title: Oral health opinions and practices of pediatricians: updated results from a national survey.
abstract: BACKGROUND
  Professional guidelines and state Medicaid policies encourage pediatricians to provide oral health screening, anticipatory guidance, and fluoride varnish application to young patients. Because oral health activities are becoming more common in medical offices, the objective of this study was to assess pediatricians' attitudes and practices related to oral health and examine changes since 2008.
  
  
  METHODS
  As part of the 2012 Periodic Survey of Fellows, a random sample of 1638 members of the American Academy of Pediatrics was surveyed on their participation in oral health promotion activities. Univariate statistics were used to examine pediatricians' attitudes, practices, and barriers related to screening, risk assessment, counseling, and topical fluoride application among patients from birth to 3 years of age. Bivariate statistics were used to examine changes since 2008.
  
  
  RESULTS
  Analyses were limited to 402 pediatricians who provided preventive care (51% of all respondents). Most respondents supported providing oral health activities in medical offices, but fewer reported engaging in these activities with most patients. Significantly more respondents agreed they should apply fluoride varnish (2008, 19%; 2012, 41%), but only 7% report doing so with >75% of patients. Although significantly more respondents reported receiving oral health training, limited time, lack of training and billing remain barriers to delivering these services.
  
  
  CONCLUSIONS
  Pediatricians continue to have widespread support for, but less direct involvement with oral health activities in clinical practice. Existing methods of training should be examined to identify methods effective at increasing pediatricians' participation in oral health activities.
authors.affiliation: Department of Pediatric Dentistry and Pediatrics, Schools of Medicine and Dentistry, University of North Carolina at Chapel Hill. Electronic address: quinoner@dentistry.unc.edu.
authors.forename: Rocio B
authors.initials: RB
authors.lastname: Quinonez
authors.affiliation: Department of Dental Research, School of Dentistry, University of North Carolina at Chapel Hill.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Kranz
authors.affiliation: Division of General Pediatrics, University of Washington and Craniofacial Center, Seattle Children's Hospital, Seattle, Wash.
authors.forename: Charlotte W
authors.initials: CW
authors.lastname: Lewis
authors.affiliation: Division of Pediatric Practice, American Academy of Pediatrics, Elk Grove Village, Ill.
authors.forename: Lauren
authors.initials: L
authors.lastname: Barone
authors.affiliation: Department of Pediatrics and Community and Family Medicine, Geisel School of Medicine at Dartmouth Medical School, Hanover, NH.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Boulter
authors.affiliation: Department of Research, American Academy of Pediatrics, Elk Grove Village, Ill.
authors.forename: Karen G
authors.initials: KG
authors.lastname: O'Connor
authors.affiliation: Division of Surgery, Duke University, Durham, NC.
authors.forename: Martha Ann
authors.initials: MA
authors.lastname: Keels
mesh_terms: D001291:Attitude of Health Personnel; D002675:Child, Preschool; D003376:Counseling; D005260:Female; D005460:Fluorides, Topical / Q000008:administration & dosage; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D009909:Oral Health; D010372:Pediatrics; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D005460:Fluorides, Topical
keywords: education; fluoride; oral health; pediatrician; practice; prevention