. The target population included general dentists and specialists involved in pediatric care across public hospitals, private clinics, and community health centers. Dentists who were retired, not currently in clinical practice, or practising outside Urumqi were excluded. Sample Size and Sampling Assuming a population of approximately 2,500 dentists in Urumqi, a minimum sample size of 333 was calculated for a 95% confidence level, a 5% margin of error, and a 50% response distribution. A multipronged, nonprobability sampling strategy was employed to ensure broad representation. Invitations with a link to the online questionnaire were disseminated through 1) the Urumqi Stomatological Association mailing list; 2) professional WeChat groups of major public hospitals (e.g., The Fifth Affiliated Hospital of Xinjiang Medical University); and 3) networks of private dental clinic chains. Questionnaire Development and Measures The questionnaire was developed through a multistage process: Framework Adaptation: The core structure was adapted from validated KAP surveys on preventive dentistry, including items from a published Italian study [10], ensuring international comparability. Contextualization: Items were modified and expanded to reflect the local context of Urumqi, including questions on awareness of the national "Children's Pit and Fissure Sealant Program," practice location (urban core, suburban, rural), and barriers specific to implementing public health outreach. Integration with Prior Research: Knowledge items on dental trauma emergency management (e.g., avulsion "golden time," storage media) were integrated, building directly on the findings of our team's prior study in Urumqi [14]. Translation and Validity: The English version was translated into Chinese by a bilingual dental researcher and back-translated by an independent translator. Content validity was assessed by three pediatric dentistry experts. A pilot test with 20 dentists confirmed clarity and a completion time of 8–10 minutes. The final questionnaire demonstrated good internal consistency (Cronbach's α = 0.82 for knowledge, 0.79 for practices). The final questionnaire comprised five sections: Sociodemographics: Age, gender, practice location, institution type, district, specialty, highest degree, and years of experience. Knowledge: 7 multiple-choice items (sugar intake, fluoride concentration, sealant timing, dental trauma emergency management). A composite knowledge score (0–7) was calculated (1 point for each correct answer, 0 for incorrect). Beliefs and Perceived Roles: 3 items on a 4-point Likert scale (Strongly Agree to Strongly Disagree) assessing attitudes toward prevention vs. treatment, responsibility for trauma education, and proactive counseling for PHI. Practices: 7 items on a 4-point frequency scale (Always to Never) regarding fluoride provision, sealants, dietary advice, oral hygiene instruction, caries risk assessment, school screenings, and trauma counseling. The composite practice score was calculated (Always = 4, Often = 3, Sometimes = 2, Never = 1). Barriers and Needs: Participants rated 12 potential barriers (Major/Minor/Not a Barrier) and selected areas needing improvement. Data Collection and Analysis Data were collected anonymously via the Wenjuanxing platform. Informed consent was obtained electronically. Data were exported to SPSS Statistics 27.0 for analysis. Descriptive statistics summarized participant characteristics and responses. Bivariate analyses (chi-square, t tests) explored associations between independent variables and dependent outcomes. Multivariate logistic regression identified predictors of "high knowledge" (score > median = 4.0) and "frequent preventive practice" (score > median = 18.0). Statistical significance was set at p < 0.05. Ethical Considerations Ethical approval was obtained from the Institutional Review Board of The Fifth Affiliated Hospital of Xinjiang Medical University (Approval No: XYDWFYLSK-2026-67). Participation was voluntary, and informed consent was secured from all participants. Results Participant Characteristics A total of 332 valid responses were analyzed. The mean age was 41.3 years (SD = 10.7). Most participants were female (63.5%), practiced in urban core areas (52.1%), and worked in public hospital dental departments (48.8%) or private clinics (38.5%). General dentists comprised 44.0% of the sample, followed by pediatric dentists (18.1%). Notably, 58.7% had ≥ 10 years of clinical experience, and 47.6% had received formal preventive training in the past 3 years (51.2% in urban core vs. 43.4% in suburban/rural areas) (Table 1 ). Table 1 Demographic characteristics of participating dentists in Urumqi (n = 332) Variable Category n (%) χ² Value p Value Gender Male 121 (36.5) 1.86 0.173 female 211 (63.5) Age (years) ≤ 30 47 (14.2) 12.39 0.006** 31–45 140 (42.2) 46–60 115 (34.6) > 60 30 (9.0) Practice location Urban core 173 (52.1) 8.74 0.003** Suburban 105 (31.6) Rural (Urumqi County) 54 (16.3) Practice institution type Public hospital dental department 162 (48.8) 23.51 < 0.001*** Private dental clinic/hospital 129 (38.5) Community health service center 28 (8.4) Dental outpatient department 13 (3.9) Other 0 (0.0) Primary specialty General dentistry 146 (44.0) 35.72 < 0.001*** Pediatric dentistry 60 (18.1) Orthodontics 40 (12.3) Oral surgery 33 (10.0) Endodontics 27 (8.1) Periodontics 18 (5.4) Prosthodontics 8 (2.4) Other 0 (0.0) Highest academic degree College diploma or below 35 (10.5) 9.87 0.020* Bachelor’s 210 (63.3) Master’s 78 (23.5) PhD 9 (2.7) Years of clinical experience 20 83 (25.0) Formal preventive training (past 3 years) Yes 158 (47.6) - - no 174 (52.4) - - Formal preventive training by practice location urban core (Yes) 89 (51.2) 3.85 0.050* suburban/rural (Yes) 69 (43.4) *Note: Data are presented as n (%) unless otherwise stated. χ²: Chi-square test. *p < 0.05, **p < 0.01, ***p < 0.001. Formal preventive training refers to systematic training on pediatric preventive dentistry (e.g., fluoride application, pit and fissure sealant placement) or dental trauma emergency management. Knowledge The mean knowledge score was 4.2 ± 1.5 (range: 0–7), with a median of 4.0. While 92.5% correctly identified milk as an acceptable storage medium for an avulsed tooth, only 58.1% were fully aware of the national sealant program. Knowledge scores were significantly higher among dentists aged ≤ 45 years (4.5 vs. 3.8, p < 0.001) and those in urban cores (4.4 vs. 3.9, p = 0.002) (Table 2 ). Table 2 Key knowledge and practice indicators of participating dentists, stratified by subgroups Indicator Total Sample (n = 332) Age ≤ 45 years (n = 187) Age > 45 years (n = 145) t/χ² Value p Value Urban Core (n = 173) Suburban/Rural (n = 159) t/χ² Value p Value Trained (n = 158) Untrained (n = 174) t/χ² Value p Value Knowledge Mean knowledge score (± SD) 4.2 ± 1.5 4.5 ± 1.4 3.8 ± 1.5 4.57 < 0.001*** 4.4 ± 1.4 3.9 ± 1.5 3.21 0.002** 4.8 ± 1.3 3.7 ± 1.5 6.89 < 0.001*** Aware of national sealant program (fully informed, n%) 193 (58.1) 115 (61.5) 78 (53.8) 2.34 0.126 109 (63.0) 84 (52.8) 3.97 0.046* 112 (70.9) 81 (46.6) 22.87 < 0.001*** Correctly identify milk as avulsed tooth storage medium (n%) 307 (92.5) 174 (93.0) 133 (91.7) 0.36 0.548 160 (92.5) 147 (92.5) 0.00 0.998 148 (93.7) 159 (91.4) 0.98 0.323 Practice Apply pit and fissure sealants "Always" (n%) 150 (45.3) 92 (49.2) 58 (40.0) 3.92 0.048* 83 (48.0) 67 (42.1) 1.35 0.245 95 (60.1) 55 (31.6) 34.51 < 0.001*** Participate in school-based screenings "Always/Often" (n%) 95 (28.6) 57 (30.5) 38 (26.2) 0.92 0.337 62 (35.8) 33 (20.8) 10.69 0.001** 63 (39.9) 32 (18.4) 22.73 < 0.001*** Provide oral hygiene instructions "Always/Often" (n%) 288 (86.7) 162 (86.6) 126 (86.9) 0.01 0.917 150 (86.7) 138 (86.8) 0.00 0.989 137 (86.7) 151 (86.8) 0.00 0.985 Inform parents of dental trauma management "Always/Often" (n%) 172 (51.8) 105 (56.2) 67 (46.2) 4.18 0.041* 98 (56.6) 74 (46.5) 3.94 0.047* 108 (68.4) 64 (36.8) 44.09 < 0.001*** *Note: Data are presented as the mean ± SD or n (%) as appropriate. t: Independent samples t test; χ²: Chi-square test. *p < 0.05, **p < 0.01, ***p < 0.001. The knowledge score ranges from 0–7 (7 multiple-choice items). "Trained" refers to dentists who received formal preventive training in the past 3 years. Composite practice score median = 18.0. Beliefs and practices The majority (78.4%) agreed or strongly agreed that prevention is more important than treatment. Although 86.7% reported 'always' or 'often' providing oral hygiene instructions, only 45.3% reported the same frequency for applying sealants. Participation in school-based PHI was low (28.6% 'always' or 'often'). Dentists in suburban/rural areas had significantly lower frequencies of sealant application (31.5% vs. 48.2% in urban cores) and school program participation (19.3% vs. 35.7% in urban cores) (Table 2 ). Trained dentists were more likely to recognize the primacy of prevention and proactively recommend PHI (Table 3 ). Table 3 Attitudes toward preventive care and PHI among participating dentists (n = 332) Indicator Response Category Total Sample (n = 332) n (%) Age ≤ 45 years (n = 187) n (%) Age > 45 years (n = 145) n (%) χ² Value p Value Urban Core (n = 173) n (%) Suburban/Rural (n = 159) n (%) χ² Value p Value Trained (n = 158) n (%) Untrained (n = 174) n (%) χ² Value p Value Prevention is more important than treatment Strongly Agree 105 (31.6) 62 (33.2) 43 (29.7) 1.28 0.734 56 (32.4) 49 (30.8) 0.17 0.917 68 (43.0) 37 (21.3) 18.59 < 0.001*** Agree 155 (46.7) 88 (47.1) 67 (46.2) 81 (46.8) 74 (46.5) 65 (41.1) 90 (51.7) Disagree 53 (16.0) 28 (15.0) 25 (17.2) 27 (15.6) 26 (16.4) 18 (11.4) 35 (20.1) Strongly Disagree 19 (5.7) 9 (4.8) 10 (6.9) 9 (5.2) 10 (6.3) 7 (4.4) 12 (6.9) Proactively recommend free PHI Strongly Agree 98 (29.5) 57 (30.5) 41 (28.3) 0.86 0.834 53 (30.6) 45 (28.3) 0.29 0.865 61 (38.6) 37 (21.3) 14.27 < 0.001*** Agree 162 (48.8) 89 (47.6) 73 (50.3) 84 (48.5) 78 (49.1) 69 (43.7) 93 (53.4) Disagree 54 (16.3) 30 (16.0) 24 (16.6) 27 (15.6) 27 (17.0) 21 (13.3) 33 (19.0) Strongly Disagree 18 (5.4) 11 (5.9) 7 (4.8) 9 (5.2) 9 (5.6) 7 (4.4) 11 (6.3) Disseminate dental trauma emergency knowledge is a core responsibility Strongly Agree 121 (36.4) 70 (37.4) 51 (35.2) 1.54 0.674 65 (37.6) 56 (35.2) 0.24 0.887 79 (50.0) 42 (24.1) 26.78 < 0.001*** Agree 148 (44.6) 82 (43.9) 66 (45.5) 78 (45.1) 70 (44.0) 62 (39.2) 86 (49.4) Disagree 47 (14.2) 25 (13.4) 22 (15.2) 22 (12.7) 25 (15.7) 13 (8.2) 34 (19.5) Strongly Disagree 16 (4.8) 10 (5.3) 6 (4.1) 8 (4.6) 8 (5.0) 4 (2.5) 12 (6.9) *Note: χ²: Chi-square test. *p < 0.05, **p < 0.01, ***p < 0.001. "Trained" refers to dentists who received formal preventive training in the past 3 years. PHI: public health initiatives. Perceived Barriers The most frequently cited 'Major Barriers' were low