Influence of mothers' oral health knowledge and attitudes on their children's dental health

Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries

BACKGROUND

Dental caries, a common chronic disease of childhood, is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC). This review updates one published in 2019.

OBJECTIVES

To assess the effects of interventions undertaken with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years).

SEARCH METHODS

We searched Cochrane Oral Health's Trials Register, Cochrane Pregnancy and Childbirth's Trials Register, CENTRAL, MEDLINE (Ovid), Embase (Ovid), CINAHL EBSCO, the US National Institutes of Health Ongoing Trials Register (clinicaltrials.gov) and WHO International Clinical Trials Registry Platform (apps.who.int/trialsearch). The latest searches were run on 3 January, 2023.

SELECTION CRITERIA

Randomised controlled trials (RCTs) comparing interventions with pregnant women, or new mothers and other primary caregivers of infants in the first year of life, against standard care, placebo or another intervention, reporting on a primary outcome: caries presence in primary teeth, dmfs (decayed, missing, filled primary surfaces index), or dmft (decayed, missing, filled teeth index), in children up to six years of age. Intervention types include clinical, oral health promotion/education (hygiene education, breastfeeding and other dietary advice) and policy or service.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed study eligibility, extracted data, assessed risk of bias, and assessed certainty of evidence (GRADE).

MAIN RESULTS

We included 23 RCTs (5 cluster-randomised), involving 25,953 caregivers (mainly mothers) and their children. Fifteen trials assessed oral health education/promotion interventions against standard care. Six trials assessed a clinical intervention for mother dentition, against placebo, or a different type of clinical intervention. Two trials assessed oral health/education promotion plus clinical intervention (for mother's dentition) against standard care. At most, five trials (maximum of 1326 children and 130 mothers) contributed data to any comparison. Enamel-only caries were included in the diagnosis of caries in some studies. For many trials, the risk of bias was unclear due to lack of methodological details reported. In thirteen trials, participants were socioeconomically disadvantaged. No trial indicated receiving funding that was likely to have influenced their results. Oral health education/promotion interventions Child diet and feeding practice advice versus standard care: We observed a probable 15 per cent reduced risk of caries presence in primary teeth with the intervention (RR 0.85, 95% CI 0.75 to 0.97; 3 trials; 782 participants; moderate-certainty evidence), and there may be a slightly lower mean dmfs (MD -0.29, 95% CI -0.58 to 0; 2 trials; 757 participants; low-certainty evidence); however, the evidence is very uncertain regarding the difference between groups in mean dmft (MD -0.90, 95% CI -1.85 to 0.05; 1 trial; 340 participants; very low-certainty evidence). Breastfeeding promotion and support versus standard care: We observed little or no difference between groups in the risk of caries presence in primary teeth (RR 0.96, 95% CI 0.89 to 1.03; 2 trials; 1148 participants; low-certainty evidence) and in mean dmft (MD -0.12, 95% CI -0.59 to 0.36; 2 trials; 652 participants; low-certainty evidence). dmfs was not reported. Child diet advice compared with standard care: We are very uncertain about the effect on the risk of caries presence in primary teeth (RR 1.08, 95% CI 0.34 to 3.37; 1 trial; 148 participants; very low-certainty evidence). dmfs and dmft were not reported. Oral hygiene, child diet and feeding practice advice versus standard care: The evidence is very uncertain about the effect on the risk of caries presence in primary teeth (RR 0.73, 95% CI 0.50 to 1.07; 5 trials; 1326 participants; very low-certainty evidence) and there maybe little to no difference in mean dmfs (MD -0.87, 95% CI -2.18 to 0.43; 2 trials; 657 participants; low-certainty evidence) and mean dmft (MD -0.30, 95% CI -0.96 to 0.36; 1 trial; 187 participants; low-certainty evidence). High-dose versus low-dose vitamin D supplementation during pregnancy: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.99, 95% CI 0.70 to 1.41; 1 trial; 496 participants; very low-certainty evidence). dmfs and dmft were not reported. Clinical interventions (for mother dentition) Chlorhexidine (CHX, a commonly prescribed antiseptic agent) or iodine-NaF application and prophylaxis versus placebo: We are very uncertain regarding the difference in risk of caries presence in primary teeth between antimicrobial and placebo treatment for mother dentition (RR 0.97, 95% CI 0.80 to 1.19; 3 trials; 479 participants; very low-certainty evidence). No trial reported dmfs or dmft. Xylitol compared with CHX antimicrobial treatment: We are very uncertain about the effect on caries presence in primary teeth (RR 0.62, 95% CI 0.27 to 1.39; 1 trial, 96 participants; very low-certainty evidence), but we observed there may be a lower mean dmft with xylitol (MD -2.39; 95% CI -4.10 to -0.68; 1 trial, 113 participants; low-certainty evidence). No trial reported dmfs. Oral health education/promotion plus clinical interventions (for mother dentition) Diet and feeding practice advice for infants and young children plus basic dental care for mothers compared with standard care: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.44, 95% CI 0.05 to 3.95; 2 trials, 324 participants; very low-certainty evidence) or on mean dmft (1 study, not estimable). No trial reported dmfs. No trials evaluated policy or health service interventions.

AUTHORS' CONCLUSIONS

There is moderate-certainty evidence that providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries (ECC). The remaining evidence is low to very-low certainty and is insufficient for determining which, if any, other intervention types and features may be effective for preventing ECC, and in which settings. Large, high-quality RCTs of oral health education/promotion, clinical, and policy and service access interventions, are warranted to determine the effects and relative effects of different interventions and inform practice. We have identified 13 ongoing studies. Future studies should consider if and how effects are modified by intervention features and participant characteristics (including socioeconomic status).

Oral health promotion through health-promoting schools in developing countries: A scoping review

OBJECTIVES

To explore and assess what is known about oral health promotion through health-promoting primary schools in developing countries.

METHODS

A scoping review was conducted using the Arksey & O'Malley framework. Web of Science, PubMed, Scopus and Cochrane Library were searched, followed by the reference lists of the resulting studies. The UN classification of developing countries was used to define the countries included and the search was between 1986 and 2021. Quality assessment was carried out using Joanna Briggs Institute's quality appraisal tools.

RESULTS

The search resulted in 33 studies of which almost half were randomized controlled trials. The oral health promotion strategies were oral health education (n = 16) delivered by teachers, parents or peers, or multicomponent involving both toothbrushing (n = 15) and dietary components (n = 2). Most of the included studies were conducted in Asia (n = 25/33).

CONCLUSIONS

Findings suggested that comprehensive, multicomponent theory-based oral health promotion showed improvements in oral health outcomes of schoolchildren, particularly if delivered using a whole-school approach. However, further research on feasibility and implementation of oral health promotion through health-promoting primary schools in developing countries should be considered.

Dental Caries Prevention Knowledge, Attitudes, and Practice among Patients at a University Hospital in Guangzhou, China

Background and Objectives: This study aimed to assess the knowledge, attitudes, and practice (KAP) of patients regarding dental caries prevention in a university hospital in Guangzhou, China. Materials and Methods: A hospital-based KAP survey was conducted in a cross-sectional manner at the First Affiliated Hospital in Guangzhou, China, from 1 September to 30 September 2022. Questionnaires were distributed to eligible patients, resulting in the participation of 251 individuals. The questionnaire consisted of five sections capturing socio-demographic data and exploring participants' knowledge, attitudes, practice, and accurate preventive dental caries knowledge. Descriptive statistics and a generalized linear model with univariate tests were used for analysis. Results: The study results show that the knowledge score 7.97 (±0.91) and attitudes score 7.67 (±0.89) among the participants were good while the practice score was 6.80 (±0.81) moderate. The majority of participants identified tooth infections (81.3%), bacteria (92%), and sugar (89.2%) as the main causes of gum bleeding and tooth decay. Brushing (96%) and fluoride (80.5%) were also recognized as essential for preventing tooth decay. Of oral diseases, 94% were recognized as potentially affecting overall health. The vast majority ranging from 92.8% to 98%, believed that oral health is crucial to overall health and that regular check-ups and proper brushing habits are beneficial. There is a significant association of gender with age (p = 0.018), occupation (p = 0.050), lifestyle habit (p = 0.012), and knowledge score; whole education is significantly associated with practice score (p = 0.050). Conclusions: The majority of patients exhibited accurate knowledge and attitudes with moderate practice towards dental caries prevention, with socio-demographic factors playing a major role. However, effective implementation of dental health education programs across the healthcare system is still required to further enhance outcomes.

Social support, oral health knowledge, attitudes, practice, self-efficacy and oral health-related quality of life in Chinese college students

Oral health is crucial for health-related quality of life. However, the research on the factors affecting oral health status is not comprehensive enough. This investigation aimed to evaluate the multifaceted determinants of college students' oral health status and explore the impact of social support, oral health literacy, attitudes, behaviors, and self-efficacy on OHRQoL. By surveying 822 students from a university. Baseline data included sociodemographics (gender, age), social support (MSPSS scale), oral health self-efficacy (SESS scale), oral health knowledge, attitudes, and practices (KAP questionnaire), and OHRQoL (OHIP-14 scale). Based on social cognitive theory, partial least squares structural equation modeling (PLS-SEM) and fuzzy set qualitative comparative analysis (fsQCA) were used to examine the relationship between the study variables. PLS-SEM results showed that knowledge, attitude, and practice predicted OHRQoL through self-efficacy. FsQCA results showed that the combination of different variables was sufficient to explain OHRQoL. The conclusion was that self-efficacy plays an important role and the combination of high-level knowledge, positive attitudes, and strong self-efficacy was important in improving OHRQoL. The results of this study provided a reference for the oral health strategy planning of college students in China.

