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Updated: May 28, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Community-dwelling older adults' satisfaction and experiences with two non-surgical caries treatments: a mixed
Gloria C Bales1, Shelley Curtan1, Kelly Hickey1
1Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, OH, United States.
Introduction:
Silver Diamine Fluoride (SDF) and Atraumatic Restorative Treatment (ART) are effective non-surgical treatments for caries, but few studies have assessed the satisfaction of these treatments with older adults. Therefore, the objective of this study was to evaluate older adults' satisfaction with SDF and ART.
Methods:
The participants were part of a larger cluster-randomized clinical trial to investigate comparative effectiveness of SDF vs. ART. They were ≥62 years of age and lived independently in subsidized housing facilities. A mixed methods approach was used to evaluate satisfaction: 1) quantitatively utilizing a 6-item satisfaction survey completed by all participants at the final follow-up visit at 52 weeks; and 2) qualitatively by focus group discussions with randomly selected participants. Multiple data sources were used to increase data triangulation. Bivariate analyses were completed for surveys, and a thematic analysis was conducted for focus groups. The discussions were transcribed, coded, and analyzed for emerging themes.
Results:
Overall, 485 participants completed the satisfaction survey, and three focus groups were conducted with a total of 20 participants (n = 6-7 per group). The survey results indicated 97% overall satisfaction with SDF and ART. Over 90% of the participants were also satisfied with the treatments' ability to treat or prevent caries, ease, lack of side effects, and they were more likely to choose non-surgical treatments over those requiring drilling or needles. Focus groups further supported these findings, and five themes were identified: 1) determinants of participant satisfaction, 2) factors of dissemination, 3) benefits of non-invasive caries treatments, 4) issues related to delayed dental care, and 5) facilitators for receiving dental care. Focus group participants reported treatments as painless, convenient, relieved dental anxiety, effective, and would recommend to other older adults.
Conclusion:
These findings indicate high satisfaction levels for SDF and ART treatments in low-income community-dwelling older adults, and that they can be delivered in clinical and community settings.