Health Practitioner Knowledge, Attitude, Practices and Knowledge Acquisition on Fluoride

Objectives: An expert workgroup convened by the Centers for Disease Control and Prevention (CDC) formulated recommendations for the use of fluoride for the prevention and management of dental caries which were published this summer in a Morbidity and Mortality Monthly Report (MMWR). Recommendations were made in the areas of the public health and clinical practice, self-care, consumer products industry, health agencies and future research. They endorsed water fluoridation,the appropriate use of fluoridated toothpastes for all and the use of other fluoride modalities for individuals based on caries risk assessment. The CDC made three special interest project (SIP) awards to Prevention Research Centers at the Univ. of California- San Francisco, the Univ. of Texas- Houston and the Columbia University in the City of New York to study methods to disseminate and promote adoption of these recommendations by three groups of health professionals; public health workers (PHWs), dentists (DDSs) and physicians (MDs) respectively.

Methods: The three SIPs each collected a core set of data that assessed the baseline knowledge, attitudes and behaviors (KAB) and preferred education modalities of the selected health professionals with regards to fluoride use. The purpose of this analysis was to compare the baseline pre-test data amongst the groups.

Results: A sample of the analyses comparing DDSs in Houston, to MDs in New York, to a mix of PHWs in California indicate that DDSs tend to rely more on journals (p=0.0002)and less on peers (p=0.0001) than PHWs. Furthermore, DDSs had greater knowledge of the mechanisms of action of fluoride than MDs (p=0.001). Finally, all respondents require greater knowledge regarding the mechanism of action of fluoride and proper supplementation schedules.

Conclusion: Health professionals have different levels of KABs with respect to fluoride and perhaps even more importantly for the promotion of the CDC fluoride recommendations, rate the effectiveness of a variety of modalities of knowledge acquisition for this topic differently.