A Systematic Review of Parents' Knowledge of Children's Oral Health

Young children's oral health is maintained mainly by adults' knowledge and attitude. This study evaluated parents' attitudes, actions, and knowledge regarding their children's dental health. We searched the electronic MEDLINE, Embase, Cochrane, and PubMed databases. Additionally, each relevant article's and book's bibliography was thoroughly searched. Included were the phrases "Knowledge" [MeSH] ", Attitude" [MeSH] ", Parents" [MeSH] ", Children" [MeSH] "And Oral Health" [MeSH]. This review emphasizes the growing global interest in parents' contributions to children's dental health. It is necessary to raise awareness about the knowledge and significance of deciduous teeth, frequent dental appointments throughout society, and implement parental oral health education programs because parents need more awareness.

Dental aesthetic related popularity and peer pressure, a survey of adolescents in Pakistan

OBJECTIVES

Most research has focused on determining how popularity and peer pressure impact behaviours, rather than identifying a key feature such as dental aesthetics and studying its impacts in relation to popularity and peer pressure.

METHODS

A cross sectional study was conducted on a sample of 527 children from four schools located in Lahore, Pakistan. A 14-point questionnaire was developed, using existing measures of peer pressure, and popularity. The selected questions were modified to investigate the issues of dental aesthetics and integrated into the WHO oral health questionnaire for children.

RESULTS

More than 50 % of the participants indicated popularity issues regarding dental aesthetics. 63.5 % of the responses indicated an influence of relatives and friends, whereas 38 % responses reported of harassment and bullying at schools. Regression analysis shows that the females were 1.99 times more likely to get comments from relative or friends about their teeth and 2.17 times more likely to be bullied or harassed at school due to their teeth when compared to the males. Fathers with a higher education brought about higher popularity and peer pressure issues. Mothers with a higher education were less likely to cause popularity and peer pressure issues than mothers with a lower education. Popularity and peer pressure were both significantly related to higher dental visitation.

CONCLUSIONS

Popularity and peer pressure have a direct link to dental aesthetics in an individual and are impacted by gender, family relatives and parental influences. The area of popularity and peer pressure related to dental aesthetics can be targeted in health education programs to empower children to adopt better oral health behaviours.

How does parents' social support impact children's health practice? Examining a mediating role of health knowledge

BACKGROUND

Family environmental factors play a vital role in shaping children's health practices (e.g., obesity prevention). It is still unclear how parents' social support affects children's obesity-related health practices. The present study argues that whether parents' social support positively associates with children's obesity-related health practice depends on if it could promote parents' obesity-related health knowledge. Thus, we hypothesize that health knowledge mediates the relationship between parents' social support and children's health practice regarding weight management.

METHODS

To test the hypothesis, we conducted a questionnaire survey and collected a nationally representative sample of 1488 household responses in Singapore. The survey included questions about parents' social support, health knowledge, children's health practices, and socio-demographic variables. All participants have at least one child 14 years old or younger. In the sample, 66.1% of the respondents are female, and 93.7% are below 50 years old. Structural equation modeling (SEM) via Stata was used to examine the associations between parents' social support, health knowledge, and children's health practice.

RESULTS

The results of our analysis support our hypothesis. Specifically, (1) parents' social support shows a positive relationship with health knowledge (Coef. = 0.17, p < 0.001 for BMI knowledge and Coef. = 0.18, p < 0.001 for nutrition knowledge); (2) parents' social support (total effect of social support = 0.081, p = 0.071) and health knowledge positively associate with children's obesity-related health practice (coefficient of BMI knowledge = 0.10, p < 0.01; coefficient of nutrition knowledge = 0.31, p < 0.001); and (3) the effects of parents' social support on children's health practice is fully mediated by parents' health knowledge (mediating effect = 100%, p = 0.007).

CONCLUSION

The present study provides fresh evidence from a multicultural context to understand the relationships between parents' social support, health knowledge, and children's obesity-related health practice. Our findings support the argument that social support from parents' social networks does not necessarily promote health outcomes. The only social support that carries proper health knowledge can facilitate good health practice.

One-year oral health outcome of a community-based trial in schoolchildren aged 6-7 years old in Tehran, Iran

Promoting schoolchildren's oral health is important, particularly in developing countries. This study was conducted to monitor the oral health of schoolchildren aged 6-7 years old following the implementation of an oral health promotion program in Tehran, Iran. The protocol was registered in the Iranian Registry of Clinical Trials (Code: IRCT20090307001749N4). A cluster random sampling method was applied, and the schools were randomly allocated to intervention and control groups. An intervention package consisting of a one-day workshop for parents and supervised toothbrushing for children was employed. In both groups, the Caries Assessment Spectrum and Treatment (CAST) and Oral Hygiene Index Simplified (OHI-S) were evaluated at baseline and at one-year follow-up in addition to the questionnaire data. Clinical data were collected by calibrated examiners at both intervals (Kappa = 89.8%, 87.68%) and analyzed using the SPSS software ver. 22.0. Of 739 children included at baseline, 593 were re-examined after one year (response rate = 74%). According to the Generalized Estimating Equation (GEE) analysis, considering the confounding effect of time, significantly more children in the control group had deciduous molars with a score of 3 and higher compared to the intervention group (OR = 1.79; 95% CI:1.17-2.73, p = 0.007). The oral hygiene status of the children significantly improved in the intervention group compared to the controls (B = -0.27; 95% CI: -0.45 --0.08, p = 0.005). After one year, the improvement in the oral health-related attitude of parents and children's oral health behavior was marginally significant in the intervention group compared to the control group [0.2 (0.17) vs. -0.13 (0.05), p = 0.096] and [0.06 (0.06) vs. -0.05 (0.04), p = 0.09], respectively. However, the impact on the oral health-related knowledge and self-reported behavior of the parents was not significant. In the intervention group, children had less caries and a better oral hygiene status compared to the controls after one year.

Associations between oral habits, dental anxiety, dental service utilization, and maternal mental health status among 6- to 12-year-old children in Ile-Ife, Nigeria

PURPOSE

The current study sought to determine the associations between maternal mental health and oral habits, dental anxiety, and dental service utilization of 6- to 12-year-old children in Ile-Ife, Nigeria.

METHODS

Data were obtained from a household survey involving 1411 mothers and their 6- to 12-year-old children. Data collected were the confounding (maternal age, child's age at last birthday, sex at birth and socioeconomic status), independent (maternal psychological distress, and depression status) and dependent (child's non-nutritive oral habits, dental anxiety level, and most recent dental visit) variables. Bivariate analyses were conducted to test the associations between the dependent and independent variables. After controlling for confounding variables, the associations between the dependent and independent variables were determined using multivariable linear and logistic regression analyses.

RESULTS

Overall, 479 (33.9%) reported one oral habit, 189 (13.4%) reported two and 99 (7.0%) children reported three or more oral habits. Only 25 (1.7%) children reported a dental visit in the year preceding the study. Higher maternal psychological distress was associated with higher dental anxiety in children (AOR: 0.094; 95% CI - 0.080 to - 0.293; p < 0.001). There was no significant association between maternal psychological distress, child's non-nutritive oral habits, and the child's most recent dental visit. There was also no association between maternal depression and the child's non-nutritive oral habits, dental anxiety level, and most recent dental visit.

CONCLUSION

Maternal psychological distress was a significant risk indicator for dental anxiety, but not for dental service utilization or non-nutritive oral habits among children in Ile-Ife, Nigeria. Maternal educational status was also associated with dental anxiety. Further research is needed to elucidate the study's findings.

Oral and Dental Health Knowledge and Attitudes among Parents of Children

Objective: This study aims to evaluate parents’ knowledge and attitudes level on oral and dental health. Methods: One hundred and thirty parents of children aged 6-12 years, were invited to participate in the study. A 33-item questionnaire covering socio-demographic characteristics, dental attitude, dietary practices, tooth eruption, dental caries, and oral hygiene practices, was distributed to parents. The relationship between categorical variables was tested with the Chi-square test. Results: The sample comprised of 100 parents with a mean age of 37.1 ± 6.4. The knowledge and attitudes towards dental caries and oral health habits among parents did not differ significantly according to the parents’ gender, education level, or dental chair experience. There was a statistically significant difference in the responses of the first primary tooth and the first exfoliating primary tooth according to the gender of the parents (p=0.031, p=0.002, respectively). Although the education level of the parents did not affect the answers about the number of primary and permanent teeth, a statistically significant difference was found in the time of first primary tooth eruption (p=0.008). Conclusion: The study showed that parents do not have enough knowledge and awareness of dental caries and oral healthcare. Oral healthcare should be promoted as a part of general health and the awareness of the public should be increased.

Predictors of Hand-Washing Practices at Critical Times Among Mothers of Under-5 Years Old Children in Rural Setting of Gedeo Zone, Southern Ethiopia

BACKGROUND

Various communicable and infectious diseases could be contained by proper hand washing leading to a reduction in mortality and morbidity of children.

OBJECTIVE

To assess predictors of hand-washing practices at critical times among mothers of under 5 years old children in rural setting of Gedeo zone, Southern Ethiopia.

