Adolescent toothbrushing and the home environment: sociodemographic factors, family relationships and mealtime routines and disorganisation

May family routines impact oral health in American children?

Objectives

The present study aimed to assess the association between family routines and dental caries and self-rated oral health status.

Methods

Data from the 2020-2021 National Survey of Children's Health (NSCH) completed at United States were used. Our outcome variables were self-reported dental caries (yes/no) and poor oral health condition (yes/no). Our independent variables were related to family routines: (1) Going to bed at the same time (yes/no); (2) Days having dinner together (0-7days); (3) Hours spent in front of the TV, computer, cell phone or other electronic devices (screen time); and (4) adequate sleep (yes/no). We used socioeconomic factors, health insurance coverage, family structure and neighborhood characteristics as covariates. Univariate and multiple logistic regression were used to analyze the data.

Results

For the dental caries outcome, children with regular bedtimes (AOR = 0.68, 95% CI: 0.58-0.79), more frequent family dinners (AOR = 0.90, 95% CI: 0.85-0.96), and supportive neighborhoods (AOR = 0.88, 95% CI: 0.78-0.99) were less likely to report dental caries. Increased screen time (AOR = 1.10, 95% CI: 1.04-1.15) was associated with higher self-reported dental caries. For oral health status, children with regular bedtimes, (AOR = 0.60, 95% CI: 0.48-0.75), supportive neighborhoods (AOR = 0.81, 95% CI: 0.68-0.97), and with more neighborhood amenities (AOR = 0.92, 95% CI: 0.88-1.00) reported better health. More screen time (AOR = 1.11, 95% CI: 1.02-1.21) and poor neighborhood conditions (AOR = 1.13, 95% CI: 1.02-1.26) correlated with poor oral health.

Conclusions

Findings from this study indicate that family routines play a significant role in children's oral health. Future research should focus on interdisciplinary family- and community-level interventions that are tailored to support healthy habits and address the needs of families.

Adolescent Toothbrushing and Its Association with Sociodemographic Factors-Time Trends from 1994 to 2018 in Twenty Countries

Regular toothbrushing is the primary self-care method to prevent the most common dental diseases and is considered an important public health indicator. This retrospective observational study aimed to examine cross-national time trends in adolescent toothbrushing behaviour and its association with sociodemographic factors between 1994 and 2018. We studied data from 20 countries that conducted seven surveys of the Health Behaviour in School-aged Children (HBSC) study. Adolescents aged 11, 13 and 15 years responded to questions on their toothbrushing frequency, family affluence and structure. Altogether, reports of 691,559 students were analysed using descriptive statistics and binominal logistic regression. The findings showed an overall positive trend in the prevalence of more-than-once-a-day toothbrushing frequency during the entire study period mainly due to a noticeable increase from 1994 to 2010 (except Denmark and Sweden); this trend continued significantly thereafter in 12 of 20 countries. Across all countries, girls and adolescents from more affluent families were more likely to brush their teeth regularly. These relationships remained unchanged throughout the study period, whereas the age-related difference in toothbrushing prevalence decreased noticeably, and the negative relationship between toothbrushing and living in a non-intact family became evident. While the prevalence of regular toothbrushing among adolescents has increased in recent decades, it is still far behind the recommended level of twice-daily brushing for everyone across all countries. The promotion of toothbrushing needs to start at an early age, with a special focus on boys and adolescents from low-affluence and non-intact families.

Early childhood factors in the development of oral health behaviours in adolescence: A structural equation modelling approach

OBJECTIVES

Oral health behaviour is a learning process that begins in the early years of an individual's life. The aim of this study was to evaluate the associations between demographic, socioeconomic, and psychosocial factors and oral health behaviours during the transition period from childhood to adolescence.

METHODS

This was a cohort study with a follow-up of 7 years. The baseline assessment occurred in 2010 with a random sample of 639 preschool children from southern Brazil. Demographic, socioeconomic and psychosocial oral health conditions were assessed at baseline. Oral health habit variables were collected at follow-up and included questions regarding dental care and oral hygiene behaviours. Structural equation modelling was performed to assess the direct and indirect relationships between predictors at baseline in oral health behaviours at follow-up.

RESULTS

A total of 449 children were re-examined at follow-up (70.3% cohort retention rate). Factors directly related to poorer oral health behaviours (lower use of dental services, dental visits for emergency reasons and lower frequency of toothbrushing) were lower household income, lower maternal education, lower frequency of visits to neighbours or friends, and male sex. Considering indirect pathways, the household income and maternal education at baseline influenced oral health behaviours at follow-up via visits to neighbours or friends.

CONCLUSIONS

Our findings suggest that household income, maternal education and social capital play an important role in the development of oral health behaviours during the transition from childhood to adolescence. Acquisition of healthy oral behaviours is an important factor to consider in childhood. With this knowledge, public health policies can be developed to intervene in specific causal factors and improve oral health during this transitional period.

Eating Behaviours, Oral Hygiene, and Caries in a Population of Spanish Children with Divorced Parents: A Cross-Sectional Study

Dental caries are a public health problem that is influenced by dietary habits. This cross-sectional study aimed to investigate the feeding and hygiene habits that divorced parents exercise over their children compared to non-divorced parents, and how this may influence the rate of caries in their children. The data of participants (n = 174) with an average age of 12.17 ± 2.04 years were examined to assess the mean decayed/missing/filled teeth (DMFT) index, and they were asked questions about their oral hygiene habits. At the same time, their parents answered the parental feeding style questionnaire. A moderation analysis was conducted with family control of oral hygiene habit levels as an independent variable, decayed teeth as a dependent variable, and feeding control as a moderating variable. Results showed that divorced parents were found to have more problems in controlling their children's hygiene and dietary habits, have less control over their children's feeding, and make more use of instrumental feeding, which led to children of divorced parents having more caries. Despite the limitations linked to the cross-sectional design of the study and considering both the convenience sample and the impossibility of controlling for all aetiological factors linked to the development of caries, it can be concluded that children of divorced parents have an increased risk of tooth decay. However, parental controlled feeding interferes with the effect of family controlled oral hygiene habits on the decayed tooth, decreasing the rate of caries.

The Impact of Child Dental Caries and the Associated Factors on Child and Family Quality of Life

Introduction

Dental caries are considered as common health hazards and a serious lifelong threat to general health and quality of life. The present study aimed at identifying the impact of child dental caries and the associated factors on both child and family quality of life (QoL). Material and Methods. In this cross-sectional study, preschool children were selected randomly through clustered sampling from five educational districts in Tabriz, Iran, 2016. To assess the QoL related to oral health, the Early Childhood Oral Health Impact Scale (ECOHIS) was used. Clinical oral examination was performed to assess the presence of caries through the index of decayed, missing, and filled teeth (dmft). Descriptive and analytic statistical methods were used. To assess the underlying predictors of ECOHIS as a whole scale and the dimensions as a linear regression model were used as univariate and multivariate.

Results

: Out of 756 children under 7 years old, 51.5% boys, mean (M) standard deviation (SD) of age 5.76 (0.78). About 85% of children had dental caries. The predictors of suboptimal ECOHIS related to both general and child dimensions were child age 6 year and above: r (756) = 2.43, and P ≤ 0.001, low-socioeconomic status: r (756) = 3.36 and P < 0.001 and high dmft: r (756) = 9.10 and P < 0.001. The predictors of suboptimal ECOHIS related to family domain were sex (girl): r (756) = 0.39 and P = 0.047; mother education (under12): r (756) = -0.92 and P < 0.001; mother job (employed) as univariate: r (756) = 0.71 and P = 0.002); and dmft: r (756) = -0.58 and P = 0.035.

