Examining parents' attitudes towards fluoride varnish application

Öz

Dental caries is one of the most common public health problems in children. Preventive interventions such as fluoride varnish are effective in reducing the incidence of dental caries in children. However, parental attitudes towards these interventions can significantly influence their acceptance and use. The aim of this study is to examine parents’ attitudes towards the application of fluoride varnish. This study, designed as a cross-sectional study with a qualitative component, was conducted in Manisa between September and November 2025. Data were collected from the parents of students attending primary schools in the research area (n=422). Data was collected using a sociodemographic information form and the Fluoride Varnish Parent Attitude, Belief Scale (FVPABS). In addition, qualitative data were collected through open-ended questions. Among the participating parents, 85.8% were mothers. The mean FVPABS score was 29.10±4.87. Overall, 54.3% reported that they had not allowed fluoride varnish to be applied to their children in previous years, while 45.5% stated that they would not allow fluoride varnish application for their children in the future. Mothers and fathers with a university education had significantly higher mean FVPABS scores than those with lower educational levels (p<0.05). In the qualitative findings, the themes of “distrust” and “lack of knowledge” emerged regarding fluoride varnish refusal. In the integration of the findings, it was found that the theme of “distrust” was more strongly associated with FVPABS scores compared to the theme of “lack of knowledge”. The findings indicate that parents need accurate and reliable information. In this context, public health professionals, dentists, and public health nurses can organize informational training sessions for parents regarding fluoride varnish application within the scope of school health.

Anahtar Kelimeler

• Fluoride
• varnish
• parents
• attitude
• oral health
• child

Destekleyen Kurum

No

Etik Beyan

Ethical approval for conducting the research was obtained from the Health Sciences Ethics Committee of Manisa Celal Bayar University (date: 16/07/2025, No: 20.478.486/3301). Every stage of this research was conducted in accordance with the principles of the Helsinki Declaration. All participants were informed about the research rights, and data were collected from voluntary participants.

Teşekkür

We thank the parents who participated in the study.

Ebeveynlerin florürlü vernik uygulamasına yönelik tutumlarının incelenmesi

Öz

Diş çürükleri çocuklarda en sık görülen halk sağlığı sorunlarındandır. Florürlü vernik gibi koruyucu girişimler diş çürüğü sıklığını azaltmada etkili yöntemlerdir. Ancak ebeveynlerin bu uygulamalara yönelik tutumları, bunların kabulünü ve kullanımını önemli ölçüde etkileyebilir. Bu araştırmanın amacı ebeveynlerin florürlü vernik uygulamasına yönelik tutumlarının incelenmesidir. Nitel bileşenli kesitsel tasarımlı bu çalışma, Eylül-Kasım 2025 tarihleri arasında Manisa ilinde yürütüldü. Veriler ilkokullarda eğitim gören öğrencilerin ebeveynlerinden toplandı (n=422). Veriler Sosyodemografik bilgi formu ve Florür Vernik Ebeveyn Tutum, İnanç Ölçeği (FVTİÖ) kullanılarak elde edildi. Ek olarak açık uçlu soru ile nitel veriler toplandı. Araştırmada nicel ve nitel bulguların entegrasyonu sağlandı. Araştırmaya katılan ebeveynlerin %85,8‘i anneydi. Ebeveynlerin FVTİÖ puan ortalamaları 29,10±4,87 olarak bulundu. Ebeveynlerin %54,3’ü önceki yıllarda çocuklarına florürlü vernik uygulanmasına izin vermediğini ifade ederken %45,5’i gelecekte çocuklarına florürlü vernik uygulanmasına izin vermeyeceğini bildirdi. Üniversite mezunu olan annelerin ve babaların FVTİÖ puan ortalamaları daha yüksek bulundu (p<0,05). Nitel bulgularda florürlü vernik reddine yönelik “güvensizlik ve bilgi eksiği” temaları ortaya çıktı. Bulguların entegrasyonunda güvensizlik temasının bilgi eksikliği temasına kıyasla FVTİÖ puanları ile daha fazla ilişkili olduğu bulundu. Bulgulara göre ebeveynlerin güvenilir bilgiye ihtiyaç duyduğu görülmektedir. Bu bağlamda halk sağlığı uzmanları, diş hekimleri ve halk sağlığı hemşireleri, florürlü vernik ile ilgili ebeveynlere bilgi sağlayabilirler.