parental awareness/acceptance (71.7%), low financial incentives (67.2%), and lack of time (59.1%). Barriers specific to PHI included difficulties coordinating with schools (52.4%), complexity of procedures (48.8%), and extra time for outreach (55.1%). Dentists in suburban/rural areas perceived significantly greater barriers related to program coordination and lack of understanding of local procedures (p < 0.01) (Table 4 ). Table 4 Perceived barriers to preventive care implementation among participating dentists (n = 332) Barrier Response Category Total Sample (n = 332) n (%) Urban Core (n = 173) n (%) Suburban/Rural (n = 159) n (%) χ² Value p Value Trained (n = 158) n (%) Untrained (n = 174) n (%) χ² Value p Value Low parental awareness/acceptance Major Barrier 238 (71.7) 121 (69.9) 117 (73.6) 0.79 0.674 108 (68.4) 130 (74.7) 1.72 0.423 Minor Barrier 76 (22.9) 45 (26.0) 31 (19.5) 42 (26.6) 34 (19.5) Not a Barrier 18 (5.4) 7 (4.0) 11 (6.9) 8 (5.1) 10 (5.7) Low financial incentive for preventive services Major Barrier 223 (67.2) 112 (64.7) 111 (69.8) 1.34 0.511 95 (60.1) 128 (73.6) 7.98 0.019* Minor Barrier 85 (25.6) 49 (28.3) 36 (22.6) 52 (32.9) 33 (19.0) Not a Barrier 24 (7.2) 12 (6.9) 12 (7.5) 11 (7.0) 13 (7.5) Difficulties coordinating with schools (public health programs) Major Barrier 174 (52.4) 78 (45.1) 96 (60.4) 9.27 0.010* 65 (41.1) 109 (62.6) 18.53 < 0.001*** Minor Barrier 115 (34.6) 68 (39.3) 47 (29.6) 64 (40.5) 51 (29.3) Not a Barrier 43 (12.9) 27 (15.6) 16 (10.1) 29 (18.4) 14 (8.0) Lack of understanding of local public health program procedures Major Barrier 148 (44.6) 67 (35.8) 81 (55.9) 14.52 < 0.001*** 59 (34.1) 89 (56.0) 19.87 < 0.001*** Minor Barrier 132 (39.8) 84 (44.9) 48 (33.1) 79 (45.7) 53 (33.3) Not a Barrier 52 (15.7) 36 (19.3) 16 (11.0) 35 (20.2) 17 (10.7) *Note: χ²: Chi-square test. *p < 0.05, **p < 0.01, ***p < 0.001. "Trained" refers to dentists who received formal preventive training in the past 3 years. Only key barriers are presented (aligned with the study focus on public health program implementation). Regression Analyses Multivariate logistic regression confirmed that younger age (OR = 2.5, 95% CI 1.5–4.1), urban practice location (OR = 1.9, 95% CI 1.1–3.2), and formal preventive training (OR = 3.1, 95% CI 1.8–5.2) were independent predictors of 'high knowledge'. Similarly, formal training (OR = 2.8, 95% CI 1.6–4.7) and stronger belief in prevention (OR = 2.2, 95% CI 1.3–3.7) predicted frequent preventive practices, while low financial incentives were a negative predictor (OR = 0.5, 95% CI 0.3–0.8) (Table 5 ). Table 5 Multivariate logistic regression analysis of predictors for high knowledge and frequent preventive practices (n = 332) Predictor Variable Category High Knowledge¹ (OR, 95% CI) p Value Frequent Preventive Practice² (OR, 95% CI) p Value Age ≤ 45 years (Ref: >45 years) 2.51 (1.52–4.14) < 0.001*** 1.48 (0.91–2.40) 0.115 Practice Location Urban Core (Ref:Suburban/Rural) 1.89 (1.13–3.16) 0.015* 1.63 (0.99–2.68) 0.054 Formal Preventive Training Yes (Ref: No) 3.12 (1.83–5.29) < 0.001*** 2.78 (1.64–4.71) 10 years (Ref: ≤10 years) 0.87 (0.54–1.41) 0.576 0.92 (0.57–1.48) 0.721 Primary Specialty Pediatric Dentistry (Ref: Others) 1.35 (0.76–2.41) 0.307 2.15 (1.19–3.88) 0.011* *Note: ¹High Knowledge: Composite knowledge score > median (4.0). ²Frequent Preventive Practice: Composite practice score > median (18.0). OR: odds ratio; CI: confidence interval; Ref: reference group. *p < 0.05, **p < 0.01, ***p < 0.001. "Trained" refers to dentists who received formal preventive training in the past 3 years. Discussion This study provides the first comprehensive assessment of KAP regarding preventive dental care for children among dentists in Urumqi. The findings reveal a dental workforce with positive attitudes toward prevention but constrained by knowledge gaps and systemic barriers, with significant urban‒rural disparities that mirror national child oral health inequities. Summary of Key Findings and Linkage to Child Health Outcomes Our survey identifies a critical intention-action gap: 78.4% of dentists believed prevention is more important than treatment, yet only 45.3% "always" applied sealants when indicated. Limited awareness of the 2024 National Children's Pit and Fissure Sealant Program (58.1%) directly contributes to low population-level sealant coverage (6.3%) in Urumqi [15]. The major barriers—low financial incentives (67.2%), lack of time (59.1%), and poor school coordination (52.4%)—explain the region's low caries filling rate (7.6%) and high disease burden [16–19]. These findings diagnose supply-side failures in translating evidence-based prevention into practice. Urban‒Rural Disparity: A Mirror of National Inequity Dentists in suburban/rural areas demonstrated lower preventive knowledge (3.9 vs. 4.4 in urban cores) and practice rates (31.5% vs. 48.2% for sealant application). This "provider-level disparity" exacerbates the national trend of higher caries prevalence in rural children, creating a vicious cycle: high-need areas lack adequately prepared providers. The gap stems from lower training coverage (43.4% vs. 51.2% in urban cores), limited infrastructure, and weaker school-dentist collaboration—issues of health justice requiring targeted resource allocation. Multifactorial Barriers: From Systemic Incentives to Parental Behavior Previous studies highlight individual factors (e.g., high sugar intake, poor brushing) as drivers of childhood caries [20]. Our findings complement this by identifying systemic disincentives: the fee-for-service model prioritizes restorative over preventive care, misaligning economic rewards with public health needs. This structural barrier explains the knowledge-practice gap and low treatment rates, requiring policy reforms beyond individual education. National Context: Comparative Insights Urumqi's challenges reflect both shared and amplified struggles across China. Shanghai's 11% decline in childhood caries over a decade [21]—driven by pay-for-performance incentives, mandatory training, and streamlined school coordination—demonstrates the impact of integrated policies. In contrast, Urumqi's low PHI awareness and participation highlight gaps in local policy execution. While low sealant (4.29%) and filling (15.75%) rates are shared with Beijing [22], Urumqi's more acute burden (20.19% first permanent molar caries rate) [23] underscores amplified impacts of systemic barriers in resource-limited regions. Implications and Recommendations Systemic interventions are needed to address identified gaps: Reform Economic Incentives: Pilot a pay-for-performance model (15% additional remuneration for sealant application and annual caries risk assessment) aligned with Shanghai's success [24–29]. Optimize PHI Implementation: Simplify administrative procedures, provide dedicated school-dentist liaisons, and offset time costs for outreach. Targeted Capacity Building: Mandate 12 CME credits/year (4 focused on PHI execution) with free online modules for suburban/rural dentists [30–32]. Integrated public campaigns: Address low parental awareness through coordinated messaging that reinforces clinical advice. Limitations and strengths This study has limitations: cross-sectional design prevents causal inference, self-reported practices may have social desirability bias, and nonprobability sampling limits generalizability. However, multipronged sampling ensured broad representation. Strengths include filling a regional knowledge gap, using a validated questionnaire, and linking dentist-level KAP to population health outcomes, providing actionable insights for policy and practice. Conclusion The oral health of children in Urumqi is threatened by both individual risk factors and systemic barriers limiting dentists' preventive potential. Urban‒rural disparities in provider preparedness exacerbate national inequities. By addressing knowledge gaps, economic disincentives, and implementation barriers, policymakers can empower dentists to reduce childhood caries and advance oral health equity across China. Abbreviations KAP Knowledge, Attitudes, and Practices PHI Public health initiatives Declarations Author contributions WA: Conceptualization, Data curation, Methodology, Project administration, writing original draft. AA (Abulajiang Anayeti): Data curation, Resources, Validation. GS: investigation, Visualization, Writing review and editing, Methodology, Visualization. TG: Software, Visualization, Writing review and editing. CTL: Data curation, Visualization, Writing review and editing. Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Data availability available from the corresponding author upon reasonable request. Clinical trial number not applicable Ethics approval and consent to participate This study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Institutional Review Board of The Fifth Affiliated Hospital of Xinjiang Medical University. Participation was voluntary, and electronic informed consent was obtained from all participants. The need for written informed consent was waived due to the anonymous nature of the survey. Consent for publication Not applicable. Not applicable competing interests The authors declare that they have no competing interests. Acknowledgments Not applicable. References Adanero A, Baquero L, Berasategui M, et al. Oral health status of 6- to 12-year-old children in Madrid, Spain: A cross-sectional study. Heliyon. 2022;8(6):e09557. https://doi.org/10.1016/j.heliyon.2022.e09557 Fiorillo L. Oral health: The first step to well-being. Medicina (Kaunas). 2019;55(10):676. https://doi.org/10.3390/medicina55100676 Wang X, Feng XP, Li ZX, et al. The Fourth National Oral Health Epidemiological Survey Report. Beijing: People's Medical Publishing House; 2018:39. Wang MY, Du S, Yu YZ, et al. 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Racial/ethnic disparities in preventive dental services use and dental caries among children. J Public Health Dent. 2023;83(2):161-168. doi: 10.1111/jphd.12563. Epub 2023 Mar 7. PMID: 36883255; PMCID: PMC10258156. Bonetti D, Clarkson JE. Fluoride Varnish for Caries Prevention: Efficacy and Implementation. Caries Res. 2016;50 Suppl 1:45-49. doi: 10.1159/000444268. Epub 2016 Apr 22. PMID: 27100219. Clarkson JE, Ramsay CR, Mannocci F, et al. Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth (PIP): a feasibility study. Pilot Feasibility Stud. 2022;8(1):77.doi: 10.1016/j.jdent.2019.06.005. Epub 2019 Jun 20. PMID: 31229496. Cushley S, Duncan HF, Lappin MJ, Tomson PL, Lundy FT, Cooper P, Clarke M, El Karim IA. Pulpotomy for mature carious teeth with symptoms of irreversible pulpitis: A systematic review. J Dent. 2019;88:103158. de Soet R, de Soet HJJ, Volgenant CMC. Oral Health and Oral Health-Related Beliefs in Young Adults With a Mild Intellectual Disability. Spec Care Dentist. 