Caries risk-based fluoride supplementation for children

Purpose: The purpose of this study was to evaluate primary care physicians' recommendation of fluoride supplements based upon a child's caries risk. Methods: A representative sample of family physicians (FPs) and pediatricians (PDs) in the United States was mailed a letter and a questionnaire that described case scenarios of 2-year-old children-one with low and the other with high caries-risk-as well as questions about opinions on fluoride supplement use. The physicians' opinions were compared with CDC experts' consensus on the some scenarios. Results: The response rates were 43% for FPS and 52% for PDs. FPS and PDs had a high agreement level (76% and 80%, respectively) with CDC experts regarding the need for fluoride supplementation of the high-risk child. For a low risk child, all physicians showed a significantly lower level of agreement with the CDC experts (75% for FPs; 7% for PDs). Conclusions: The majority of primary care physicians follow the current fluoride supplementation guideline without considering the caries risk status of a child. If caries risk status is to be used to tailorpreventive regimens, then physicians need to be educated on how to identify children with the highest need for prevention.