Pediatric Dental Providers' Experiences With Parent Refusal of Radiographic Imaging

Purpose: To investigate pediatric dental providers' experiences with parent radiographic imaging refusal and identify practice and parent characteristics associated with refusal. Methods: American Academy of Pediatric Dentistry (AAPD) members were invited via email in October and November 2024 to participate in an online questionnaire about radiograph imaging refusal (intraoral, extraoral, and cone beam computed tomography [CBCT]). Chi-square tests identified factors associated with refusal. Results: A total of 695 of 8,295 dental providers responded to the survey (8.4%). Most were women (60.7%) and White (71.8%). Between 9% and 23% reported parent radiographic imaging refusal as a big or medium-sized problem (intraoral=23%; extraoral=12%; CBCT=9%). Intraoral and extraoral refusal was more commonly reported by private practice providers (versus community health centers or university/hospitals) and providers treating fewer than 50% Medicaid-insured patients (versus more than 50% Medicaid-insured patients; P<0.05). Providers reported that parents who refused bitewing radiographs also tended to refuse fluoride and immunizations. Most providers (87.6%) continued to use lead shielding because of the belief that it improves acceptance of radiographs (71.9%). Conclusions: Parent intraoral radiography refusal is a commonly reported challenge in dentistry and highlights the importance of developing chairside strategies aimed at supporting parent decision-making and timely dental disease diagnosis and treatment.