University of Washington School of Medicine, Department of Pediatrics (C Lewis), Seattle, Wash; Seattle Children's (C Lewis), Seattle, Wash.
Division of Pediatric Dentistry and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill (R Quinonez), Chapel Hill, NC.
Acad Pediatr. 2022 Nov-Dec;22(8):1443-1451. doi: 10.1016/j.acap.2022.06.008. Epub 2022 Jun 19.
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.
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, and attitudes about and barriers to oral health involvement. Predicted values from separate multivariable logistic regression models examined the independent effect of survey year.
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.
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.
口腔健康是儿童整体健康的关键组成部分，但过去的研究发现，儿科医生在将口腔健康纳入实践方面存在障碍。最近，政策进一步明确了口腔健康在初级医疗保健中的重要性。我们试图确定自 2008 年以来，儿科医生的实践和感知到的与口腔健康相关的障碍发生了怎样的变化。
对提供健康监督的美国儿科学会（AAP）成员进行了 3 次具有全国代表性的、横断面的、以口腔健康为重点的定期调查：2008 年（n=1104；回复率（rr）=69%）、2012 年（n=646；rr=48%）和 2018 年（n=485；rr=48%）。这些调查询问了儿科医生在 3 岁及以下儿童中进行口腔健康任务的频率、自我评估执行这些任务的能力，以及对口腔健康参与的态度和障碍。来自单独多变量逻辑回归模型的预测值检查了调查年份的独立影响。
2018 年，儿科医生报告说，他们更有可能在年幼时提供氟化物涂料和牙科转诊，而不太可能进行龋齿风险评估或口腔检查。他们报告说，将口腔健康纳入儿科实践的障碍有所减少。其他口腔健康活动，特别是口腔筛查检查和龋齿风险评估，仍然未被儿科医生充分利用。
从 2008 年到 2018 年，越来越多的儿科医生报告了一系列口腔健康任务的执行情况，报告的障碍减少。需要继续努力，提高儿科医生对所有儿科患者从婴儿期开始进行口腔筛查检查和龋齿风险评估的关注，并促进进一步使用氟化物涂料。
