US pediatric dentists' counseling practices in addressing childhood obesity.

PURPOSE: Pediatric dentists could be in an excellent position to identify and intervene early for children at high risk for overweight or obesity; however, current practices and attitudes are uncertain. This study's purpose was to explore the practices and attitudes of pediatric dentists regarding weight-and caries-related counseling. METHODS: Data were analyzed from 1,779 pediatric dentists responding to a 2008-09 survey of 4,154 randomly selected pediatric and 3,846 general dentists. Data were weighted to account for unequal probability of selection and nonresponse rates among regions and dentist types. RESULTS: Sixty-five percent of respondents reported increased proportions of overweight/obese pediatric patients since they began practice, and approximately 9% offered weight-related counseling. By contrast, approximately 80% provided caries-related counseling. Major barriers to providing weight-related counseling included fears of offending parents/patients (~54%) and appearing judgmental (~53%), lack of patient acceptance of weight-loss advice from dentists (~47%), not enough trained personnel to provide counseling (~43%), and insufficient time (~28%). Multivariable predictors of providing weight-related counseling included female sex, Hispanic ethnicity, nongroup practice setting, practice ownership, and dentist self-reported normal- or underweight status. CONCLUSIONS: Primary barriers to weight-related counseling cited by pediatric dentists reflect concerns about offending patients and caregivers. Training and counseling addressing these concerns may help boost counseling rates.