Oral Health Instruction and Practices Among Iowa Family Physicians/Pediatricians

Objectives: Medical professionals serve more 0-to-36-month-old children when compared to dental professionals. However, lack of knowledge is one of the most significant barriers for medical professionals to provide oral-health related services for the prevention of early childhood caries (ECC). The objective of this study was to determine if Iowa Family Physicians and Pediatricians have ever received any instruction on topics related to oral/dental health during medical school, residency, fellowship, and/or continuing education courses. An additional objective was to investigate the impact that reported instructions during medical training had on oral-health knowledge, perceived comfort level, and practices among these health professionals.
Methods: A 17-item survey was mailed to all licensed family physicians (n=1648) and pediatricians (n=465) 75-years-old and younger in the state of Iowa. Bivariate and logistic regression analyses were used to analyze the data (alpha=0.1).
Results: The overall response rate was 28% (n=364). Mean age of participants was 48.8(SD=11.6) years. 80.8% reported receiving oral/dental health instructions. On average, participants saw 78.1(SD=36.8) patients a week with 19.7(SD=18.8) between 0-36 months-old. Bivariate analysis indicated that participants who reported receiving instructions were more likely to believe brushing with fluoride toothpaste prevents cavities (p=0.0488) and consider routinely applying fluoride varnish (p=0.0261). Moreover, they were more likely to feel comfortable examining teeth for caries (p=0.0003), identifying caries (p=0.0035) and oral pathology (p=0.0044), deciding if a child needs a dental referral (p=0.0705), and lifting the child’s lip to check for early signs of ECC 75-100% of the time (p=0.0809). Logistic regression analysis showed that participants who reported receiving instructions were more likely to believe cavities in young children start with white-spots (OR=1.78; p=0.0457) and feel comfortable evaluating caries-risk factors for tooth decay (OR=2.68; p=0.0011).

Conclusions: Reported oral/dental health instructions during medical training was positively related to physicians’ knowledge, comfort, and practices regarding important ECC-preventive oral-health care.