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Fluoride Prescribing Behaviors for Medicaid-Enrolled Children in Oregon
Journal article   Peer reviewed

Fluoride Prescribing Behaviors for Medicaid-Enrolled Children in Oregon

Alice Ko, Jordan T. Banks, Courtney M. Hill and Donald L. Chi
American journal of preventive medicine, Vol.62(2), pp.E69-E76
02/01/2022
DOI: 10.1016/j.amepre.2021.06.016
PMCID: PMC8748272
PMID: 34602339
url
https://www.ncbi.nlm.nih.gov/pmc/articles/8748272View
Open Access

Abstract

Introduction: This study aims to examine physician and dentist fluoride prescription patterns and identify the factors associated with fluoride prescriptions for Medicaid-enrolled children. The hypothesis is that dentists will be the primary prescribers of fluoride and that caries risk factors will be associated with fluoride prescriptions. Methods: Data were analyzed for Oregon children aged 0-17 years enrolled in Medicaid for >= 300 days in both 2016 and 2017. The outcome variable was receiving a fluoride prescription in 2017. A 2-tailed chi-square test was used to assess fluoride prescribing differences between physicians and dentists. Multivariable logistic regression models were used to examine the likelihood of receiving a fluoride prescription in 2017 and to generate ORs. Model covariates included child's age, sex, race, ethnicity, Medicaid plan type, previous fluoride prescription, previous restorative dental treatment, and water fluoridation status. Results: Of 200,169 Medicaid-enrolled children, 6.7% (n=13,337) received fluoride prescriptions. Physicians were >3 times as likely to prescribe fluoride as dentists (73.4% vs 23.0%, p<0.001). Children with a history of fluoride prescriptions (OR=14.30, p<0.001) and any restorative dental treatment (OR=1.58, p<0.001) were significantly more likely to receive a fluoride prescription, whereas children living in areas with water fluoridation were significantly less likely (OR=0.50, p=0.01). Conclusions: Physicians play an important role in prescribing fluoride to Medicaid-enrolled children, especially those at increased dental caries risk. Additional research is needed on strategies to ensure that all high-risk children have an opportunity to benefit from prescription fluoride. (C) 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Public, Environmental & Occupational Health Science & Technology

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