Abstract
Objectives
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.
Methods
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.
Results
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.
Conclusion
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
Abbreviations:
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)To read this article in full you will need to make a payment
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References
- National Call To Action To Promote Oral Health. Rockville, Maryland:National Institute of Dental and Craniofacial Research.National Institutes of Health, 2003
- American Academy of Pediatrics Section on Pediatric Dentistry. Oral health risk assessment timing and establishment of the dental home.Pediatrics. 2003; 111 (May): 1113-1116https://doi.org/10.1542/peds.111.5.1113
- American Academy of Pediatrics Section on Oral Health. Maintaining and improving the oral health of young children.Pediatrics. 2014; 134: 1224-1229https://doi.org/10.1542/peds.2014-2984
- Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement.Pediatrics. 2014; 133: 1102-1111https://doi.org/10.1542/peds.2014-0483
- Screening and interventions to prevent dental caries in children younger than 5 years: updated evidence report and systematic review for the US Preventive Services Task Force.JAMA. 2021; 326: 2179-2192https://doi.org/10.1001/jama.2021.15658
National Institutes of Health. Oral Health in America: Advances and Challenges. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Institute of Dental and Craniofacial Research, 2021.
- Oral health and pediatricians: results of a national survey.Acad Pediatr. 2009; 9: 457-461https://doi.org/10.1016/j.acap.2009.09.016
- Oral health opinions and practices of pediatricians: updated results from a national survey.Acad Pediatr. 2014; 14: 616-623https://doi.org/10.1016/j.acap.2014.07.001
- The role of the pediatrician in the oral health of children: a national survey.Pediatrics. 2000; 106: E84https://doi.org/10.1542/peds.106.6.e84
Oral Health Practice Tools. American Academy of Pediatrics. Accessed March 4, 2022. https://www.aap.org/en/patient-care/oral-health/oral-health-practice-tools/
- Effectiveness on early childhood caries of an oral health promotion program for medical providers.Am J Public Health. 2017; 107: S97-S103https://doi.org/10.2105/AJPH.2017.303817
- Assessment of New York primary care physicians' knowledge, attitudes, and practices related to fluoride varnish in an urban medical-setting.J Clin Pediatr Dent. 2020; 44: 249-255https://doi.org/10.17796/1053-4625-44.4.6
- Oral health prevention and toddler well-child care: routine integration in a safety net system.Pediatrics. 2016; 137e20143532https://doi.org/10.1542/peds.2014-3532
- A resident-led QI project to improve dental health at a primary care pediatric practice.J Grad Med Educ. 2020; 12: 571-577https://doi.org/10.4300/JGME-D-19-00959.1
- AAP Section on Oral Health. Fluoride use in caries prevention in the primary care setting.Pediatrics. 2020; 146e2020034637https://doi.org/10.1542/peds.2020-034637
- Fluoride and dental caries prevention in children.Pediatr Rev. 2014; 35: 3-15https://doi.org/10.1542/pir.35-1-3
- American Academy of Pediatric Dentistry. Oral health policies.Pediatr Dent. 1999; 21: 18-37
- Income-based disparities in a yearly dental visit in United States adults and children: trend analysis 1997 to 2016.Acad Pediatr. 2020; 20: 942-949https://doi.org/10.1016/j.acap.2020.06.003
- Fluoride varnish use in primary care: what do providers think?.Pediatrics. 2005; 115 (Jan): e69-e76https://doi.org/10.1542/peds.2004-1330
- Chapter Oral Health Advocates: a nationwide model for pediatrician peer education and advocacy about oral health.Int J Dent. 2013; 498906https://doi.org/10.1155/2013/498906
- Perception and utilization of oral screenings and fluoride application in medical offices following the Michigan caries prevention program training.J Dent Hyg. 2021; 95: 50-56
- American Academy of Political and Social Science. The nonresponse challenge to surveys and statistics.Ann Am Acad Pol Soc Sci. 2013; : 645
- Response rates and response bias for 50 surveys of pediatricians.Health Serv Res. 2005; 40: 213-226https://doi.org/10.1111/j.1475-6773.2005.00350
- Oral Health in America: A Report of the Surgeon General.National Institute of Dental and Craniofacial Research, National Institutes of Health, Rockville, MD2000
- Disparities in access to oral health care.Annu Rev Public Health. 2020; 41: 513-535https://doi.org/10.1146/annurev-publhealth-040119-094318
Article Info
Publication History
Accepted:
June 15,
2022
Received:
March 4,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Published by Elsevier Inc. on behalf of Academic Pediatric Association
