Elsevier

Academic Pediatrics

Volume 14, Issue 6, November–December 2014, Pages 616-623
Academic Pediatrics

Children's Oral Health
Oral Health Opinions and Practices of Pediatricians: Updated Results From a National Survey

https://doi.org/10.1016/j.acap.2014.07.001Get rights and content

Abstract

Background

Professional guidelines and state Medicaid policies encourage pediatricians to provide oral health screening, anticipatory guidance, and fluoride varnish application to young patients. Because oral health activities are becoming more common in medical offices, the objective of this study was to assess pediatricians' attitudes and practices related to oral health and examine changes since 2008.

Methods

As part of the 2012 Periodic Survey of Fellows, a random sample of 1638 members of the American Academy of Pediatrics was surveyed on their participation in oral health promotion activities. Univariate statistics were used to examine pediatricians' attitudes, practices, and barriers related to screening, risk assessment, counseling, and topical fluoride application among patients from birth to 3 years of age. Bivariate statistics were used to examine changes since 2008.

Results

Analyses were limited to 402 pediatricians who provided preventive care (51% of all respondents). Most respondents supported providing oral health activities in medical offices, but fewer reported engaging in these activities with most patients. Significantly more respondents agreed they should apply fluoride varnish (2008, 19%; 2012, 41%), but only 7% report doing so with >75% of patients. Although significantly more respondents reported receiving oral health training, limited time, lack of training and billing remain barriers to delivering these services.

Conclusions

Pediatricians continue to have widespread support for, but less direct involvement with oral health activities in clinical practice. Existing methods of training should be examined to identify methods effective at increasing pediatricians' participation in oral health activities.

Section snippets

Methods

Data on oral health promotion practices of pediatricians were collected as part of the AAP Periodic Survey of Fellows. The AAP conducts these surveys on topics of importance to pediatricians 3 to 4 times per year. Surveys are 8-page self-administered questionnaires sent to a unique random sample of nonretired US AAP members. Periodic Survey 82 was sent to 1638 AAP members between July and December 2012. Oral health assessment was 1 of 3 topics included in this survey, with questions replicated

Sample Characteristics

In 2012, 790 completed questionnaires were received for a response rate of 48%. To assess possible nonresponse bias, respondents and nonrespondents were compared on variables available from the AAP membership file. No significant differences were found for gender (57.0% female). Respondents were slightly older than nonrespondents on average (47 years vs 43 years; P < .001). Practice location varied significantly among respondents and nonrespondents, respectively (Northeast respondents, 22.5% vs

Discussion

Consistent with previous surveys, this national survey of pediatricians found support for preventive oral health activities in medical offices. Respondents agreed they should identify caries and provide counseling on oral hygiene practices and diet. Since 2008, more pediatricians agree they should apply fluoride varnish (2008, 19%; 2012, 41%). Despite agreement that oral health activities should occur during medical visits, pediatricians' participation in these activities continues to be

Conclusion

Pediatricians support providing oral health activities in medical offices. Although the number of pediatricians who received oral health training has grown, research is needed to identify how best to train pediatricians so that they are more confident engaging in these activities and more children receive quality preventive oral health services. Additional research should examine the varying state-level training requirements and payment, which might affect pediatricians' participation.

Acknowledgment

The views expressed in this article are those of the authors and do not necessarily represent those of the AAP.

Financial disclosure: This study was supported by the AAP. Dr Kranz received support from an NIH NRSA T90 Training Grant (Grant NIH/NIDCR 5T90DE021986-03).

Authorship Statement: Dr Quinonez conceptualized the study and drafted the manuscript with Dr Kranz. Dr Kranz provided additional data analysis. Dr Lewis conceptualized the study, designed the data collection instruments, and

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    The authors have no conflicts of interest to disclose.

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