Conclusion

Adverse oral health of children imposes adverse effects on the QoL of children and families. Children's age, family socioeconomic level, presence of dental caries, child's gender, and mother's educational level were associated with the impact on QoL.

Socioeconomic inequalities in toothbrushing behaviours in young children: a children's lifestyle survey in a representative population of A city, Okinawa prefecture, Japan

PURPOSE

We have less understanding of which socioeconomic status (SES) indicators may be reflective of latent socioeconomic inequalities in toothbrushing behaviours, especially finishing-toothbrushing by parents in young children. The aim of this study was to reveal the socioeconomic inequalities in children's toothbrushing and finishing-toothbrushing by parents and if it varies by SES indicators.

METHODS

We used data from 'Survey on Children's Life' conducted by A city of Okinawa Prefecture, Japan. The multiple imputed data of 902 (boys, 453) included self-reported children's toothbrushing behaviour and finishing-toothbrushing by parents in three-to six-year-old children. SES was assessed using self-reported household income and parental educational attainment. Absolute and relative inequalities in toothbrushing behaviours were quantified using the slope index of inequality (SII) and relative index of inequality (RII), respectively.

RESULTS

There were significant absolute and relative inequalities of children's toothbrushing for household income (SII and RII were 0.241 and 2.73, respectively), of finishing-toothbrushing by parents for household income (SII and RII were 0.133 and 3.28, respectively), and educational attainment (SII and RII were 0.166 and 5.55, respectively). The same inequality trends were observed after adjusting for covariates (child's age and sex, family structure, breakfast and dinner frequency, and sleep duration).

CONCLUSION

Socioeconomic inequalities in children's toothbrushing and finishing-toothbrushing by parents varied according to SES indicators.

Family Related Variables' Influences on Adolescents' Health Based on Health Behaviour in School-Aged Children Database, an AI-Assisted Scoping Review, and Narrative Synthesis

Objects

Health Behaviours in School-aged Children (HBSC) is an international survey programme aiming to investigate adolescents' health behaviours, subjective perception of health status, wellbeing, and the related contextual information. Our scoping review aimed to synthesise the evidence from HBSC about the relationship between family environmental contributors and adolescents' health-related outcomes.

Methods

We searched previous studies from six electronic databases. Two researchers identified the qualified publications independently by abstract and full-text screening with the assistance of an NLP-based AI instrument, ASReview. Publications were included if they were based on HBSC data and investigated the effects of family environment on adolescents' health outcomes. Researches addressed family-related factors as mediators or moderators were also included.

Results

A total of 241 articles were included. Family environmental contributors could be mapped into six categories: (1) Demographic backgrounds (N = 177); (2) General family's psycho-socio functions (N = 44); (3) Parenting behaviours (N = 100); (4) Parental health behaviours (N = 7); (5) Family activities (N = 24); and (6) Siblings (N = 7). Except for 75 papers that assessed family variables as moderators (N = 70) and mediators (N = 7), the others suggested family environment was an independent variable. Only five studies employed the data-driven approach.

Conclusion

Our results suggest most research studies focussed on the influences of family demographic backgrounds on adolescents' health. The researches related to parental health behaviours and siblings are most inadequate. Besides, we recommend further research studies to focus on the mediator/moderator roles of the family, for exploring the deep mechanism of the family's impacts. Also, it would be valuable to consider data-driven analysis more in the future, as HBSC has mass variables and data.

Worse sleep health predicts less frequent breakfast consumption among adolescents in a micro-longitudinal analysis

BACKGROUND

Poor self-reported sleep health has been linked to not consuming breakfast in adolescents, but it is unknown whether poor sleep measured objectively predicts next-day breakfast consumption within adolescents. We investigated within- and between-person associations of objectively measured sleep dimensions and subjective sleep quality with adolescent breakfast consumption.

METHODS

Data were collected from a micro-longitudinal substudy of the Year 15 wave of the Fragile Families and Child Wellbeing Study (n = 590). Adolescents wore an actigraphy device and completed daily diaries for ~ 1 week (M ± SD = 5.6 ± 1.4 nights per adolescent, range: 3-9), where they rated their sleep quality and reported whether they had eaten breakfast that day, with no specific definition of breakfast provided (M ± SD = 5.5 ± 1.4 days per adolescent, range: 3-9). Separate mixed models assessed whether actigraphy-measured sleep duration (linear and quadratic, sleep duration x sleep duration), timing, maintenance efficiency, and subjective quality predicted odds of breakfast consumption both within and between adolescents. Variability of sleep duration and timing (standard deviation per person), sleep regularity index (SRI), and social jetlag were tested as additional between-person predictors. Analyses with predictors other than sleep duration were adjusted for sleep duration.

RESULTS

Following nights when adolescents had shorter or longer sleep duration (p = .005; curvilinear association), later sleep onset, or later sleep midpoint (both p = .025) than their own usual, they had lower odds of consuming breakfast the next day (within-person associations). Adolescents who on average had later sleep onset (p = .013) or midpoint (p = .013) or who reported lower sleep quality (p = .011) had lower average odds of consuming breakfast (between-person associations). Adolescents with greater variability of sleep duration (p = .005), midpoint (p = .004), or offset (p < .001) had lower average odds of consuming breakfast (between-person associations). Sleep maintenance efficiency (within or between adolescents), SRI, and social jetlag were not associated with breakfast consumption (all p > .10).

CONCLUSIONS

Multiple dimensions of sleep health are associated with breakfast consumption, both within and between adolescents. Poor sleep and dietary behaviors in adolescence may negatively impact future metabolic health.

Dental Caries, Oral Health Behavior, and Living Conditions in 6-8-Year-Old Romanian School Children

Dental caries still have a high prevalence in Romania. The aim of this paper is to determine the prevalence of caries in children (aged 6 to 8 years) correlated with individual-level predictors and socio-economic variables. A stratified, randomized nationally representative sample was established, taking into consideration the total number of preschool children and based on administrative units and residence. Self-assessment was performed by means of the Oral Health Questionnaire for Children (WHO). Examinations were conducted by 10 standardized examiners, with International Caries Detection and Assessment System (ICDAS) caries codes higher than 3 considered as dentinal caries, missing teeth as MT, and restorations as FT. DMFT and SiC indexes were calculated accordingly. The dataset for each outcome variable was analyzed by the Hurdle approach analyzed. The gender distribution was similar (47.22% male and 52.78% female), with 42.65% residing in rural areas. The mean DMFT value for the sample was 4.89 and SiC index 9.83. A negative association could be seen between DMFT and the father’s level of education (β = −0.33, SE = 0.07, p < 0.01) as well as the mother’s education (β = −0.25, SE = 0.07, p < 0.01). In conclusion, caries prevalence is very high in Romania as compared to the World Health Organization (WHO) recommendation for this age group in correlation with socio-economic factors and oral health behavior.