METHOD

An institutional-based cross-sectional survey was conducted among 422 women with children under the age of 5 attended the Dilla Zuria health facility and were chosen using a systematic sampling method. Data was gathered using pre-tested interview-administered structured questionnaires. Data was entered into EPI info version 17 and analyzed using SPSS version 25. Binary logistic regression was employed to identify the association between dependent and independent variables. Finally, for variables with a P < .05 in multivariable analysis, adjusted odds ratio (AOR) with a 95% confidence interval (CI) was determined and interpreted.

RESULTS

The hand washing practice of mothers at critical times was 44.9% [95% CI: 40.1, 49.7%]. The pertinent predictors were favorable attitude [AOR = 7.77, 95% CI: 4.56, 10.37], availability of water source near the household [AOR = 5.31, 95% CI: 3.56, 10.37], and constant availability of soaps at household [AOR = 2.32, 95% CI: 1.33, 6.70].

CONCLUSION

In our study, hand-washing practices at critical times was low. The pertinent predictors were attitude, the presence of a water source near the household, and the presence of soap. Therefore, it is advised to encourage domestic hygiene education to improve mothers' attitudes and to increase the availability of water and soap close to the household to promote handwashing with soap and water at critical times.

Prevalence of Dental Caries in Children in Mymensingh and Its Associated Risk Factors: A Cross-Sectional Study

Background: Children suffer from various oral and periodontal diseases. Dental caries is one of the most prevalent oral diseases among children in the world. This study was conducted to identify the prevalence and risk factors of dental caries in children in Mymensingh, Bangladesh. Methods: A cross-sectional study was conducted on 362 pediatric patients who attended the Dental Unit of Mymensingh Medical College from March to September 2019. The sample size was calculated using a statistical formula and the children were selected using a systematic random sampling technique. Children and their guardians were interviewed and data were recorded using a structured questionnaire. Risk factors were analyzed using multivariate logistic regression. Results: The overall prevalence of dental caries was 82.7%. The prevalence of caries was significantly higher in aged children (8–10 years) and also in rural, low-income, and illiterate families. Seven significant risk factors were identified that included residence in the rural area (OR: 7.31 [1.73–30.83]), a parental income of BDT ≤ 20,000 per month (OR: 4.75 [1.49–15.05]), reduced duration (≤1 min) of teeth cleaning (OR: 18.54 [2.05–168.17]), teeth cleaning before breakfast (OR: 93.30 [10.95–795.32]), the spoon-feeding method (OR: 12.57 [2.09–75.61]), long-term (37–48 months) breastfeeding (OR: 212.53 [8.69–5195.25]), and family oral problem (OR: 8.20 [2.57–26.16]). Conclusions: The prevalence of dental caries among the children in Mymensingh is very high and was associated with residence in rural areas, parental income, reduced duration of teeth cleaning, teeth cleaning before breakfast, the spoon-feeding method, long-term breastfeeding, and family oral problems.

Self-perceived oral health-related salutogenic factors in orally healthy older Swedes. A qualitative interview study

OBJECTIVE

This study aimed to explore oral health-related salutogenic factors in orally healthy older Swedish people, applying the three components of Antonovsky's Sense of Coherence (SOC) concept: comprehensibility, manageability and meaningfulness.

MATERIAL AND METHOD

Interviews were conducted with 12 orally healthy patients, aged 75 years and older, enrolled at public dental clinics. The interviews were subjected to qualitative content analysis, applying the SOC concept as the theoretical framework.

RESULTS

Three themes were formulated under the predefined SOC components, describing the central meaning of the informants' perception of factors favourable to their good oral health. The theme 'comprehension of cause and effect' consisted of three categories, for example importance of oral hygiene, and reflected the component comprehensibility. The theme 'living in confidence and trust in supporting society' consisted of five categories, for example self-esteem, and reflected the component manageability. The theme 'good oral health as a basis for satisfaction and social confidence' consisted of two categories, for example social norms, and reflected the component meaningfulness.

CONCLUSION

This study discloses how orally healthy elderly Swedish people perceive the lifelong impact of salutogenic factors in response to lifelong stressors on their oral health and highlights the important roles of their internal resources, dental professionals, family and society in supporting and reinforcing lifelong oral health.

Oral Health Status of Mothers According to Different Personality Traits and Influence on their Child&#39;s Oral Health: A Cross-sectional Survey

Objective

Oral hygiene practices vary as per different personalities. The objective of this study was to evaluate the oral health status of mothers of various personality traits and its influence on their child's oral health.

Materials and methods

The present study was a cross-sectional survey conducted among 450 mothers of 20–40 years having child of 3–7 years. “Eysenck Personality Questionnaire” was given to all the mothers to classify them into four different personality traits, i.e., Extroversion, Neuroticism, Lie scale, and Psychoticism; followed by an assessment of oral health status of both mothers and their child. Collected data were compiled in MS-Excel sheet and subjected to statistical analysis.

Results

Results were statistically analyzed with the analysis of variance (ANOVA). For pairwise intergroup multiple comparisons, post hoc Tukey test was applied. Association of child's oral health status with mother's oral health with respect to four different personality traits was done by linear regression analysis. From the present study it was seen that severity of dental caries status was more in psychoticism group as compared to other personality groups (p < 0.05) for mothers as well as children. Simplified Oral Hygiene Index (OHI-S) was seen to be statistically significant with highest mean in Lie scale group.

Conclusion

From the present study, it was concluded that there is a positive correlation with mother's personality traits and oral health status of mothers and their children.

How to cite this article

Khobragade VR, Vishwakarma P, Dodamani AS, et al. Oral Health Status of Mothers According to Different Personality Traits and Influence on their Child's Oral Health: A Cross-sectional Survey. Int J Clin Pediatr Dent 2022;15(3):316-321.

Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income Countries

Introduction: Collective evidence on risk factors for dental caries remains elusive in low- and middle-income countries (LMICs). The objective was to conduct a systematic review and meta-analysis on risk factors for dental caries in deciduous or permanent teeth in LMICs. Methods: Studies were identified electronically through databases, including Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, PubMed/MEDLINE, and CINAHL, using “prevalence, dental caries, child, family, socioeconomic, and LMIC” as the keywords. A total of 11 studies fit the inclusion criteria. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale (NOS). The MedCalc software and Review Manager 5.4.1 were used. Results: From 11,115 participants, 38.7% (95% CI: 28.4−49.5%) had caries and 49.68% were female. Among those with caries, 69.74% consumed sugary drinks/sweets (95% CI: 47.84−87.73%) and 56.87% (95% CI: 35.39−77.08%) had good brushing habits. Sugary drinks had a two times higher likelihood of leading to caries (OR: 2.04, p < 0.001). Good oral hygiene reduced the risk of caries by 35% (OR: 0.65, p < 0.001). Concerning maternal education, only secondary education reduced the likelihood of caries (OR: 0.96), but primary education incurred 25% higher risks (OR: 1.25, p = 0.03). A 65% reduction was computed when caregivers helped children with tooth brushing (OR: 0.35, p = 0.04). Most families had a low socioeconomic status (SES) (35.9%, 95% CI: 16.73−57.79), which increased the odds of caries by 52% (OR: 1.52, p < 0.001); a high SES had a 3% higher chance of caries. In the entire sample, 44.44% (95% CI: 27.73−61.82%) of individuals had access to dental services or had visited a dental service provider. Conclusion: Our findings demonstrate that high sugar consumption, low maternal education, and low and high socioeconomic status (SES) increased the risk of dental caries in LMICs. Good brushing habits, higher maternal education, help with tooth brushing, and middle SES provided protection against caries across LMIC children. Limiting sugars, improving oral health education, incorporating national fluoride exposure programs, and accounting for sociodemographic limitations are essential for reducing the prevalence of dental caries in these settings.

Parent Training for Dental Care in Underserved Children With Autism: A Randomized Controlled Trial

OBJECTIVE

Children with autism spectrum disorder (ASD) have difficulty participating in dental care and experience significant unmet dental needs. We examined the efficacy of parent training (PT) for improving oral hygiene and oral health in underserved children with ASD.

METHOD

Families of Medicaid-eligible children with ASD (ages 3-13 years, 85% boys, 62% with intellectual disability) reporting difficulty with dental care participated in a 6-month randomized controlled trial comparing PT (n = 60) with a psychoeducational dental toolkit (n = 59). Primary outcomes were parent-reported frequency of twice-daily toothbrushing and dentist-rated visible plaque. Secondary outcomes included parent-reported child behavior problems during home oral hygiene and dentist-rated caries. Dentists were blind to intervention assignment. Analyses were intention to treat.

RESULTS

Retention was high at posttreatment (3 months, 93%) and 6-month follow-up (90%). Compared with the toolkit intervention, PT was associated with increased twice-daily toothbrushing at 3 (78% vs 55%, respectively; P < .001) and 6 (78% vs 62%; P = .002) months and a reduction in plaque at 3 months (intervention effect, -0.19; 95% confidence interval [CI], -0.36 to -0.02; P = .03) and child problem behaviors at 3 (-0.90; 95% CI, -1.52 to -0.28; P = .005) and 6 (-0.77; 95% CI, -1.39 to -0.14; P = .02) months. Comparatively fewer caries developed in children receiving the PT intervention over 3 months (ratio of rate ratios, 0.73; 95% CI, 0.54 to 0.99; P = .04).

CONCLUSIONS

PT represents a promising approach for improving oral hygiene and oral health in underserved children with ASD at risk for dental problems.

