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Caries risk-based fluoride supplementation for children
Woosung Sohn1, Amid I Ismail, L Susan Taichman
1School of Dentistry, University of Michigan, Ann Arbor, MI, USA. woosung@umich.edu
Insights
Primary care physicians often overlook a child's specific cavity risk when prescribing fluoride supplements. Education is needed to help doctors tailor preventive care based on individual caries risk assessments.
Area of Science:
- Pediatric Dentistry
- Public Health
- Preventive Medicine
Background:
- Fluoride supplementation is a key strategy for preventing childhood caries.
- Current guidelines recommend tailoring fluoride use based on a child's caries risk.
- Primary care physicians play a crucial role in implementing preventive dental recommendations.
Purpose of the Study:
- To assess primary care physicians' (PCPs) adherence to caries risk-based fluoride supplement recommendations.
- To compare PCP decisions with expert consensus (CDC) for varying caries risk scenarios.
Main Methods:
- A national survey was conducted using mailed questionnaires with case scenarios of 2-year-old children (low vs. high caries risk).
- Participants included a representative sample of US family physicians (FPs) and pediatricians (PDs).
- Physician responses were compared against Centers for Disease Control (CDC) expert recommendations.
Main Results:
- Physician agreement with CDC recommendations was high for high-caries-risk children (76% FPs, 80% PDs).
- Agreement significantly dropped for low-caries-risk children (15% FPs, 7% PDs).
- Response rates were 43% for FPs and 52% for PDs.
Conclusions:
- Most PCPs do not consistently individualize fluoride supplement recommendations based on caries risk.
- Physicians require enhanced education to accurately identify and manage children at high risk for caries.
- Improved risk assessment education can optimize the effectiveness of preventive dental regimens.
Purpose:
The purpose of this study was to evaluate primary care physicians' recommendation of fluoride supplements based upon a child's caries risk.
Methods:
A representative sample of family physicians (FPs) and pediatricians (PDs) in the United States was mailed a letter and a questionnaire that described case scenarios of 2-year-old children-one with low and the other with high caries-risk -as well as questions about opinions on fluoride supplement use. The physicians' opinions were compared with CDC experts' consensus on the same scenarios.
Results:
The response rates were 43% for FPs and 52% for PDs. FPs and PDs had a high agreement level (76% ond 80%, respectively) with CDC experts regarding the need for fluoride supplementation of the high-risk child. For o low risk child, all physicians showed a significantly lower level of agreement with the CDC experts (15% for FPs; 7% for PDs).
Conclusions:
The majority of primary care physicians follow the current fluoride supplementation guideline without considering the caries risk status of a child. If caries risk status is to be used to tailor preventive regimens, then physicians need to be educated on how to identify children with the highest need for prevention.
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