Molar-incisor hypomineralization and dental caries: A hierarchical approach in a populational-based study

The last couple of decades has seen an increasing interest in molar-incisor hypomineralization (MIH) studies. Hypomineralized defects can have several consequences such as hypersensitivity, increased dental plaque accumulation, and consequently higher caries risk. This cross-sectional study aimed to investigate the prevalence of MIH and its association with dental caries in schoolchildren from a city in southern Brazil. A random cluster sample of schoolchildren was selected. Clinical examinations were carried out to collect information on MIH (following the European Academy of Pediatric Dentistry criteria), dental caries (using the DMF-T index) and gingivitis. Socioeconomic, demographic and behavior variables were collected using a standardized questionnaire answered by the children's parents/caregivers. Prevalence ratios (PR) were estimated using Poisson regression analysis with robust variance through a hierarchical approach (p<0.05). A total of 513 schoolchildren were included in the study. MIH and caries prevalence was 19.7% and 31.6%, respectively. The mean age was 11.6 (+1.9) years. Dental caries was more prevalent in children with MIH (PR 1.39; 95% CI 1.05 - 1.85). Older children and children whose families were enrolled in conditional cash transference programs (PR 1.97 95% CI 1.47 - 2.64), and children who did not have their mother or father as the head of the family (PR 1.56 95% CI 1.06 - 2.30) presented a higher prevalence of dental caries. Our findings suggest that children with MIH are more likely to have dental caries.

Do School-Level Factors Affect the Health Behaviors of High School Students in Korea?

We conducted a multilevel analysis to identify the individual- and school-level factors that affect Korean high school students' tooth brushing, soda intake, smoking, and high-intensity physical activity. We sampled 27,919 high school students from the 15th Korea Youth Risk Behavior Web-Based Survey. The individual-level variables included demographic, socioeconomic, and health-related factors. The school-level variables included school system and school type. Regarding the individual-level factors, economic level and academic performance had a significant effect on health behavior when the demographic variables were adjusted. In the final model, the school-level factors had a significant effect on health behavior. The odds ratio (OR) of brushing less than twice a day in vocational schools compared to general schools was 1.63 (p < 0.001), and the OR of soda intake more than three times a week in vocational schools was 1.33 (p < 0.001). In addition, the OR of smoking in vocational schools was 2.89 (p < 0.001), and the OR of high-intensity physical activity in vocational schools was 0.80 (p < 0.001). Therefore, both individual- and school-level factors affect Korean students' health behaviors. A school-based comprehensive health promotion strategy should be developed that considers schools' characteristics to equip all students with health awareness, regardless of socioeconomic status.

Motivators and barriers to oral hygiene self-care among adolescents in Malaysia: A qualitative study

OBJECTIVE

Having good oral hygiene self-care, especially a regular toothbrushing habit will promote lifelong oral health. Therefore, understanding the factors that influence an adolescent's oral hygiene behaviour is important in developing effective oral health programmes for this age group. This study aimed to explore the motivators and barriers to adolescents' oral hygiene self-care by exploring the perspectives of secondary school students from three government schools in the state of Selangor, Malaysia.

METHODS

Focus group discussions (FGD) were conducted with Form 2 (14-years-old) and Form 4 (16-years-old) students from selected secondary schools in Selangor using a semi-structured topic guide until data saturation was reached. Data were transcribed verbatim and analysed using framework method analysis.

RESULTS

A total of 10 FGDs were conducted involving 77 adolescents. The motivators for good oral hygiene self-care were appearance, fear of oral disease, consequences of oral disease and past toothache experience. The barriers for oral hygiene self-care were poor attitude towards oral care, lack of confidence in toothbrushing skills, snacking habit and the taste of toothpaste.

CONCLUSION

Understanding the motivators and barriers to adolescents' oral hygiene self-care is the first step in designing effective oral health education messages. The findings from this study can be used as a guide for oral health education programmes and development of materials that fulfil the needs of the adolescent population.

Caries Prevalence Associated with Oral Health-Related Behaviors among Romanian Schoolchildren

Oral health-related behaviors and living conditions play an important role in general and oral health. This study aimed to evaluate caries prevalence and severity in schoolchildren residing in rural and urban areas of Romania, and to correlate these with oral health-related behaviors. An estimation of the required sample size was conducted (sampling error of ±3% at a 95% confidence level), followed by the stratification of administrative units and then the selection of 49 schools. The Hurdle approach was used to analyze the dataset, requiring two sets of analyses for each outcome variable: a multilevel binary model to predict prevalence, and a multilevel Poisson analysis using only non-zero values. The mean and standard deviation (SD) for the dentinal caries index was 4.96 (5.33). Girls were more likely to have non-zero restoration codes (β = 0.14, SE = 0.08, p < 0.05). Low education levels of each parent were associated with an increased likelihood of having non-zero carious tooth surfaces (β = 0.23, SE = 0.06, p = 0.01; β = 0.22, SE = 0.06, p < 0.01). The presence of cavities was predicted by the consumption of carbonated soft drinks (β = 0.19, SE = 0.07, p < 0.01), candies (β = 0.13, SE = 0.06, p < 0.01), sweetened milk (β = 0.12, SE = 0.06, p < 0.05), tea (β = 0.16, SE = 0.08, p < 0.05), or cocoa (β = 0.13, SE = 0.06, p < 0.05). Furthermore, the non-zero values of the dentinal caries index were more likely in rural schools (β = -0.37, SE = 0.11, p < 0.01), and a negative association between the county development index and the fillings/restorations index (β = -0.01, SE = 0.01, p < 0.05) was also established. The outcome of this research highlights that the presence of caries (dentinal caries index) in Romanian schoolchildren is influenced by their socioeconomic background, as well as their specific consumption behaviors.

Influence of breastfeeding duration on the incidence of dental caries in preschoolers: a cohort study

Abstract Objectives: investigate the association between breastfeeding duration and the incidence of severe caries in preschoolers. Methods: a cohort study was conducted with 132 pairs of mothers and children in the city of Diamantina, Brazil. Data collection was performed in 2 moments: when the children were between two and three years of age (baseline- 2013/2014) and after three years (T1-2016/2017). In both moments, children were evaluated for dental caries (International Caries Detection and Assessment System - ICDAS) and a questionnaire was administered to the mothers addressing socioeconomic aspects and thee habits of children. The outcome evaluated was the incidence of severe caries (Dentin caries - ICDAS Codes 5 and 6). Data analysis involved descriptive statistics, chi-squared test and Poisson hierarchical regression with robust variance. Results: children who breastfed for more than 24 months (RR = 2.24 CI95%= 1.23-4.08), those whose parents were separated (RR = 1.73 CI95%= 1.11-2.69), and those with estab-lished/severe caries (RR = 2.74 CI95%= 1.37-5.49) at baseline were at greater risk of incidence of severe caries after three years. Conclusion: breastfeeding for more than 24 months is a risk factor for incidence of severe caries. In addition, family structure and established or severe baseline caries were associated.

Lifestyle and psychosocial correlates of oral hygiene practice among Indonesian adolescents

Poor oral hygiene leads to poor oral health, which in turn has negative impacts on overall health and quality of life. This study aimed to evaluate the prevalence and associated factors of oral hygiene practice among school-going adolescents in Indonesia. Secondary analysis of cross-sectional, nationally representative data from the 2015 Indonesia Global School-based Health Survey, covering 11,142 students aged 11-18 years, was performed. Multiple logistic regression was employed to explore associations between lifestyle, psychosocial factors, and tooth-brushing frequency. Around 10.8% of the students brushed their teeth less frequently than the recommended twice-daily regimen. Male gender, lower socio-economic status, poor dietary practice, longer sedentary time, drug use, psychological distress, less peer support, and no parental support were associated with infrequent tooth brushing. The findings support the need to integrate oral health promotion into general health actions that target families, schools, and social environments of adolescents to develop healthier habits.

