The Role of the Pediatrician in the Oral Health of Children: A National Survey

• Published in: Pediatrics (Evanston) 2000-12, Vol.106 (6), p.e84-e84
• Main Authors: Lewis, Charlotte W, Grossman, David C, Domoto, Peter K, Deyo, Richard A
• Format: Article
• Language: English
• Subjects: Child; Dental Caries - prevention & control; Health Care Surveys; Health Knowledge, Attitudes, Practice; Health Promotion - statistics & numerical data; Health Services Accessibility - statistics & numerical data; Humans; Oral Hygiene - statistics & numerical data; Pediatrics; Pediatrics - statistics & numerical data; Physician's Role; Preventive Dentistry - statistics & numerical data; Random Allocation; Referral and Consultation - statistics & numerical data; Socioeconomic Factors; United States
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.106.6.e84

To assess pediatricians' knowledge, attitudes, and professional experience regarding oral health, and to determine willingness to incorporate fluoride varnish into their practices. Poor and minority children suffer disproportionately from dental caries and have limited access to dental care. In a recent analysis of national survey data, the General Accounting Office reported that poor children had 5 times more untreated decay than did children from higher income families. Untreated decay can lead to problems with eating, speaking, and attending to learning. Children who are poor suffer 12 times the number of restricted activity days because of dental problems, compared with more affluent children. Despite higher rates of dental decay, poor children had one half the number of dental visits compared with higher income children in 1996. Medicaid's Early Periodic Screening Diagnosis and Treatment (EPSDT) program is intended to provide regular dental screenings and appropriate treatment but has apparently played a limited role in improving access to dental care for poor children. According to a report by the Office of the Inspector General of the Department of Health and Human Services, only 20% of children under 21 years of age, who were enrolled in Medicaid and eligible for EPSDT, actually received preventive dental services. By increasing their involvement in oral health prevention during well-child care visits, pediatricians may be able to play an important role in improving the dental health of their patients who have difficulty obtaining access to professional dental care. However, it is unclear to what degree pediatricians are knowledgeable about preventive oral health and the extent to which they may already be participating in prevention and assessment. Also, little is known about the incidence of dental problems in pediatric practice, and whether pediatricians perceive barriers to their patients' receiving professional dental care. Finally, it is important to know how pediatricians value the promotion of oral health and whether they would be willing to take on additional activities aimed at its improvement. We addressed these questions in a national survey of pediatricians. We surveyed a national sample of 1600 pediatricians randomly selected from the American Medical Association Master File to assess their knowledge, current practice, and opinion on their role in the promotion of oral health; experience with dental decay among patients and in referri