Pediatric dentists who accept new Medicaid-enrolled children report higher willingness to advocate for community water Fluoridation

Abstract

Abstract Background Dentists, who advocate for Community Water Fluoridation (CWF), can help decrease the dental caries disparity gap between low and high socioeconomic groups. Advocating for CWF, a cause that promotes oral health at the population level is an altruistic behavior. Dentists who accept and provide services to Medicaid-insured children, who are from low socioeconomic backgrounds, are also considered altruistic. We tested the association between accepting new Medicaid-insured children every month, and willingness to advocate for CWF programs in pediatric dentists (PDs). Methods In 2016, a 22-item pilot tested online survey was sent to 5394 PD members of the American Academy of Pediatric Dentistry. Descriptive analysis and a multiple adjusted logistic regression model was conducted. Results Dentists who accept new Medicaid-insured children every month (OR: 1.62; 95% CI: 1.06–2.47; p = 0.02) were more willing to advocate for CWF compared to their counterparts. Those practicing primarily in rural (OR = 4.67; 95% CI: 1.82–11.9; p = 0.001), and urban areas (OR = 2.27; 95%CI: 1.05–4.89; p = 0.04), and those willing to promote fluoridated water consumption to parents in the clinic (OR = 3.40; 95% CI: 1.87–6.21; p = < 0.0001) were significantly more likely to be willing to advocate for CWF. PDs trained in public health advocacy during pediatric residency alone (OR = 2.37; 95% CI: 1.24–4.51; p = 0.009), or during both pre-doctoral dental education and pediatric residency (OR = 3.51; 95% CI: 1.87–5.6; p = < 0.0001) were more willing to advocate for CWF compared to their counterparts. Conclusions PDs who accepted new Medicaid-insured children every month were more willing to advocate for CWF programs compared to those who did not.

Keywords

• Fluoridation
• Advocacy
• Oral health advocacy
• Medicaid
• Social responsibility
• Rural dentists