Selected Behavioural Factors Affecting Oral Health in Schoolchildren: Results from the Health Behaviour in School-Aged Children (HBSC) Slovak Study

Oral diseases, particularly dental caries, affect as much as nine in 10 persons globally. Its development starts during childhood. Behavioural factors play an important role in its aetiology. The aim of the research was to analyse the prevalence of selected behavioural factors associated with dental caries in Slovak adolescents. Selected factors, such as toothbrushing less than once a day, consumption of sweets and sweetened soft drinks daily and their combination, were analysed using data from Health Behaviour in School-Aged Children surveys carried out in 2005/2006, 2009/2010, 2013/2014 and 2017/2018 in Slovakia. The target group consisted of 11- to 13-year-old schoolchildren. The results were analysed by sex and socioeconomic status. The consumption of sweets and sweetened soft drinks, despite declining, remains widespread (41.3% of boys and 39.6% of girls in 2017/2018). The absence of daily toothbrushing, similarly as a co-occurrence of factors, were more frequent in boys (10.6% and 5.0% in 2017/2018, respectively) than in girls (5.1% and 2.3% in 2017/2018, respectively). The absence of daily toothbrushing was associated with a lower socioeconomic situation. In conclusion, behavioural risk factors affecting oral health are widespread in Slovak adolescents. Despite the positive development of the epidemiological situation, effective interventions, as well as the improvement of oral hygiene in lower socioeconomic groups, are needed.

The Effect of the Economic Crisis on Adolescents' Perceived Health and Risk Behaviors: A Multilevel Analysis

Background: Previous studies have analyzed the impact of economic crises on adult’s health and lifestyles, but evidence among children and adolescents is limited. The objective of this study was to analyze the impact of the economic crisis on self-perceived health and some risk behaviors in the Spanish adolescent population. Methods: We used data from four waves (2002, 2006, 2010, 2014) of the Health Behavior in School-Aged Children (HBSC) survey in Spain. Separate multilevel logistic and linear regression models were applied for health complaints, self-rated health, life satisfaction, smoking, alcohol consumption, and breakfast skipping. Annual change in Spanish regional unemployment rates was used as a proxy of the economic crisis. An increasing set of control variables were included, consisting of individual, socioeconomic, and family and peer relationships indicators. Median odds ratios were estimated to quantify the cross-region and cross-school variation. Results: Increases in unemployment rates were linked to a higher risk of poorer health and bad habits in the simplest models. The effect was no longer statistically significant when indicators of family and peer relationships were included, suggesting a protective effect against the impact of the economic crisis. Our findings also show that schools had a larger effect on health and lifestyles than regions. Conclusion: The child’s social context—family, peers, school, and region—play an important role on the effects of the economic crisis on health and risk behaviors.

Divorce and conversational difficulties with parents: Impact on adolescent health and self-esteem

Background: Divorce experience (DE) may cause health and self-conceptual problems, but these consequences might also be caused by conflicts and lack of conversational confidence (CC) with one or both parents. We investigated how DE impacted CC and how DE and CC impacted health complaints and self-esteem in a two-year longitudinal cohort study. Methods: The study was performed between 2011 and 2013 among 1225 students in junior high school (aged 11 and 13 years in 2011). We used binary logistic analyses to account for how DE impacted CC, and linear regression analyses to examine how DE and CC impacted on subjective health and self-esteem in 2013. Results: The study revealed that former and recent DEs impacted CC with fathers only. The impact was most evident for the more severe forms of conversational difficulties. DE in itself predicted only self-esteem, and CC with parents mediated this association. CC with both mothers and fathers had strong temporal causal associations with the outcomes two years later. Only CC with fathers impacted changes of the health complaints and self-esteem in full-model residual change analyses. Conclusions: The study proves a sex-specific effect on loss of CC between fathers and children after divorce. The impairment of CC has predictive repercussions on the health and self-conception of adolescents in their middle teenage years. From a public-health perspective, preserving the relation and the confidence between children and their fathers after divorce seems an important task.

Sex-related change in BMI of 15- to 16-year-old Norwegian girls in cross-sectional studies in 2002 and 2017

Background

The prevalence of overweight and obesity (OWOB) has stabilized in some countries, but a portion of children with high body mass index (BMI) may have become heavier. This study aimed to describe the distributions of BMI and the point prevalence of OWOB in Norwegian adolescents in 2002 and 2017.

Methods

A cross-sectional study involving 15- to 16-year-old adolescents in Oppland, Norway, was undertaken in 2002 and 2017. We calculated their BMI, BMI z-scores (BMIz), and the prevalence of OWOB.

Results

The mean BMI increased from 20.7 to 21.4 (p < 0.001) for girls but remained unchanged at 21.5 vs 21.4 (p = 0.80) for boys. The prevalence of OWOB increased from 9 to 14% among girls (difference 5, 95% CI: 2, 8) and from 17 to 20% among boys (difference 3, 95% CI: − 1, 6%). The BMI density plots revealed similar shapes at both time points for both sexes, but the distribution for girls shifted to the right from 2002 to 2017.

Conclusion

Contrary to previous knowledge, we found that the increase in OWOB presented a uniform shift in the entire BMI distribution for 15–16-year-old Norwegian girls and was not due to a larger shift in a specific subpopulation in the upper percentiles.

Physical activity, BMI and oral health behaviour among adolescents: Finnish School Health Promotion Study

BACKGROUND

To assess associations between oral health behaviour and physical activity and related factors among adolescents.

METHODS

The study population (n = 76 529) consisted of a representative sample of 16- to 18-year-old Finnish adolescents (boys: 37 211, girls: 39 318). An anonymous, confidential and voluntary classroom-administered questionnaire included questions about tooth brushing frequency, physical activity, BMI and eating habits. Moderate-to-vigorous physical activity (MVPA) was used to assess the adolescents' physical activity. The chi-square test and multiple binary logistic regression were used for statistical analyses. Adjusted odds ratios (OR) and their 95% confidence intervals (CI) were calculated for MVPA, BMI, breakfast, smoking and socioeconomic factors as parents' education and school type.

RESULTS

The prevalence of twice daily tooth brushing was highest among adolescents reporting 4 hours or more of MVPA (51-77%). Obese and smoking adolescents exercised less often than normal weighted and non-smokers. Girls brushed their teeth twice daily significantly more often than boys (P < 0.001), and high-school students brushed their teeth significantly more often than vocational school students (P < 0.001). Logistic regression models showed that obesity (OR = 2.14, 95% CI 1.92-2.37) and irregular breakfast eating (OR = 2.35, 95% CI 2.19-2.52) among boys, and obesity (OR = 2.81, 95% CI 2.48-3.17), physical inactivity (OR = 1.89, 95% CI 1.78-2.00) and irregular breakfast eating (OR = 1.91, 95% CI 1.79-2.04) among girls were strong predictors for poor tooth brushing.

CONCLUSIONS

Physically active adolescents had better oral health behaviour than less active adolescents. Obesity and smoking were associated with infrequent tooth brushing.

Self-Reported Oral Health Related Behaviour and Gum Bleeding of Adolescents in Slovakia in Relation to Socioeconomic Status of Their Parents: Cross-Sectional Study Based on Representative Data Collection

BACKGROUND

Oral health strongly affects overall health and is related to many factors. The aim of our study was to analyse oral health related behaviours (OHRBs) and gum bleeding among Slovak adolescents and assess the effect of socioeconomic factors on the outcomes.

METHODS

Data from the Health Behaviour in School-aged Children study (HBSC) were used (N = 8896, age range = 10-16 years, M = 13.4; SD = 1.4; 50.9% boys). Sociodemographic and socioeconomic indicators and frequency of OHRBs (dental hygiene, toothbrush changing, preventive check-up) and gum bleeding were collected. Effects of sociodemographic and socioeconomic variables on outcome variables were analysed by binary logistic regression.

