Parental perspectives on early childhood caries: A qualitative study

Caries indicators in relation to healthcare access and hygienic-dietary habits in Spanish preschoolers

INTRODUCTION

Dental caries continues to be a public healthcare problem due to its high prevalence and morbidity. It was proposed to evaluate caries indicators in relation to healthcare access and hygienic-dietary habits in Spanish preschoolers.

MATERIALS AND METHODS

A cross-sectional study was carried out on a random sample consisting of 343 patients ranging from 3 to 5 years of age in the primary care setting, the main measurements were: dental care access, hygienic-dietary habits, and caries registration according to WHO criteria.

RESULTS

The prevalence of caries was 35.3% and mean ± standard deviation (SD) dft was 1.51 ± 2.93. Preschoolers who had ever visited the dentist had a higher dft occurrence than those who had never attended the dentist. The lower prevalence of caries was significantly associated with the frequency of two daily brushings versus non-daily brushing (p = 0.007; 25.3% vs. 47.1%) and was 10.7% lower in patients who had the habit of night brushing (p = 0.041). The consumption of sugary liquids between meals implied a higher dft index.

CONCLUSIONS

The high prevalence of early childhood caries and the dental care access associated with poor oral health suggest the need to implement a multidisciplinary oral healthcare program that involves both healthcare and dental healthcare professionals in Primary Health Care Units without forgetting the participation of the community and local administrations.

Decoding early childhood caries: an in-depth analysis of YouTube videos for effective parental education

PURPOSE

To assess the coverage of information about early childhood caries (ECC) available on YouTube videos in three different languages, regarding technical characteristics of videos and interaction metrics.

METHODS

Search strategies were developed in English, Spanish, and Portuguese to make a comprehensive collection of videos from YouTube, encompassing 60 samples for each language, regarding all video types. The videos were assessed by a thematic checklist regarding 17 items on ECC. Videos were dichotomized according to the median of the thematic score and the nature of their authorship (health and non-health authors) to compare groups. The statistical analysis was performed using the Statistical Package for Social Science (version 25.0), applying Spearman's rank correlation coefficient and Mann-Whitney U test. P < 0.05 values were considered significant.

RESULTS

Among 120 videos meeting inclusion criteria, ECC aetiology and prevention information proved incomplete, with a median score of 5 (Q1-Q3 = 3-7). No correlation emerged between this score and other video characteristics. However, interaction metrics like views, likes, dislikes, and viewing rates displayed significant correlations. Health authors primarily created these videos, yet non-health author channels had more subscribers. Surprisingly, videos focused on the impact of regular sugary food and beverage consumption on ECC progression received the most attention.

CONCLUSIONS

Videos that presented information about the aetiology and prevention of ECC invariably focused on partial aspects of the disease. This highlights the need for better-quality educational videos and the importance of dental professionals in guiding patients toward reliable sources of information.

Are parents of high caries risk Dutch children motivated to brush their children's teeth? An assessment using the health action process approach questionnaire

PURPOSE

To assess the social cognitive constructs of the Health Action Process Approach (HAPA) of parents of high caries risk children to be treated under intravenous sedation (IVS) or with behavioural guidance techniques (BGT), and to assess the changes in these constructs for each treatment group after treatment.

DESIGN

In this cohort study, 160 children aged 3-10 years were allocated by their paediatric dentist to either IVS (77.4%) or BGT. Their parents filled out a HAPA questionnaire, before (T1, n = 160), immediately (T2, n = 108) and three months (T3, n = 71) after their children's dental rehabilitation.

RESULTS

Before treatment, all parents had high scores on all social cognitive constructs. There were no differences in mean HAPA scores between the treatment groups (p > 0.05). After treatment, mean scores changed in both groups. In the BGT group, action self-efficacy changed from 3.64 (T1) to 3.36(T2) (p = 0.027) and to 3.13 (T3) (p = 0.021) and coping self-efficacy changed from 3.63 (T1) to 3.23 (T2) (p = 0.015). In the IVS group, action planning changed from 3.25 (T1) to 3.05(T3) (p = 0.036) and action control changed from 2.58 (T1) to 2.82 (T2) (p = 0.012) and to 2.87 (T3) (p = 0.006).

CONCLUSIONS

High scores on social cognitive constructs of parents of children referred to a paediatric dentist showed that they seem to be motivated to brush their children's teeth, irrespective of the treatment group. Small changes were observed in the HAPA constructs, however, these are not considered clinically relevant.