2025;45(1):e70011.doi: 10.1111/scd.70011. PMID: 39992082; PMCID: PMC11849441. Yi Mohammadi JJ, Franks K, Hines S. Effectiveness of professional oral health care intervention on the oral health of residents with dementia in residential aged care facilities: a systematic review protocol. JBI Database System Rev Implement Rep. 2015;13(10):110-122. doi: 10.11124/jbisrir-2015-2330. PMID: 26571287. Aierken W, Ayoufu A, Abuduweili R, et al. Knowledge and practice gaps in the emergency management practices of children with dental trauma: a cross-sectional survey among primary school health teachers and parents in Urumqi. BMC Oral Health. 2025;25:1480.https://doi.org/10.1186/s12903-025-06904-4 Ma T, Meng FQ, Han J, et al. Principal component analysis of factors related to dental caries in children aged 3–5 years in Urumqi. Journal of Prevention and Treatment for Stomatological Diseases. 2023;31(03):179-185. Zhang D. Dose‒response relationship between the frequency of sugary beverage intake and the incidence of dental caries in preschool children. In: China Association of Geriatric Health. Proceedings of the 4th Conference on the Integration of Traditional Chinese and Western Medicine to Facilitate Modern Medical Development (Vol. 2). Baoding Great Wall Yaboshi Dental Clinic; 2025:310-312. https://doi.org/10.26914/c.cnkihy.2025.066929 Xi YM, Zhang SS, Liu XN, et al. Analysis of economic burden and regional difference characteristics of deciduous tooth caries among 5-year-old children in China in 2005 and 2015. Chinese Journal of Practical Stomatology. 2025;18(05):585-592. https://doi.org/10.19538/j.kq.2025.05.013. Righolt AJ, Jevdjevic M, Marcenes W, Listl S. Global-, Regional-, and Country-Level Economic Impacts of Dental Diseases in 2015. J Dent Res. 2018 May;97(5):501-507. doi: 10.1177/0022034517750572. Epub 2018 Jan 17. PMID: 29342371. ZHANG Lili, LI Hui, BAO Wenya. Oral health status of children aged 6-12 years in Beijing[J]. South China Journal of Preventive Medicine, 2023, 49(4): 427-431. Sun HN, Zhou SY, Zhang CC, Hou L, Wang J. Prevalence and influencing factors of dental caries among children aged 6–12 years in Songjiang District, Shanghai. South China Journal of Preventive Medicine. 2024;50(12):1199-1202. Zhang LL, Li H, Bao WY. Oral health status of children aged 6-12 years in Beijing. South China Journal of Preventive Medicine. 2023;49(4):427-431. Wang M, Zhao H. Meta-analysis of dental caries prevalence among 5-year-old children in the Beijing-Tianjin-Hebei region. Medical Information. 2021;34(21):77-80+87. Zhang RH, Wang LP, Liu YS. Epidemiological survey of dental caries in children aged 7–9 years in Urumqi. Chinese Journal of Conservative Dentistry. 2018;28(04):229-232+196. DOI:10.15956/j.cnki.chin.j.conserv.dent.2018.04.008. Yu J, Zeng XL, Jiang YW, et al. Structural equation modeling of factors influencing oral health behaviors in Shanghai children. In: Chinese Stomatological Association, Committee of Preventive Dentistry. Proceedings of the 24th Annual Conference on Oral Prevention. Fudan University Affiliated Stomatological Hospital, Shanghai Stomatological Hospital; 2024:96. DOI:10.26914/c.cnkihy.2024.070555. Jevdjevic M, Listl S. Global, Regional, and Country-Level Economic Impacts of Oral Conditions in 2019. J Dent Res. 2025;104(1):17-21. doi: 10.1177/00220345241281698. Epub 2024 Nov 13. PMID: 39535193; PMCID: PMC11662506. Dunleavy G, Verma N, Raghupathy R, et al. Inequalities in oral health: estimating the longitudinal economic burden of dental caries by deprivation status in six countries. BMC Public Health. 2024;24:3239. doi: 10.1186/s12889-024-20652-0. PMID: 39574014; PMCID: PMC11580539. van Meijeren-van Lunteren AW, You Y, Raat H, Wolvius EB, Kragt L. Caries Preventive Interventions and Oral Health Inequalities: A Scoping Review. JDR Clin Trans Res. 2023;8(4):311-325. doi: 10.1177/23800844221109116. Epub 2022 Jul 31. PMID: 35912710; PMCID: PMC10504820. Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Community-based interventions to reduce dental caries among 24-month-old children: a pilot study of a field trial. BMC Oral Health. 2021;21:637. doi: 10.1186/s12903-021-01999-x. PMID: 34893041; PMCID: PMC8665609. Marshman Z, Ainsworth H, Fairhurst C, et al. Behavior change intervention (education and text) to prevent dental caries in secondary school pupils: BRIGHT RCT, process and economic evaluation. Health Technol Assess. 2024;28(52):1-142.doi: 10.3310/JQTA2103. PMID: 39258962; PMCID: PMC11417644. Kassebaum NJ, Smith AGC, Bernabé E, et al. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990–2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res. 2017;96(4):380-387. doi: 10.1177/0022034517693566. PMID: 28792274; PMCID: PMC5912207. Celis A, Conway DI, Macpherson LMD, McMahon AD. Data Resource Profile: National Child Oral Health Improvement Programmes for Chile. Int J Epidemiol. 2023;52(2):e110-e115. doi: 10.1093/ije/dyac191. PMID: 36264249; PMCID: PMC10115402. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8524531","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":603201081,"identity":"df414f3f-d355-4d5b-8ca2-2ab78660721c","order_by":0,"name":"Wusimanjiang Aierken","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7klEQVRIiWNgGAWjYNACHgYGfmbmAwYfGCRI0CLZ3pZQOIN4LUBgcOaMwWceYlTy859O/FwgY5fHcCPBcLPNH4s8/gbmh49u4NEiOSN3s/QMnuRixhkJyca5bRLFEgfYjI1z8LnnBu8GaR4e5sRmiYRjxrkNEokNB3jYpPFqOX92828envrENonE9t8WfyQS5xPUciB3G9CWw4k9PIcZjBnYJBI3ENIC9Ms2ax6e44kz2NsYDHuBdm08TMAv/PxnN9/m7alO3H+Y/4PBjz91ifOONz98jE8LGDD2IPOYCSkHgx9EqRoFo2AUjIKRCgAM+Uu5X1LpxAAAAABJRU5ErkJggg==","orcid":"","institution":"Fifth affliated hospital of Xinjiang medical unversitity","correspondingAuthor":true,"prefix":"","firstName":"Wusimanjiang","middleName":"","lastName":"Aierken","suffix":""},{"id":603201082,"identity":"ddaf1462-224d-4b01-a2e1-cc72d09e9450","order_by":1,"name":"Abulajiang Anayeti","email":"","orcid":"","institution":"Fifth affliated hospital of Xinjiang medical unversitity","correspondingAuthor":false,"prefix":"","firstName":"Abulajiang","middleName":"","lastName":"Anayeti","suffix":""},{"id":603201083,"identity":"c6722988-21b8-491d-ae4c-34a2a08bdb84","order_by":2,"name":"tao Guo","email":"","orcid":"","institution":"Fifth affliated hospital of Xinjiang medical unversitity","correspondingAuthor":false,"prefix":"","firstName":"tao","middleName":"","lastName":"Guo","suffix":""},{"id":603201084,"identity":"af7a0ed2-1f3d-410c-9edb-5f6193f4a3c1","order_by":3,"name":"Gulinuer Shawuti","email":"","orcid":"","institution":"Fifth affliated hospital of Xinjiang medical unversitity","correspondingAuthor":false,"prefix":"","firstName":"Gulinuer","middleName":"","lastName":"Shawuti","suffix":""},{"id":603201086,"identity":"3dedc872-3280-4359-8a03-f940d37e0cad","order_by":4,"name":"Chuntao Leng","email":"","orcid":"","institution":"Fifth affliated hospital of Xinjiang medical unversitity","correspondingAuthor":false,"prefix":"","firstName":"Chuntao","middleName":"","lastName":"Leng","suffix":""}],"badges":[],"createdAt":"2026-01-05 19:53:34","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8524531/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8524531/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104405806,"identity":"6f1f4dfb-f709-4f85-80d8-391956c1054a","added_by":"auto","created_at":"2026-03-11 12:23:52","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1370588,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8524531/v1/88c9bcbe-6e74-41c4-ba59-d2c3c37d7353.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessing preventive dental care in Urumqi: insights from a KAP survey of dentists regarding children's oral health","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe global burden of dental caries in children remains a significant public health challenge, with profound implications for quality of life, nutrition, and socioeconomic costs [1, 2]. In China, the situation is particularly pressing. The Fourth National Oral Health Epidemiological Survey reveals alarming rates: 71.9% of 5-year-old children have caries in their deciduous teeth, with an average of 4.24 decayed teeth per affected child [3, 4]. This prevalence is significantly higher in rural areas than in urban areas. Among 12-year-olds, the permanent tooth caries rate is 34.5%, representing an increase of approximately 5 percentage points over the past decade [5]. These figures underscore that dental caries is the most prevalent chronic disease threatening children's oral health in China, necessitating urgent, science-based preventive strategies and early intervention.\u003c/p\u003e \u003cp\u003eThe efficacy of evidence-based preventive interventions, such as fluoride application and pit and fissure sealants, is well established [6, 7]. However, a persistent gap exists between this evidence and its translation into routine clinical practice, often attributed to a historically curative-centric model of dental care [8\u0026ndash;10].\u003c/p\u003e \u003cp\u003eDentists are the primary gatekeepers for delivering clinical preventive care. Their knowledge, beliefs, and practices directly influence patient outcomes [8]. KAP surveys have been widely used to understand healthcare providers' adoption of preventive measures, revealing that factors such as age, gender, practice setting, and financial incentives significantly influence behavior [11\u0026ndash;13]. For instance, a recent study found that younger dentists had superior knowledge but faced greater time constraints, while gender influenced perceptions of remuneration for preventive services [12].\u003c/p\u003e \u003cp\u003e In the context of Northwest China, specifically the Xinjiang Uygur Autonomous Region and its capital Urumqi, oral health research has been limited. A previous study in Urumqi revealed critical knowledge gaps among schoolteachers and parents regarding the emergency management of dental trauma in children, highlighting a need for improved frontline response [14]. However, the preparedness of the professional dental workforce\u0026mdash;who is responsible for providing the cornerstone of clinical prevention (e.g., sealants, fluoride) and managing complex cases\u0026mdash;remains unassessed. This assessment is crucial following the launch of the 2024 national \"Children's Pit and Fissure Sealant Program,\" which aims to provide free preventive care. The program\u0026rsquo;s success hinges on dentist engagement, knowledge, and ability to overcome local implementation barriers.