Article Data

  • Views 349
  • Dowloads 126

Original Research

Open Access

Knowledge, attitudes, and practice of general pediatricians and pediatric subspecialists towards oral health in children: a survey in Turkey

  • Ecem Akbeyaz Sivet1,*,
  • Ece Yilmazkasapoglu Turkay1
  • Ismail Hakki Akbeyaz2
  • Betul Kargul1

1Department of Pediatric Dentistry, School of Dentistry, Marmara University, 34854 Istanbul, Turkey

2Department of Pediatrics, Pendik Training and Research Hospital, Marmara University, 34899 Istanbul, Turkey

DOI: 10.22514/jocpd.2024.087 Vol.48,Issue 4,July 2024 pp.139-148

Submitted: 04 August 2023 Accepted: 15 September 2023

Published: 03 July 2024

*Corresponding Author(s): Ecem Akbeyaz Sivet E-mail:


This study aimed to evaluate the level of knowledge, attitudes, and practices of general pediatricians (GPs) and pediatric subspecialists (PSs) practicing in Turkey toward oral health in children. A national sample of 642 pediatricians who attended the Turkish National Pediatrics Congress completed a survey consisting of 36 questions. The results are segmented based on sex, years of experience, and whether the pediatrician was a general pediatrician or pediatric subspecialist. Relationships between dependent categorical variables were tested using the Chi-square test. Four hundred eighty-seven questionnaires were completed, resulting in a 75.8% response rate; 69.8% of general pediatricians and 74.1% of pediatric subspecialists recommended the first dental visit before the first year or eruption of the first teeth; 62.6% agreed that pediatricians have a role in inculcating oral hygiene habits in patients; 98.2% of the respondents indicated they had performed oral examinations on their patients since birth; 72.8%of PSs suggested bottle-feeding to their patients, whereas only 33.5% of GPs did; 65.4% of PSs, 78.2% of GPs (p = 0.003), and 76.8% of the physicians with <5 years experience recommended fluoridated toothpaste under 2 years of age. There were statistically significant differences between the knowledge and attitudes of GPs and PSs. Female respondents were more knowledgeable than male respondents about oral health in children. Additionally, years of experience did not correlate with increased knowledge and proper attitudes toward oral health in children.


Knowledge; Attitudes; Oral health; Pediatrician; Pediatric subspecialist

Cite and Share

Ecem Akbeyaz Sivet,Ece Yilmazkasapoglu Turkay,Ismail Hakki Akbeyaz,Betul Kargul. Knowledge, attitudes, and practice of general pediatricians and pediatric subspecialists towards oral health in children: a survey in Turkey. Journal of Clinical Pediatric Dentistry. 2024. 48(4);139-148.


[1] GBD 2017 Oral Disorders Collaborators; Bernabe E, Marcenes W, Hernandez CR, Bailey J, Abreu LG, Alipour V, et al. Global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017: a systematic analysis for the global burden of disease 2017 study. Journal of Dental Research. 2020; 99: 362–373.

[2] Qin X, Zi H, Zeng X. Changes in the global burden of untreated dental caries from 1990 to 2019: a systematic analysis for the Global Burden of Disease study. Heliyon. 2022; 8: e10714.

[3] Zou J, Du Q, Ge L, Wang J, Wang X, Li Y, et al. Expert consensus on early childhood caries management. International Journal of Oral Science. 2022; 14: 35.

[4] Alkhtib AO, Mohamed HG. Current knowledge about early childhood caries in the gulf cooperation council with worldwide reflection: scoping review of the scientific literature (2010–2021). PLOS Global Public Health. 2023; 3: e0001228.

[5] Hung M, Licari FW, Lipsky MS, Moffat R, Cheever VJ, Mohajeri A, et al. Early preventive dental visits: do they reduce future operative treatments? Dentistry Journal. 2022; 10: 53

[6] Buldur B. Pathways between parental and individual determinants of dental caries and dental visit behaviours among children: validation of a new conceptual model. Community Dentistry and Oral Epidemiology. 2020; 48: 280–287.

[7] Qu X, Houser SH, Tian M., Zhang Q, Pan J, Zhang W. Effects of early preventive dental visits and its associations with dental caries experience: a cross-sectional study. BMC Oral Health. 2020; 22: 150.