Anahtar Kelimeler

• Florür
• vernik
• ebeveyn
• tutum
• ağız sağlığı
• çocuk

Destekleyen Kurum

Yok

Etik Beyan

Araştırmanın yürütülmesi için Manisa Celal Bayar Üniversitesi Sağlık Bilimleri Etik Kurulu'ndan etik onay alınmıştır (tarih: 16/07/2025, No: 20.478.486/3301). Bu araştırmanın her aşaması Helsinki Deklarasyonu ilkelerine uygun olarak yürütülmüştür. Tüm katılımcılar araştırma hakları konusunda bilgilendirilmiş ve veriler gönüllü katılımcılardan toplanmıştır.

Teşekkür

Araştırmaya katılan ebeveynlere teşekkür ederiz.

Kaynakça

1. Peres MA, Macpherson LM, Weyant RJ, Daly B, Venturelli R, Mathur MR, et al. Oral diseases: a global public health challenge. Lancet. 2019; 394:249-60. DOI:10.1016/S0140-6736(19)31146-8.
2. Taqavi Yazdi M, Najminouri F, Nakhaee N, Ghorbani Nia R. Improving the participation of 3–14 aged children’s parents in fluoride varnish program: a quasi-experimental study. BMC Public Health. 2026;26(1):957. DOI:10.1186/s12889-026-26627-7
3. World Health Organization. Fluoride varnish: application for inclusion in the WHO Model List of Essential Medicines [Internet]. 2023 [cited 2026 Apr 16]. Available from: https://cdn.who.int/media/docs/default-source/essential-medicines/2023-eml-expert-committee/applications-for-new-formulations-strengths-of-existing-listed-medicines/f5c_fluoride-varnish.pdf
4. Petersen PE, Ogawa H. Prevention of dental caries through the use of fluoride—the WHO approach. Community Dent Health. 2016;33(2):66-8. DOI:10.1922/CDH_Petersen03.
5. Public Health England. Delivering better oral health: an evidence-based toolkit for prevention. 4th ed. London: Department of Health and Social Care; 2021. Available from: https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention
6. T.C. Sağlık Bakanlığı. Koruyucu Ağız ve Diş Sağlığı Programı Florürlü Vernik Uygulama Rehberi [Internet]. 2023 [cited 2026 July 12]. Available from: https://hsgm.saglik.gov.tr/tr/yayinlarimiz-v2.html
7. Manisa Ağız ve Diş Sağlığı Merkezi. Pedodonti (Çocuk Diş) Kliniği [Internet]. [cited 2026 Jul 14]. Available from: https://manisaadsm.saglik.gov.tr/TR-612303/pedodonti-cocuk-dis-klinigi.html
8. Macpherson LM, Rodgers J, Conway DI. Childsmile after 10 years part 1: background, theory and principles. Dent Update. 2019;46(2):113-6. DOI:10.12968/denu.2019.46.2.113.

