The association between intensive parenting attitudes and topical fluoride opposition

Abstract

Introduction. Despite evidence that topical fluoride is safe and effective, opposition to it is a growing clinical and public health challenge. Intensive parenting attitudes may affect a caregiver’s preventive care decision-making for their children, including decisions about fluoride, but no studies exist on how intensive parenting attitudes influence topical fluoride opposition. The objective of this study is to investigate the association between intensive parenting attitudes and topical fluoride opposition. Methods. This was a secondary analysis of data on caregivers’ beliefs about fluoride for their children. An 85-item survey was administered from November 2020 to September 2021 (N=1,135). Participants were eligible if they were an English-speaking caregiver of a child under 18 years. The outcome variable was topical fluoride opposition, defined as how opposed the caregiver was to topical fluoride for their child (self-reported scale of 0-10). The explanatory variable was intensive parenting attitudes, defined as the extent of child-centered, time-intensive, and self-sacrificing parenting, measured as a composite score from three survey items. Linear regression was used to test the study hypothesis, adjusting for confounders. All analyses were performed in SPSS. Results. The mean±SD caregiver age was 41.7±8.8 years, with most caregivers being women (73.0%), white (55.5%), non-Hispanic (79.3%), having greater than a 4-year degree (28.5%), and having private dental insurance (45.1%). The mean±SD topical fluoride opposition score was 2.0±3.1, and the mean±SD intensive parenting attitudes score was 1.7±0.4. After adjusting for confounders, a 1-point increase in intensive parenting attitudes score was associated with a 0.3-point increase in topical fluoride opposition score (95% CI: 0.1, 0.4; p<0.001). Conclusions. Intensive parenting attitudes were significantly and positively associated with topical fluoride opposition. Clinicians can utilize these findings to assess caregivers’ intensive parenting attitudes, learn about concerns, and address them by tailoring communication strategies to discuss appropriate risk-based recommendations about topical fluoride.