"It's really no more difficult than putting on fluoride varnish":a qualitative exploration of dental professionals' views of silver diamine fluoride for the management of carious lesions in children

Background Despite evidence that Silver Diamine Fluoride (SDF) can be effective in managing carious lesions in primary teeth, the use of SDF in the UK remains limited. This study explored dental professionals’ views and experiences of using SDF for managing carious lesions in children. In addition, it explored what they perceived to be the advantages, disadvantages, barriers and enablers to the use of SDF in practice. Methods Fifteen semi-structured face-to-face or over-the-phone interviews were conducted with 14 dental professionals from NHS Tayside and NHS Grampian in Scotland. Interviews were transcribed verbatim, coded and analysed using a thematic approach. Results Thirteen of 14 dental professionals interviewed were familiar with, or had some existing knowledge of, SDF. Four had used it to treat patients. The majority of participants thought that the main advantage of SDF was that it required minimal patient cooperation. SDF was also perceived as a simple, pain-free and non-invasive treatment approach that could help acclimatise children to the dental environment. However, SDF-induced black staining of arrested carious lesions was most commonly reported as the main disadvantage and greatest barrier to using it in practice. Participants believed that this discolouration would concern some parents who may fear that the black appearance may instigate bullying at school and that others may judge parents as neglecting their child’s oral health. Participants thought that education of clinicians about SDF use and information sheets for parents would enhance the uptake of SDF in dental practice. Participants believed that younger children might not be as bothered by the discolouration as older ones and they anticipated greater acceptance of SDF for posterior primary teeth by both parents and children. Conclusion Dental professionals were aware that SDF can be used for arresting carious lesions. They pointed out that the staining effect of carious lesions is a major disadvantage that could be a barrier for many parents. Participants considered the application process to be simple and non-invasive and requires a minimum level of child cooperation. Participants appreciated the potential of SDF in paediatric dentistry and suggested actions that could help overcome the barriers they highlighted

Birds of a Feather can Butt Heads: When Machiavellian Employees Work with Machiavellian Leaders

Machiavellians are manipulative and deceitful individuals willing to utilize any strategy or behavior needed to attain their goals. This study explores what occurs when Machiavellian employees have a Machiavellian leader with the same negative, manipulative disposition. We argue that Machiavellian employees have a negative worldview and are likely to trust their leaders less. This reduced trust likely results in these employees experiencing higher stress and engaging in more unethical behavior. In addition, we expect these negative relationships to be exacerbated when such followers experience Machiavellian leadership. Thus, we test a moderated mediation model assessing whether Machiavellianism affects employees and whether combining Machiavellian leaders and Machiavellian employees is toxic in the sense of exacerbating the negative impact of Machiavellianism on employee trust. Results do not support the proposed conditional indirect effect of trust for either stress or unethical behavior. Instead, we find a conditional direct effect of employee Machiavellianism on both trust and stress: When Machiavellian employees have Machiavellian leaders, their trust in their leader significantly decreases, and their level of stress significantly increases. We also find support for an unconditional indirect effect of trust for employee stress (but not for unethical work behaviors), Machiavellianism in employees relates to stress via lowered trust in the leader. For unethical behavior, we only find a main effect of employee Machiavellianism