Fluoride in Focus: How Dentists’ Demographics, Practice Settings, and Perceptions Shape Caries Prevention Strategies

Objective(s): Dental caries remains a prevalent chronic disease globally, with fluoride being a cornerstone in its prevention. Despite its proven efficacy, the implementation of fluoride-based strategies depends heavily on dentists' knowledge, attitudes, and practices. This study assessed the knowledge, attitudes, and practices of Iranian dentists concerning fluoride application, as well as the barriers to its use. Methods: A cross-sectional study was conducted among a convenient sample of 296 dentists. A validated questionnaire was used to collect data on dentists’ age, gender, dental specialty, working sectors and queries, such as the availability of specific guidelines for prescribing fluoride products in the workplace, self-reported practices regarding fluoride application, perceptions of barriers to fluoride use and level of agreement with statements regarding the effectiveness of fluoride in caries prevention.  Descriptive statistics and chi-square tests were employed to summarize and compare responses based on demographic and professional characteristics at p<0.05. Results: 40% of dentists had access to fluoride prescription guidelines. Younger dentists and those in both public and private sectors were more likely to report guideline availability. While 73-97% of dentists agreed with the effectiveness of fluoride in caries prevention, only 50% recognized its benefits for individuals over 12 years old. Fluoride application was more prevalent for children under 12 (30-35%), compared to adults (10%). Barriers to fluoride use included low treatment tariffs (45%), skepticism about its effectiveness (42%), and time constraints (25%). Dentists favored restorative treatments for high-risk cases, with 80% recommending fluoride varnish and gel for children but fewer for adults. Conclusion: This study highlighted gaps in knowledge and practice regarding use of fluoride among Iranian dentists, particularly for adult patients. Barriers such as low reimbursement rates and skepticism about fluoride's effectiveness need to be addressed. Enhanced training, standardized guidelines, and policy interventions are essential to improve fluoride application efforts in Iran.