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Mothers' Sources of Information and Misinformation Regarding Fluoride Treatments in Children From Social Connections
TAKE-HOME MESSAGE
- This qualitative study of 126 mothers with children aged between 3 and 5 years evaluated the social relationships from which mothers received information and misinformation regarding fluoride treatments in children and how the information received affected child oral health. Mothers obtained information regarding fluoride treatments from three types of social relationships: healthcare clinicians, family members, and community members. The information that mothers received from the aforementioned sources was inconsistent, resulting in confusion and difficulty in assessing and reconciling such information.
- This study indicates that mothers receive inconsistent information regarding fluoride use in children from their social relationships; healthcare providers should listen to mothers and educate them about misconceptions regarding fluoride use in children. This study highlights the need for interventions that target mothers' social relationships to provide adequate information regarding fluoride use in children.
abstract
This abstract is available on the publisher's site.
Access this abstract nowImportance
Fluoride delivered either topically (eg, fluoride varnish) or systemically (eg, water fluoridation, prescription fluoride supplements) is widely used as a caries preventive agent in children. The widespread existence of misinformation, including inaccurate information that attaches negative values or suspicion to fluoride treatments, raises concerns that misinformation will lead to underutilization of fluoride and contribute to avoidable increases in caries prevalence.
Objective
To describe the social relationships from which mothers obtain child fluoride information and misinformation.
Design, Setting, and Participants
This qualitative study analyzed 126 mothers with children aged 3 to 5 years to explore how their social networks were associated with their child's oral health. Mothers were recruited from community-based sites in Pittsburgh, Pennsylvania, and throughout the state of West Virginia from 2018 to 2020. In-person, semi-structured qualitative interviews were conducted. Data were transcribed, coded, and analyzed using Nvivo 12. Three investigators analyzed data using template analysis, a qualitative technique that combines inductive and deductive approaches to identify patterns until primary themes are identified.
Main Outcomes and Measures
Sources of information regarding fluoride from the mother's social relationships.
Results
Of the 126 mothers with children aged 3 to 5 years in Pittsburgh and West Virginia, 120 (95%) identified as non-Hispanic White and 5 (4%) identified as Hispanic White; 38 (30%) had a bachelor's degree, 77 (61%) had private dental insurance for their child, and 52 (41%) had an income less than $50 000; 82 (65%) reported that they discussed child fluoride information with members of their social network. Mothers described that they obtained fluoride information from family members, health care clinicians, and community members. The receipt of inconsistent child fluoride information from multiple sources resulted in confusion and difficulty assessing whether fluoride information was accurate.
Conclusions and Relevance
This qualitative study found that mothers received inconsistent child fluoride information from multiple sources, which resulted in confusion and difficulty assessing the accuracy of the fluoride information. These findings suggest that social relationships can be a potential target for interventions to communicate fluoride information related to children.
Additional Info
Disclosure statements are available on the authors' profiles:
Mothers' Sources of Child Fluoride Information and Misinformation From Social Connections
JAMA Netw Open 2022 Apr 01;5(4)e226414, JM Burgette, ZT Dahl, JS Yi, RJ Weyant, DW McNeil, B Foxman, ML MarazitaFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The US Surgeon General, in 2021, issued an Advisory regarding a major threat to the health and well-being of the American public. What was this threat? Health misinformation, believe it or not. I think clinicians are not necessarily surprised by this, particularly amidst the global pandemic. However, it was novel to see this formally articulated at a very high level.
It’s not just about COVID; this qualitative study of 126 mothers of preschool-aged children analyzed how the social networks of these mothers were associated with their children's oral health. What is the connection? There is a lot of misinformation about fluoride, particularly around inclusion in drinking water and fluoride varnish or supplementation. Mind you, this was not merely “social networks” as in social media but largely who these mothers talked to, such as family, friends, and professionals.
Qualitative research is less common; however, it allows capturing of themes and nuances, particularly around emotionally charged topics like the decision to follow or not to follow medical advice. It is hard to summarize in a commentary like this (so I would recommend reading the paper, particularly the quotations in Tables 2–5), but it helped articulate numerous themes. Most notable, I believe, was this line from the authors: “…the type of relationship and the validity of the fluoride information may not be as important as the trust in the source.”
Clinically, what does this mean? It highlights — much as we have seen in work on vaccine misinformation — that the content of the information is less relevant than how it is presented, but also what the prior track record of trust is. It has implications for how primary care medical homes matter, including continuity of clinicians over time. Although reliable accurate information is a must, thinking about how one approaches the conversation, the use of supportive listening and empathy, and keeping the focus on the shared goal, which is the best health and well-being of the child, are also important.