Caregivers’ understanding of fluoride varnish: implications for future clinical strategies and research on preventive care decision making

Donald, L.; Richman, Julia; Senturia, Kirsten; Zahlis, Ellen H.

doi:10.1111/jphd.12277

Cited by 4 publications

(8 citation statements)

References 8 publications

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“…Caregivers may have espoused differing views because the purpose and effects of each form of fluoride was not fully understood. This is consistent with a previous qualitative study reporting caregivers with incomplete information about the form, mechanism of action and source of fluoride 16 . No other studies have investigated differential decision‐making behaviours about fluoride.…”

Section: Discussionsupporting

confidence: 92%

“…This is consistent with a previous qualitative study reporting caregivers with incomplete information about the form, mechanism of action and source of fluoride. 16 No other studies have investigated differential decision-making behaviours about fluoride. As with childhood vaccines, it is important that caregivers receive tailored information about their child's specific risk of developing cavities, the benefits and sources of fluoride, the potential health consequences of skipping fluoride and compensatory health behaviours like reducing added sugar intake that could help reduce caries risk.…”

Section: Discussionmentioning

confidence: 99%

“…One study reported that 13% of caregivers refused topical fluoride treatments for their child during dental or medical visits 15 . Caregivers' concerns about fluoride include potential side effects and incomplete or inaccurate understanding of its purpose and how it prevents tooth decay 16 . While one study reported significant associations between topical fluoride and childhood vaccine refusal, 16 more recent findings suggest these are distinct behaviours 17 .…”

Section: Introductionmentioning

confidence: 99%

“…15 Caregivers' concerns about fluoride include potential side effects and incomplete or inaccurate understanding of its purpose and how it prevents tooth decay. 16 While one study reported significant associations between topical fluoride and childhood vaccine refusal, 16 more recent findings suggest these are distinct behaviours. 17 What is unknown is whether caregivers opposed to one form of fluoride are opposed to all forms, which is a critical knowledge gap that can uncover potential nuances in preventive care decision-making among caregivers.…”

Section: Introductionmentioning

confidence: 99%

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Fluoride hesitancy: A mixed methods study on decision‐making about forms of fluoride

Donald

2022

Comm Dent Oral Epid

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ObjectivesTo investigate whether professionally applied topical fluoride‐hesitant caregivers are also hesitant about other forms of fluoride for their child.MethodsThis was a mixed methods study of 56 caregivers hesitant about professionally applied topical fluoride for their child recruited from the University of Washington Center for Paediatric Dentistry and Seattle Children's Hospital's Odessa Brown Children's Dental Clinic. A 32‐item semi‐structured interview script was piloted and finalized. One‐time interviews with caregivers were conducted by phone in 2019. Associations between hesitancy of topical fluoride, fluoridated water and toothpaste were assessed quantitatively via two‐tailed chi‐squared tests. Qualitative data were coded using an inductive approach and content analytic methods to investigate reasons for hesitancy.ResultsThere were significant associations between hesitancy in all three pairwise comparisons of fluoride form (p < .01). Similar proportions of caregivers strongly or somewhat opposed fluoridated water compared with toothpaste (75% and 65%, respectively), but four times as many caregivers strongly or somewhat favoured fluoridated toothpaste compared to water for their child (25% and 7%, respectively). Concerns about harm were the most common reason caregivers opposed both fluoridated water and toothpaste. However, fluoride‐hesitant caregivers reported being more comfortable with fluoridated toothpaste because amount and frequency can be controlled, and ingestion can be prevented.ConclusionsProfessionally applied topical fluoride hesitancy is significantly associated with fluoridated water and toothpaste hesitancy, but caregivers who were hesitant about topical fluoride was more comfortable with fluoridated toothpaste than fluoridated water for their child.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Fluoride hesitancy: A mixed methods study on decision‐making about forms of fluoride

Donald

2022

Comm Dent Oral Epid

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“…This approach contrasts with the large body of research that emphasizes patient characteristics associated with receipt of preventive dental services-an approach that implicitly assigns responsibility for sealants to the patient, parent, or guardian. However, oral health literacy research suggests that many people lack the required knowledge to request specific preventive services for their child (Chi et al 2018).…”

Section: Discussionmentioning

confidence: 99%

Variation in General Dentists’ Patterns of Sealant Use in Children with Elevated Caries Risk

