Table 1. Questionnaire used to assess possible barrier factors.

	Item
General	Type of operator occupation and place of clinic Operator age Operator gender Year of graduation of operator School were operator has graduated Years working in present clinic
Barrier factors	Operators were asked to indicate whether they "strongly agree", "agree", are "undecided", "disagree" or "strongly disagree" with the following statements:
1. Patient load / work load	I have to treat too many patients during the day I have no time to do ART in my clinic ART fillings take longer to do than amalgam or composite fillings.
2. Operator opinion	I have attended the ART course and I find applying ART in the public clinic an effective service for patients When I do fillings, I prefer to use the drill, because I find it easier I consider ART an inferior treatment option as compared with other restorations I feel a sense of accomplishment when I am able to restore a tooth I feel better when I do not have to give a local anaesthetic. I feel a sense of accomplishment when I do not have to drill when preparing a cavity I prefer to use the drill because it is much quicker I prefer to use the drill because it is better I would like to spend more time rendering ART in my clinic
3. Patient opinion	In my clinic, patients prefer tooth extraction to restorations In my clinic, patients prefer ART to other tooth restorations My patients are very grateful and satisfied, if I restore their teeth using the ART technique. My patients are very grateful and satisfied, when I don’t have to inject them. My patients are very grateful and satisfied, when I don’t have to drill their teeth
4. Oral health service management	My clinic manager fully understands the concept of ART My clinic manager fully supports ART in our clinic
5. Material supply	I have a constant and adequate supply of ART materials to my clinic I have sufficient instruments available in my clinic, in order to render ART
6. Clinical ART skill	I have had adequate training, in order for me to feel confident when rendering ART I would like to have more training in the theoretical aspect of ART
7. Chair-side assistance	My chairside assistant is skilled to assist me in rendering ART