Reacting, Sharing, and Commenting: How Many Facebook Users Are Engaging with Posts Related to Dental Caries That Contain Misinformation?

Recent studies have been concerned about the vast amount of misinformation detected on social media that directly hampers the prevention and control of chronic diseases. Based on these facts, the aim of this study was to identify and characterize misinformation about dental caries-related content found on Facebook, regarding the predictive factors of user interaction with posts. Then, CrowdTangle retrieved 2,436 posts published in English, ordered by the total interaction of the highest users. A total of 1,936 posts were selected for inclusion and exclusion criteria to select a sample of 500 posts. Subsequently, two independent investigators characterized the posts by their time of publication, author's profile, motivation, the aim of content, content facticity, and sentiment. The statistical analysis was performed using Mann-Whitney U and χ2 tests and multiple logistic regression models to determine differences and associations between dichotomized characteristics. p values <0.05 were considered significant. In general, posts were predominantly originated from the USA (74.8%), related to business profiles (89%), presented preventive content (58.6%), and noncommercial motivation (91.6%). Furthermore, misinformation was detected in 40.8% of the posts and was positively associated with positive sentiment (OR = 3.43), business profile (OR = 2.22), and treatment of dental caries (OR = 1.60). While the total interaction was only positively associated with misinformation (OR = 1.44), the overperforming score was associated with posts from the business profile (OR = 5.67), older publications (OR = 1.57), and positive sentiment (OR = 0.66). In conclusion, misinformation was the unique predictive factor of increased user interaction with dental caries-related posts on Facebook. However, it did not predict the performance of the diffusion of posts such as business profiles, older publications, and negative/neutral sentiment. Therefore, it is essential to promote the development of specific policies toward good quality information on social media, which includes the production of adequate materials, the increase of the critical sense of consuming health content, and information filtering mediated by digital solutions.

Early Feeding and Weaning Practices of Indian Children with Early Childhood Caries: A Qualitative Exploration

OBJECTIVE

To describe the early feeding, weaning, and oral hygiene practices of children with early childhood caries (ECC), their parents' knowledge and attitudes regarding infant feeding, and the feeding-related challenges faced by the parents.

METHODS

This descriptive qualitative study involved parents of children with ECC who sought dental treatment at an academic dental college in India. Data were collected though focus groups conducted with the 27 parents of children with ECC, using a focus group discussion guide. Data were analyzed using the content analysis method.

RESULTS

Community norms, such as learning from the older women in the families or neighborhoods, guided the feeding method, duration of feeding, and weaning. Breastfeeding or bottle-feeding at bedtime beyond 12 mo of age and feeding sugary drinks during weaning were standard practices, despite knowing the risk for dental caries. Parents faced multiple challenges regarding weaning and were unaware of the significance of infant oral hygiene practices.

CONCLUSION

In children with ECC, infant feeding practices included prolonged breastfeeding or bottle-feeding beyond the required age, feeding at bedtime, and feeding sugary drinks. Although the parents knew that these feeding habits could increase the risk for caries, they lacked the self-efficacy to translate their knowledge into action during weaning. Also, they lacked awareness regarding infant oral hygiene practices.

KNOWLEDGE TRANSFER STATEMENT

The study provides information on the feeding habits of infants that can increase the risk for caries, the challenges faced by the parents of these children in altering these risky habits, and their lack of knowledge on infant oral hygiene practices. Policy/decision makers can advocate for pediatricians and pediatric dentists to incorporate anticipatory guidance or motivational interviewing techniques to tailor the preventive program for ECC for Indian children.

Necessity and relevance of qualitative research in pediatric dentistry. A literature review

Objectives

This review aims to understand the essence and relevance of qualitative research in pediatric dentistry and summarizes the most important information needed for a pediatric dentist before conducting a qualitative study.

Methods

An electronic search was conducted on studies published from December 2019 until December 2021 using PubMed, Scopus, and King Abdulaziz University Digital library. Several keywords were used to identify the studies for this review.

Results

Thirty-three studies involving qualitative methods in pediatric dentistry have been conducted on parents and dentists. Qualitative studies in pediatric dentistry are used to explore the perceptions of mothers and their children and to understand their behavior in different areas related to pediatric dentistry. Barriers to conducting qualitative studies with children include credibility, the influence of others on children's opinions, and differences that influence children's behavior while conducting the study.

