Topical fluoride hesitancy and opposition are significantly and positively associated: A cross-sectional study

The goal of this study was to evaluate the associations between topical fluoride hesitancy and opposition to determine if hesitancy is a potential precursor to opposition. We administered an 85-item survey (11/2020-09/2021) to 1,135 caregivers that included the 20-item, 5-domain Fluoride Hesitancy Identification Tool (FHIT), from which we created five domain-specific scores of topical fluoride hesitancy (none/moderate/high for each domain); a score reflecting any topical fluoride hesitancy (moderate/high on any of the five domains); and a topical fluoride hesitancy severity score (total number of moderate/high responses to the five domains; range 0–5). The survey measured degree of topical fluoride opposition (0–10 with no = 0 and yes ≥ 1). We ran confounder-adjusted logistic regression models to evaluate associations between topical fluoride hesitancy scores and opposition. The analyses included 1,042 caregivers; mean age was 42.0 years (SD: 8.3), 78.7% were woman, and 58.3% were white. General hesitancy was reported by 82.9% of surveyed caregivers. Domain-specific hesitancy prevalence (moderate/high) was 81.3% for the necessity domain, 31.3% for chemicals, 19.5% for harm, 30.1% for uncertainty, and 25.2% for distrust. For severity, 14.7% of caregivers reported moderate/high hesitancy for all 5 domains, 7.7% for 4, 6.8% for 3, 9.3% for 2, and 43.9% for 1 domain. Opposition was reported by 39.1%. In the regression models, every hesitancy measure had a statistically significant (p