[8] Zaror C, Matamala-Santander A, Ferrer M, Rivera-Mendoza F, Espinoza-Espinoza G, Martínez-Zapata MJ. Impact of early childhood caries on oral health‐related quality of life: a systematic review and meta-analysis. International Journal of Dental Hygiene. 2022; 20: 120–135.

[9] Buldur B, Güvendi ON. Conceptual modelling of the factors affecting oral health‐related quality of life in children: a path analysis. International Journal of Paediatric Dentistry. 2020; 30: 181–192.

[10] American Academy of Pediatric Dentistry. Perinatal and infant oral health care. The Reference Manual of Pediatric Dentistry. American Academy of Pediatric Dentistry: Chicago, Ill. 2022: 277–281.

[11] Okuji D, Kritz-Silverstein D, Pham H, Chen E, Wu Y, Chan WY. Opportunities for age-specific interprofessional collaboration between physicians and dentists in pediatric patients. Pediatric Dentistry. 2020;42: 203–207.

[12] Taneli B. Paediatrics education and speciality in Turkey. The Journal of Pediatric Research. 2015; 2: 114–117.

[13] Wang TT, Mathur MR, Schmidt H. Universal health coverage, oral health, equity and personal responsibility. Bulletin of the World Health Organization. 2020; 98: 719–721.

[14] Macy ML, Leslie LK, Turner A, Freed GL. Growth and changes in the pediatric medical subspecialty workforce pipeline. Pediatric Research. 2021; 89: 1297–1303.

[15] Catenaccio E, Rochlin JM, Simon HK. Differences in lifetime earning potential for pediatric subspecialists. Pediatrics. 2021; 147: e2020027771.

[16] Sezer RG, Paketci C, Bozaykut A. Paediatricians’ awareness of children’s oral health: knowledge, training, attitudes and practices among Turkish paediatricians. Paediatrics & Child Health. 2013; 18: e15–e19.

[17] Alshunaiber R, Alzaid H, Meaigel S, Aldeeri A, Adlan A. Early childhood caries and infant’s oral health; pediatricians’ and family physicians’ practice, knowledge and attitude in Riyadh city, Saudi Arabia. The Saudi Dental Journal. 2019; 31: S96–S105.

[18] Koirala A, O’Connor E, Widmer R, Kilpatrick N, Goldfeld S. Oral health care: the experience of Australian paediatricians. Journal of Paediatrics and Child Health. 2019; 55: 1374–1380.

[19] Ramroop V, Kowlessar A, Ramcharitar-Maharaj V, Morris L, Naidu R. Knowledge, attitudes and behaviour towards preventive oral care in early childhood among paediatricians in Trinidad and Tobago: findings of a national survey. International Dental Journal. 2019; 69: 67–76.

[20] Morera-Domingo J, Maura-Solivellas I, Llagostera-Benedico J, Arce-Casas A, Valls-Sirera C,Ferrés-Amat E. Knowlege and attitude in paediatric dentistry among paediatricians. European Journal of Paediatric Dentistry. 2022; 23: 61–65.

[21] von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. The Lancet. 2007; 370: 1453–1457.

[22] Nammalwar R, Rangeeth P. Knowledge and attitude of pediatricians and family physicians in Chennai on pediatric dentistry: a survey. Dental Research Journal. 2012; 9: 561–566.

[23] Lewis CW, Grossman DC, Domoto PK, Deyo RA. The role of the pediatrician in the oral health of children: a national survey. Pediatrics. 2000; 106: E84.

[24] Cubukcu C, Ercan I, Ozkaya G. Dental caries severity and related factors of 1307 Turkish boarding school children. Nigerian Journal of Clinical Practice. 2021; 24: 1476–1484.

[25] World Health Organization. WHO Executive Board 148th Resolutions and Annexes 2020. Achieving better oral health as part of the universal health coverage and noncommunicable disease agendas towards 2030. 2020. Available at: (Accessed: 05 September 2023).

[26] Northridge ME, Kumar A, Kaur R. Disparities in access to oral health care. Annual Review of Public Health. 2020; 41: 513–535.

[27] Cull WL, Frintner MP, Starmer AJ, Leslie LK. Longitudinal analyses of pediatrician burnout. Academic Pediatrics. 2019; 19: 256–262.