Conclusion

Qualitative methods in pediatric dentistry have been conducted on parents and dentists; however, little is known about the credibility and trustworthiness of conducting qualitative research with children. Future studies are needed to investigate effective interview techniques with children and more research should be conducted to evaluate the credibility and trustfulness of using children as a source to collect data in qualitative research.

Effects of a Novel, Intelligent, pH-Responsive Resin Adhesive on Cariogenic Biofilms In Vitro

Background: Secondary caries often result in a high failure rate of resin composite restoration. Herein, we studied the dodecylmethylaminoethyl methacrylate−modified resin adhesive (DMAEM@RA) to investigate its pH-responsive antimicrobial effect on Streptococcus mutans and Candida albicans dual-species biofilms and on secondary caries. Methods: Firstly, the pH-responsive antimicrobial experiments including colony-forming units, scanning electron microscopy and exopoly-saccharide staining were measured. Secondly, lactic acid measurement and transverse microradiography analysis were performed to determine the preventive effect of DMAEM@RA on secondary caries. Lastly, quantitative real-time PCR was applied to investigate the antimicrobial effect of DMAEM@RA on cariogenic virulence genes. Results: DMAEM@RA significantly inhibited the growth, EPS, and acid production of Streptococcus mutans and Candida albicans dual-species biofilms under acidic environments (p < 0.05). Moreover, at pH 5 and 5.5, DMAEM@RA remarkably decreased the mineral loss and lesion depth of tooth hard tissue (p < 0.05) and down-regulated the expression of cariogenic genes, virulence-associated genes, and pH-regulated genes of dual-species biofilms (p < 0.05). Conclusions: DMAEM@RA played an antibiofilm role on Streptococcus mutans and Candida albicans dual-species biofilms, prevented the demineralization process, and attenuated cariogenic virulence in a pH-dependent manner.

Perspectives on Dental Caries: A Cross-Sectional Study among Parents of Primary School Children in Saudi Arabia

Background:

Dental caries is one of the most prevalent chronic childhood diseases affecting many people worldwide. Many people do not recognize the early signs of dental caries or its causes, which is crucial for the prevention and early intervention of the disease and consequently less-invasive and cheaper treatment options.

Objective:

This study aimed to evaluate the perspectives of parents about the meaning, causes, and early signs of dental caries, the association of tooth discoloration with decay, and the effect of different socio-demographic variables on the knowledge of patients regarding caries.

Methods:

Questionnaires were distributed to parents of primary school children in the region of Madinah, Saudi Arabia. Meaning of dental caries, early signs, causes of tooth discoloration related to decay, and the effect of different socio-demographic variables were calculated. Multiple linear regression analysis was carried out to identify significant predictor variables associated with caries knowledge scores.

Results:

There was a total of 2690 respondents. The majority had average caries knowledge scores. Lighter shades of tooth discoloration were reported to be associated with stains and warranted home care only, while darker shades were associated with caries and yielded a necessity for a visit to the dentist. Different socio-demographic variables had an effect on the caries knowledge of the parents.

Conclusion:

There is a need for increased knowledge about the early signs of dental caries among parents. Delayed recognition of signs of dental caries has a detrimental effect on the teeth of children and leads to seeking dental care at the later stages of the disease process. Community-oriented programs are fundamental for improving caries knowledge, its clinical presentations starting from its early signs, causes, and prevention.

Perspectives on Dental Caries: A Cross-Sectional Study among Parents of Primary School Children in Saudi Arabia

Background:

Dental caries is one of the most prevalent chronic childhood diseases affecting many people worldwide. Many people do not recognize the early signs of dental caries or its causes, which is crucial for the prevention and early intervention of the disease and consequently less-invasive and cheaper treatment options.

Objective:

This study aimed to evaluate the perspectives of parents about the meaning, causes, and early signs of dental caries, the association of tooth discoloration with decay, and the effect of different socio-demographic variables on the knowledge of patients regarding caries.

Methods:

Questionnaires were distributed to parents of primary school children in the region of Madinah, Saudi Arabia. Meaning of dental caries, early signs, causes of tooth discoloration related to decay, and the effect of different socio-demographic variables were calculated. Multiple linear regression analysis was carried out to identify significant predictor variables associated with caries knowledge scores.

Results:

There was a total of 2690 respondents. The majority had average caries knowledge scores. Lighter shades of tooth discoloration were reported to be associated with stains and warranted home care only, while darker shades were associated with caries and yielded a necessity for a visit to the dentist. Different socio-demographic variables had an effect on the caries knowledge of the parents.

