Oral Health Knowledge, Attitude, and Practices of Sharjah Mothers of Preschool Children, United Arab Emirates

Bibliometric Analysis of Cross-Sectional Studies on Early Childhood Caries

BACKGROUND/OBJECTIVES

Early childhood caries (ECC) is a significant global public health issue with economic and psychosocial consequences, impacting families and pediatric dentists. It affects children's quality of life, causing pain and infection. Despite increasing research on ECC cross-sectional studies worldwide, inconsistencies and gaps remain in terms of geographical disparities. This study aimed to conduct a bibliometric analysis of cross-sectional surveys on ECC by examining the co-authorship, citation analysis, co-citation networks, and keyword co-occurrence.

METHODS

An advanced search was performed using relevant terms in the Dimensions database from 2005 to 2024. Bibliometric parameters were retrieved through the database's analytical view tool and VOSviewer software.

RESULTS

A total of 571 documents were identified, with the highest output between 2019 and 2023 (355 records). Saul Martins Paiva authored the most articles (10), with 294 citations and a total link strength of 19. Brazil and the U.S. had the highest numbers of publications (56 and 52) and total link strengths, i.e., a measure of collaborative ties (21 and 50). The Universidade Federal de Minas Gerais in Brazil had the most published documents (15). BMC Oral Health led in terms of citations (44 articles, 899 citations, average 20.43%). The frequently co-occurring terms included ECC (1147 occurrences), oral health (417), and preschool child (301).

CONCLUSIONS

This bibliometric analysis highlights the global interest in cross-sectional ECC studies beyond pediatric dentistry, helping researchers understand the field's scope and progress.

Mothers' Knowledge, Attitude, and Behavior Concerning Their Kindergarten Children's Oral Health: A Cross-Sectional Study

OBJECTIVES

To evaluate the level of oral health-related knowledge, attitudes, and behavior among a group of mothers with kindergarten (KG) children aged 3-5 years toward their own and their children's oral health and assess its influence on their children's oral health status.

MATERIAL AND METHODS

This was a cross-sectional study conducted in Jeddah, Saudi Arabia. The sample was selected randomly from public and private KGs in Jeddah. Self-administrated questionnaires were distributed to the mothers of KG schoolchildren aged 3-5 years, which contained translated and validated Mothers' Behavior Questionnaire about their own oral health behaviors, Mothers' Attitude Questionnaire about their children's oral health, and Mothers' Knowledge Questionnaire about their children's oral health. The oral health of the KG school children was examined to determine the decayed, missed, and filled index (dmft).

RESULTS

A total of 461 child-mother pairs completed the study. The mean values of dmft were 5.41 ± 4.81. The children's oral health (dental caries) and the mothers' oral health-related knowledge, attitudes, and behavior were significantly associated with KG type (public vs. private), mothers' age, mothers' education, and family income. A multiple linear regression model indicated that younger mothers (< 30-40 years), highly educated mothers, high family income, and mothers with higher knowledge scores were significantly associated with lower dmft scores.

CONCLUSIONS

Mothers whose children attended private KGs exhibited better oral health-related attitudes, habits, and knowledge. School type, mother's age, mother's education level, and monthly income were factors that strongly impacted the behaviors, attitudes, and knowledge of the mothers. Dental caries was lower among children whose mothers were young, well-educated, from high family income families, and had higher knowledge related to oral health. Implementing targeted educational programs for mothers, particularly those with lower educational attainment and from low-income backgrounds, is essential for enhancing the oral health of children in kindergarten age.

Parental knowledge and practice on childhood caries prevention in northern Vietnam

