Association Between Caregiver Opposition to Topical Fluoride and Dental Radiographs

Abstract

Purpose: The primary objective of this study was to examine the association between caregiver opposition to topical fluoride and opposition to dental radiographs. The secondary aim was to identify reasons for dental radiograph opposition. Methods: The study was conducted at six pediatric dentistry clinics, all affiliated with universities or hospitals. English-speaking caregivers of children aged < 18 years were eligible to participate. A 108-item web-based survey was administered from February to November 2024. The predictor variable was topical fluoride opposition (no/yes) and the outcome was dental radiograph opposition (no/yes). Confounder-adjusted logistic regression models were used to assess the association. Results: Nine-hundred-sixty-nine caregivers were included in the study. Mean child age was 7.4 years (SD 4.19), mean caregiver age was 40.6 years (SD 8.29), 81% of caregivers were female, 53% self-reported as white, and 56% were insured by Medicaid. Thirty-eight percent of caregivers were opposed to topical fluoride, and 31% were opposed to dental radiographs. There was a significant positive association between topical fluoride opposition and dental radiograph opposition (Odds Ratio = 7.04, 95% CI: 4.72-10.65, p < 0.001). The top three reasons for dental radiograph opposition were concerns about unknown future harm (58%), radiation accumulation (51%), and cancer risk (47%). Conclusions: Caregivers opposed to topical fluoride were significantly more likely to oppose dental radiographs for their child, emphasizing the need for targeted interventions and education focusing on common reasons for opposition.