\u003c/p\u003e \u003cp\u003eUrumqi, as a major multiethnic urban center with distinct urban core, suburban, and rural districts, presents a unique microcosm to study how geography and resource distribution affect professional practice. This is especially relevant given the national survey's finding of higher caries rates in rural child populations. No study has yet examined the KAP of dentists in this region regarding integrated preventive care for children. Therefore, this study aimed to (1) evaluate the knowledge, beliefs, practices, and perceived barriers of dentists in Urumqi regarding preventive dental care for children; (2) analyze the associations between these factors and sociodemographic variables, particularly practice location; and (3) assess awareness and perceived challenges related to national oral health PHI. The findings will inform the development of targeted interventions to strengthen the preventive care capacity of the dental workforce in Urumqi and similar regions, contributing to the national goal of reducing the high burden of childhood caries.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Population\u003c/h2\u003e \u003cp\u003eA cross-sectional survey was conducted among dentists actively practicing in Urumqi between Apr and Oct 2025. The target population included general dentists and specialists involved in pediatric care across public hospitals, private clinics, and community health centers. Dentists who were retired, not currently in clinical practice, or practising outside Urumqi were excluded.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample Size and Sampling\u003c/h3\u003e\n\u003cp\u003eAssuming a population of approximately 2,500 dentists in Urumqi, a minimum sample size of 333 was calculated for a 95% confidence level, a 5% margin of error, and a 50% response distribution. A multipronged, nonprobability sampling strategy was employed to ensure broad representation. Invitations with a link to the online questionnaire were disseminated through 1) the Urumqi Stomatological Association mailing list; 2) professional WeChat groups of major public hospitals (e.g., The Fifth Affiliated Hospital of Xinjiang Medical University); and 3) networks of private dental clinic chains.\u003c/p\u003e\n\u003ch3\u003eQuestionnaire Development and Measures\u003c/h3\u003e\n\u003cp\u003eThe questionnaire was developed through a multistage process:\u003c/p\u003e \u003cp\u003eFramework Adaptation: The core structure was adapted from validated KAP surveys on preventive dentistry, including items from a published Italian study [10], ensuring international comparability.\u003c/p\u003e \u003cp\u003eContextualization: Items were modified and expanded to reflect the local context of Urumqi, including questions on awareness of the national \"Children's Pit and Fissure Sealant Program,\" practice location (urban core, suburban, rural), and barriers specific to implementing public health outreach.\u003c/p\u003e \u003cp\u003eIntegration with Prior Research: Knowledge items on dental trauma emergency management (e.g., avulsion \"golden time,\" storage media) were integrated, building directly on the findings of our team's prior study in Urumqi [14].\u003c/p\u003e \u003cp\u003eTranslation and Validity: The English version was translated into Chinese by a bilingual dental researcher and back-translated by an independent translator. Content validity was assessed by three pediatric dentistry experts. A pilot test with 20 dentists confirmed clarity and a completion time of 8\u0026ndash;10 minutes. The final questionnaire demonstrated good internal consistency (Cronbach's α\u0026thinsp;=\u0026thinsp;0.82 for knowledge, 0.79 for practices).\u003c/p\u003e \u003cp\u003eThe final questionnaire comprised five sections:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eSociodemographics: Age, gender, practice location, institution type, district, specialty, highest degree, and years of experience.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eKnowledge: 7 multiple-choice items (sugar intake, fluoride concentration, sealant timing, dental trauma emergency management). A composite knowledge score (0\u0026ndash;7) was calculated (1 point for each correct answer, 0 for incorrect).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eBeliefs and Perceived Roles: 3 items on a 4-point Likert scale (Strongly Agree to Strongly Disagree) assessing attitudes toward prevention vs. treatment, responsibility for trauma education, and proactive counseling for PHI.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePractices: 7 items on a 4-point frequency scale (Always to Never) regarding fluoride provision, sealants, dietary advice, oral hygiene instruction, caries risk assessment, school screenings, and trauma counseling. The composite practice score was calculated (Always\u0026thinsp;=\u0026thinsp;4, Often\u0026thinsp;=\u0026thinsp;3, Sometimes\u0026thinsp;=\u0026thinsp;2, Never\u0026thinsp;=\u0026thinsp;1).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eBarriers and Needs: Participants rated 12 potential barriers (Major/Minor/Not a Barrier) and selected areas needing improvement.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e\n\u003ch3\u003eData Collection and Analysis\u003c/h3\u003e\n\u003cp\u003eData were collected anonymously via the Wenjuanxing platform. Informed consent was obtained electronically. Data were exported to SPSS Statistics 27.0 for analysis. Descriptive statistics summarized participant characteristics and responses. Bivariate analyses (chi-square, t tests) explored associations between independent variables and dependent outcomes. Multivariate logistic regression identified predictors of \"high knowledge\" (score\u0026thinsp;\u0026gt;\u0026thinsp;median\u0026thinsp;=\u0026thinsp;4.0) and \"frequent preventive practice\" (score\u0026thinsp;\u0026gt;\u0026thinsp;median\u0026thinsp;=\u0026thinsp;18.0). Statistical significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003e \u003cstrong\u003eEthical approval\u003c/strong\u003e \u003cp\u003e was obtained from the Institutional Review Board of The Fifth Affiliated Hospital of Xinjiang Medical University (Approval No: XYDWFYLSK-2026-67). Participation was voluntary, and informed consent was secured from all participants.\u003c/p\u003e \u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eParticipant Characteristics\u003c/h2\u003e \u003cp\u003eA total of 332 valid responses were analyzed. The mean age was 41.3 years (SD\u0026thinsp;=\u0026thinsp;10.7). Most participants were female (63.5%), practiced in urban core areas (52.1%), and worked in public hospital dental departments (48.8%) or private clinics (38.5%). General dentists comprised 44.0% of the sample, followed by pediatric dentists (18.1%). Notably, 58.7% had\u0026thinsp;\u0026ge;\u0026thinsp;10 years of clinical experience, and 47.6% had received formal preventive training in the past 3 years (51.2% in urban core vs. 43.4% in suburban/rural areas) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of participating dentists in Urumqi (n\u0026thinsp;=\u0026thinsp;332)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ\u0026sup2; Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121 (36.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.173\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003efemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e211 (63.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47 (14.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.006**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u0026ndash;45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e140 (42.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46\u0026ndash;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115 (34.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePractice location\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban core\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e173 (52.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.003**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSuburban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e105 (31.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural (Urumqi County)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54 (16.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePractice institution type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePublic hospital dental department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e162 (48.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrivate dental clinic/hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e129 (38.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCommunity health service center\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28 (8.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDental outpatient department\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (3.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary specialty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral dentistry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e146 (44.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePediatric dentistry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60 (18.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOrthodontics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40 (12.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOral surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33 (10.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEndodontics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (8.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePeriodontics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18 (5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProsthodontics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0 (0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHighest academic degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCollege diploma or below\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35 (10.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.020*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor\u0026rsquo;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e210 (63.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster\u0026rsquo;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78 (23.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePhD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYears of clinical experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58 (17.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79 (23.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112 (33.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e83 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFormal preventive training (past 3 years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e158 (47.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eno\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e174 (52.