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

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.