Fluoride Supplement Prescribing and Dental Referral Patterns Among Academic Pediatricians
Department of Surgery, Duke University, Durham, North Carolina, United States PEDIATRICS
(Impact Factor: 5.47).
02/1998; 101(1):E6. DOI: 10.1542/peds.101.1.e6
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.
Available from: Carmelo G A Nobile
- "Those pediatricians active for many years were trained and began practice in an era in which they provided care for their patients in virtually all settings, whereas in recent decades, pediatricians are now trained in residency programs where the scope of practice has become limited, wearing away their ability to provide comprehensive care to their patients. The pediatricians were also asked to indicate the correct dietary fluoride supplements to children who drank water with low fluoride level and our findings were in agreement with the results observed among primary care faculty pediatricians in the United States . Moreover, it should be stressed that pediatricians should be more accurately informed about techniques of individualized fluoridation, and this is relevant to public health because physicians who are not aware may form opinions about inappropriate supplementation, leading to poor decision making . "
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ABSTRACT: Pediatricians are in an ideal position to advise families about the prevention and management of oral diseases in children. The objective of the study was to determine knowledge, attitude, and practices regarding the prevention of oral diseases among pediatricians in Italy.
A systematic random sample of 1000 pediatricians received a questionnaire on socio-demographic and practice characteristics; knowledge on risk factors; attitude and practices towards the prevention of oral diseases.
A total of 507 pediatricians participated. More than half knew the main risk factors for oral diseases and this knowledge was higher in primary care pediatricians (p = 0.007), in those with a higher number of hours worked per week (p = 0.012), and who believed that oral diseases may be prevented (p = 0.017). Pediatricians with higher knowledge about the main risk factors (p = 0.006) believe that they have an important role in preventing oral diseases and that they can perform an oral examination. Almost all (89%) prescribed fluoride supplements and those younger (p = 0.016), with a higher number of patients seen in workday (p = 0.001), with longer practice activity (p = 0.004), those who believe that fluoride is effective in preventing caries (p < 0.0001), and who learned about prevention from scientific sources (p = 0.002) were more likely to prescribe fluoride. One-fourth and 40.6% provides and recommends a dental visit once a year and primary care pediatricians (p = 0.014) and those who believed that routine visit is important in preventing oral diseases (p < 0.0001) were more likely to recommend a dental visit once a year.
The results showed a lack of knowledge among pediatricians although almost all believed that they had an important responsibility in preventing oral diseases and provided an oral examination.
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ABSTRACT: The purposes of this study were to: describe children's drinking water sources; determine if any demographic factors are associated with water choice; describe parents' reasons for selecting bottled water; and determine parents' ability to provide enough information about their drinking water for providers to assess children's fluoride exposure.
Subjects were parents of children 6 months to 15-years-old. A questionnaire was verbally administered in English or Spanish. Chi-square analyses were used to evaluate associations among study variables.
Of 194 parents, 134 (69%) gave their children bottled water either exclusively or with tap water. Bottled water use was not significantly associated with the primary source of tap water, parent's education level, or household income. Reasons for giving children bottled water included: fear of contaminants in tap water; taste and/or smell of tap water; and convenience of bottled water. For parents using bottled water, over 65% did not know the brand's fluoride content.
Barriers to an accurate fluoride assessment include frequent bottled water use and parental uncertainty about its fluoride content. By initiating communication with parents and educating them about fluoride sources, health care and dental providers may be able to better evaluate the adequacy of children's fluoride exposure and decide whether fluoride supplementation is necessary.
Available from: Lisa J Heaton
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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.
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