RESULTS

We found that prevalence of OHRBs slightly decreases with age, and worse outcomes were reported by boys compared to girls (OHRB odds ratio range 0.45-0.75, (95% C.I. range 0.40-0.91), gum bleeding 1.38 (95% C.I. 1.19-1.61), p < 0.05). OHRBs were in most cases significantly associated with socioeconomic variables, lower affluence predicts worse outcomes (odds ratio range 0.76-0.88 (95% C.I. range 0.68-0.96), p < 0.05).

CONCLUSION

Our study provides representative findings on ORHBs in Slovakia and shows important associations of socioeconomic factors related to adolescents' oral health issues.

Socio-economic inequality in oral health in childhood to young adulthood, despite full dental coverage

The aim of this cross‐sectional study was to assess differences in caries experience according to socio‐economic status (SES) in a health‐care system with full coverage of dental costs for children up to the age of 18 yr. In 2011 and 2014, by performing hurdle negative binomial models, we obtained data on 3,022 children and young adults aged 5, 8, 11, 14, 17, 20, and 23 yr, living in four cities in the Netherlands. At all ages between 5 and 23 yr, the percentages of children with caries‐free dentitions were lower and mean caries experience were higher in low‐SES than in high‐SES participants. In 5‐yr‐old children with dmft > 0, mean caries experience was 3.6 in those with low SES and 2.3 in those with high SES. In 23‐yr‐old participants, these estimates were 6.8 and 4.4, respectively (P < 0.05). Low‐SES children have a greater risk of more caries experience than high‐SES children. Thus, in a system with full free paediatric dental coverage, socio‐economic inequality in caries experience still exists. Dental health professionals, well‐child care doctors and nurses, general practitioners, and elementary school teachers should collaborate to promote oral health at the community level, with specific targeting of low‐SES families. We further need policy measures to curtail, at community level, the increasing availability and consumption of highly processed, carbohydrate‐rich foods, with particular attention for low‐SES families.

Sugar Restriction for Caries Prevention: Amount and Frequency. Which Is More Important?

The World Health Organization guideline to use less sugar may be an opportunity and support for dentistry in its goal to get the message of using less sugar across to the public. Two ways (with all the combinations of these) to achieve a reduction of sugar consumption are the reduction of the amount of sugar in products or the reduction of the frequency of consumption of sugar-containing products. Which sugar-reducing strategy is best for caries prevention? To answer this question, this manuscript discusses the shape of the dose-response association between sugar intake and caries, the influence of fluoridated toothpaste on the association of sugar intake and caries and the relative contribution of frequency and amount of sugar intake to caries levels. The results suggest that when fluoride is appropriately used, the relation between sugar consumption and caries is very low or absent. The high correlation between amount and frequency hampers the decision related to which of both is of more importance, but frequency (and stickiness) fits better in our understanding of the caries process. Reducing the amount without reducing the frequency does not seem to be an effective caries preventive approach in contrast to the reciprocity. Goals set in terms of frequency may also be more tangible for patients to follow than goals set in amount. Yet, in sessions of dietary counselling to prevent dental caries, the counsellor should not forget the importance of quality tooth brushing with fluoride toothpaste.

Experience of maintaining tooth brushing for children born with a cleft lip and/or palate

BACKGROUND

Children with a Cleft Lip and/or Palate (CL/P) have been reported to have poorer oral health than those without the condition. The consequences for these children can be particularly problematic due to implications for future treatments. Tooth brushing is an important behaviour contributing to children's oral health, but is under researched in the CL/P population. The aim of the study is to explore the experience of maintaining tooth brushing among children in the United Kingdom (UK) with a CL/P and their parents.

METHODS

Semi-structured interviews were carried out with twenty-two parents and sixteen children with a CL/P (5-11 years), recruited at a cleft centre in the UK. Thematic analysis was used for data analysis.

RESULTS

Three key themes were drawn from the qualitative data: first, parents of children with a CL/P generally had strong motivation to look after their children's teeth but children's motivation was inconsistent. Second, parents were primary enablers of children's tooth brushing behaviour, often employing approaches adapted to their child's characteristics to encourage tooth brushing. Third, a range of obstacles were encountered by parents and children in maintaining regular tooth brushing behaviours. They reported obstacles such as issues related to CL/P, 'forgetting' and childhood illness.

CONCLUSIONS

The paper suggests that parents of children with a CL/P need support to enact their intention to maintain regular tooth brushing and prioritise tooth brushing within the context of demanding and dynamic family life.

Prevalence and family structures related factors associated with crown trauma in school children resident in suburban Nigeria

BACKGROUND

Multiple risk factors have been identified for traumatic dental injuries, including crown fractures, in various age groups and various populations. The objective of this study was to determine the prevalence, risk factors and family related factors for crown trauma among 8 to 16 year-old children in a suburban population, Nigeria.

METHODS

This is a secondary analysis of a data of 2107 children collected through a school-based survey. Study participants were 8 to 16 year-old resident in suburban Nigeria. The independent variables for the study were age, sex, socioeconomic status, and birth rank, family size and parenting status (one parent, step parent, both parents, and guardians). Details were collected using an interviewer administered questionnaire. Intraoral examination was conducted to identify presence of crown fracture. The independent variables associated with and predictors of crown trauma were determinedusing chi-square and logistic regression analysis respectively.

RESULTS

Only 167 (7.9 %) of the 2107 study participants had crown trauma. The teeth level prevalence of crown trauma was 0.33 %. Children with middle socioeconomic status had reduced odds of having crown trauma when compared with children with low socioeconomic status (AOR 0.50; CI 0.32-0.80). The odds of having crown traumawas more than doubled in males when compared with females (AOR 2.41; CI 1.72-3.39) and almost doubled in children living with single parents when compared with children living with both parents (AOR 1.94; CI 1.29-3.05).

CONCLUSIONS

The prevalence of crown traumawas low in this study population. Being a female and having lowsocioeconomic status significantly reduced the risk factors for crown traumawhile living with single parents increased risk for crown trauma.

Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren

This study evaluated the impact of molar-incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perceptions of schoolchildren and their parents/caregivers. This cross-sectional study consisted of a sample of 594 schoolchildren between 11 and 14 years of age and their parents/caregivers who answered the questionnaires CPQ11-14ISF:16 and P-CPQ, respectively. The main independent variable of this study was MIH of the schoolchildren. Experience of dental caries, malocclusion, and socioeconomic status were treated as confounding variables. Statistical analysis used descriptive analysis and Poisson regression with robust variance. The prevalence of MIH was 18.9%. The overall P-CPQ score ranged from 0 to 35 (average = 7.26 ± 6.84), and the overall CPQ11-14ISF:16 score ranged from 0 to 47 (average = 11.92 ± 7.98). Severe MIH was associated with a greater negative impact of the "functional limitation" domain (RR = 1.41; 95%CI = 1.01-1.97), according to parents'/caregivers' perceptions. Severe MIH was associated with a greater negative impact of the "oral symptom" domain (RR = 1.30; 95%CI = 1.06-1.60) and functional limitation domain (RR = 1.42; 95%CI = 1.08-1.86), according to the schoolchildren's perceptions. Schoolchildren with severe MIH had a greater negative impact on the oral symptom and functional limitation domains than those without MIH. According to parents'/caregivers' perceptions, schoolchildren with severe MIH had a greater negative impact on the functional limitation domain than those without MIH.

Impact of parent-related factors on dental caries in the permanent dentition of 6-12-year-old children: A systematic review

OBJECTIVE

To synthesise data from the literature on the effects of various parent-related characteristics (socio-demographic, behavioural and family environment) on dental caries in the permanent dentition of children.