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFormal preventive training by practice location\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eurban core (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e89 (51.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.050*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003esuburban/rural (Yes)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69 (43.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e*Note: Data are presented as n (%) unless otherwise stated. χ\u0026sup2;: Chi-square test. *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, **p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, ***p\u0026thinsp;\u0026lt;\u0026thinsp;0.001. Formal preventive training refers to systematic training on pediatric preventive dentistry (e.g., fluoride application, pit and fissure sealant placement) or dental trauma emergency management.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eKnowledge\u003c/h3\u003e\n\u003cp\u003eThe mean knowledge score was 4.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5 (range: 0\u0026ndash;7), with a median of 4.0. While 92.5% correctly identified milk as an acceptable storage medium for an avulsed tooth, only 58.1% were fully aware of the national sealant program. Knowledge scores were significantly higher among dentists aged\u0026thinsp;\u0026le;\u0026thinsp;45 years (4.5 vs. 3.8, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and those in urban cores (4.4 vs. 3.9, p\u0026thinsp;=\u0026thinsp;0.002) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKey knowledge and practice indicators of participating dentists, stratified by subgroups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"14\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal Sample (n\u0026thinsp;=\u0026thinsp;332)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAge\u0026thinsp;\u0026le;\u0026thinsp;45 years (n\u0026thinsp;=\u0026thinsp;187)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAge\u0026thinsp;\u0026gt;\u0026thinsp;45 years (n\u0026thinsp;=\u0026thinsp;145)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003et/χ\u0026sup2; Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eUrban Core (n\u0026thinsp;=\u0026thinsp;173)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSuburban/Rural (n\u0026thinsp;=\u0026thinsp;159)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003et/χ\u0026sup2; Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eTrained (n\u0026thinsp;=\u0026thinsp;158)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eUntrained (n\u0026thinsp;=\u0026thinsp;174)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003et/χ\u0026sup2; Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean knowledge score (\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.002**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e3.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e6.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAware of national sealant program (fully informed, n%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e193 (58.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e115 (61.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78 (53.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e109 (63.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e84 (52.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.046*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e112 (70.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e81 (46.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e22.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCorrectly identify milk as avulsed tooth storage medium (n%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e307 (92.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e174 (93.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e133 (91.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.548\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e160 (92.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e147 (92.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.998\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e148 (93.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e159 (91.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.323\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePractice\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eApply pit and fissure sealants \"Always\" (n%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e150 (45.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92 (49.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58 (40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.048*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e83 (48.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e67 (42.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e95 (60.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e55 (31.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e34.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParticipate in school-based screenings \"Always/Often\" (n%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e95 (28.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57 (30.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38 (26.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.337\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e62 (35.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e33 (20.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e10.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.001**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e63 (39.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e32 (18.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e22.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProvide oral hygiene instructions \"Always/Often\" (n%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e288 (86.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e162 (86.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e126 (86.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.917\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e150 (86.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e138 (86.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.989\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e137 (86.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e151 (86.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.985\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInform parents of dental trauma management \"Always/Often\" (n%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e172 (51.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e105 (56.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67 (46.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.041*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e98 (56.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e74 (46.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e0.047*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e108 (68.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e64 (36.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e44.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"14\"\u003e*Note: Data are presented as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or n (%) as appropriate. t: Independent samples t test; χ\u0026sup2;: Chi-square test. *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, **p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, ***p\u0026thinsp;\u0026lt;\u0026thinsp;0.001. The knowledge score ranges from 0\u0026ndash;7 (7 multiple-choice items). \"Trained\" refers to dentists who received formal preventive training in the past 3 years. Composite practice score median\u0026thinsp;=\u0026thinsp;18.0.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eBeliefs and practices\u003c/h2\u003e \u003cp\u003eThe majority (78.4%) agreed or strongly agreed that prevention is more important than treatment. Although 86.7% reported 'always' or 'often' providing oral hygiene instructions, only 45.3% reported the same frequency for applying sealants. Participation in school-based PHI was low (28.6% 'always' or 'often'). Dentists in suburban/rural areas had significantly lower frequencies of sealant application (31.5% vs. 48.2% in urban cores) and school program participation (19.3% vs. 35.7% in urban cores) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Trained dentists were more likely to recognize the primacy of prevention and proactively recommend PHI (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAttitudes toward preventive care and PHI among participating dentists (n\u0026thinsp;=\u0026thinsp;332)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"15\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c15\" colnum=\"15\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndicator\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse Category\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTotal Sample (n\u0026thinsp;=\u0026thinsp;332) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAge\u0026thinsp;\u0026le;\u0026thinsp;45 years (n\u0026thinsp;=\u0026thinsp;187) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAge\u0026thinsp;\u0026gt;\u0026thinsp;45 years (n\u0026thinsp;=\u0026thinsp;145) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eχ\u0026sup2; Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eUrban Core (n\u0026thinsp;=\u0026thinsp;173) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSuburban/Rural (n\u0026thinsp;=\u0026thinsp;159) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eχ\u0026sup2; Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\"\u003e \u003cp\u003eTrained (n\u0026thinsp;=\u0026thinsp;158) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c13\"\u003e \u003cp\u003eUntrained (n\u0026thinsp;=\u0026thinsp;174) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\"\u003e \u003cp\u003eχ\u0026sup2; Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c15\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrevention is more important than treatment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e105 (31.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62 (33.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e43 (29.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.734\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e56 (32.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e49 (30.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.917\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e68 (43.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e37 (21.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e18.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e155 (46.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e88 (47.