Beliefs/Practices of Canadian Pediatric Dentists Regarding Caries-risk Assessment and Prevention

Objectives: To survey Canadian pediatric dentists to determine the risk stratification of children in their practices and to assess their beliefs/practices regarding caries-risk assessment and prevention in children.

Methods: A ten-item questionnaire was mailed in February, 2002 to all 175 members of the Canadian Academy of Pediatric Dentistry/Académie Canadienne de Dentisterie Pédiatrique in active practice. Survey items included caries-risk assessment (proportion of low/high caries-risk children; factors considered for caries-risk stratification), recall examination intervals, rubber cup pumice prophylaxis, professional topical fluoride application, and placement of dental sealants on permanent molars.

Results: The anonymous survey had a response rate of 50%. Respondents considered the following factors to be among their top five factors for classifying a child's caries-risk: dietary factors, oral hygiene, family dental history, socioeconomic status, dental history (past and present caries experience), fluoride exposure, and general health considerations. Eighty-one percent of respondents reported a positive disposition towards caries prevention based upon risk stratification of children. Seventy-four percent of respondents stated that the time interval between recall dental examinations should be individualized based upon assessment of the child's oral health status, mental and/or physical condition.

Fifty-one percent of respondents reported that greater than half of their patients were at high risk for caries; while 53% of respondents reported that low caries-risk patients comprised less than one-quarter of patients. Four out of five respondents reported that greater than half of the children in their practices would benefit from six-monthly professional topical fluoride application (81%) as also dental sealants on their permanent molars (85%). Fifty-three percent of respondents did not consider rubber cup pumice prophylaxis to be a required procedure prior to topical fluoride application. However, 59% of respondents considered rubber cup pumice prophylaxis as a required procedure prior to the placement of sealants.

Conclusions: Canadian pediatric dentists reported that many children in their practices were at high risk for dental caries and would benefit from six-monthly topical fluoride applications as also dental sealants on permanent molars.

(This survey was supported by the Canadian Academy of Pediatric Dentistry/Académie Canadienne de Dentisterie Pédiatrique).