DATA

Available studies in which the effects of parent-related characteristics on dental caries experience in the permanent dentition of children aged 6-12 years were evaluated.

SOURCES

PubMed, Medline via OVID and CINAHL Plus via EBSCO, restricted to scientific articles, were searched in April 2015. English language and time filters (articles published from 2000) were used.

STUDY SELECTION

A total of 4162 titles were retrieved, of which 2578 remained after duplicates were removed. After review of titles and their abstracts by two independent reviewers, 114 articles were considered relevant for full text review. Of these, 48 were considered for final inclusion. Data extraction was performed by two authors using piloted data extraction sheets.

CONCLUSIONS

Most of the literature on determinants of dental caries has been limited to socio-economic and behavioural aspects: we found few studies evaluating the effects of family environment and parental oral hygiene behaviour. Children belonging to lower socio-economic classes experienced more caries. In more than half the studies, children of highly educated, professional and high income parents were at lower risk for dental caries. There were conflicting results from studies on the effect of variables related to family environment, parents' oral hygiene behaviour and parent's disease status on dental caries in their children.

Trends in Social Inequality in Tooth Brushing among Adolescents: 1991-2014

This study examines whether social inequality in tooth brushing frequency among adolescents changed from 1991 to 2014. The data material was seven comparable cross-sectional studies of nationally representative samples of 11- to 15-year-olds in Denmark with data about frequency of tooth brushing and occupation of parents. The total number of participants was 31,464, of whom 21.7% brushed their teeth less than the recommended 2 times a day. The absolute social inequality measured as prevalence difference between low and high social class increased from 7.7% in 1991 to 14.6% in 2014. The relative social inequality assessed by odds ratios for infrequent tooth brushing also increased from 1991 to 2014.

Oral Hygiene Facilitators and Barriers in Greek 10 Years Old Schoolchildren

Aim: The aim of this study was to determine the oral hygiene facilitators and barriers for 10 years old Greek children, via a questionnaire and clinical examination.

Materials and methods: This was a cross-sectional study of 266, 10 years old, children recruited from schools in 3 locations in Greece. Data were collected via questionnaires and clinical examination. Questionnaires referred to Children’s oral hygiene knowledge, behavior and attitude as well as parents’ oral hygiene behavior and educational level. Children were clinically examined by two calibrated pediatric dentists using a WHO probe and artificial light to assess dental plaque (hygiene index-HI), gingivitis (simplified gingival index-GIs) and dental caries (DMFT-BASCD criteria).

Results: Regarding oral hygiene knowledge, although 80% of the children were literate of the proper means of oral hygiene, only 58.64% brushed their teeth twice daily and 36.84% used dental floss. Children’s oral hygiene knowledge was positively correlated with both parental brushing frequency (ρ = 0.175, p < 0.05) and educational level (ρ = -0.216, p < 0.05). Toothpaste use was reported by 92.11% of the children. Regarding Children’s attitude, 62.28% were concerned whether their teeth were clean, with girls showing greater concern than boys (p < 0.001). Their reported beliefs regarding brushing avoidance were boredom (84.06%), low oral health literacy (73.91%) and forgetfulness (56.52%).

Conclusion: Oral hygiene facilitators were found to be the concern about how clean were their teeth, oral health literacy of both children and parents and toothpaste appeal to children. Oral hygiene barriers were Children’s boredom, low oral health literacy, forgetfulness and low socioeconomic level.

How to cite this article: Angelopoulou M, Kavvadia K, Oulis C, Reppa C. Oral Hygiene Facilitators and Barriers in Greek 10 Years Old Schoolchildren. Int J Clin Pediatr Dent 2015;8(2):87-93.

Family socioeconomic status and nutrition habits of 7-8 year old children: cross-sectional Lithuanian COSI study

Background

Nutritional habits are a useful way to characterize whole diets and they are also known to be influenced by a wide range of social and economic factors. The above factors in each country may have different effect on children’s eating habits. In Lithuania the data of children nutrition in association with socio-economic status of family is poor. There are few studies done, where links between nutrition habits of children and socio-economic status of family was evaluated. The aim of this paper is to evaluate association among nutrition habits of first-formers and family socio-economic status in Lithuania.

Methods

Data were obtained participating in the international study, which was performed in all ten districts of Lithuania. A cross-sectional study was carried out in 2010, using the protocol and methodology prepared by the experts from the WHO and countries participating in the Initiative. The data were collected by means of COSI standardized questionnaire, which was filled out by parents of selected first-formers’. In this paper a part of questions regarding children nutrition habits and parents’ socio-economic status is presented. Statistical analysis was performed by using SPSS 20.0 software for Windows. Correlation among variables was evaluated by χ². Links among nutrition habits of first-formers and family socioeconomic status were determined using binary logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI). For all tests p < 0.05 was considered significant.

Results

It was established that the majority (76%) of Lithuanian first-formers eat breakfast every day or 4–6 times a week. Significant differences were found between breakfast consumption and gender – girls eat breakfast less frequently than boys. Odds ratio of children daily breakfast consumption were 1.3 times higher in families where fathers’ were older than 30 years comparing with younger fathers. Meanwhile mothers’ age had significant influence just on children daily soft drinks with sugar consumption.

Conclusions

Results from the national survey of primary school age children of Lithuania reveals that family socio-economic position plays one of the major role in breakfast, fresh fruit and soft drinks with sugar consumption among younger school age children.

Impact of lifestyle factors on caries experience in three different age groups: 9, 15, and 21-year-olds

OBJECTIVES

To study the impact of lifestyle factors on dental caries experiences in addition to the effect of demographic characteristics at the ages of 9, 15, and 21 years.

METHODS

The data were obtained from the study 'Oral health in children and adolescents in the Netherlands'. Data were collected through questionnaires and a clinical oral examination. Because the DMFS count data were highly skewed with a peak at zero, the negative binomial hurdle model was used for the analyses. The first part of the hurdle predicted the probability of having caries experience or not, and the second part predicted the degree of caries experience.

RESULTS

For the 9- and 15-year-old age groups, the breakfast frequency per week was related with having caries experience, while the frequency of brushing teeth per day was related with the degree of caries experience. In addition, the number of food and drinks consumed per day was important for the younger age group. These relations were not found in the 21-year-olds age group.

CONCLUSIONS

Findings of this study suggest that components to promote structure and regularity, including having breakfast and the number of food and drink moments, may be important to include in programs to prevent dental caries in children.

Cues to Action as Motivators for Children's Brushing

Dental caries is the most common chronic childhood disease. Home self-care procedures are the most important strategies to prevent tooth decay. Brushing is the most important single intervention for the prevention of tooth decay, yet compliance is not practiced and there is limited understanding of children's behavioral decisions. Guided by the Health Belief Model, this study consisted of eight focus groups with children in the second through fifth grades at three different socioeconomic-level school districts to determine the cues to action that are motivating or can motivate their brushing behavior. Results indicated children are primarily motivated to brush for aesthetic reasons, mainly due to viewed media pictures of "perfect" teeth. Other less commonly expressed motivations for brushing stemmed from interpersonal connections, such as relatives with dentures. Social media, on the other hand, played a key role in some children's understanding of more advanced oral health connections such as links between cardiovascular and oral disease, and smoking and oral cancer. These links were viewed as threatening to children to motivate better brushing. Additionally, the study found that home computers can be used as an external motivator to deliver tailored messages to encourage better brushing.

