In the UK, resin-bonded bridges (RBBs) are used regularly only by a minority of National Health Service (NHS) dentists despite evidence of their clinical effectiveness. Objectives: To identify barriers and examine attitudes to the use of RBBs in primary dental care. Methods: Using the payment database for dental services under the UK's NHS, we drew a nationally representative sample of 600 dentists stratified by usage of RBBs. Barriers and perceptions were examined using a set of 27 statements in a pre-validated postal questionnaire of the sample. These statements were generated from in-depth interviews of dentists and levels of agreement were scored using a five-point Likert scale. Results: The response rate was 62%. After weighting, 43% of dentists had placed 4 or more RBBs (high users) and 57% had placed 0-3 RBBs (low users) in the previous year. 94% of all respondents felt that RBBs were good for patients because they involved minimal tooth preparation and 71% would choose to have an RBB themselves if a bridge was indicated. 78% felt that the NHS fee structure was not cost effective. Low users were significantly more likely to express negative attitudes. High users saw RBBs as predictable and were confident in the technique (p<0.001). They more strongly agreed that postgraduate education had influenced their practice and were more likely to be aware of research evidence (p<0.001). Unlike high users, low users agreed that past failures had put them off and they were happy with the concept of removing sound tooth tissue for conventional bridgework (p<0.001). Undergraduate training did not seem to affect the pattern of usage. Conclusions: Most dentists accepted the clinical benefits of RBBs. Experience, training, attitudes to tooth preparation and the fee structure appeared to influence the use of RBBs by NHS primary care dentists. Supported by the NHS Executive, UK.

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