Mothers’ Sources of Child Fluoride Information and Misinformation From Social Connections

Importance: 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.