Acceptability and Preferences for Early Childhood Caries Preventive Treatments

Determining treatment acceptability (TA) may assist in healthcare planning, resource allocation, implementation, and identifying treatment preferences (TP) among efficacious preventive dental treatments.

Objective: Determine parent/caregiver TA and TP of 5 preventive dental treatments for early childhood caries (ECC) in young Hispanic children.

Methods: We developed an acceptability interview to evaluate TA of five treatments: three for children- tooth brushing with fluoride toothpaste, fluoride varnish, and xylitol in food; and two for mothers- xylitol gum and chlorhexidine rinse. The assessment included presentation of: illustrated cards describing treatment with a verbal explanation; picture/video clip; and product samples. Parent/caregivers in Head Start (N=211) completed the interview, rated TA of each treatment (1-5 scale) and TP in each of 10 possible pairs. TP were summed to create overall preference (range 0–4). Participants provided open-ended explanations for their choices within each pair.

Results: We found that while each treatment was highly acceptable (means ranged 4.6-4.9), the Friedman two-way Rank Test showed that there were significant differences (Chi-Square = 23.4, p. < 001). Chlorhexidine, tooth brushing, and fluoride varnish were most acceptable, not different from each other, but more acceptable than xylitol gum or xylitol in food (p<.01). Summed TP revealed greater variability (means ranged 1.4-2.6; Friedman Rank Test, Chi-Square = 128.2, p. < .001). Fluoride varnish and brushing were preferred 1.8 times more than gum, 1.7 times more than xylitol in food, and 1.2 times more than chlorhexidine (all p < .001).

Conclusions: All 5 treatments were highly acceptable, however when choosing among treatments in pairs, overall, fluoride varnish and tooth brushing were favored over other treatments. These results may be useful in planning preventive treatment programs for young children in Hispanic communities.

Support: Funded by US DHHS NIH: NIDCR and NCMHD U54 DE14251.