Knowledge, Attitude, and Practice of Parents toward Their Children\'s Oral Health and its Influence on the Dental Caries Status of 5-10-year-old Schoolchildren in Nashik, Maharashtra: A Cross-sectional Study

Aim

The aim of the present study is to assess the knowledge, attitude, and practices of parents toward their children's oral health and its influence on the dental caries status of 5-10 years old schoolchildren in Nashik, Maharashtra.

Materials and methods

A cross-sectional questionnaire-based study was conducted among parents of 5-10 years old school children who visited our hospital. A total of 504 children and their parents were included in the study. Clinical examination of children was done using DMFT and deft index. A self-designed questionnaire was given to the parents to assess their knowledge, attitude and practices toward their children's oral health. Statistical analysis was performed using EPI INFO version 6.04. ANOVA test was used to test the association between dental caries status and KAP. p -value < 0.05 was considered to be statistically significant.

Results

The mean DMFT was 1.6 ± 1.5 and mean deft was 6.6 ± 3.4. Majority of the parents (64.9%) showed fair knowledge, attitude, and practices. There was no significant difference between mean DMFT/deft and parental KAP.

Conclusion

Overall the parents in the present study had reasonable KAP about oral health of their children. Deficient areas of oral health awareness include importance of milk teeth and their treatment, regular dental visits, and dietary practices.

Clinical significance

Oral health awareness programs should be directed toward parents and should emphasize on topics such as importance of milk teeth and their treatment, regular dental visits, and dietary practices.

How to cite this article

Patil AN, Karkare S, Jadhav HS, et al. Knowledge, Attitude, and Practice of Parents toward Their Children's Oral Health and its Influence on the Dental Caries Status of 5-10-year-old School-children in Nashik, Maharashtra: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(S-2):S126-S130.

Relationship between dental experiences, oral hygiene education and self-reported oral hygiene behaviour

Many preventive approaches in dentistry aim to improve oral health through behavioural instruction or intervention concerning oral health behaviour. However, it is still unknown which factors have the highest impact on oral health behaviours, such as toothbrushing or regular dental check-ups. Various external and internal individual factors such as education, experience with dentists or influence by parents could be relevant. Therefore, the present observational study investigated the influence of these factors on self-reported oral heath behaviour. One hundred and seventy participants completed standardized questionnaires about dental anxiety (Dental Anxiety Scale (DAS), and dental self-efficacy perceptions (dSEP)). They also answered newly composed questionnaires on oral hygiene behaviours and attitudes, current and childhood dental experiences as well as parental oral hygiene education and care. Four independent factors, namely attitude towards oral hygiene, attitude towards one's teeth, sense of care and self-inspection of one's teeth were extracted from these questionnaires by rotating factor analysis. The results of the questionnaires were correlated by means of linear regressions. Dental anxiety was related to current negative emotions when visiting a dentist and negative dental-related experiences during childhood. High DAS scores, infantile and current negative experiences showed significant negative correlations with the attitude towards oral hygiene and one's teeth. Dental anxiety and current negative dental experiences reduced participants' dental self-efficacy perceptions as well as the self-inspection of one's teeth. While parental care positively influenced the attitude towards one's teeth, dental self-efficacy perceptions significantly correlated with attitude towards oral hygiene, self-inspection of one's teeth and parental care. Dental anxiety, dental experiences, parents' care for their children's oral hygiene and dental self-efficacy perceptions influence the attitude towards oral hygiene and one's own oral cavity as well as the autonomous control of one's own dental health. Therefore, oral hygiene instruction and the development of patient-centred preventive approaches should consider these factors.

Comparison of the effect of mothers and students' education on the promotion of oral health behaviours in female students, using the health belief model

BACKGROUND

Oral diseases are considered an important health challenge around the world, especially among children. This study aimed to compare the effects of mothers and students' education on female students' oral health behaviours.

METHODS

This three-arm randomized controlled educational trial was conducted on 261 fifth- and sixth-grade female students. The participants were selected and divided into two intervention groups (students' mothers and students) and a control group through simple random sampling. The intervention included four 60-min and two 90-min education sessions for the students and their mothers, respectively. The data were analysed using the SPSS 22 software.

RESULTS

The results revealed a significant increase in the mean scores of knowledge (p < 0.001), self-efficacy (p = 0.038), and cues to action (p < 0.001) in the students' intervention group. However, in the students-mothers' group the mean score of knowledge significantly increased (p < 0.001), and perceived barriers significantly decreased (p = 0.001). After the intervention, a significant difference was observed among the three study groups regarding the mean scores of knowledge (p < 0.001), perceived susceptibility (p = 0.005), perceived severity (p = 0.005), perceived benefits (p = 0.011), cues to action (p < 0.001) and brushing and flossing behaviours (p < 0.001).

CONCLUSION

In this study, the mothers' education did not have any additional effects on the students' education. It seems that, in underprivileged communities where mothers had a low level of education, it might be better for oral health education to focus more on the students.

Family structure, sociodemographic factors and type of dental service associated with oral health literacy in the early adolescence

The aim of this study was to evaluate associations between oral health literacy and family, sociodemographic and dental service characteristics in early adolescents. A cross-sectional study was conducted with 740 schoolchildren. The following variables were investigated using validated questionnaires: oral health literary (BREALD-30), sociodemographic characteristics, type of dental service and family functioning (FACES III). Associations were tested using robust Poisson regression analysis (α=5%). Higher oral health literacy was associated with the female sex (RR=1.09; 95%CI: 1.03-1.14), connected type of family cohesion (RR=1.12; 95%CI: 1.05-1.20), rigid (RR=1.14; 95%CI: 1.04-1.25) and structured (RR=1.11; 95%CI: 1.04-1.20) types of family adaptability, more than eight years of mother's schooling (RR=1.16; 95%CI: 1.10-1.22), age of caregiver more than 38 years (RR=1.07; 95%CI: 1.02-1.13) and the use of private dental services (RR=1.06; 95%CI: 1.01-1.12). The level of oral health literacy in early adolescents was associated with sex, family structure, mother's schooling, caregiver's age and type of dental service used.

The influence of family socioeconomic status on toothbrushing practices in Australian children

OBJECTIVE

To assess the relationship between toothbrushing behavior and socio-demographic characteristics in Australian children.

METHODS

Data were collected through the 2012-2014 Australian National Child Oral Health Survey (NCOHS). NCOHS was a cross-sectional survey of representative school children aged 5-14 years of Australia with a total sample size of 24,664 children.

RESULTS

Two-thirds (69%) of Australian children brushed twice or more times a day and the mean age of starting toothbrushing with fluoridated toothpaste was 24 months. Males were less consistent with toothbrushing than females (OR = 0.85; 95% CI: 0.74-0.97) and the likelihood of brushing twice or more a day improved with the increase in age (OR = 1.05; 95% CI: 1.02-1.08). Children with university educated (OR = 1.80; 95% CI: 1.44-2.26), vocational trained parents'/guardians' (OR = 1.45, 95% CI 1.11-1.90), living in families with an income of >AU$120,000 (OR = 1.42; 95% CI: 1.08-1.89) and having an overseas born parent (OR = 1.30; 95% CI: 1.07-1.58) were more likely to brush their teeth twice or more a day than their comparative counterparts. Children in households with two children (OR = 1.33; 95% CI: 1.07-1.64) were more likely to brush twice or more than single-child households. Children with a health welfare card tended to delay the start of toothbrushing by 1.4 months in comparison to those without a welfare card. Children with one of the caregivers born overseas started brushing later than those with Australia born caregivers (B = 1.04; SE = 0.46). Children living in high income and educated families and households with two or more children tended to start toothbrushing at an earlier age.

CONCLUSIONS

Several family socio-demographic factors influenced toothbrushing habits in Australian children.

Caries incidence of the first permanent molars according to the Caries Assessment Spectrum and Treatment (CAST) index and its determinants in children: a cohort study

Background

There are limited information on caries incidence, especially from developing countries, the aim of the present study was to explore caries incidence in the first permanent molar teeth according to the CAST index in 7- to 8-year-old-children and its socio-demographic, oral health related and diet determinants.

Methods

A multi-stage cluster random sample of 7–8 years old children was applied in Tehran, Iran. The oral examination using the CAST index and the Oral Hygiene Index-Simplified (OHI-S) performed by trained dentists in 2017 and 2019 calibrated with an expert (Kappa of 0.89 and 0.76, respectively). A 3-day food record was used to record sugary snacks consumption. Oral health related knowledge of the parents was assessed using a valid and reliable self-administered questionnaire. The data were analyzed using the SPSS software version 23.0 and descriptive and analytical statistics including the negative binomial regression was applied.

Results

Two hundred and ninety schoolchildren aged 7–8 years old were followed up for two years. All of them had complete data obtained via oral examination and questionnaires. The annual caries incidence rate was 0.16 and 53% (95% CI 47.4–58.9) of the children developed at least one new dental caries (enamel or dentine) during two years. Multi-variate analysis revealed that the children of mothers with high school education or diploma (IRR = 1.47, 95% CI 1.02–2.12; p = 0.04) and those with low socio-economic status (IRR = 1.86, 95% CI 1.27–2.73; p < 0.001) were more likely to develop caries. There was no significant association between gender, father’s educational level, child birth order, housing area per person, OHI-S score, oral health knowledge of parents, and sugary snacks consumption per day and caries increment at an individual level.

