Fluoride supplement prescribing and dental referral patterns among academic pediatricians
ABSTRACT To determine how well the current fluoride supplementation schedule was known by academic pediatricians and to examine the fluoride supplement prescribing and dental referral practices among primary care faculty pediatricians at four medical centers.
Four university medical centers in North Carolina.
Primary care faculty pediatricians.
A questionnaire pretested for clarity was distributed to all identified full-time primary care pediatric faculty (42 members).
A total of 40 completed questionnaires were returned. Thirty-seven (93%) primary care faculty pediatricians reported that they routinely addressed the need for fluoride supplements for their patients, but only 28 (70%) determined the fluoride content of the drinking water before prescribing supplements. Thirty-five (87.5%) began supplements at the correct age, but fewer knew the correct doses for children of various ages. Only 23 (58%) referred their patients for oral examination and preventive care before the age of 36 months, contrary to American Academy of Pediatrics recommendations.
Pediatricians in an academic setting would be expected to be more knowledgeable of current recommendations than those in private practice. Failure to know and teach correct fluoride supplement recommendations and failure to recommend early professional dental involvement can result in less than optimum oral health.
Current problems in pediatric and adolescent health care 10/2003; 33(8):253-70. DOI:10.1016/S1538-5442(03)00093-2 · 1.56 Impact Factor
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ABSTRACT: Due to a complex set of circumstances including culture, poverty, low educational achievement, and limited access to dental care, the oral health of rural Appalachians is poorer than that of people in other parts of Kentucky. Limited health care dollars go to primary medical care which may be the only contact these individuals have with the health care system. Consequently, primary care physicians can help improve oral health. The University of Kentucky College of Dentistry (UKCD) and the Pikeville College School of Osteopathic Medicine (PCSOM) developed an oral health education block for third-year PCSOM students. Eleven UKCD faculty and one PCSOM faculty participated in the two-day, sixteen-hour oral health curriculum. Knowledge retention data from the post-tests was collected four months after the educational program. Students significantly improved their performance in six of the topic areas, with performance staying the same in one area and dropping significantly in one area. Focus groups were conducted with sixteen (two groups of eight) randomly selected students one year after the educational program. Students reported using the knowledge and oral exam techniques included in the course and felt that it was a valuable addition to their curriculum.Journal of dental education 12/2002; 66(11):1289-96. · 1.04 Impact Factor
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ABSTRACT: Almost 20% of children aged 2 to 5 years have untreated dental caries. Physician interventions to prevent and manage dental caries in preschool children could help address this common problem. To review the evidence for effectiveness of five possible physician interventions- (1) screening and risk assessment, (2) referral, (3) provision of dietary supplemental fluoride, (4) application of fluoride varnish, and (5) counseling-for the prevention of dental caries for the U.S. Preventive Services Task Force. Articles from 1966 to 2001 addressing the effectiveness of primary care clinicians' interventions to prevent or manage dental caries were identified in MEDLINE. The evidence for effectiveness of supplemental fluorides, fluoride varnish, and counseling for caries prevention performed by dental personnel was also examined through existing and new systematic reviews. For most key questions related to the five interventions, the evidence for primary care clinician effectiveness was rated as poor owing to the scarcity of studies. Ten surveys of physicians' knowledge and behavior about fluoride supplementation provided fair evidence, suggesting that supplementation decisions were often made without consideration of other fluoride exposures. Reviews of the dental literature identified fair evidence supporting the effectiveness of both fluoride supplements and varnish, although information describing effectiveness and adverse outcomes of supplementation with the most recent dosage schedule is not available. Evidence for the effectiveness of traditionally recommended primary care clinician interventions (screening, referral, counseling) to prevent dental caries in preschool children is lacking. There is fair evidence for the effectiveness of two fluoride-based interventions (fluoride supplementation and varnish) applicable in primary care practice. However, there is also fair evidence indicating that physicians' consideration of fluoride exposure is incomplete, thus increasing the risk for fluorosis among those prescribed supplements.American Journal of Preventive Medicine 06/2004; 26(4):315-25. DOI:10.1016/j.amepre.2003.12.001 · 4.28 Impact Factor