353 - Fluoride Refusal by Parents of Pediatric Dental Patients

Purpose: The objective of this study was to evaluate the characteristics of pediatric dental patients whose parents refused fluoride varnish compared to those who received fluoride varnish.

Methods: Data were abstracted through an EHR (Axium) chart review of University of Iowa Department of Pediatric Dentistry patients who did and did not receive fluoride varnish during at least one exam from 6/30/2018 to 1/1/2020. Subjects who were true fluoride refusers were matched by age and sex with those who received fluoride. A manual chart review was completed of the matched subjects. Statistical analyses consisted of descriptive and bivariate analyses (alpha=0.05).

Results: Over the study period, 3,652 subjects who received fluoride varnish were randomly selected for matching by age (±1 year) and sex with the 110 subjects who identified as true fluoride refusers. Subjects who had a self-pay arrangement were more likely to refuse fluoride than those with private insurance or Medicaid (82% vs. 47% or 48%; P=.021). Subjects who visited the Muscatine clinic were less likely to refuse fluoride than those who visited the Center for Disabilities and Development clinic or College of Dentistry clinic (24% vs. 48% or 57%; P=.038). Level of provider (dental student, resident, and faculty), history of caries, and Spanish speaking were not associated with fluoride refusal by parents of pediatric patients.

Conclusion: Type of insurance and dental clinic visited were associated with fluoride varnish refusal and should be considered when educating pediatric dental patients and their parents about the benefits of fluoride.