What Do Mothers (or Caregivers) Know about Their Children’s Oral Hygiene? An Update of the Current Evidence

Factors associated with oral health knowledge, attitudes, and practices among legal guardians of preschool children in the Peruvian capital

BACKGROUND

Legal guardians frequently serve as role models for their children. The habits they instill in their children may prove effective strategies for establishing healthy oral hygiene behaviors. The present study examined the factors associated with the level of oral health knowledge, attitudes, and practices among legal guardians of preschool children in the Peruvian capital. Furthermore, the correlation between knowledge, attitudes, and practices in oral health was assessed.

METHODS

This cross-sectional, analytical study evaluated 560 legal guardians of preschool children from 30 private educational institutions between July and December 2022. A validated 20-question questionnaire was employed to assess legal guardians' knowledge, attitudes, and practices regarding oral health. Pearson's chi-squared test and Fisher's exact test were utilized for bivariate analysis. For multivariate analysis, a Poisson regression model with robust variance was applied using the adjusted prevalence ratio (APR). Statistical significance was set at p < 0.05.

RESULTS

A total of 82.3%, 76.2%, and 78.4% of legal guardians showed insufficient knowledge, unfavorable attitudes, and incorrect practices in oral health, respectively. The results indicated that legal guardians with high school and non-university higher education were 5.62 and 4.17 times, respectively, more likely to have insufficient oral health knowledge than those with university higher education. The same legal guardians were 6.18 and 5.02 times more likely to have an unfavorable attitude towards oral health than those with a university education (APR = 6.18, 95% CI 2.88-13.26 and APR = 5.02, 95% CI 2.32-10.90, respectively). Furthermore, these legal guardians were 4.35 and 3.08 times more likely to have incorrect oral health practices compared to those with university education (APR = 4.35; 95% CI: 2.39-7.90, and APR = 3.08; 95% CI: 1.66-5.69, respectively). On the other hand, legal guardians with a monthly family income of less than 270 USD were 14% and 15% less likely to have unfavorable attitudes and incorrect practices, respectively, compared to those with an income of 270 USD or more (APR = 0.86; 95% CI: 0.78-0.95, and APR = 0.85; 95% CI: 0.77-0.93, respectively). Finally, there was a moderate direct correlation between knowledge and attitudes (Rho = 0.56, 95% CI 0.51-0.62), knowledge and practices (Rho = 0.59, 95% CI 0.53-0.65), and attitudes and practices (Rho = 0.43, 95% CI 0.36-0.50).

CONCLUSION

The majority of legal guardians had insufficient knowledge, unfavorable attitudes, and incorrect practices in oral health. High school and non-university higher education were risk factors for poor knowledge, unfavorable attitudes, and incorrect practices. Having a monthly family income of less than 270 USD was a protective factor for unfavorable attitudes and incorrect practices. Finally, a moderate direct correlation was identified between legal guardians' oral health knowledge, attitudes, and practices.

Substance use during pregnancy and childhood dental caries: a Brazilian cohort study

This study aimed to evaluate the association between substance use during pregnancy (SUDP) and dental caries considering the Tooth Development Hypothesis and the Behavioral Hypothesis. This is a Brazilian cohort study conducted on 865 children (12-36 months). Exposure to SUDP was the latent variable and consisted of the use of alcohol, tobacco, and illicit drugs. The dependent variable was the number of dental caries lesions according to the Nyvad criteria. Structural equation modeling was used for analysis, estimating the standardized coefficient (SC) in two models: traditional (1) and with bias-corrected bootstrap estimates (2). The models were adjusted for socioeconomic status (SES), child's age, maternal age, symptoms of minor psychiatric disorders, sugar consumption, feeding, developmental defects of enamel, and gingival bleeding on brushing (GBoB) (α = 5%). SUDP did not affect dental caries. SES (SCmodel1=0.168, p = 0.037; SCmodel2=0.134, p = 0.056), GBoB (SCmodel1=0.407, p < 0.001; SCmodel2=0.297, p < 0.001), child's age (SCmodel1=0.087, p = 0.003; SCmodel2=0.087, p = 0.005), and sugar consumption (SCmodel1=0.167, p = 0.021; SCmodel2=0.167, p = 0.048) had a direct effect on the outcome. Child's age exerted a specific indirect effect mediated by GBoB (SCmodel1=0.048, p = 0.017; SCmodel2=0.048, p = 0.034). SUDP did not increase the risk of dental caries considering the Tooth Development Hypothesis and the Behavioral Hypothesis, suggesting that child-directed oral health care and tooth development may be similar between mothers exposed and not exposed to SUDP.