Conclusion

This 2-year longitudinal study on 7- to 8-year-old children showed that caries incidence according to the CAST index was associated with socio-economic status and mother education but not associated with having 2 or more sugary snack per day and oral hygiene status.

Does maternal tooth brushing-related sef-efficacy predict child's brushing adherence?

BACKGROUND

Dental plaque is a root cause of dental caries. Effective plaque control in young children can be achieved with twice-daily assisted tooth brushing. Self-efficacy relates to one's confidence in performing a task. Self-efficacy is shown to facilitate the behavior change in treatments for lifestyle diseases. The influence of maternal self-efficacy in children's oral health behaviors is less studied.

AIM

The aim of this study is to evaluate an association between maternal tooth brushing-related self-efficacy (MTBSE) and child's brushing adherence.

SETTINGS AND DESIGN

This cross-sectional study was conducted in schools and included 781 mother-child dyads with children between the age group of 2 and 6 years.

METHODS

Selected mothers were asked to complete the questionnaires on sociodemographic data, mother's oral health knowledge (MOHK), tooth-brushing practices, and MTBSE. Brushing adherence was evaluated as complete adherence if the child followed twice daily assisted brushing using the toothbrush and toothpaste.

STATISTICAL ANALYSIS

Nonparametric tests were used to compare the variables. Binary logistic regression was used to evaluate the predictors of brushing adherence.

RESULTS

Complete brushing adherence (assisted brushing with toothbrush and toothpaste at least twice per day) was seen only in 26.9% children. More children with complete brushing adherence were single children (P < 0.001). Children with complete brushing adherence had mothers with significantly higher MTBSE (P < 0.001). The presence/absence of siblings, MOHK, and MTBSE were found to be strong and significant predictors of brushing adherence in children.

CONCLUSIONS

MTBSE plays a significant role in complete adherence to toothbrushing in children aged 2-6 years.

Parental Awareness and Knowledge toward their Children's Oral Health in the City of Dammam, Saudi Arabia

Introduction

Two main factors have a great influence on the youth's oral well-being. These are their dental health and age. These two factors are significantly directed by parents through establishing a system of proper oral hygiene and a preventative routine for those young adults.

Aim and objective

The following study was run in the Dammam region, Saudi Arabia, to assess guardian awareness of youngster's dental health.

Materials and methods

This community-based study was designed in a cross-sectional pattern, where a sample size of 248 parents who fulfilled inclusion criteria was selected and a well-designed validated questionnaire was used for the collected database using SPSS (VER. 24).

Results

The main found included that, about 51% of participants were fathers and 49% were mothers, 90% of them above the age of 26 years old and most of the participants had a secondary certificate or university degree, 38% and 45%, respectively, only 64% of parents have checked their children teeth, the average of overall knowledge of parents toward dental health was medium 7.97 points out of 16.0 points and there was a statistically significant relationship between parents type, educational level, and overall knowledge related to oral health.

Conclusion

From our study, it was acknowledged that the perception of children's oral health status by their parents in the Dammam region is relatively medium, so general awareness of parents' knowledge should be raised by conducting effective oral health programs and interventions.

How to cite this article

Alshammari FS, Alshammari RA, Alshammari MH, et al. Parental Awareness and Knowledge toward their Children's Oral Health in the City of Dammam, Saudi Arabia. Int J Clin Pediatr Dent 2021;14(1):100-103.

Oral Hygiene Awareness and Practices among a Sample of Primary School Children in Rural Bangladesh

Inadequate oral health knowledge and awareness is more likely to cause oral diseases among all age groups, including children. Reports about the oral health awareness and oral hygiene practices of children in Bangladesh are insufficient. Therefore, the objective of this study was to evaluate the oral health awareness and practices of junior school children in Mathbaria upazila of Pirojpur District, Bangladesh. The study covered 150 children aged 5 to 12 years of age from three primary schools. The study reveals that the students have limited awareness about oral health and poor knowledge of oral hygiene habits. Oral health awareness and hygiene practices amongst the school going children was found to be very poor and create a much-needed niche for implementing school-based oral health awareness and education projects/programs.

Oral health behaviour, attitude towards, and knowledge of dental caries among mothers of 0- to 3-year-old children living in Kaunas, Lithuania

OBJECTIVES

This study aimed to investigate the oral health behaviours of mothers with young children and their attitudes towards dental caries.

METHODS

The survey targeted all mothers with children under 3 years attending a primary healthcare centre (Department of Family Medicine at the Lithuanian University of Health Sciences [LSMU] Hospital) in Kaunas, Lithuania. The Bioethics Centre of the LSMU approved the study (No. BEC-OF-14). Of 176 mothers, 123 (69.9%) took part in the 2016-2017 study. The self-administered questionnaire enquired about mothers' attitudes towards oral health and behaviours related to the potential transmission of oral bacteria to their children, dietary habits, tooth brushing, smoking, and background factors. The chi-squared test and univariate/multivariate logistic regression analyses served for the statistical analysis. (p values ≤ .05 indicated statistically significant differences).

RESULTS

Most (76; 68.5%) of the mothers brushed their teeth twice daily, and 97 (87.4%) reported themselves as nonsmokers. We found a statistically significant association between mothers who brushed their own teeth twice daily and those who cleaned their children's teeth likewise (OR = 5.42, 95% CI [1.28-6.63]; p = .005). We observed significant associations among mothers who gave their children sugar-sweetened beverages (SSBs) daily and the mothers' college or lower education (OR = 6.51, 95% CI [1.59-27.19]; p = .01) and maternal tooth brushing less than twice daily (OR = 3.88, 95% CI [0.99-15.18]; p = .05).

CONCLUSIONS

A majority of mothers who took part in this survey did not brush their children's teeth as recommended. Mothers with a lower education and who brushed their teeth less than twice daily offered their children SSBs more frequently.

A cross sectional study of Mexican caregiver social status, dental knowledge, self-efficacy, and caregiver/child oral health. A structural equation model

OBJECTIVES

To test hypothetical models relating caregivers' social status, knowledge, and self-efficacy to caregiver/child (C/C) oral health-related outcomes.

METHODS

One hundred fifty C/C pairs participated (recruitment = 87.7 percent). Three C/C outcomes were clinically assessed: "Oral self-care"; "Functional dentitions"; and "Dental treatment needs." Information about caregiver (CG) social status, knowledge, and self-efficacy was also gathered. Structural equation modeling tested measurement models (MMs) for CG social status, CG knowledge, and CG self-efficacy. The structural models (SMs) hypothesized causal paths among CG social status, CG knowledge, CG self-efficacy, and C/C oral health outcomes.

RESULTS

All three MMs had a good overall fit (nonsignificant χ² estimates, Goodness of Fit Index >0.95, Normed Fit Index ~ >0.95, Confirmatory Fit Index >95, Root Mean Square Error Approximation <0.05). For the SMs, the best overall fit was for "Functional dentitions," while SMs for "Oral self-care," and "Dental treatment needs" required revisions. In all the SMs, the path between "Caregiver social status" and "Caregiver knowledge" was significant. In the "C/C Functional dentitions" SM, the significant path linked "CG self-efficacy" and "Child functional dentition." In the "C/C Dental treatment needs" SM, the significant path linked "CG self-efficacy" and "CG functional dentition."

CONCLUSIONS

Hypothetical models for three oral health-related outcomes were partly or fully validated.

Does the Association between Guardians' Sense of Coherence and their Children's Untreated Caries Differ According to Socioeconomic Status?

Untreated caries is the most prevalent disease in the world. A sense of coherence (SOC) is believed to contribute to oral health. We aimed to clarify the association between guardians' SOC and their children's caries based on socioeconomic status (SES) in Japan. This study's subjects were Japanese public junior high schoolers (N = 1730), aged 12-15, and their guardians in Kosai City. We administered a questionnaire survey among guardians in 2016 to assess their SOC and family environment. With their students' consent, public junior high schools shared the results of the dental examinations that were part of their school physicals. Multivariate logistic regression was conducted to clarify the association between guardians' SOC and their children's untreated decayed permanent teeth. We also conducted a stratified analysis according to a relative poverty line. We observed in the multivariate regression a significant inverse association between children's untreated decay and their guardians' SOC (OR 0.93, 95%CI 0.87-1.00). The association of SOC was stronger in the low economic group (OR 0.64, 95%CI 0.43-0.95). Guardians with higher SOC were associated with children having fewer caries. Guardians' SOC is a factor for the prevalence of caries and access to dental care, especially among children with low economic status.

The role of parental education in the dental health behavior of Turkish secondary school children

Background/Aim: Parents are usually the major factor influencing children's development of routine oral health behavior. A higher education level of the parents is generally associated with having a more positive influence on their children's health habits and motivation to maintain healthy dentition. From this perspective, the aim of the present study was to investigate the frequency of certain habits influencing dental health, such as toothbrushing, regular visits to the dentist, and changing toothbrushes, in a group of Turkish secondary school children, and to explore its relation to the education level of their mothers and fathers. Material and Methods: The study consisted of the use of a questionnaire designed to collect demographic information, oral health behavior of the children, and the parents' education level. Demographic characteristics and oral health behavior of the children were asked of the children in a face-to-face interview by one investigator. Only the parents' education level was asked of the children's parents. Results: The mean age of the 444 children was 11.66 ± 0.98. According to chi-square testing applied, there was a statistically significant correlation between the parents' education level and their children's dental visit frequency (p< 0.05), whereas there was no statistically significant link between the parents' education level and the frequency of the children's toothbrushing and replacing their toothbrushes (p> 0.05). Conclusions: Irrespective of the education level of their parents, positive oral health attitudes and behavior were not observed in Turkish secondary school children.