Factors associated with dental caries experience and oral health status among New South Wales adolescents

OBJECTIVE

To investigate the potential social and behavioural risk factors influencing the oral health of teenagers aged 14 and 15 years living in New South Wales Australia.

METHODS

Quantitative and qualitative methodologies were used in this research project. Data were obtained from both the clinical and questionnaire components of the NSW Teen Dental Survey 2010 and were analysed in SAS 9.2. The analyses allowed for various demographic and behavioural risk factors to be assessed using caries experience, severe caries and DMFT (decayed, missing or filled teeth) counts as the key outcome variables.

RESULTS

Of the 1,256 14- and 15-year-olds who had a dental examination, 1,199 (95.5%) provided questionnaire data. The clinical examinations found that 44.4% of teenagers overall had caries experience in at least one tooth, while 10.6% of the sample had experienced severe caries. Severe dental caries was found to be significantly related to a variety of factors, including family income, fluoridation status, tooth brushing behaviour and sugary drink consumption.

CONCLUSIONS

The oral health of 14- and 15-year-olds in NSW is influenced by social and dietary factors as well as access to fluoridated water supplies. There was also a strong relationship between self-rated oral health status with DMFT and with caries experience.

IMPLICATIONS

The findings of this study will assist policy makers by highlighting the current caries risk factors that should be part of future health promotion programs.

Geographic and socioeconomic variations in adolescent toothbrushing: a multilevel cross-sectional study of 15 year olds in Scotland

BACKGROUND

This study examined urban-rural and socioeconomic differences in adolescent toothbrushing.

METHODS

The data were modelled using logistic multilevel modelling and the Markov Chain Monte Carlo method of estimation. Twice-a-day toothbrushing was regressed upon age, family affluence, family structure, school type, area-level deprivation and rurality, for boys and girls separately.

RESULTS

Boys' toothbrushing was associated with area-level deprivation but not rurality. Variance at the school level remained significant in the final model for boys' toothbrushing. The association between toothbrushing and area-level deprivation was particularly strong for girls, after adjustment for individuals' family affluence and type of school attended. Rurality too was independently significant with lower odds of brushing teeth in accessible rural areas.

CONCLUSION

The findings are at odds with the results of a previous study which showed lower caries prevalence among children living in rural Scotland. A further study concluded that adolescents have a better diet in rural Scotland. In total, these studies highlight the need for an examination into the relative importance of diet and oral health on caries, as increases are observed in population obesity and consumption of sugars.

Oral and hand hygiene behaviour and risk factors among in-school adolescents in four Southeast Asian countries

The aim of this study was to investigate oral and hand hygiene behaviour and risk factors among 13 to 15 year-old in-school adolescents in four Southeast Asian countries. Data were collected by self-reported questionnaire from nationally representative samples (total 13,824) of school children aged 13 to 15 years in India, Indonesia, Myanmar and Thailand. Results indicate that overall, 22.4% of school children reported sub-optimal oral hygiene (<twice a day tooth brushing), 45.2% did not always wash their hands before meals, 26.5% after toileting and 59.8% washing their hands with soap (59.8%). In multivariate analysis, male gender, health risk behaviours and lack of protective factors were associated with sub-optimal tooth brushing, and lower socioeconomic status, health risk behaviours, psychological distress and lack of protective factors were found to be associated with sub-optimal hand washing hygiene behaviour. As a conclusion, the cross-national data on oral and hand hygiene behaviour from four Southeast Asian countries found sub-optimal hygiene behaviour. Several determinants of sub-optimal hygiene behaviour were identified that can inform programmes in order to improve oral and hand hygiene behaviour of this adolescent population.

Conceptualizing and contextualizing food insecurity among Greenlandic children

Objective

To review the context of food insecurity in Greenlandic children, to review and compare the outcomes related to food insecurity in Greenlandic children, in other Arctic child populations and in other western societies, and to explore the measure used by the Health Behaviour in School-aged Children (HBSC) study.

Design

The study includes literature reviews, focus group interviews with children and analyses of data from the HBSC study. HBSC is an international cross-national school-based survey on child and adolescent health and health behaviour in the age groups 11, 13 and 15 years and performed in more than 40 countries. The item on food insecurity is “Some young people go to school or to bed hungry because there is not enough food in the home. How often does this happen to you?” (with the response options: “Always”, “Often”, “Sometimes”, or “Never”).

Results

The context to food security among Inuit in Arctic regions was found to be very similar and connected to a westernization of the diet and contamination of the traditional diet. The major challenges are contamination, economic access to healthy food and socio-demographic differences in having a healthy diet. The literature on outcomes related to food insecurity in children in Western societies was reviewed and grouped based on 8 domains. Using data from the Greenlandic HBSC data from 2010, the item on food security showed negative associations on central items in all these domains. Focus group interviews with children revealed face and content validity of the HBSC item.

Conclusion

Triangulation of the above-mentioned findings indicates that the HBSC measure of food shortage is a reliable indicator of food insecurity in Greenlandic schoolchildren. However, more research is needed, especially on explanatory and mediating factors.

The impact of socioenvironmental characteristics on domains of oral health-related quality of life in Brazilian schoolchildren

BACKGROUND

Recent researches have pointed out the need to consider the functional and psychosocial dimensions of oral health, such as Oral Health-related Quality of Life (OHRQoL). The aim of this study was to investigate the influence of oral health status, socioeconomic factors and home environment of children on the four health domains of Child Perceptions Questionnaire (CPQ11-14).

METHODS

A cross-sectional study was conducted in Brazil with a sample of 286 schoolchildren aged 12 years and their parents. The schoolchildren were clinically examined, and participants were asked to complete the CPQ11-14, as well as a questionnaire about home environment. In addition, a questionnaire was sent to each child's parents asking them about family socioeconomic status. The chi-square test and Poisson's regression analysis were performed.

RESULTS

After adjusting for potential confounders, variables sex, monthly family income, mothers' education showed a statistically significant association with all health domains of the CPQ11-14. The family structure and presence of bleeding impacted on emotional (p = 0.0135), and social (p = 0.0010) well-being health domain scores. Orthodontic treatment need showed a strong negative effect on functional limitations domain score (p = 0.0021).

CONCLUSIONS

Clinical and socio-environmental factors had different impacts on domains of oral health-related quality of life, demonstrating the need to consider these conditions in planning strategies for the oral health of schoolchildren.

Irregular breakfast consumption in adolescence and the family environment: underlying causes by family structure

Data from the 2002, 2006 and 2010 Scottish Health Behaviour in School-aged Children (HBSC) surveys were analysed using logistic multilevel regression for outcome variable irregular breakfast consumption (IBC). IBC prevalence in Scotland was higher among young people from reconstituted and single parent families, and particularly single father families. Family characteristics, found previously to be associated with breakfast consumption, such as number of siblings, perceived parenting, parental involvement and family affluence, differed by family structure. Family structure inequalities in IBC existed, also after adjustment for year and child's sex, age, grade and ethnicity. Across all family structures, IBC was more prevalent at the older age groups, among those who had difficult communication with their parents, and where household routines were infrequent. Greater number of siblings and lower family affluence were associated with higher odds of IBC in single mother and both parent families, while having a second home was associated with higher odds in reconstituted households. Fair parenting and being close to at least one parent was associated with reduced odds of IBC in single mother households, while being close to all parents was in single father households. In single mother homes, having a working mother was also positively associated with IBC. Family structure differences should be considered when addressing irregular breakfast consumption in adolescence.