This study was conducted to describe the knowledge and practices on dental caries prevention among parents of preschool children in Vietnam and identify associated factors. A cross-sectional study was conducted in three preschools in Northern Vietnam in 2020. A total of 316 parents of preschool children were randomly recruited. Knowledge and practices regarding early dental caries prevention were asked by using a structured questionnaire. Multivariate Tobit regression was used to examine factors associated with knowledge and practice scores. Results showed four aspects of knowledge that had the lowest proportion of parents having correct responses included timing of complete primary tooth replacement (12.3%), benefits of undergoing regular dental examination (31.7%), technique for brushing a child's teeth (33.9%), and duration for brushing (36.7%). The knowledge of parents was moderately low at 6.3/12 (SD = 2.3). The practices of parents were moderately good with the mean practice score at 6.1/9 (SD = 2.0). The proportion of parents taking children for regular checkups (56.2%) and replacing toothbrush every 3 months (53.7%) were the lowest. Information source, occupation, education and perceived necessity of oral care were found to be associated with parents' knowledge and practices. To conclude, parents had moderate levels of knowledge and practices regarding early dental caries prevention in preschool children. Further studies and interventions should be performed to improve parental knowledge and practices that could enhance the oral health of children.

The Knowledge, Attitude, and Practice of Lebanese Mothers Toward Their Children's Oral Health: A Cross-Sectional Survey

OBJECTIVES

This study aims to assess the knowledge, attitude, and practice of Lebanese mothers toward their children's oral health, examine the association between the three variables, and identify their predictors.

METHODS

A cross-sectional online survey was administered to Lebanese mothers residing in Lebanon with children aged six months to 12 years between April and May 2022. The survey was administered to mothers from various geographical areas who presented to academic medical centers, private clinics, and dispensaries. The survey gathered sociodemographic data as well as assessed the knowledge, attitude, and practice of the participating mothers toward their children's oral health.

RESULTS

A total of 357 responses were included in the final analysis. The mean age of mothers was 32.67 years +/- 6.35. The majority of mothers had one or two children (35.8% and 37.5%, respectively). More than two-thirds of the mothers were unemployed. Only 13% of the mothers followed best practices for their children's dental health, while 48.6.2% possessed above-average knowledge and 88.9% had great attitudes. Mothers with a university education had higher knowledge, better attitudes, and practice scores than those with school-level education (elementary, high school). Employed mothers had a significantly better knowledge score (p=0.036) and practice score (p=0.043) than unemployed mothers. The decrease in the number of children was associated with an increase in the maternal knowledge score. An increase in the mother's age was associated with a higher knowledge score.

CONCLUSION

The findings of this study suggest the need for targeted oral health education programs for Lebanese mothers to enhance their attitudes and practices toward their children's oral health. It highlights the importance of early oral health interventions and emphasizes the significant role of mothers in promoting good oral health practices for their children. Further research is needed on a larger scale to comprehensively understand these variables and inform the development of appropriate national oral health programs for children in Lebanon.

Rural-urban disparities in knowledge, attitude, and practice toward child oral health among mothers of 9-36-month-old children

Objective: To assess and compare the knowledge, attitude, and practice of mothers of pre-school children in urban and rural areas toward maintaining child oral health. Materials and Methods: A cross-sectional comparative study was conducted in a convenient sample of 400 mothers of pre-school children (aged 9 months to 3 years) visiting the outpatient department of the Department of Dentistry, Shyam Shah Medical College, Rewa (M.P), India between February 1 and April 21, 2022. The study sample was divided into two groups based on whether they belonged to a rural area (Group A) or urban area (Group B). Group A included 236 participants, and Group B 186 participants. They were served a 24-item questionnaire to assess and compare their knowledge, attitude, and practice toward child oral health. The data were represented as mean and proportions, and a student t test and analysis of variance were performed. Results: In Group A and Group B, 93.64% and 98.17% mothers respectively had the knowledge of cariogenic food. While 66.10% of mothers in Group A and 73.78% in Group B were aware that regular cleaning of teeth protects against tooth decay, only 5.49% of mothers in Group B and none in Group A reported taking their children to routine dental visits; the majority (94.07% in Group A and 78.05% in Group B) had never taken their children to the dentist. Urban background was significantly associated with better knowledge, attitude, and practice scores. Mother's' age and education level were significantly associated with better Knowledge, Attitude, and Practice scores in both groups. Conclusion: Mothers can play an important role in promoting positive attitudes and healthy practices toward oral health care in children. Knowledge, attitude, and practice score were found to be significantly low in mothers who belonged to the rural subgroup.

