Department of Health Systems and Population Health, University of Washington, Seattle, Washington, United States of America.
Department of Oral Health Sciences, University of Washington, Seattle, Washington, United States of America.
PLoS One. 2024 Jul 19;19(7):e0307085. doi: 10.1371/journal.pone.0307085. eCollection 2024.
The goal of this study was to describe medical providers' fluoride-related beliefs and practices, experiences with fluoride-hesitant caregivers, and barriers to incorporating oral health activities into their practice. In this cross-sectional study, we specifically tested the hypothesis of whether these factors differed between pediatric and family medicine providers. A 39-item online survey was administered to a convenience sample of pediatric and family medicine providers in Washington state and Ohio (U.S.A.). Responses to the fluoride survey were compared between pediatric and family medicine providers with a chi-square test (α = 0.05). Of the 354 study participants, 45% were pediatric providers and 55% were family medicine providers. About 61.9% of providers believed fluoridated water was highly effective at preventing tooth decay while only 29.1% believed prescription fluoride supplements were highly effective. Nearly all providers recommend over-the-counter fluoride toothpaste (87.3%), 44.1% apply topical fluoride in clinic, and 30.8% prescribe fluoride supplements. Most providers reported fluoride hesitancy was a small problem or not a problem (82.5%) and the most common concerns patients raise about fluoride were similar to those raised about vaccines. Lack of time was the most commonly reported barrier to incorporating oral health into practice, which was more commonly reported by family medicine providers than pediatric providers (65.6% vs. 50.3%; p = .005). Pediatric and family medicine providers have early and frequent access to children before children visit a dentist. Improving the use of fluorides through children's medical visits could improve pediatric oral health and reduce oral health inequities, especially for vulnerable populations at increased risk for tooth decay.
本研究旨在描述医疗服务提供者的氟化物相关信念和实践，以及他们与氟化物抵触的照护者打交道的经验，以及将口腔健康活动纳入其常规治疗的障碍。在这项横断面研究中，我们特别检验了以下假设，即这些因素是否在儿科和家庭医学提供者之间存在差异。我们向华盛顿州和俄亥俄州（美国）的儿科和家庭医学提供者进行了一项 39 项在线调查。使用卡方检验（α = 0.05）比较儿科和家庭医学提供者对氟化物调查的回答。在 354 名研究参与者中，45%为儿科提供者，55%为家庭医学提供者。约 61.9%的提供者认为加氟水在预防龋齿方面非常有效，而只有 29.1%的提供者认为处方氟化物补充剂非常有效。几乎所有的提供者都推荐使用非处方氟化物牙膏（87.3%），44.1%在诊所使用局部氟化物，30.8%开氟化物补充剂。大多数提供者报告说氟化物抵触是一个小问题或不是问题（82.5%），患者对氟化物提出的最常见担忧与对疫苗提出的担忧相似。缺乏时间是将口腔健康纳入常规治疗的最常见障碍，家庭医学提供者比儿科提供者更常报告这一障碍（65.6%比 50.3%；p =.005）。儿科和家庭医学提供者在儿童看牙医之前很早就有机会频繁接触儿童。通过儿童的医疗访问来改善氟化物的使用，可以改善儿科的口腔健康，并减少口腔健康方面的不平等，特别是对那些有增加龋齿风险的脆弱人群。
