Pediatricians’ oral health recommendations for 0- to 3-year-old children: results of a survey in Thuringia, Germany

BACKGROUND German societies of pediatricians and dentists disagree about oral health-related preventive recommendations (use of fluoride supplements, fluoride-containing toothpaste) for children aged 0-3 years. After failure to reach a consensus, there is no study that has evaluated the guidelines that pediatricians use in daily practice. METHODS A standardized questionnaire was sent to all 167 practicing pediatricians in the state of Thuringia, Germany, to assess the current oral health-related preventive recommendations. Data were analyzed using descriptive statistics. RESULTS The response rate was 52.0%. More than 9.0% of the pediatricians advise parents with regard to diet, use of baby bottles, oral hygiene and dental visits. The majority of pediatricians recommend to start tooth-brushing after the 1st birthday and recommend the use of toothpaste and a 1st dental visit after the 2nd birthday (78.0%). Additionally, 23.3% (n = 20) of pediatricians prescribe solely vitamin D, and 20.9% (n = 18) prescribe vitamin D combined with fluoride. Fluoride supplements are given as required by 37.2% (n = 32) of pediatricians, primarily between the 1st and 6th birthdays. The guidelines of the Pediatric Society were used by 1.2% of the pediatricians, the guidelines of the dentists were used by 5.8%, and a mix of both was used by 93.0%. The simultaneous use of fluoride supplements and fluoride toothpaste in the first three years was recommended by 45.9% of the pediatricians. CONCLUSIONS Pediatricians' oral health recommendations are based on a mix of the guidelines from the German societies of pediatricians and dentists and led to no use or possible overdose of fluoride. Against the background of early childhood caries and dental fluorosis, there is a need for uniform guidelines.