Family structure and breakfast consumption of 11-15 year old boys and girls in Scotland, 1994-2010: a repeated cross-sectional study

Background

The benefits of breakfast during childhood and adolescence have been reported previously though few studies have considered family structure inequalities in breakfast consumption. The proportion of young people living in non-traditional family types has increased in recent years, strengthening the need to describe and monitor the impact of the changing family unit on adolescent breakfast consumption. This study aimed to describe changes in daily breakfast consumption among adolescents in Scotland between 1994 and 2010, while also considering family structure inequalities, and the degree to which these have changed over time.

Methods

Data from the 1994, 1998, 2002, 2006 and 2010 Scottish Health Behaviour in School-aged Children (HBSC) surveys were analysed using logistic multilevel regression models for binary outcome variable daily breakfast consumption.

Results

Daily breakfast consumption among adolescents increased between 1994 and 2010, although there were differences by age and sex. In fact those aged over 14.5 years saw decreases in breakfast consumption, and girls saw significantly larger increases than boys. Daily breakfast consumption was more prevalent among adolescents from 'both parent' families, with lowest prevalence among those from single parent families. Trends in daily breakfast consumption between 1994 and 2010 also varied by family structure. While prevalence of daily breakfast consumption increased among those living with 'both parents', the largest proportion of the population, prevalence decreased over time among adolescents of single parent families, and particularly among those living with their father.

Conclusions

Family structure inequalities in daily breakfast consumption increased between 1994 and 2010, while breakfast consumption across the population as a whole increased. As the proportion of young people living in an alternative family structure continues to grow it is important to understand why these inequalities have increased and how these may be overcome. Possible reasons for family structure inequalities and their increase in recent years are discussed.

Adolescent risk behaviours and mealtime routines: does family meal frequency alter the association between family structure and risk behaviour?

Family structure is associated with a range of adolescent risk behaviours, with those living in both parent families generally faring best. This study describes the association between family structure and adolescent risk behaviours and assesses the role of the family meal. Data from the 2006 Health Behaviour in School-Aged Children survey were modelled using Multilevel Binomial modelling for six risk behaviour outcomes. Significantly more children from 'both parent' families ate a family meal every day and fewer 'hardly ever or never' did. Family structure was associated with boys' and girls' smoking, drinking, cannabis use and having sex and with girls' fighting. Frequency of eating a family meal was associated with a reduced likelihood of all risk behaviours among girls and all but fighting and having sex among boys. Eating a family meal regularly nullified the association between family structure and drinking alcohol for boys and girls and cannabis use for boys and reduced the effect size of alternative family structures on boys having sex and smoking. The family meal, associated with a reduced likelihood of many adolescent risk behaviours, reduces or eliminates the association with family structure and may therefore help to overcome inequalities in adolescent risk behaviours.

The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life

Background

The objective this study was to investigate the influence of clinical conditions, socioeconomic status, home environment, subjective perceptions of parents and schoolchildren about general and oral health on schoolchildren's oral health-related quality of life (OHRQoL).

Methods

A sample of 515 schoolchildren, aged 12 years was randomly selected by conglomerate analysis from public and private schools in the city of Juiz de Fora, Brazil. The schoolchildren were clinically examined for presence of caries lesions (DMFT and dmft index), dental trauma, enamel defects, periodontal status (presence/absence of bleeding), dental treatment and orthodontic treatment needs (DAI). The SiC index was calculated. The participants were asked to complete the Brazilian version of Child Perceptions Questionnaire (CPQ_11-14) and a questionnaire about home environment. Questions were asked about the presence of general diseases and children's self-perception of their general and oral health status. In addition, a questionnaire was sent to their parents inquiring about their socioeconomic status (family income, parents' education level, home ownership) and perceptions about the general and oral health of their school-aged children. The chi-square test was used for comparisons between proportions. Poisson's regression was used for multivariate analysis with adjustment for variances.

Results

Univariate analysis revealed that school type, monthly family income, mother's education, family structure, number of siblings, use of cigarettes, alcohol and drugs in the family, parents' perception of oral health of schoolchildren, schoolchildren's self perception their general and oral health, orthodontic treatment needs were significantly associated with poor OHRQoL (p < 0.001). After adjusting for potential confounders, variables were included in a Multivariate Poisson regression. It was found that the variables children's self perception of their oral health status, monthly family income, gender, orthodontic treatment need, mother's education, number of siblings, and household overcrowding showed a strong negative effect on oral health-related quality of life.

Conclusions

It was concluded that the clinical, socioeconomic and home environment factors evaluated exerted a negative impact on the oral health-related quality of life of schoolchildren, demonstrating the importance of health managers addressing all these factors when planning oral health promotion interventions for this population.

Factor structure of health and oral health-related behaviors among adolescents in Arusha, northern Tanzania

OBJECTIVE

This study aimed to evaluate the factor structure of health and oral health-related behaviors and it's invariance across gender and to identify factors associated with behavioral patterns.

MATERIALS AND METHODS

A cross-sectional study included 2412 students attending 20 secondary schools in Arusha. Self-administered questionnaires were completed at school.

RESULTS

Principal component analysis of seven single health and oral health-related behaviors (tooth brushing, hand wash after latrine, hand wash before eating, using soap, intake of sugared mineral water, intake of fast foods and intake of sweets) suggested two factors labeled hygiene behavior and snacking. Confirmatory factor analyses, CFA, provided acceptable fit for the hypothesized two-factor model; CFI = 0.97. Multiple group CFA across gender showed no statistically significant difference in fit between unconstrained and constrained models (p = 0.203). Logistic regression revealed ORs for hygiene behaviors of 1.5, 0.5, 1.5, 1.5 and 0.6 if being a girl, current smoker, reporting good relationship with school, access to hygiene facilities and bad life satisfaction, respectively. ORs for snacking were 1.3, 1.4, 0.4 and 0.5 if female, in the least poor household quartile, low family socio-economic status and high perceived control, respectively.

CONCLUSION

The two factors suggest that behaviors within each might be approached jointly in health promoting programs. A positive relationship with school and access to hygiene facilities might play a role in health promotion. Provision of healthy snacks and improved perceived behavioral control regarding sugar avoidance might restrict snacking during school hours.

Tooth-brushing behaviour in 6-12 year olds

BACKGROUND

A common clinical finding is that many schoolchildren display a nonacceptable oral hygiene.

AIM

To evaluate the tooth-brushing behaviour in children aged 6-12 years.

DESIGN

The study used a cross-sectional descriptive design. Children aged 6, 8, 10, and 12 years in an elementary school in a middle class area in Umeå, a city in northern Sweden, were invited and 82 (82%) consented. Visible plaque on buccal surfaces of incisors and canines was recorded from photographs of the participant's teeth before and after brushing using the scores of the Green and Vermillion Oral Hygiene Index. Brushing technique was recorded with a video camera. A questionnaire was used to collect data about oral hygiene habits at home.

RESULTS

The ratio between the sum of plaque scores after and before brushing was statistically significantly higher in the 6-year-old group compared with the 10-year olds, (P < 0.05). There was a negative correlation between time spent for brushing and the ratio between the sum of plaque scores after and before brushing (r = -0.31, P < 0.01). The lowest correlation was displayed in the youngest age group (r = 0.07, P > 0.05). Six-year olds spent statistically significantly less time for brushing than older children (P < 0.05).

CONCLUSION

Plaque removal from buccal surfaces from brushing was poor and averaged 19% for 6-year olds and 30% for older children. The results of brushing for children aged 8-12 years could benefit from increasing tooth-brushing time. Children could be given an increasing responsibility from 7 to 8 year of age but parental help is motivated up to 10 years of age.