9. Chi DL. Caregivers who refuse preventive care for their children: the relationship between immunization and topical fluoride refusal. Am J Public Health. 2014;104(7):1327–33. DOI:10.2105/AJPH.2014.301927.
10. Lim J, Carle AC, Carpiano RM, Chi DL. Topical fluoride hesitancy and opposition are significantly and positively associated: A cross-sectional study. PLoS One. 2025;20(4):e0322027. DOI:10.1371/journal.pone.0322027.
11. Ko A, Carle AC, Tanbonliong TS, Chi DL. The Association Between Intensive Parenting Attitudes and Topical Fluoride Opposition. J Public Health Dent. 2026;86(1):60-6. DOI:10.1111/jphd.70033.
12. Kockanat A. Evaluation of parents’ information sources perceptions and attitudes regarding fluoride toothpastes and topical fluoride applications: a cross-sectional study. Fluoride. 2025;58(18):1-11.
13. Aljami A, Alshehri T, Altuwaijri A, Aldossary A, Almutairi W, Farooqi FA, et al. Is It Mum or the Dad? Parental Factors That Influence the Use and Acceptance of Fluoride Varnish among Parents in Eastern Saudi Arabia. Int J Dent. 2022;2022:9109967. DOI:10.1155/2022/9109967.
14. Chi DL, Basson AA. Surveying Dentists’ Perceptions of Caregiver Refusal of Topical Fluoride. JDR Clin Trans Res. 2018;3(3):314-20. DOI:10.1177/2380084418761846.
15. Tayhan A, Çetinkaya A. Development and psychometric analysis: Fluoride varnish parent attitude, belief scale. Public Health Nurs. 2024;41(1):1-9. DOI:10.1111/phn.13251.
16. George D, Mallery P, editors. Descriptive statistics. In: IBM SPSS Statistics 25 step by step. 15th ed. New York: Routledge; 2018. p.126-34.
17. Braun V, Clarke V. Thematic analysis: a practical guide. Thousand Oaks (CA): SAGE; 2021.
18. Lorenzini E, Osorio-Galeano SP, Schmidt CR, Cañon-Montañez W. Practical Guide to Achieve Rigor and Data Integration in Mixed Methods Research [Guía práctica para alcanzar el rigor y la integración de datos en la investigación de métodos mixtos]. Invest Educ Enferm. 2024;42(3):e02. DOI:10.17533/udea.iee.v42n3e02.
19. Kalyoncu İÖ, Has S, Eren Giray F, Kargül B. Velilerin ‘Okullarda Florürlü Vernik Uygulaması’ Programı Hakkında Tutum Ve Yaklaşımlarının Değerlendirilmesi. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2019;29(4):556-62. DOI:10.17567/ataunidfd.479300.
20. Kara M, Yavuz CI. The prevalence of fluoride varnish application among primary school children and parent refusals: a cross-sectional study in Turkey. Fluoride. 2023;56(4):575-90.
21. Lotto M, Sá Menezes T, Zakir Hussain I, Tsao SF, Ahmad Butt Z, P Morita P, et al. Characterization of False or Misleading Fluoride Content on Instagram: Infodemiology Study. J Med Internet Res. 2022;24(5):e37519. DOI:10.2196/37519.
22. Kanchan S, Gaidhane A. Social Media Role and Its Impact on Public Health: A Narrative Review. Cureus. 2023;15(1):e33737. DOI:10.7759/cureus.33737.
23. Carle AC, Pallotto I, Edwards TC, Carpiano R, Kerr DC, Chi DL. Psychometric properties of the Fluoride Hesitancy Identification Tool (FHIT). PLoS One. 2024;19(1):e0297188. DOI:10.1371/journal. pone.0297188.
24. Burgette JM, Dahl ZT, Yi JS, Weyant RJ, McNeil DW, Foxman B, et al. Mothers’ sources of child fluoride information and misinformation from social connections. JAMA Netw Open. 2022;5(4): e226414. DOI:10.1001/jamanetworkopen.2022.6414.
25. Tang S, Liu X, Jia Y, Chen H, Zheng P, Fu H, et al. Education level modifies parental hesitancy about COVID-19 vaccinations for their children. Vaccine. 2023;41(2):496-503. DOI:10.1016/j. vaccine.2022.11.060.
26. Saini SJ, Carle AC, Forsyth AR, Chi DL. Association between caregiver opposition to topical fluoride and COVID-19 vaccines. Vaccine. 2023;41(5):1035-41. DOI:10.1016/j.vaccine.2022.12.018.
27. Cruz S, Holland H, Chi DL. Validating a Conceptual Model on Topical Fluoride Hesitancy With Latino Parents. Health Educ Behav. 2024;51(5):719-32. DOI:10.1177/10901981241231500.
28. Basch CH, Milano N, Hillyer GC. An assessment of fluoride related posts on Instagram. Health Promot Perspect. 2019;9(1):85-8. DOI:10.15171/hpp.2019.11.
29. Chi DL, Kerr D, Patiño Nguyen D, Shands ME, Cruz S, Edwards T, et al. A conceptual model on caregivers’ hesitancy of topical fluoride for their children. PLoS One. 2023;18(3):e0282834. DOI:10.1371/journal. pone.0282834.
30. Kranz AM, Chen AY, Mizushima Y, Li K, Dick AW, Geissler KH. Changes in children’s receipt of fluoride varnish during medical visits and the COVID-19 pandemic. Acad Pediatr. 2025;25(8):102881. DOI:10.1016/j.acap.2025.102881.