Dental Health Status and Oral Health Care in Nursery School-Aged Children and their Parents Living in Poznan (Poland)

OBJECTIVES

The aim of this study was to evaluate the dental health status of nursery age children and parents. The use of dental services was assessed.

SUBJECTS AND METHODS

The study was performed in nursery schools located in Poznan, Western Poland. Clinical examination was carried out in 157 children (48.41% males and 51.59% females), aged 10-42 months. Dental health status (the number of teeth with caries, fillings and extracted) of their parents was determined on the basis of data obtained from a questionnaire. The questions also concerned information on child's and parents' dental check-ups and opinion on their predisposition to dental caries.

RESULTS

Clinical examination revealed that 21.05% of boys and 18.51% of girls had dental caries. Most mothers had from 1 to 5 either carious and/or filled teeth (47.13%) or extracted teeth due to carious process (61.15%); the fathers' values were similar at 46.50 and 66.24%, respectively. More mothers (84.71%) than fathers (72.62%) had regular dental check-ups (p = 0.02). The analysis of mother-father-child triads showed that when both parents visited the dentist regularly, more children were free of caries (56.68%) in comparison to those with the disease (13.38%; p < 0.001).

CONCLUSIONS

This study showed that the dental health status, as well as oral care of nursery school children and their parents, is unsatisfactory. Therefore, there is a need to introduce an intensive dental educational program focusing on dental prophylaxis for nursery age children and their parents or caregivers.

Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries

BACKGROUND

Dental caries is one of the most common chronic diseases of childhood and is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC).

OBJECTIVES

To assess the effects of interventions with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years of age).

SEARCH METHODS

Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 14 January 2019), Cochrane Pregnancy and Childbirth Group's Trials Register (to 22 January 2019), Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Register of Studies, to 14 January 2019), MEDLINE Ovid (1946 to 14 January 2019), Embase Ovid (1980 to 14 January 2019) and CINAHL EBSCO (1937 to 14 January 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on language or publication status.

SELECTION CRITERIA

Randomised controlled trials (RCTs) comparing one or more interventions with pregnant women, mothers, or other caregivers of infants in the first year of life (intervention types included clinical, oral health education/promotion such as hygiene education, breastfeeding and other dietary advice, and policy or health service), versus standard care or placebo or another intervention. For inclusion, trials had to report at least one caries outcome.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed trial eligibility, extracted data, assessed risk of bias, and assessed certainty of evidence using the GRADE approach.

MAIN RESULTS

We included 17 RCTs (4 cluster-randomised), involving 23,732 caregivers (mainly mothers) and their children. Eleven RCTs assessed four oral health education/promotion interventions against standard care: child diet advice, child diet and feeding practice advice, breastfeeding promotion and support, and oral hygiene with child diet and feeding practice advice. Six trials assessed clinical interventions in mother's dentition, four trials chlorhexidine (CHX, a commonly prescribed antiseptic agent) or iodine-NaF application and prophylaxis versus placebo, and two trials xylitol against CHX or CHX + xylitol. At most, three trials (maximum of 1148 children and 130 mothers) contributed data to any comparison. For many trials, risk of bias was judged unclear due to lack of methodological details reported, and there was high risk of attrition bias in some trials. None of the included trials indicated receiving funding that is likely to have influenced their results. The trials were performed in high-, middle- and low-income countries. In nine trials, participants were socioeconomically disadvantaged. For child diet and feeding practice advice versus standard care, we observed a probable 15 per cent reduced risk of caries presence in primary teeth with the intervention (RR 0.85, 95% CI 0.75 to 0.97; 3 trials; 782 participants; moderate-certainty evidence), and there may be a lower mean dmfs (decayed, missing, filled primary surfaces) score (MD -0.29, 95% CI -0.58 to 0; 2 trials; 757 participants; low-certainty evidence); however, we are uncertain regarding the difference between the groups in mean dmft (decayed, missing, filled teeth) score (MD -0.90, 95% CI -1.85 to 0.05; 1 trial; 340 participants; very low-certainty evidence). For breastfeeding promotion and support versus standard care, we observed that there may be little or no a difference between groups in the risk of caries presence in primary teeth (RR 0.96, 95% CI 0.89 to 1.03; 2 trials; 1148 participants; low-certainty evidence), or mean dmft score (MD -0.12, 95% CI -0.59 to 0.36; 2 trials; 652 participants; low-certainty evidence). Dmfs was not reported for this comparison. We are uncertain whether child diet advice only compared with standard care reduces risk of caries presence in primary teeth (RR 1.08, 95% CI 0.34 to 3.37; 1 trial; 148 participants; very low-certainty evidence). Dmfs and dmft were not reported for this comparison. For oral hygiene, child diet and feeding practice advice versus standard care, we observed little or no reduced risk of caries presence in primary teeth (RR 0.91, 95% CI 0.75 to 1.10; 2 trials; 365 participants; low-certainty evidence), and are uncertain regarding difference between the groups in mean dmfs score (MD -0.99, 95% CI -2.45 to 0.47; 1 trial; 187 participants; very low-certainty evidence) and dmft score (MD -0.30, 95% CI -0.96 to 0.36; 1 trial; 187 participants; very low-certainty evidence). We observed there may be little or no difference in risk of caries presence in primary teeth between antimicrobial and placebo treatment in mother's dentition (RR 0.97, 95% CI 0.80 to 1.19; 3 trials; 479 participants; very low-certainty evidence). No trials assessing this comparison reported dmfs or dmft. For xylitol compared with CHX antimicrobial treatment, we observed there may be a lower mean dmft score with xylitol (MD -2.39; 95% CI -4.10 to -0.68; 1 trial, 113 participants; low-certainty evidence); however, we are uncertain regarding the difference between groups in caries presence in primary teeth (RR 0.62, 95% CI 0.27 to 1.39; 1 trial, 96 participants; very low-certainty evidence). Neither trial evaluating this comparison reported dmfs. No trials assessed a health policy or service intervention.

AUTHORS' CONCLUSIONS

Moderate-certainty evidence suggests that providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries (ECC). The remaining evidence is low to very low certainty and is insufficient for determining which, if any, other interventions types and features may be effective for preventing ECC. Large, high-quality RCTs of oral health education/promotion, clinical, and policy and service access interventions, are warranted to determine effects and relative effects of different interventions and inform practice. We have identified 12 studies currently in progress. Those designing future studies should describe the intervention components, setting and participants, consider if and how effects are modified by intervention features and participant characteristics, and adopt a consistent approach to measuring and reporting ECC.

Maternal anxiety, social status, and dental caries formation in children: a cross-sectional study

Objective

We sought to evaluate the association of maternal anxiety and social status with caries formation in children.

Methods

Participants comprised 258 pairs of children and their mothers. We collected information regarding age, sex, birth order of children, and mothers’ education and marital status using a questionnaire. The Spielberger Trait Anxiety Inventory was used to determine maternal trait anxiety levels. The children underwent oral examination. Total values for decayed, missing, filled, and total permanent/primary teeth (DMFT/dmft) were evaluated according to standards of the World Health Organization.

Results

No significant relationship was found between the mother's anxiety level and DMFT/dmft scores in their children. A negative correlation was observed between the child’s age and dental caries in children. The sex of the child, mother's education level, and marital status of the mother showed a weak negative correlation with the number of dental caries observed in their children.

Conclusion

Although social, economic, and environmental factors might contribute substantially to the development of dental caries, we failed to demonstrate a clear relationship between maternal anxiety and social status and dental caries in children. We can therefore conclude that biological factors are decisive in the formation of dental caries among children.

First dental visit: Age, reason, and experiences of Saudi children

Objective:

A study was conducted among parents/guardians of children attending the Outpatient Department of King Khalid University College of Dentistry, Abha, to assess the attitude and knowledge regarding children's first dental visit and related aspects.

Materials and Methods:

A cross-sectional questionnaire-based study was conducted among a convenient sample of 320 parents/guardians. All the parents/guardians willing to participate in the study and whose children visiting the dentist for the first time were included in the study. Children's behavior was assessed using Frankl's scale.

Results:

Majority (29%) of the children visited the dentist for the first time at the age of 3–6 years, while the least percentage (8%) visited the dentist for the first time at the age of 0–1 year. A statistically significant difference was found between the responses (P ≤ 0.05). Most (72.67%) of the children were being accompanied by parents during their first dental visit. About 40.33% of the parents said that overall experience of the first visit of their children was good. About 39.67% of the children had positive behavior during their first dental visit. About 37.33% of the participants said that pain was the main reason for them to get their children to dentist.

Conclusion:

It was concluded that bulk of the parents were unaware about the appropriate age of their children's first dental visit. Most of the parents brought their children to dentist after their children experienced pain or suffered from dental caries. There is a need to raise awareness among masses regarding the importance of taking oral health care of their children quite seriously at the earliest budding stage of their life.

Apps for oral hygiene in children 4 to 7 years: Fun and effectiveness

Background

Nowadays apps in preschool age are largely used in learning improvement. The aim of this work was to test effectiveness of apps in improving oral hygiene in children patients aged from 4 to 7 years and evaluating correlation between parents educational attainment and children oral hygiene.

