Incorporating Oral Health into Pediatric Practice: National Trends 2008, 2012, 2018



      Oral health is a critical component of children's overall health, but past research has found that pediatricians report barriers to implementing oral health into practice. Recently, policies have further delineated the importance of oral health in primary medical care. We sought to determine how pediatricians’ practices and perceived barriers related to oral health involvement have changed since 2008.


      There have been 3 nationally representative, cross-sectional, oral-health-focused periodic surveys of US American Academy of Pediatrics (AAP) members who provide health supervision: in 2008 (n=1104; response rate (rr)=69%), 2012 (n=646; rr=48%), and 2018 (n=485; rr=48%). The surveys asked about frequency of performing oral health tasks in children 3 years and younger, self-rated ability to perform these tasks, attitudes about and barriers to oral health involvement. Predicted values from separate multivariable logistic regression models examined the independent effect of survey year.


      In 2018, pediatricians reported they were more likely to provide fluoride varnish and dental referrals at a younger age and less likely to complete a caries risk assessment or oral examination. They reported diminished barriers to incorporating oral health into pediatric practice. Other oral health activities, notably the oral screening examination and caries risk assessment, remain underutilized by pediatricians.


      From 2008 to 2018, more pediatricians reported performing a range of oral health tasks with fewer reported barriers. Ongoing efforts are needed to increase pediatricians’ attention to oral screening examinations and caries risk assessments for all pediatric patients beginning in infancy, and to promote further use of fluoride varnish.

      Key Words


      AAP (American Academy of Pediatrics), CI (confidence interval), NIH (National Institutes of Health), PV (predicted value), rr (response rate), USPSTF (US Preventive Service Task Force)
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