McKernan

Momany

Sukalski

et al. 2022

JDR Clinical & Translational Research

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Introduction: Strong evidence supports use of dental sealants to prevent tooth decay, and professional guidelines recommend use in children with elevated caries risk. However, not all children indicated for sealants receive this preventive intervention, even when they use routine dental care. Objective: The aim of this study was to explore the extent to which dentists’ use of sealants varied in pediatric patients with elevated caries risk. Methods: Claims and enrollment data from a private dental program were used to identify a cohort of 6- to 17-y-olds with elevated caries risk (N = 27,677) and general dentists (N = 818) who provided services to the children. Children were identified as having elevated caries risk based on history of restorative treatment over a 5-y period (2010–2014). The 2 outcomes of interest were whether a dentist provided any sealants to children with elevated risk and, if so, the extent to which these were used during a 2-y observation period (2013–2014). A 2-stage hurdle model was used for multivariable analysis to identify dentist characteristics associated with sealant use. Results: Over the observation period, 13.3% (n = 109) of dentists did not provide any sealants to their elevated risk patients from the study cohort. Logistic regression found that female dentists were significantly more likely to have used sealants (odds ratio = 2.27); dentist age and practice in an isolated small rural town were negatively associated with any sealant use. However, among dentists who did place sealants (n = 709), female dentists, older dentists, dentists in solo practice, and those working full-time were significantly more likely to provide sealants to a child. Overall, substantial variation in practitioners’ use of sealants was observed. Conclusion: This is the first study to explore provider-level variation in sealant use, representing a critical step in future efforts to increase routine use of sealants by dentists and eliminate oral health disparities. Knowledge Transfer Statement: Findings from this study can be used to design targeted policy and behavioral interventions to increase sealant use by general dentists. This study provides foundational evidence for future research that explores motivation and barriers to routine use of preventive dental interventions by clinicians.

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A Mixed-Methods Study on Topical Fluoride Beliefs and Refusal Behaviors for Caregivers of Children with Special Health Care Needs

Koh,

Kerr,

Hill

et al. 2023

Matern Child Health J

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Objective To understand topical fluoride-related beliefs and refusal behaviors for caregivers of children with special health care needs (CSHCN). Methods This was an explanatory sequential mixed methods study. For the quantitative analyses, we surveyed 520 caregivers to (a) compare fluoride-related beliefs between caregivers of CSHCN and caregivers of healthy children and (b) evaluate the association between special health care need (SHCN) status and topical fluoride refusal. We used logistic regression models to generate unadjusted odds ratios, confounder-adjusted odds ratios (AOR), and 95% confidence intervals (CI). For the qualitative analyses, we interviewed 56 caregivers who refused or were hesitant about topical fluoride. Data were coded deductively and compared by SHCN status to an existing conceptual model of topical fluoride refusal. Results In the quantitative analysis, 41.3% of caregivers refused or thought about refusing topical fluoride. There were no significant differences in fluoride beliefs by SHCN status (p-values > 0.05) nor was there a significant association between SHCN status and topical fluoride refusal (AOR: 0.65, 95% CI 0.37–1.14; p = 0.13). In the qualitative analysis, the relative importance of each domain of the conceptual model was similar between the caregiver groups. Two differences were that all caregivers of CSHCN thought fluoride was unnecessary and wanted to keep chemicals out of their child’s body. Conclusions for Practice While caregivers of CSHCN were not more likely to refuse topical fluoride than caregivers of healthy children, there may be important differences in the underlying reasons for refusing topical fluoride.

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Caregivers’ understanding of fluoride varnish: implications for future clinical strategies and research on preventive care decision making

Abstract: Many caregivers have an incomplete or inaccurate understanding of fluoride varnish, which has implications for how healthcare providers communicate about preventive care and future research on caregiver decision making.

Cited by 4 publications

References 8 publications

Fluoride hesitancy: A mixed methods study on decision‐making about forms of fluoride

Fluoride hesitancy: A mixed methods study on decision‐making about forms of fluoride

Variation in General Dentists’ Patterns of Sealant Use in Children with Elevated Caries Risk

A Mixed-Methods Study on Topical Fluoride Beliefs and Refusal Behaviors for Caregivers of Children with Special Health Care Needs

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