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e67 (46.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e81 (46.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e74 (46.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e65 (41.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e90 (51.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28 (15.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25 (17.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e27 (15.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e26 (16.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e18 (11.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e35 (20.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (5.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e9 (5.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e10 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e7 (4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e12 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProactively recommend free PHI\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e98 (29.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57 (30.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e41 (28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.834\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e53 (30.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e45 (28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.865\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e61 (38.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e37 (21.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e14.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e162 (48.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89 (47.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e73 (50.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e84 (48.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e78 (49.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e69 (43.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e93 (53.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54 (16.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30 (16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24 (16.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e27 (15.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e27 (17.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e21 (13.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e33 (19.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18 (5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e9 (5.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e9 (5.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e7 (4.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e11 (6.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDisseminate dental trauma emergency knowledge is a core responsibility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121 (36.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e70 (37.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e51 (35.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.674\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e65 (37.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e56 (35.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.887\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e79 (50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e42 (24.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e26.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c15\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e148 (44.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e82 (43.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e66 (45.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e78 (45.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e70 (44.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e62 (39.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e86 (49.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47 (14.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25 (13.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e22 (12.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e25 (15.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e13 (8.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e34 (19.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStrongly Disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16 (4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10 (5.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6 (4.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8 (4.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e4 (2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e12 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c15\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"15\"\u003e*Note: χ\u0026sup2;: Chi-square test. *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, **p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, ***p\u0026thinsp;\u0026lt;\u0026thinsp;0.001. \"Trained\" refers to dentists who received formal preventive training in the past 3 years. PHI: public health initiatives.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003ePerceived Barriers\u003c/h2\u003e \u003cp\u003eThe most frequently cited 'Major Barriers' were low parental awareness/acceptance (71.7%), low financial incentives (67.2%), and lack of time (59.1%). Barriers specific to PHI included difficulties coordinating with schools (52.4%), complexity of procedures (48.8%), and extra time for outreach (55.1%). Dentists in suburban/rural areas perceived significantly greater barriers related to program coordination and lack of understanding of local procedures (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePerceived barriers to preventive care implementation among participating dentists (n\u0026thinsp;=\u0026thinsp;332)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBarrier\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eResponse Category\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTotal Sample (n\u0026thinsp;=\u0026thinsp;332) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUrban Core (n\u0026thinsp;=\u0026thinsp;173) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSuburban/Rural (n\u0026thinsp;=\u0026thinsp;159) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eχ\u0026sup2; Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eTrained (n\u0026thinsp;=\u0026thinsp;158) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eUntrained (n\u0026thinsp;=\u0026thinsp;174) n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eχ\u0026sup2; Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLow parental awareness/acceptance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMajor Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e238 (71.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e121 (69.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e117 (73.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.674\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e108 (68.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e130 (74.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.423\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMinor Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76 (22.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45 (26.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e31 (19.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e42 (26.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e34 (19.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot a Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e7 (4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8 (5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e10 (5.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLow financial incentive for preventive services\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMajor Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e223 (67.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e112 (64.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e111 (69.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e1.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.511\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e95 (60.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e128 (73.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e7.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e0.019*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMinor Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85 (25.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49 (28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e36 (22.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e52 (32.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e33 (19.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot a Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12 (6.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e12 (7.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e11 (7.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e13 (7.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDifficulties coordinating with schools (public health programs)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMajor Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e174 (52.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e78 (45.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e96 (60.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e9.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.010*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e65 (41.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e109 (62.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e18.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMinor Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e115 (34.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68 (39.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e47 (29.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e64 (40.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e51 (29.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot a Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (12.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27 (15.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16 (10.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e29 (18.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e14 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLack of understanding of local public health program procedures\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMajor Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e148 (44.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67 (35.