Infant oral health- knowledge and practices among Israeli pediatricians

Background: The American Academy of Pediatrics (AAP) recommends pediatricians provide preventive dental services during well child care visits. However, little is known regarding the implementation of these recommendations by Israeli pediatricians. Objectives: The purpose of this paper was to assess knowledge, views and current practices, of Israeli pediatricians, in oral health promotion in toddlers, and to identify perceived barriers, in order to propose intervention or further research on this matter. Methods: A self-administered survey was distributed among 130 randomly selected pediatricians who participated at the annual conference of HIPAK (Israeli Clinical Pediatric Society). Results: Response rate was 67%. Eighty three percent of the pediatricians feel they play an important role in the oral health of toddlers. However, 50% don't always inquire about sweet beverages at night and only 63% examine the child's teeth. Only 43% think they should assess a child's risk to develop caries, and only 21% recommend the first dental visit at one year of age. 52% and 62% feel little or no confidence to assess a child's risk to develop caries or to identify early caries, respectively. Those who feel more confident to identify early caries and assess the risk for caries are more likely to carry out oral health related practices. Pediatricians that received oral health training during medical school or residency felt more confident to perform those practices. Conclusions: Although most pediatricians report to believe they play an important role in the oral health of toddlers, many don't carry out essential practices such as oral examination. Insufficient training and lack of skills and knowledge pose barriers to implementing the AAP's recommendations. Therefore additional training is needed to expand pediatricians' involvement in oral health promotion in toddlers, as well as adoption of the AAP's approach by the Israel Society of Pediatrics.