Parents' View and Awareness About Their Children's Fluoride Therapy: A Systematic Review

To deliver a comprehensive overview of scientific evidence on the parents' awareness and perception of fluoride use in their children's oral care routine.

Scientific literature search was conducted for the period from 1974 to February 2023, using the keywords 'fluoride, parents, attitude, perception, children'. Quality and Risk of Bias assessment was performed using the appropriate critical appraisal checklists.

The final list of records included 33 articles published from 2006 to 2022 (9 of which were excluded after critical appraisal). Findings revealed that 30% to 36.9% of parents were aware of the recommended frequency of fluoride toothbrushing, while 90.2% were unaware of the fluoride concentration in the toothpaste used for their children. Mostly, the parents supported the use of topical fluoride products. However, 40% of parents had concerns about the safety of fluoride varnish. Fluoride therapy refusal varied from 5% to 50% across different studies, and a relationship between fluoride and vaccination refusal was reported.

Many studies did not specifically focus on parental attitudes as a primary outcome. As a result, the interpretation of their findings may have been affected by the inadequacy or inappropriateness of the questionnaires used in these studies. However, a prominent finding across all studies was the notable deficiency of awareness and the lack of evidence-based scientific perspectives among parents. The findings highlight the need for further high-quality research and interventions to address the issue of fluoride refusal among parents and caregivers, particularly those who are more likely to do so.