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Member Research & Reports

Member Research & Reports

Washington Study Links Immunization Hesitancy to Topical Fluoride Refusal

Parents who refused to immunize their children also tended to turn down fluoride treatments for them, according to a study conducted by Dr. Donald Chi, adjunct associate professor of Health Services at the University of Washington School of Public Health.

Donald Chi

[Photo: Dr. Donald Chi]

The study, published in the American Journal of Public Health, found that parents who refused immunization for children under their care were 60 percent more likely to refuse topical fluoride treatment, which helps prevent tooth decay. The study looked at records from three dental clinics in Washington state and used follow-up surveys to caregivers. A total of 361 surveys were completed.

“Tooth decay is the most common chronic disease in children, affecting more than 40 percent of them,” said Dr. Chi, also an associate professor of oral health sciences in the School of Dentistry. “It can lead to toothaches, missed school, and poor grades. It’s a major public health problem.”

The study found that topical fluoride refusal rates ranged from 4.9 percent to 14.6 percent, which Dr. Chi termed high. At a population level, that translates to several million children who are not receiving evidence-based preventive dental care. Half of caregivers who refused topical treatment reported they were concerned about the safety of fluoride. Dr. Chi said the study results indicate that new tools for health providers and community-based strategies are needed to educate the public and to target the growing numbers of parents who are hesitant about preventive care.

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