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e81 (55.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e14.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e59 (34.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e89 (56.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e19.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMinor Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e132 (39.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e84 (44.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48 (33.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e79 (45.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e53 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNot a Barrier\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52 (15.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36 (19.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16 (11.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e35 (20.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e17 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"11\"\u003e*Note: χ\u0026sup2;: Chi-square test. *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, **p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, ***p\u0026thinsp;\u0026lt;\u0026thinsp;0.001. \"Trained\" refers to dentists who received formal preventive training in the past 3 years. Only key barriers are presented (aligned with the study focus on public health program implementation).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eRegression Analyses\u003c/h2\u003e \u003cp\u003eMultivariate logistic regression confirmed that younger age (OR\u0026thinsp;=\u0026thinsp;2.5, 95% CI 1.5\u0026ndash;4.1), urban practice location (OR\u0026thinsp;=\u0026thinsp;1.9, 95% CI 1.1\u0026ndash;3.2), and formal preventive training (OR\u0026thinsp;=\u0026thinsp;3.1, 95% CI 1.8\u0026ndash;5.2) were independent predictors of 'high knowledge'. Similarly, formal training (OR\u0026thinsp;=\u0026thinsp;2.8, 95% CI 1.6\u0026ndash;4.7) and stronger belief in prevention (OR\u0026thinsp;=\u0026thinsp;2.2, 95% CI 1.3\u0026ndash;3.7) predicted frequent preventive practices, while low financial incentives were a negative predictor (OR\u0026thinsp;=\u0026thinsp;0.5, 95% CI 0.3\u0026ndash;0.8) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariate logistic regression analysis of predictors for high knowledge and frequent preventive practices (n\u0026thinsp;=\u0026thinsp;332)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePredictor Variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh Knowledge\u0026sup1; (OR, 95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFrequent Preventive Practice\u0026sup2; (OR, 95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;45 years (Ref: \u0026gt;45 years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.51 (1.52\u0026ndash;4.14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.48 (0.91\u0026ndash;2.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.115\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePractice Location\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban Core (Ref:Suburban/Rural)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.89 (1.13\u0026ndash;3.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.015*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.63 (0.99\u0026ndash;2.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFormal Preventive Training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes (Ref: No)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.12 (1.83\u0026ndash;5.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.78 (1.64\u0026ndash;4.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale (Ref: Female)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.08 (0.68\u0026ndash;1.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.745\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.23 (0.77\u0026ndash;1.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.392\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYears of Clinical Experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;10 years (Ref: \u0026le;10 years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.87 (0.54\u0026ndash;1.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.576\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.92 (0.57\u0026ndash;1.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.721\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary Specialty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePediatric Dentistry (Ref: Others)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.35 (0.76\u0026ndash;2.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.307\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.15 (1.19\u0026ndash;3.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.011*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e*Note: \u0026sup1;High Knowledge: Composite knowledge score\u0026thinsp;\u0026gt;\u0026thinsp;median (4.0). \u0026sup2;Frequent Preventive Practice: Composite practice score\u0026thinsp;\u0026gt;\u0026thinsp;median (18.0). OR: odds ratio; CI: confidence interval; Ref: reference group. *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05, **p\u0026thinsp;\u0026lt;\u0026thinsp;0.01, ***p\u0026thinsp;\u0026lt;\u0026thinsp;0.001. \"Trained\" refers to dentists who received formal preventive training in the past 3 years.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study provides the first comprehensive assessment of KAP regarding preventive dental care for children among dentists in Urumqi. The findings reveal a dental workforce with positive attitudes toward prevention but constrained by knowledge gaps and systemic barriers, with significant urban‒rural disparities that mirror national child oral health inequities.\u003c/p\u003e \u003cp\u003eSummary of Key Findings and Linkage to Child Health Outcomes\u003c/p\u003e \u003cp\u003eOur survey identifies a critical intention-action gap: 78.4% of dentists believed prevention is more important than treatment, yet only 45.3% \"always\" applied sealants when indicated. Limited awareness of the 2024 National Children's Pit and Fissure Sealant Program (58.1%) directly contributes to low population-level sealant coverage (6.3%) in Urumqi [15]. The major barriers\u0026mdash;low financial incentives (67.2%), lack of time (59.1%), and poor school coordination (52.4%)\u0026mdash;explain the region's low caries filling rate (7.6%) and high disease burden [16\u0026ndash;19]. These findings diagnose supply-side failures in translating evidence-based prevention into practice.\u003c/p\u003e \u003cp\u003eUrban‒Rural Disparity: A Mirror of National Inequity\u003c/p\u003e \u003cp\u003eDentists in suburban/rural areas demonstrated lower preventive knowledge (3.9 vs. 4.4 in urban cores) and practice rates (31.5% vs. 48.2% for sealant application). This \"provider-level disparity\" exacerbates the national trend of higher caries prevalence in rural children, creating a vicious cycle: high-need areas lack adequately prepared providers. The gap stems from lower training coverage (43.4% vs. 51.2% in urban cores), limited infrastructure, and weaker school-dentist collaboration\u0026mdash;issues of health justice requiring targeted resource allocation.\u003c/p\u003e \u003cp\u003eMultifactorial Barriers: From Systemic Incentives to Parental Behavior\u003c/p\u003e \u003cp\u003ePrevious studies highlight individual factors (e.g., high sugar intake, poor brushing) as drivers of childhood caries [20]. Our findings complement this by identifying systemic disincentives: the fee-for-service model prioritizes restorative over preventive care, misaligning economic rewards with public health needs. This structural barrier explains the knowledge-practice gap and low treatment rates, requiring policy reforms beyond individual education.\u003c/p\u003e \u003cp\u003eNational Context: Comparative Insights\u003c/p\u003e \u003cp\u003eUrumqi's challenges reflect both shared and amplified struggles across China. Shanghai's 11% decline in childhood caries over a decade [21]\u0026mdash;driven by pay-for-performance incentives, mandatory training, and streamlined school coordination\u0026mdash;demonstrates the impact of integrated policies. In contrast, Urumqi's low PHI awareness and participation highlight gaps in local policy execution. While low sealant (4.29%) and filling (15.75%) rates are shared with Beijing [22], Urumqi's more acute burden (20.19% first permanent molar caries rate) [23] underscores amplified impacts of systemic barriers in resource-limited regions.\u003c/p\u003e \u003cp\u003eImplications and Recommendations\u003c/p\u003e \u003cp\u003eSystemic interventions are needed to address identified gaps:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eReform Economic Incentives: Pilot a pay-for-performance model (15% additional remuneration for sealant application and annual caries risk assessment) aligned with Shanghai's success [24\u0026ndash;29].\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eOptimize PHI Implementation: Simplify administrative procedures, provide dedicated school-dentist liaisons, and offset time costs for outreach.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eTargeted Capacity Building: Mandate 12 CME credits/year (4 focused on PHI execution) with free online modules for suburban/rural dentists [30\u0026ndash;32].\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eIntegrated public campaigns: Address low parental awareness through coordinated messaging that reinforces clinical advice.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eLimitations and strengths\u003c/p\u003e \u003cp\u003eThis study has limitations: cross-sectional design prevents causal inference, self-reported practices may have social desirability bias, and nonprobability sampling limits generalizability. However, multipronged sampling ensured broad representation. Strengths include filling a regional knowledge gap, using a validated questionnaire, and linking dentist-level KAP to population health outcomes, providing actionable insights for policy and practice.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe oral health of children in Urumqi is threatened by both individual risk factors and systemic barriers limiting dentists' preventive potential. Urban‒rural disparities in provider preparedness exacerbate national inequities. By addressing knowledge gaps, economic disincentives, and implementation barriers, policymakers can empower dentists to reduce childhood caries and advance oral health equity across China.