Frontiers in oral health · 2026
Assessment of medical and dental students' knowledge, attitudes and practices related to fluoride exposure: a cross-sectional study from Jordan.
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Taha Hana, AlHabahbeh Ruba, Alakhras Mohammad Abdallah, AlKharabsheh Rahmeh, Alhasan Omar Wael, Alhasan Juman Wael, Awamleh Malek, Al Khabazi Shadi, Awamleh Suhib, Taha Fatima, Jönsson Linus
Аннотация
BACKGROUND: Fluoride is protective against dental caries, but chronic overexposure causes dental and skeletal fluorosis and has been associated with neurological, endocrine, and renal effects. Jordan has endemic fluorosis, with dental fluorosis affecting 40%-70% of residents in several regions, yet no study has examined whether its future clinicians are prepared to recognize and manage fluoride toxicity. We assessed the knowledge, attitudes, and practices (KAP) of medical and dental students regarding fluoride exposure.
METHODS: In this cross-sectional study, 583 medical and dental students were recruited by convenience sampling at a single institution, the University of Jordan (June-December 2025), and completed a 27-item self-administered questionnaire adapted from a validated population-based instrument. It captured demographic and academic characteristics and three scored domains: Knowledge (range 0-14), Attitudes (5-25), and Practices (8-40). Domain scores were compared by program, gender, curriculum exposure, and year of study using t-tests and Welch's ANOVA with Games-Howell post-hoc tests, and independent predictors were identified with multivariable linear regression.
RESULTS: Mean Knowledge was low-to-moderate (5.38 ± 3.22; Cronbach's α = 0.806), with particularly poor awareness of non-dental complications, the WHO maximum permissible level (1.5 mg/L; correctly identified by 27.8%), and regulatory monitoring. Attitudes (16.92 ± 2.64) and Practices (22.15 ± 3.81) were broadly favorable but passive. Dental students and female participants scored higher across all three domains (p ≤ .025), and fluoride curriculum exposure showed direct association with Knowledge and Practices. Dental-program enrollment (β = 2.19) and detailed curriculum exposure (β = 4.84) were the strongest independent predictors of Knowledge which correlated most strongly with Practices (r = 0.410).
CONCLUSION: Medical and dental students demonstrated limited knowledge of the systemic and regulatory dimensions of fluoride toxicity, and generally favorable attitudes did not translate into active protective behavior. Formal curriculum exposure showed the strongest association with preparedness, although the cross-sectional design does not permit causal inference. As the sample was drawn from a single institution and was overwhelmingly resident in the Central region, these findings should not be generalized to all Jordanian medical and dental students, particularly those in fluorosis-endemic areas. They nonetheless support targeted continuing education in fluorosis-endemic regions, and parallel investment in water safety.
METHODS: In this cross-sectional study, 583 medical and dental students were recruited by convenience sampling at a single institution, the University of Jordan (June-December 2025), and completed a 27-item self-administered questionnaire adapted from a validated population-based instrument. It captured demographic and academic characteristics and three scored domains: Knowledge (range 0-14), Attitudes (5-25), and Practices (8-40). Domain scores were compared by program, gender, curriculum exposure, and year of study using t-tests and Welch's ANOVA with Games-Howell post-hoc tests, and independent predictors were identified with multivariable linear regression.
RESULTS: Mean Knowledge was low-to-moderate (5.38 ± 3.22; Cronbach's α = 0.806), with particularly poor awareness of non-dental complications, the WHO maximum permissible level (1.5 mg/L; correctly identified by 27.8%), and regulatory monitoring. Attitudes (16.92 ± 2.64) and Practices (22.15 ± 3.81) were broadly favorable but passive. Dental students and female participants scored higher across all three domains (p ≤ .025), and fluoride curriculum exposure showed direct association with Knowledge and Practices. Dental-program enrollment (β = 2.19) and detailed curriculum exposure (β = 4.84) were the strongest independent predictors of Knowledge which correlated most strongly with Practices (r = 0.410).
CONCLUSION: Medical and dental students demonstrated limited knowledge of the systemic and regulatory dimensions of fluoride toxicity, and generally favorable attitudes did not translate into active protective behavior. Formal curriculum exposure showed the strongest association with preparedness, although the cross-sectional design does not permit causal inference. As the sample was drawn from a single institution and was overwhelmingly resident in the Central region, these findings should not be generalized to all Jordanian medical and dental students, particularly those in fluorosis-endemic areas. They nonetheless support targeted continuing education in fluorosis-endemic regions, and parallel investment in water safety.