Material and Methods

100 patients aged from 4 to 7 years were randomly assigned by an external office in the study group (SG: 32 females, 18 males) and in the control group (CG: 28 females and 22 males). Plaque index (PI) and carious lesions localisation were detected. At baseline all patients and one of the parents were instructed at chair-side about the proper oral hygiene techniques. SG patients were also given app as an aid in oral hygiene practice. Follow-up was 12 months. Measurements were made every three months at chair-side visits. Information about children compliance in oral hygiene and educational level of parents were obtained by questionnaires at t0 and after 12 months.

Results

SG patients showed stronger oral hygiene and PI lower than those in CG. Questionnaire showed higher compliance of SG patients and parents educational level seemed to affect children oral hygiene.

Conclusions

Apps in children allowed achieving encouraging results with improvement of oral hygiene and health. Key words:Apps, oral hygiene compliance, children oral hygiene, motivation, educational attainment.

The Impact of Sibling Behavior on Oral Health: A Narrative Review

Objective

The repetition of any behavior until it becomes a learned behavior begins in childhood. Oral health practices being no exception to this, are also acquired at this tender age, and have the potential of greatly affecting one in their lives. Oral health behaviors are learned through a multifactorial interplay, of which the family is a crucial and relatively unexplored area and will be highlighted in this review. This review discusses gender differences among siblings in relation to oral health, familial influence on acquisition and maintenance of oral hygiene habits, media influence on oral health attitudes and more.

Methods

A thorough literature search between 1972 and 2017 was done using Scopus, PubMed, and Google Scholar databases, results reviewed, prioritized, and findings compiled. The keywords of the search strategy was as below: Siblings, sibling behavior, sibling oral health, siblings in dentistry, maternal oral health, family influence on oral health. 35 studies were evaluated for the review. The keywords were limited to activities of siblings and their behavior patterns in relation to dentistry and oral health.

Results

Results showed that sibling dynamics have been involved in influencing the learning of oral health behaviors in children. Other factors include peer pressure and maternal influences.

Conclusion

Sibling relationships play a vital role in shaping behavior characteristics including tooth brushing, oral hygiene, dental perceptions, and snacking behaviors which are pertinent to dentistry.

Oral health of 6-7 year-old children according to the Caries Assessment Spectrum and Treatment (CAST) index

Background

The index of Caries Assessment Spectrum and Treatment (CAST) reveals a range of caries development from a non-cavitated status to advanced lesions. The aim of the present study was to explore the oral health status of 6- to 7-year-old children based on the CAST index in relation to oral health knowledge and background determinants.

Methods

A multi-stage cluster random sampling method was applied and after ethical clearance, clinical examination was performed (Kappa = 0.89). The status of caries and oral hygiene was recorded according to the CAST index and OHI-Simplified (OHI-S) index, respectively. A self-administered questionnaire was used to collect the data of parental knowledge of oral health. SPSS version 22.0 was used for data analysis and p-value less than 0.05 were considered significant.

Results

Seven hundred and thirty-nine children and their parents in 24 schools participated in this study (88%), of whom 48.6% were boys and the rest were girls. In permanent molars, a healthy status (code 0–2) was observed in 89.3–93.7% of the teeth. In primary molar teeth, dentinal lesions ranged from 25.3 to 31.2%, the prevalence of pulp involvement was between 2.9 and 10.5%, and less than 1% had abscess/fistula. Serious morbidity (codes 6 and 7) were more common in the first primary molars than the second ones. Multi-variable logistic regression analysis indicated that children with a low level of father’s education were 2.45 times more likely to have a CAST score of 3 and higher (95% CI 1.35–4.46, p = 0.003) compared to children whose fathers had academic education. For each one-unit increment of OHI_S, the likelihood of a CAST score 3 and higher in primary dentition increased by 1.77 times (OR = 1.77; 95% CI 1.08–2.93, p = 0.02).

Conclusion

The consequences of dental caries including abscess and fistula were more prevalent in the first and second primary teeth. There was a significant correlation between a CAST score of 3 and higher with father’s education (as an indicator of social rank) and oral hygiene status. The CAST index is a useful and practical index in epidemiological surveys.

Electronic supplementary material

The online version of this article (10.1186/s12903-018-0709-x) contains supplementary material, which is available to authorized users.

Prenatal Oral Health Care and Early Childhood Caries Prevention: A Systematic Review and Meta-Analysis

Despite the advancement of early childhood caries (ECC) prediction and treatment, ECC remains a significant public health burden in need of more effective preventive strategies. Pregnancy is an ideal period to promote ECC prevention given the profound influence of maternal oral health and behaviors on children's oral health. However, studies have shown debatable results with respect to the effectiveness of ECC prevention by means of prenatal intervention. Therefore, this study systematically reviewed the scientific evidence relating to the association between prenatal oral health care, ECC incidence, and Streptococcus mutans carriage in children. Five studies (3 randomized control trials, 1 prospective cohort study, and 1 nested case-control study) were included for qualitative assessment. Tested prenatal oral health care included providing fluoride supplements, oral examinations/cleanings, oral health education, dental treatment referrals, and xylitol gum chewing. Four studies that assessed ECC incidence reduction were included in meta-analysis using an unconditional generalized linear mixed effects model with random study effects and age as a covariate. The estimated odds ratio and 95% confidence intervals suggested a protective effect of prenatal oral health care against ECC onset before 4 years of age: 0.12 (0.02, 0.77) at 1 year of age, 0.18 (0.05, 0.63) at 2 years of age, 0.25 (0.09, 0.64) at 3 years of age, and 0.35 (0.12, 1.00) at 4 years of age. Children's S. mutans carriage was also significantly reduced in the intervention group. Future studies should consider testing strategies that restore an expectant mother's oral health to a disease-free state during pregnancy.

Knowledge, Attitude, and Practice of Mothers towards Infant Oral Healthcare

Background

Among all the oral diseases, dental caries is the most common chronic disease affecting the children. Early childhood caries is one of the most severe forms of dental caries affecting the children less than 3 years. Though dental caries is preventable, not much importance has been given to the preventive aspect of dental caries. This is because of the lack of oral health education. Vertical colonization occurs from caregiver usually mother to the child. Since mother play an important role in a child's life, their knowledge about child's oral health will have a significant impact on the child's oral health status. A proper knowledge for the mothers regarding infant's oral health care will be beneficial in reducing the burden of dental caries in children. Hence a study was conducted to evaluate the mother's knowledge, attitude and practice towards infant oral health care.

Material and methods

A cross-sectional study was conducted among a convenient sample of 185 first time mothers with a child aged 9 to 24 months of age visiting Department of Pediatrics and Department of Pedodontics and Preventive Dentistry. Permission to carry out the study was obtained from the Institutional Ethical Board. Data were collected using a structured questionnaire. The questionnaire used in this study was divided into two sections. The first section contained demographic details and the second section contained knowledge about primary teeth and practice of oral health care. All the participants fulfilling the inclusion criteria were enrolled. The purpose of the study and the questionnaire were explained to each participant. The questionnaire was completed and returned before leaving the clinic. The data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22.

Results

Total 52.5% of the mothers responded that first tooth erupt after 6 months. A total of 86.5% of the mothers were not aware of the first dental visit. 77.8% did not agree that caries causing bacteria is transferred from mother to the child; 53% mothers did not agree that night time bottle feeding causes dental caries and 78.4% disagreed that nocturnal breastfeeding can cause dental caries in children. A total of 65.4% mothers feel dental check-up is not necessary when the first tooth erupt, and 95.7% mother did not have any information on infant oral health care. 72.4% of mothers started using toothbrush and paste after all the primary teeth erupted and only 5.9% of the mother had the knowledge about proper dispensing of toothpaste for children.

Conclusion

Overall knowledge and attitude of mothers towards oral health care of children is poor. Health care professionals like a gynecologist, pediatrician Anganwadi workers who contact first-time mothers need to be trained to disseminate appropriate infant oral health care information. The mother needs to be educated about oral health during their antenatal check upHow to cite this article: Dhull KS, Dutta B, Devraj IM, Samir PV. Knowledge, Attitude, and Practice of Mothers towards Infant Oral Healthcare. Int J Clin Pediatr Dent. 2018;11(5):435-439.

The impact of anticipatory guidance on early childhood caries: a quasi-experimental study

Background

This study evaluated the impact of anticipatory guidance on the caries incidence of 2–3-year-old preschool children and their 4–6-year-old siblings, as well as on their mothers’ oral health literacy, as compared to the conventional Ministry of Health (MOH) programme.

Methods

This quasi-experimental study was conducted at two government dental clinics in Batu Pahat District, Malaysia. The samples comprised of 478 mother-child-sibling trios (233 families in the intervention group, and 245 families in the control group). An oral health package named the Family Dental Wellness Programme (FDWP) was designed to provide dental examinations and oral health education through anticipatory guidance technique to the intervention group at six-month intervals over 3 years. The control group received the standard MOH oral health education activities. The impact of FDWP on net caries increment, caries prevented fraction, and mother’s oral health literacy was assessed after 3 years of intervention.

Results

Children and siblings in the intervention group had a significantly lower net caries increment (0.24 ± SD0.8; 0.20 ± SD0.7) compared to the control group (0.75 ± SD1.2; 0.55 ± SD0.9). The caries prevented fraction for FDWP was 68% for the younger siblings and 63.6% for the older children. The 2–3-year-old children in the intervention group had a significantly lower incidence of white spot lesions than their counterpart (12% vs 25%, p < 0.05). At three-year follow-up, there were significant increments in the oral health literacy scores of mothers in the intervention group compared to the control group.