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eKAP \u0026nbsp; \u0026nbsp; Knowledge, Attitudes, and Practices\u003c/p\u003e\n\u003cp\u003ePHI \u0026nbsp; \u0026nbsp; \u0026nbsp;Public health initiatives\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWA: Conceptualization, Data curation, Methodology, Project administration, writing original draft. AA (Abulajiang Anayeti): Data curation, Resources, Validation. GS: investigation, Visualization, Writing review and editing, Methodology, Visualization. TG: Software, Visualization, Writing review and editing. CTL: Data curation, Visualization, Writing review and editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eavailable from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003enot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Institutional Review Board of The Fifth Affiliated Hospital of Xinjiang Medical University. Participation was voluntary, and electronic informed consent was obtained from all participants. The need for written informed consent was waived due to the anonymous nature of the survey.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNot applicable\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ecompeting\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Not applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAdanero A, Baquero L, Berasategui M, et al. Oral health status of 6- to 12-year-old children in Madrid, Spain: A cross-sectional study. 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Effectiveness of professional oral health care intervention on the oral health of residents with dementia in residential aged care facilities: a systematic review protocol. JBI Database System Rev Implement Rep. 2015;13(10):110-122. doi: 10.11124/jbisrir-2015-2330. PMID: 26571287.\u003c/li\u003e\n\u003cli\u003eAierken W, Ayoufu A, Abuduweili R, et al. Knowledge and practice gaps in the emergency management practices of children with dental trauma: a cross-sectional survey among primary school health teachers and parents in Urumqi. BMC Oral Health. 2025;25:1480.https://doi.org/10.1186/s12903-025-06904-4\u003c/li\u003e\n\u003cli\u003eMa T, Meng FQ, Han J, et al. Principal component analysis of factors related to dental caries in children aged 3\u0026ndash;5 years in Urumqi. Journal of Prevention and Treatment for Stomatological Diseases. 2023;31(03):179-185.\u003c/li\u003e\n\u003cli\u003eZhang D. 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PMID: 29342371.\u003c/li\u003e\n\u003cli\u003eZHANG Lili, LI Hui, BAO Wenya. Oral health status of children aged 6-12 years in Beijing[J]. South China Journal of Preventive Medicine, 2023, 49(4): 427-431.\u003c/li\u003e\n\u003cli\u003eSun HN, Zhou SY, Zhang CC, Hou L, Wang J. Prevalence and influencing factors of dental caries among children aged 6\u0026ndash;12 years in Songjiang District, Shanghai. South China Journal of Preventive Medicine. 2024;50(12):1199-1202.\u003c/li\u003e\n\u003cli\u003eZhang LL, Li H, Bao WY. Oral health status of children aged 6-12 years in Beijing. South China Journal of Preventive Medicine. 2023;49(4):427-431.\u003c/li\u003e\n\u003cli\u003eWang M, Zhao H. Meta-analysis of dental caries prevalence among 5-year-old children in the Beijing-Tianjin-Hebei region. Medical Information. 2021;34(21):77-80+87.\u003c/li\u003e\n\u003cli\u003eZhang RH, Wang LP, Liu YS. Epidemiological survey of dental caries in children aged 7\u0026ndash;9 years in Urumqi. Chinese Journal of Conservative Dentistry. 2018;28(04):229-232+196. DOI:10.15956/j.cnki.chin.j.conserv.dent.2018.04.008.\u003c/li\u003e\n\u003cli\u003eYu J, Zeng XL, Jiang YW, et al. Structural equation modeling of factors influencing oral health behaviors in Shanghai children. In: Chinese Stomatological Association, Committee of Preventive Dentistry. Proceedings of the 24th Annual Conference on Oral Prevention. Fudan University Affiliated Stomatological Hospital, Shanghai Stomatological Hospital; 2024:96. DOI:10.26914/c.cnkihy.2024.070555.\u003c/li\u003e\n\u003cli\u003eJevdjevic M, Listl S. Global, Regional, and Country-Level Economic Impacts of Oral Conditions in 2019. J Dent Res. 2025;104(1):17-21. doi: 10.1177/00220345241281698. Epub 2024 Nov 13. PMID: 39535193; PMCID: PMC11662506.\u003c/li\u003e\n\u003cli\u003eDunleavy G, Verma N, Raghupathy R, et al. Inequalities in oral health: estimating the longitudinal economic burden of dental caries by deprivation status in six countries. BMC Public Health. 2024;24:3239. doi: 10.1186/s12889-024-20652-0. PMID: 39574014; PMCID: PMC11580539.\u003c/li\u003e\n\u003cli\u003evan Meijeren-van Lunteren AW, You Y, Raat H, Wolvius EB, Kragt L. Caries Preventive Interventions and Oral Health Inequalities: A Scoping Review. JDR Clin Trans Res. 2023;8(4):311-325. doi: 10.1177/23800844221109116. Epub 2022 Jul 31. PMID: 35912710; PMCID: PMC10504820.\u003c/li\u003e\n\u003cli\u003eDeghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Community-based interventions to reduce dental caries among 24-month-old children: a pilot study of a field trial. BMC Oral Health. 2021;21:637. doi: 10.1186/s12903-021-01999-x. PMID: 34893041; PMCID: PMC8665609.\u003c/li\u003e\n\u003cli\u003eMarshman Z, Ainsworth H, Fairhurst C, et al. Behavior change intervention (education and text) to prevent dental caries in secondary school pupils: BRIGHT RCT, process and economic evaluation. Health Technol Assess. 2024;28(52):1-142.doi: 10.3310/JQTA2103. PMID: 39258962; PMCID: PMC11417644.\u003c/li\u003e\n\u003cli\u003eKassebaum NJ, Smith AGC, Bernab\u0026eacute; E, et al. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990\u0026ndash;2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res. 2017;96(4):380-387. doi: 10.1177/0022034517693566. PMID: 28792274; PMCID: PMC5912207.\u003c/li\u003e\n\u003cli\u003eCelis A, Conway DI, Macpherson LMD, McMahon AD. Data Resource Profile: National Child Oral Health Improvement Programmes for Chile. Int J Epidemiol. 2023;52(2):e110-e115. doi: 10.1093/ije/dyac191. PMID: 36264249; PMCID: PMC10115402.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Preventive dental care, Knowledge, attitudes, and practices (KAP), Dentists, Children, Dental caries, Public health initiatives, Urumqi","lastPublishedDoi":"10.21203/rs.3.rs-8524531/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8524531/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eDental caries pose a severe public health threat to Chinese children. According to the Fourth National Oral Health Epidemiological Survey, the prevalence of dental caries is 71.9% among 5-year-olds (deciduous teeth) and 34.5% among 12-year-olds (permanent teeth), with a significant urban‒rural disparity. Effective preventive care is crucial to curb this trend, yet its integration into routine practice faces multifaceted barriers. In Urumqi, while previous research has highlighted gaps in emergency dental trauma management among nonprofessionals, the knowledge, practices, and perceived barriers of dentists\u0026mdash;the key providers of preventive care\u0026mdash;remain unexplored. This study aimed to assess these aspects among dentists in Urumqi, focusing on sociodemographic correlates and the impact of national Public Health Initiatives (PHI).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA cross-sectional online survey was conducted among dentists practicing in Urumqi from Apr to Oct 2025. A structured questionnaire adapted from international knowledge, attitudes, and practices (KAP) surveys and refined for the local context was distributed via dental associations and professional networks. It assessed 1) sociodemographics, 2) knowledge of preventive care and dental trauma, 3) beliefs regarding professional roles, 4) self-reported preventive practices, and 5) perceived barriers. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOf the 450 invited dentists, 332 valid responses were collected (response rate: 73.8%), with 1 incomplete questionnaire excluded\u0026mdash;slightly below the calculated minimum sample size of 333. The sample was 63.5% female, with the largest age group being 31\u0026ndash;45 years (42.2%). Only 58.1% were fully aware of the national \"Children's Pit and Fissure Sealant Program.\" Knowledge scores were significantly higher among younger dentists (\u0026lt;\u0026thinsp;45 years) and those working in urban cores (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). While 78.4% agreed that prevention is more important than treatment, only 45.3% reported \"always\" applying sealants when indicated. Key barriers included low parental awareness/acceptance (71.7%), low financial incentive (67.2%), and lack of time (59.1%). Dentists in suburban/rural areas reported significantly greater challenges in coordinating school-based PHI (p\u0026thinsp;=\u0026thinsp;0.01). Formal training in prevention was the strongest predictor of both higher knowledge (OR\u0026thinsp;=\u0026thinsp;3.1, 95% CI 1.8\u0026ndash;5.2) and frequent preventive practice (OR\u0026thinsp;=\u0026thinsp;2.8, 95% CI 1.6\u0026ndash;4.7).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eSignificant gaps exist in the knowledge and practice of preventive care among dentists in Urumqi, influenced by age, practice location, and training. The urban-suburban/rural disparity in dentist preparedness mirrors the national trend of higher caries prevalence in rural child populations. Despite positive attitudes, substantial systemic and perceptual barriers hinder implementation. The findings underscore an urgent need for targeted continuing education, enhanced policy support for public health program implementation, and strategies tailored to urban-suburban disparities to optimize preventive oral healthcare for children and address the high caries burden identified in the national survey.\u003c/p\u003e","manuscriptTitle":"Assessing preventive dental care in Urumqi: insights from a KAP survey of dentists regarding children's oral health","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-11 06:25:45","doi":"10.21203/rs.3.rs-8524531/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-03-23T02:50:20+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"72659427747098544013312432004062997328","date":"2026-03-12T14:48:00+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-05T13:57:46+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-10T08:14:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-12T11:01:26+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-12T10:56:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2026-01-05T19:44:13+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"91074534-af3a-4b07-b5a6-5d448737c5d9","owner":[],"postedDate":"March 11th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-11T06:25:45+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-11 06:25:45","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8524531","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8524531","identity":"rs-8524531","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}