Elsevier

Academic Pediatrics

Volume 9, Issue 6, November–December 2009, Pages 457-461
Academic Pediatrics

The Oral Health Workforce
Oral Health and Pediatricians: Results of a National Survey

https://doi.org/10.1016/j.acap.2009.09.016Get rights and content

Objective

Pediatricians have regular opportunities to perform screening dental examinations on young children and to educate families on preventive oral health. We sought to assess pediatricians' current attitudes and practices related to oral health of children 0–3 years old.

Methods

A Periodic Survey of Fellows, focused on oral health in pediatricians' office settings, was sent to 1618 postresidency fellows of the American Academy of Pediatrics.

Results

The response rate was 68%. More than 90% of pediatricians said that they should examine their patients' teeth for caries and educate families about preventive oral health. However, in practice, only 54% of pediatricians reported examining the teeth of more than half of their 0–3-year-old patients. Four percent of pediatricians regularly apply fluoride varnish. The most common barrier to participation in oral health–related activities in their practices was lack of training, which was cited by 41%. Less than 25% of pediatricians had received oral health education in medical school, residency, or continuing education. Most pediatricians (74%) reported that availability of dentists who accept Medicaid posed a moderate to severe barrier for 0–3-year-old Medicaid-insured patients to obtain dental care.

Conclusions

Pediatricians see it within their purview to educate families about preventive oral health and to assess for dental caries. However, many pediatricians reported barriers to fully implementing preventive oral health activities into their practices. Pediatricians and dentists need to work together to improve the quality of preventive oral health care available to all young children.

Section snippets

Methods

Data were collected via the AAP Periodic Survey of Fellows, which informs policy, developing initiatives, and modifying or evaluating existing projects.9 In 2008, Periodic Survey #70 focused on oral health within pediatric practices. Survey items were developed by the AAP Division of Health Services Research in conjunction with experts from the AAP Partnership to Reduce Oral Health Disparities in Early Childhood Project Advisory Committee. The survey addressed pediatricians' practices and

Characteristics of Respondents

After 7 mailings, 1103 completed questionnaires were returned, a response rate of 68.2%. Analyses were limited to the 698 postresidency pediatricians (63% of all respondents) who provide health supervision. The average respondent was in his or her 40s and worked full-time in direct patient care (Table 1). Most practiced in suburban communities and in group practices.

Training in Oral Health Care

Approximately 36% of respondents reported previous oral health training: 13% had received at least some during medical school, 16%

Discussion

These results indicate that pediatricians see it within their purview to educate families about preventive oral health and to assess patients for dental caries. However, relatively fewer respondents reported actually performing oral health–related activities. This discrepancy highlights the complexity of adopting new practices and adhering to recommendations. Lack of confidence in one's abilities, particularly for performing a dental examination and applying fluoride varnish, seems to diminish

Acknowledgments

Dr Mouradian acknowledges the US Department of Health and Human Services, Maternal and Child Health Bureau Leadership Education in Pediatric Dentistry grant (T17MC000020), the Dental Trade Alliance Foundation, the Washington Dental Service/Washington Dental Service Foundation, and the Oral Health Institute for support of this work.

Funded by a grant from the US Department of Health and Human Services, Maternal and Child Health Bureau (G97MC06336-01), and supported by the American Academy of

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