Conclusion

The FDWP is more effective than the standard MOH programme in terms of children’s and siblings’ caries incidence and mother’s oral health literacy.

Trial registration

ClinicalTrials.gov NCT03478748. Registered on March 26th 2018. Retrospectively registered.

Intergenerational and Social Interventions to Improve Children's Oral Health

Dental caries and gingival and periodontal diseases are commonly occurring, preventable chronic conditions in children. These diseases are more common in disadvantaged communities and marginalized populations. Thus, public health approaches that stress prevention are key to improving oral health equity. There is currently limited evidence on which community-based, population-level interventions are most effective and equitable in promoting children's oral health. More rigorous measurement and reporting of study findings are needed to improve the quality of available evidence. Improved understanding of the multilevel influences of children's oral health may lead to the design of more effective and equitable social interventions.

The influence of mothers' oral health behaviour and perception thereof on the dental health of their children

Objective

The study aims to investigate how mothers' oral health behaviour and perception thereof influence the dental health in their children.

Methods

A total of 556 Vietnamese mother-child pairs participated in the current study. Mothers self-reported their oral status and oral health behaviour and perception. Dental caries of the children were examined using the index of decayed, missing, and filled teeth. The Dental Anxiety Scale instrument was used to assess the dental anxiety level in mothers and children.

Results

Among mothers, 41.3% had gingival bleeding, 40% perceived their dentition and gingival status to be at a good level, 68% brushed their teeth more than twice a day, and 17% had never visited a dentist. Mothers' oral health behaviour and their perception thereof were positively correlated with their frequency of dental visits (r = (0.105-0.221), p < 0.001) and negatively correlated with dental anxiety (r = (- 0.149- - 0.105), p < 0.05).Caries-free children were positively correlated with mothers having more than 20 teeth (r = 0.085, p < 0.05). Positive correlations between mothers and children were found in terms of frequency of fresh fruits consumption (r = 0.090, p < 0.05), drinking sweet beverages (r = 0.072, p < 0.05), and dental anxiety (r = 0.183, p < 0.001).

Conclusions

Maternal oral health was significantly associated with dental health of their children. Not only did maternal dental anxiety influence oral health of mothers but it was also a concomitant factor in the development of children's dental anxiety. The education programme on mothers' oral health-related knowledge can be a target for improvement of the oral health of mothers and children.

Knowledge and Attitude about Early Childhood Caries among Pregnant Mothers from Low Socioeconomic Status: A Questionnaire Study

Background:

For health and well-being, oral health is an integral component. Unfortunately, many children are afflicted with dental caries at an early age, even those as young as 12 months. By imparting knowledge, awareness among parents about this disease can bring about reduction of early childhood caries (ECC) at an early stage.

Aim:

The aim of this study was to evaluate knowledge and attitude of expectant mothers about ECC and to reassess the level of knowledge after giving anticipatory guidance.

Materials and Methods:

The questionnaire consisted of 10 questions which were distributed to 100 participants after which anticipatory guidance was given to them. After 15 days, the same questionnaire was distributed among the participants with order of the questions interchanged. Chi-square test was used for statistical analysis.

Results:

There was a significant improvement in the knowledge and attitude about the disease after giving the anticipatory guidance among the participants. P < 0.01 and the result were statistically significant.

Conclusion:

Knowledge and attitude of mothers were found to increase on provision of anticipatory guidance, which was retained even after 15 days.

Caregivers' oral health knowledge, attitude and behavior toward their children with disabilities

Background/purpose

This study was undertaken to document the knowledge, attitude and behavior among family caregivers, and to identify the related factors influencing their behavior in promoting their and children's oral health.

Materials and methods

A cross-sectional study was conducted to collect self-administered questionnaires from 503 family caregivers, who cared for 6-12 year-old children with disabilities in 10 special schools. Multiple regression models were used to analyze the association between caregiver's oral health behaviors and related factors.

Results

Most caregivers were female (74.8%). The top three sources of oral health knowledge among caregivers were dentists (66.60%), books (34.59%) and television (31.21%). Comparison of oral health knowledge and attitude scores among different education levels of caregivers yielded statistically significant differences (p < 0.05). Eighty-four percent of caregivers cleaned their teeth twice a day and 46.12% used dental floss. More than half of caregivers (60.44%) assisted their children to brush teeth. Only 12.65% took their children to receive fluoride varnish services. Caregivers' favorable oral health behavior was found to be significantly associated with a higher education level, better knowledge and positive attitude. The determining factor of caregivers' preventive behavior was attitude. Education level influenced the caregiver's knowledge. Knowledge is positively associated with attitude.

Conclusion

Inadequate knowledge is the major factor preventing caregivers from favorable oral health behavior. Oral health related educational programs aimed at promoting caregivers' behavior must take into consideration the caregivers' knowledge level first. Education programs should be recommended to caregivers with a lower education level.

The influence of general health on the need for dental general anaesthesia in children

AIM

To analyse the occurrence and causes of dental general anaesthesia (DGA) in healthy and medically compromised children, and to investigate if there are differences between those groups considering factors associated with DGA and DGA procedures.

METHODS

The data was collected from medical records of children under 7 years of age treated under DGA in the years 2009 and 2010 at the Oulu University Hospital, Finland. The children were divided into two groups: 0-35-month-olds and ≥36-month olds. Background information (year, age, gender, dental diagnosis, health) and the procedures performed were registered. The procedures were analysed considering the child's age and tooth types.

RESULTS

The number of children treated under DGA increased between 2009 (58) and 2010 (82), particularly in the group of healthy children. The two main diagnoses leading to DGA were dental caries and dental fear. Dental caries as the first dental diagnosis leading to DGA was more common among the medically compromised children (61.5%) compared to the healthy children (38.6%). The procedures performed were similar among the two groups. However, they varied between the age groups and tooth types and even between upper and lower teeth. The medically compromised children had been treated more frequently under DGA in the past.

CONCLUSIONS

The threshold for treating medically compromised children under DGA seems to be lower than for healthy children. However, the occurrence of DGA among healthy children has increased recently. To avoid unnecessary DGA, the control of caries should be carried out according to individual needs and independent of whether the child is healthy or has a chronic disease.

Toothbrushing frequency among 4-6-year-old Iranian children and associated maternal attitude and sociobehavioral factors

Background:

Toothbrushing is an important aspect of children's oral health self-care. This study aimed to explore toothbrushing frequency among 4–6-year-old Iranian children and associated maternal attitude and sociobehavioral factors.

Materials and Methods:

This cross-sectional study was conducted on 407 mother–child (aged 4–6 years) pairs through stratified random sampling in Tabriz, Iran. Data were collected using self-reported questionnaires including demographic characteristic, maternal attitude, and toothbrushing frequency of both mothers and children. Logistic regression was used to determine the predicators of children's toothbrushing. Statistical significance was set at P < 0.05 for all tests.

Results:

The mean ages were 32.6 ± 4.8 and 5.3 ± 1.1 years for mothers and children respectively. Twice-daily toothbrushing was observed at a relative frequency of 12.8% in children and 18.4% in mothers. About 43.7% of children brushed their teeth once daily. Nearly 38.7% of children started toothbrushing behavior regularly at 4 years of age, and 41% had dental visits. Multiple logistic regression analysis indicated that children's toothbrushing (once daily or more) was associated with maternal brushing frequency (odds ratio [OR] =2.0, 95% confidence interval [CI] =1.53–2.86), maternal attitude toward oral health (OR = 1.15, CI = 1.08–1.22), and children's age (OR = 1.21, 95% CI = 1.02–1.77).

Conclusion:

The descriptive results indicated that maternal and children toothbrushing behaviors are unfavorable. Furthermore, maternal toothbrushing behavior is a strong predicator of children's brushing behavior. Health promotional activities seem necessary for mothers to enhance oral health behavior of their children.

Can undergraduate student learning in prevention influence oral health self-care practices? - a report from a South African University

INTRODUCTION

Student attitudes and behaviour towards their own oral health status could reflect their understanding of the importance of oral health promotive activities.

OBJECTIVES

This was a qualitative and exploratory study designed to gain a deeper understanding of the extent to which the undergraduate curriculum could act as an enabler for student oral health self-care practices.

METHODS

Data collection comprised of document analysis (curriculum review) and in-depth face-to-face interviews with undergraduate dental therapy and oral health students and academic staff at the University of KwaZulu-Natal. Ten students volunteered to participate in the study while five academic staff were purposively selected. A separate interview schedule was developed for students and staff, respectively. The emergent themes from document analysis were compared to the analysed data from the interviews.

RESULTS

The curriculum was underpinned by a strong foundation in prevention, and there was consensus among respondents that the curriculum met the needs for undergraduate training in preventive dentistry. The following themes emerged from data analysis: curriculum support for self-care practices; depth and scope of clinical training; role of clinical supervisors and challenges in clinical training. Respondents agreed that the curriculum could influence students' attitudes towards self-care practices such as toothbrushing and flossing but that academic responsibilities and clinical contact time placed constraints on these practices.

CONCLUSION

The undergraduate curriculum does provide support for enabling student knowledge acquisition and positive attitudes, but more effort is required to enable oral health behavioural modifications among students.