Journal of Oral Health and Community Dentistry

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VOLUME 7 , ISSUE 3 ( September-December, 2013 ) > List of Articles


Provision of Preventive Oral Health Services to Infants and Toddlers: North Carolina General Dentists’ Readiness

TBH McFarland, RB Quiñonez, C Phillips, J Lee, Y Chung

Citation Information : McFarland T, Quiñonez R, Phillips C, Lee J, Chung Y. Provision of Preventive Oral Health Services to Infants and Toddlers: North Carolina General Dentists’ Readiness. J Oral Health Comm Dent 2013; 7 (3):140-147.

DOI: 10.5005/johcd-7-3-140

License: CC BY-NC 3.0

Published Online: 01-03-2015

Copyright Statement:  Copyright © 2013; The Author(s).



Stage of readiness can contribute to providers’ clinical behavioral patterns, but little is understood about its impact in dentistry. The purpose of this investigation is to (1) describe the stage of readiness of general dentists in North Carolina (NC) to deliver preventive oral health services to infants and toddlers and (2) assess factors that may be associated with stage of readiness.


Utilizing a survey study design, 1,010 surveys were distributed to NC General Dentists. The outcome variable, stage of readiness, was categorized into three stages: pre-contemplation, contemplation/preparation and action/maintenance. Explanatory variables included comfort, knowledge, and demographic characteristics. Univariate, bivariate, and proportional odds modeling was performed using SAS 9.1. Level of significance was set at p<0.05.


A 40% (N=406) response rate was achieved. Over half (58%, N=235) of providers reported delivering preventive services to infants and toddlers, 12% (N=48) were considering delivering these services, and 30% (N=119) reported no involvement with this age group. Comfort was significantly associated with general dentists’ stage of readiness. As practitioners’ comfort increased, the likelihood of practitioners performing these services (action stage) was 3.4 (2.1, 5.5; p<.0001) and 5.8 (3.9, 8.6, 8.25; p<.0001) times greater when compared to those contemplating and those not willing to perform these services, respectively. Increased comfort also increased the likelihood that practitioners would consider providing these services, versus those who were not considering it (1.7 [1.0, 2.7] p=0.03).


Strategies to increase general practitioners’ comfort levels could positively affect the likelihood of providing care to infants and toddlers.

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  1. Trends in oral health status: United States, 1988-1994 and 1999-2004. Vital Health Stat 2007;11 (248):1–92.
  2. Guidelines on infant oral health care. Adopted 1986, Revised 2009. Pediatr Dent 2011;33(6):124–28. Available at: Accessed September 4th, 2012.
  3. Available at: Accessed September 4th, 2012.
  4. First oral health assessment policy. Available at: Accessed September 4th, 2012.
  5. Early preventive dental visits: effects on subsequent utilization and costs. Pediatrics 2004;114(4):418–23.
  6. Effectiveness of preventive dental treatments by physicians for young Medicaid enrollees. Pediatrics 2011;127(3):682–89.
  7. Practices and opinions of pediatric and general dentists in Connecticut regarding the age 1 dental visit and dental care for children younger than 3 years old. Pediatr Dent 2008;30(4): 348–51.
  8. Survey of Iowa general dentists regarding the age 1 dental visit. Pediatr Dent 2005;28(4):325–31.
  9. Survey of treatment provided for young children by West Virginia general dentists. Pediatr Dent 2008;30(4):352–57.
  10. Access to dental care for children in the United States: a survey of general practioners. JADA 2003;134(12):1630–40.
  11. Transtheoretical therapy: toward a more integrative model of change. Psychother – Theor Res, Prac 1982;19(3):276–288.
  12. Measuring processes of change: applications to the cessation of smoking. J Consult Clin Psychol 1988;56(4):520–28.
  13. Stages and process of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983;51(3):390–95.
  14. Toward a comprehensive model of change. In Miller WR, Heather N, editors. Treating Addictive Behaviors: processes of change. 1st ed. New York: Plenum; 1986. p3–27.
  15. The five stages of physician reaction to change. J Health Manag 2005;50(1):5–7.
  16. Available at: Archived at: Accessed May 1st, 2012.
  17. Stages of change in the trajectory of postpartum weight self-management. J Obstet Gynecol Neonatal Nurs 2012;41(1): 57–70.
  18. Changing physician behavior to improve disease prevention. Prev Med 1994; 23(3):284–91.
  19. A model of stage of change to recommend colonoscopy among urban primary care physician. J Health Psychol 2006;25(1):65–73.
  20. Prescribing α- blockers after myocardial infarction: a preliminary study of physician motivations and barriers. Clin Ther 2008;30(2): 2241–49.
  21. Effects on readiness to change of an educational intervention on depressive disorders for general physicians in primary care based on a modified Prochaska model- a randomized controlled study. Fam Pract 2008;25(2): 98–104.
  22. Preventing dental oral cancer: oral health care providers' readiness to provide health behavior counseling and oral cancer examinations. J Am Dent Assoc 2005;136(5):594–601.
  23. Quinonez RB. Phillips C. Introducing infant oral health into dental curricula: a clinical intervention. J Dent Educ 2009;73(10):1171–77.
  24. Male involvement in family planning in rural Vietnam: An application of the transtheoretical model. Health Educ Res 2003;18(2):171–80.
  25. Development and validation of a stages of change algorithm for calcium intake for college female students. J Am Coll Nutr 2002;21(6):530–35.
  26. Women's readiness to follow milk product consumption recommendations: Design and evaluation of a 'stage of change' algorithm. J Hum Nutr Diet 2001;14(4): 277–86.
  27. A power primer. Psychol Bull 1992;112(1):155–59.
  28. SAS Institute Inc., Cary, NC.
  29. Available at: Accessed February 4th, 2012.
  30. Efficacy of educational interventions targeting primary care providers' practice behaviors: an overview of published systematic reviews. J Public Health Dent 2004;64(3):164–72.
  31. Illinois: Chapter Oral Health Advocates. Available at: Archived at: Accessed November 2nd, 2011.
  32. “Adolescence is difficult, some kids are difficult”: General practitioners perceptions of working with young children. Aust J Prim Health 2011;17(1): 54–59.
  33. Physical activity behavior change interventions based on the transtheoretical model: a systematic review. Health Educ and Behav 2009;36(5):829–46.
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