Prevalence of Fluoride Treatments Among US Children, Associated Factors, and State-Level Variation

Professional fluoride treatment effectively reduces caries, but uptake remains low. This study identified factors associated with the report of professional fluoride treatment at dental visits (hereon referred to as fluoride treatment) among children aged 1-17 and examined state-specific variation in its prevalence.

We used the National Survey of Children's Health data from 2022 (n = 51,630). The primary outcome was fluoride treatment. Chi-square tests examined associations between the outcome and sociodemographic and other included variables, and a logistic regression model was used to obtain adjusted odds ratio estimates. State-specific prevalence of fluoride treatment was estimated for all 50 US states and DC, and 2022 estimates were compared with 2017 to examine differences. All analyses were weighted, accounting for the complex survey design.

The overall fluoride treatment prevalence in 2022 was 45.7%, and 32.7% of children had a preventive dental visit, but did not receive fluoride treatment. Children aged 1-5, non-Hispanic Black, non-Hispanic Asian and other, uninsured, in fair or poor health, with no preventive medical visit, living in low-income households, or with less-educated parents had a significantly lower report of fluoride treatment compared to their counterparts. State-specific fluoride treatment prevalence in 2022 varied widely. Compared to 2017, three states saw an increase and four states saw a decrease in prevalence in 2022 (p < 0.05).

Fluoride treatment prevalence among US children remains low overall and varies greatly across states. To improve fluoride treatment uptake, dental and medical providers and parents should be educated about its importance and need.