[28] Singhal S, Figueiredo R, Dupuis S, Skellet R, Wincott T, Dyer C, et al. Knowledge, attitude, willingness and readiness of primary health care providers to provide oral health services to children in Niagara, Ontario: a cross-sectional survey. CMAJ Open. 2017; 5: E249–E254.

[29] Soares IMV, Silva AMRBD, Moura LDFADD, Lima MDDMD, Sousa Nétto OBD, Moura MSD. Conduct of pediatricians in relation to the oral health of children. Revista De Odontologia Da UNESP. 2013; 42: 266–272.

[30] Hadjipanayis A, Grossman Z, del Torso S, Michailidou K, Van Esso D, Cauwels R. Oral health training, knowledge, attitudes and practices of primary care paediatricians: a European survey. European Journal of Pediatrics. 2018; 177: 675–681.

[31] Aburahima N, Hussein I, Kowash M, Alsalami A, Al Halabi M. Assessment of paediatricians’ oral health knowledge, behaviour, and attitude in the United Arab Emirates. International Journal of Dentistry. 2020; 2020: 1–8.

[32] Singh Dhull K, Indira M, Nandlal B. Knowledge, attitude and practice toward infant oral healthcare among the pediatricians of mysore: a questionnaire survey. International Journal of Clinical Pediatric Dentistry. 2015; 8: 211–214.

[33] Sabbagh H, El-Kateb M, Al Nowaiser A, Hanno A, Alamoudi N. Assessment of pediatricians dental knowledge, attitude and behavior in Jeddah, Saudi Arabia. Journal of Clinical Pediatric Dentistry. 2011; 35: 371–376.

[34] American Academy of Pediatric Dentistry. Fluoride therapy. The reference manual of pediatric dentistry. American Academy of Pediatric Dentistry: Chicago, Ill. 2023; 352–358.

[35] Zampetti P, Scribante A. Historical and bibliometric notes on the use of fluoride in caries prevention. European Journal of Paediatric Dentistry. 2020; 21: 148–152.

[36] Duruk G, Acar B. Turkish Pediatricians’ awareness of children’s oral health. Journal of Dentistry for Children. 2021; 88: 17–22.

[37] Goyal A, Nishant, Morankar R, Gauba K, Jaiswal M. Awareness among pediatricians regarding oral health care in children including those with special care needs: a cross-sectional survey. Journal of Family Medicine and Primary Care. 2020; 9: 4151–4155.

[38] Bozorgmehr E, Mohammadi TM, Hajizamani A, Vahidi A, Khajoee F. Knowledge, attitude, and practices of pediatricians about children’s oral health. Journal of Oral Health and Oral Epidemiology, 2012; 1: 93–98.

[39] Wagner Y, Heinrich-Weltzien R. Pediatricians’ oral health recommendations for 0- to 3-year-old children: results of a survey in Thuringia, Germany. BMC Oral Health. 2014; 14: 44.

[40] Lochib S, Indushekar KR, Saraf BG, Sheoran N, Sardana D. Knowledge, attitude and practices of pediatricians in Faridabad towards infant oral health care. Universal Research Journal of Dentistry. 2014; 4: 97–100.

[41] Turkish Dental Association. Fluoride status report update. 2019. Available at: (Accessed: 05 September 2023).

[42] Ramos-Gomez F. Early maternal exposure to children’s oral health may be correlated with lower early childhood caries prevalence in their children. Journal of Evidence Based Dental Practice. 2012; 12: 113–115.

[43] Wakaguri S, Aida J, Osaka K, Morita M, Ando Y. Association between caregiver behaviours to prevent vertical transmission and dental caries in their 3-year-old children. Caries Research. 2011; 45: 281–286.

[44] Chan KM, King NM, Kilpatrick NM. Can infants catch caries? A review of the current evidence on the infectious nature of dental caries in infants. New Zealand Dental Journal. 2005; 101: 4–11.

[45] Pitts NB, Twetman S, Fisher J, Marsh PD. Understanding dental caries as a non-communicable disease. British Dental Journal. 2021; 231: 749–753.

[46] Simón-Soro A, Mira A. Solving the etiology of dental caries. Trends in Microbiology. 2015; 23: 76–82.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 1.8 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time