Knowledge and use of fluoride among Indiana dental professionals

Objectives: This study assessed the knowledge of Indiana dentists and dental hygienists about fluoride's predominant mode of action and their protocols for the use of fluoride for dental caries prevention. Methods: In 2000, questionnaires were mailed to 6,681 Indiana dentists and hygienists prior to the 2001 release of recommendations for the use of fluoride by the US Centers for Disease Control and Prevention. In 2005, the questionnaires were again sent to Indiana dental professionals to assess changes in knowledge and protocols. In addition, a 10 percent sample of Illinois dentists and hygienists were surveyed to determine the similarity of Indiana and Illinois responses. Results: Questionnaires were anonymously completed and returned. In 2000, a minority of Indiana health professionals (17 percent) correctly identified that remineralization was fluoride's predominant mode of action. There was a significant increase in Indiana respondents correctly identifying this predominant mode of action between 2000 and 2005 (17 percent versus 25 percent, respectively, P < 0.0001). Fourteen percent of Illinois respondents answered correctly in 2005. Preemptive incorporation of fluoride into enamel was the most frequently cited incorrect response (IN 2000, 79 percent; IN 2005, 71 percent; IL 2005, 82 percent). Some protocols for use of fluoride products reflected inadequate understanding of fluoride's predominant posteruptive mode of action. Conclusions: The majority of dental professionals surveyed were unaware of the current understanding of fluoride's predominant posteruptive mode of action through remineralization of incipient carious lesions. Additional research is indicated to assess fluoride knowledge and protocols of dental professionals nationwide. Educational efforts are needed to promote the appropriate use of fluoride.