Conclusion:

There is a need for increased knowledge about the early signs of dental caries among parents. Delayed recognition of signs of dental caries has a detrimental effect on the teeth of children and leads to seeking dental care at the later stages of the disease process. Community-oriented programs are fundamental for improving caries knowledge, its clinical presentations starting from its early signs, causes, and prevention.

Parental-oriented educational mobile messages to aid in the control of early childhood caries in low socioeconomic children: A randomized controlled trial

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Educational mobile text messages were effective to control the severity of ECC.

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They influenced changes in parental reports about children’s sugar consumption.

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Also, they seemed beneficial to improve parental electronic health literacy levels.

Objectives

To evaluate the effectiveness of educational messages as an aid in the control of early childhood caries (ECC) in low socioeconomic children.

Methods

A single-blinded, randomized, and parallel-group study was conducted with 104 dyads of parents and children aged between 36–60 months, recruited in preschools from Bauru, Brazil. The participants were randomly allocated into control and intervention groups (1:1), stratified by parental eHealth literacy scores (eHEALS) and children's caries experience. Every 2 weeks, text messages were sent to parents of intervention group via WhatsApp. Visible plaque index (VPI) and the International Caries Detection and Assessment System (ICDAS) were assessed at baseline, 3- and 6-month follow-ups, while eHEALS and dietary habits were determined at baseline and 6-month follow-up. Statistical analysis was performed to intra and intergroup comparisons through Fischer’s exact and McNemar tests, and Mann-Whitney U and Friedman tests, respectively (P < 0.05).

Results

Despite similarities between groups, intervention increased parental eHEALS scores, influencing the reports about the children’s consumption of sugar-free sweets and controlling the severity of ECC.

Conclusion

Therefore, mobile text messages were effective to control the severity of ECC in low socioeconomic preschoolers, improving parental eHealth literacy and changing children’s dietary patterns.

Clinical significance

These findings demonstrate that parental-oriented WhatsApp messages can contribute to oral health education of socioeconomic vulnerable parents towards risk behavior changes to control ECC.

Perception of Dental Caries and Parental Difficulties in Implementing Oral Hygiene for Children Aged Less Than 6 Years: A Qualitative Study

BACKGROUND

Despite extensive prevention programs, dental hygiene remains inadequate, particularly among children under the age of six, and early childhood caries (ECC) are still a concern. Oral hygiene behavior and preventive practices seem difficult to change at a family level.

AIM

The present study aimed to better understand the reasons behind this behavior and to identify the different barriers to the implementation of adequate preventive measures.

METHODS

A qualitative study was conducted in the pediatric dentistry service of the Montpellier University Hospital (France) in 2019. A thematic analysis concerning three domains was performed: family environment, dental literacy, and oral hygiene.

RESULTS

The main barriers encountered by the parents were, respectively, (1) a weakness in the organization of familial life, together with a low-medium family income and a lack of authority, (2) ignorance of the necessity of treating carious primary teeth, and (3) a lack of time for brushing or supervising their children's teeth.

CONCLUSION

These results showed that oral hygiene and primary teeth care could not be easily achieved in the family environment of the participants, and oral health strategies should be focused not only on children but also on their parents.

Evaluation of the Efficacy of Different Remineralizing Agents on Artificial Early Enamel Lesions of Primary Teeth: An In Vitro Study

Aim:

To analyze the remineralization efficacy of casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) and 8% arginine on artificial early enamel lesions on primary teeth enamel samples.

Materials and Methods:

In this in vitro study, artificial enamel lesions were created in 120 primary teeth. Teeth were randomly divided into 5 groups: group C: CPP–ACP paste; group CF: CPP–ACPF paste with 900 ppm flour; group A: paste with 8% arginine; group K+: 500 ppm NaF as a positive control; and group K–: deionized water as a negative control. After 4 weeks of the remineralization process, the effect of remineralization on samples of agents used the microhardness, atomic force microscope, and scanning electron microscope analyses. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS version 20.0, SPSS Inc., Chicago, IL, USA). ANOVA and Tukey Post-Hoc multiple comparison test were applied ( p < .05).

Results:

Increasing percentage values of the microhardness at groups C, CF, and A were significantly better than group K– ( p < .05), whereas there is no statistically significant difference with group K+ ( p > .05). The average surface roughness values of groups C and CF were similar with group K+ in AFM analysis, whereas average surface roughness values of group A were significantly higher than K+ group.

Conclusion:

The CPP–ACP, CPP–ACPF, and arginine are effective agents for remineralization of early childhood caries lesions.