An examination of dental fluoride applications and the perspectives and approaches of parents, pediatric dentists and pediatricians

"An Examination of Dental Fluoride Applications and the Perspectives and Approaches of Parents, Pediatric Dentists and Pediatricians" Specialty Thesis, Trakya University Faculty of Dentistry, Department of Pediatric Dentistry, Edirne, 2025. Background and Aim: This study aimed to evaluate the knowledge levels, attitudes, and approaches of parents, pediatric dentists, and pediatricians regarding fluoride applications. It examined parents' information sources, reasons for hesitation, and decision-making processes; pediatric dentists' clinical approaches, communication strategies, and experiences with parents; and pediatricians' knowledge levels, referral practices, and perspectives on fluoride use. Materials and Methods: The study included parents of children under 13 years of age who applied to Trakya University Faculty of Dentistry (n=385), pediatric dentists working in the Trakya region (n=17), and pediatricians working in the same region (n=74). Separate questionnaires were prepared for the three target groups. Quantitative data were analyzed using SPSS 27.0, while open-ended questions were evaluated through thematic analysis with MAXQDA 24 software. Results: Among parents, 43.4% reported that their children used fluoride toothpaste, while 39.9% expressed concerns about fluoride applications. The most common source of information was dentists (65.1%), followed by the internet (19.8%) and pediatricians (19.0%). Misconceptions and concerns were mainly associated with online and social sources. All pediatric dentists recommended fluoride toothpaste and topical fluoride applications; however, there was wide variability in the recommended starting ages. Additionally, 52.9% stated that parental opposition to fluoride had increased, while the majority emphasized that informing parents positively influenced their attitudes. Among pediatricians, 49.3% reported lacking knowledge about topical fluoride, 56.1% believed fluoride prevents dental caries, but only 23% knew the appropriate fluoride concentration in children's toothpaste. Moreover, 44.6% supported dental fluoride applications and 43.2% supported school-based fluoride programs. Conclusion: This study revealed clear differences in knowledge and attitudes toward fluoride applications among parents, pediatric dentists, and pediatricians. Parents' knowledge and perceptions of safety were shaped by multiple factors, and misinformation contributed to hesitation. Pediatric dentists were identified as the most competent group, not only as practitioners but also in correcting misconceptions through accurate communication. However, the variation in recommendations regarding fluoride toothpaste and topical applications highlights the need for stronger adherence to standardized guidelines. Knowledge deficiencies among pediatricians limited their ability to provide accurate guidance and reduced the effectiveness of preventive dental care. To promote the acceptance of fluoride applications at the community level, parents' access to reliable information should be improved, pediatric dentists should strengthen communication strategies, and pediatricians should be supported in their guiding roles. Widespread adoption and dissemination of fluoride applications will only be possible through effective collaboration among these three complementary groups. Keywords: Fluoride, fluoride applications, parental attitudes, pediatric dentist, pediatrician