Knowledge, attitude, and practice of adolescents and parents toward malocclusion and orthodontic treatment

Malocclusion is the misalignment of teeth and jaws, affecting oral health and appearance. This study aimed to examine the knowledge, attitude, and practice (KAP) of both adolescents and parents toward malocclusion. This web-based cross-sectional study was conducted at Tianjin between July 2019 and July 2022, enrolled adolescents and their parents. The structural equation model (SEM) was used to analyze the interactions between KAP. A total of 478 adolescents and 380 parents were included. For knowledge, the scores were 6.95 ± 2.69 for adolescents and 7.07 ± 2.90 for parents (possible range, 0-12). For attitude, the scores were 36.96 ± 7.86 for adolescents and 33.26 ± 9.20 for parents (possible range, 13-65). For practice, the scores were 39.88 ± 7.85 for adolescents and 25.75 ± 8.56 for parents (possible range, 11-55). In parents, knowledge, practice, being a service personnel and production personnel, and acquiring knowledge through the Internet were associated with receiving orthodontic treatment. The SEM showed that knowledge directly affected attitudes (β = 0.551, P < 0.001) and practices (β = 1.122, P < 0.001). But attitudes did not affect practices (β=-0.003, P = 0.923). Adolescents and parents demonstrate unsatisfactory levels of knowledge, attitudes, and practices toward malocclusion. Improvements can be made by focusing on enhancing knowledge and encouraging proactive practices.

Polish pregnant women's knowledge on early childhood caries prevention and oral hygiene in children

BACKGROUND

Early childhood caries (ECC) is one of the most common chronic diseases among children. In Poland 86.9% of six-year-olds have ECC. One of the factors determining adherence to ECC prophylaxis and oral hygiene is mothers' knowledge. The aim of this study was to assess the level of knowledge demonstrated by pregnant women about ECC prevention and oral hygiene, and to analyse the determinants of this knowledge.

METHODS

A quantitative survey was conducted using Computer Assisted Telephone Interview technique on a randomly selected representative sample of 1,000 women over the age of 18 in their second and third trimesters of pregnancy. The significance level was established at 0.05 and p-values were presented as: p < 0.05, p < 0.01 and p < 0.001.

RESULTS

The highest percentage of wrong or "I don't know" answers were related to questions about: the number of free dental check-ups for children (76.8%), the date of the child's first visit to the dentist (66.5%), the age when the child has mixed dentition (72.2%). Women with higher education had better knowledge than women with lower or secondary education. Women with good and very good financial situation showed a higher level of knowledge compared to women with average, bad and very bad financial situation.

CONCLUSIONS

When developing prevention strategies and educational programs as part of prenatal care for women to reduce the incidence of ECC, it is important to take into account the identified areas that need support and specific target groups (mothers with lower socioeconomic status).

Association of Maternal Sense of Coherence With Oral Health Behavior of Children With Special Health Care Needs: A Cross-Sectional Study

BACKGROUND

Sense of coherence (SOC) has been adopted to analyze stress coping skills as well as to find its association with health and oral health behavior. The Arabic version of SOC has not been developed and adopted in the Saudi Arabian population; furthermore, few studies have attempted to analyze the association of a mother's sense of coherence with the oral health behavior of Special Care Health Needs (SCHN) children. Hence, this study aimed to observe the association of mothers' SOC scores with their children's oral health behavior, along with the validation of the scale.

MATERIALS AND METHODS

A cross-sectional study was conducted among 170 mothers of children with SCHN. Participants were recruited from two schools in Riyadh City and one school in Makkah, respectively. Descriptive statistics, validation, reliability, factor analysis, and multinomial logistic regression were carried out using the Statistical Package for the Social Sciences (SPSS, Version 20, 2011; IBM Corp., Armonk, USA).

RESULTS

The mean SOC-13 score was 61.6 (±10.1), with a median value of 61. The SOC scale elicited a Cronbach's alpha value of 0.77. The Spearman-Brown-Brownuttman split-half reliability coefficients were found to be 0.70, respectively. The analysis confirmed a three-factor solution, which explains about 51.9% of the total variance. Mothers with higher SOC tend to utilize dental services for children [OR 5.69, P = 0.029, CI 1.19-27.02] and restrict sugary drinks to once a day [OR 9.31, P = 0.00, CI 1.95-44.44].

CONCLUSION

The reliability of the Arabic scale that was adopted after translation in the present study was found to be high; the scale confirms the three-factor solution. Mothers who scored low on the SOC scale tended to utilize less dental service for their children as well as overlook the sugary drink/day intake of the children.