Acceptability of fluoridated salt in a rural Latino community in California

Objective: To assess acceptability of salt fluoridation in a representative farmworker community in California's Central Valley without access to fluoridated municipal drinking water, and limited access to oral health education and dental care. Methods: Qualitative in-depth interviews (N=30) and five focus groups (N=40) were conducted in Spanish with Latino women and men. Topics included participants' knowledge of fluoride and the acceptability of fluoridated salt (NaF) as a preventive for dental caries. Audio recordings were translated to English, transcribed, and text data coded for emerging themes. Results: Salt (NaCl) was very present in multiple aspects of family and work life. Fluoride was often confused with iodine in salt. Aside from knowing fluoride was in toothpaste, most participants were unaware of its value in dental caries prevention. Before using NaF in their daily lives, the majority indicated they would first need to know and evaluate information about what fluoride is, what it does, how it tastes, its cost and benefits, as well as potential harms. On being given this information, participants deemed it acceptable. Most said they would be willing to try NaF including for their children. Dentists and health educators would be the most trusted information sources. Asked if fluoridated salt would alter their daily salt intake, participants expressed doubts because “salt is salt,” and taste governs the quantity they consume. Conclusions: Salt fluoridation as a caries preventive would be acceptable to high-risk rural Hispanic populations if trustworthy information about its properties and benefits were available.