Evaluation of the Behavioral Determinants of Infant Oral Hygiene Practices in a Rural Area

Background Dental caries is one of the most common oral health diseases in children. Early childhood caries (ECC) in children can lead to delayed overall growth in the future. This can be prevented by early initiation of infant oral hygiene practices (IOHP). As mothers are the primary caregivers, assessing their behavioral factors that play a significant role in IOHP can help design a customized health prevention plan for appropriate infant oral hygiene practices. Methodology A questionnaire based-study was carried out in an Anganwadi (rural child care center in India) of Nagpur region, Central India, for two months. Parents of young children were interviewed about the oral health care of children. The study was planned to evaluate the various methods used by parents to perform IOHP and to identify various behavioral determinants that affect IOHP. An integrative model of behavior change was used to evaluate factors determining the behavioral determinants in performing oral hygiene. Results Out of 144 parents, 105 (72.92%) initiated IOHP immediately after birth. Most of them (76, 52.78%) used a moist cloth to clean the oral cavity. The other methods used were the parent's finger, water, etc. Most of the parents were unaware of commercially available oral wipes. Out of the various factors of behavioral determinants of integrative theory, oral health beliefs, emotional reactions, self-standard, and skills played a significant role in modifying parents' intention to maintain the oral hygiene of young children. There was a direct correlation between the educational qualification of the mother and oral hygiene practices. Conclusion The results of this study reveal an integrative structure that includes factors like oral health beliefs, emotional reactions, self-standard, external support, social norms, and skills that are responsible for the behavior of parents towards oral health care. These factors vary from individual to individual. Modifying these specific behavioral determinants in parents could improve the oral hygiene practices of infants and toddlers. Community-based oral health care programs should be tailormade to target these specific barriers.

Knowledge, attitudes, and practices regarding the oral health of children

Parents are responsible for their children’s health care, and their oral health-related knowledge, attitude, and habits can affect their children’s oral health. Aim: The objective of this study was to evaluate parents’ knowledge, attitudes, and practices regarding their children’s oral health. Methods: In this study, a sample of 398 parents of 4- to 6-year-old children completed a self-designed questionnaire. The parents’ oral health-related knowledge, attitudes, and practices were assessed. Children’s oral health was evaluated using decayed, missing, and filled tooth index (dmft). Data were analyzed using the SPSS version 23.0 with a p < 0.05 as statistically significant. Categorical data were reported as frequency (%), and continuous data were reported as mean ± SD. Moreover, Spearman’s correlation, multiple regression, Mann-Whitney test, Kruskal Wallis test, and Kolmogorov-Smirnov test were used. Results: Most of the parents had a satisfactory level of knowledge and positive attitudes regarding their children’s oral health. The knowledge and attitude scores were higher among parents with higher education (p<0.001), and the knowledge score was higher among mothers (p=0.004). Also, the attitude score was correlated with the number of decayed, missed, and filled teeth of children (p=0.01, p=0.04, and p=0.007, respectively). However, there was no significant relationship between dmft and the parents’ knowledge, attitudes, and practices using multiple regression. The mean dmft of children was 6.86 ± 3.56, and most of the parents had poor oral health-related practices. Conclusion: The parents’ level of knowledge and attitudes were satisfactory, but they had poor oral health practices. Moreover, there was no significant relationship between children’s oral health and their parents’ level of knowledge, attitudes, and practices. Educating programs and strategies are needed to enhance parents’ oral health-related attitudes and knowledge and, more importantly, change their oral health practices.

Knowledge, Attitudes, and Practices of Parents on Early Childhood Caries in Qatar-A Questionnaire Study

OBJECTIVES

 The aims of the present study were to evaluate the level of knowledge, attitudes, and practices (KAP) toward early childhood caries (ECC) in a group of Qatari parents and to assess the association of sociodemographic factors on their KAP.

MATERIALS AND METHODS

 A cross-sectional study which was based on a piloted self-administered questionnaire was conveniently distributed to parents who attended the Pediatric Dentistry Section, Hamad Dental Center (HDC), Doha, Qatar. The questionnaire comprised four parts which asked about sociodemographic characteristics, knowledge, attitudes, and practices. A score for each domain was given based on the percentage of correct answers.

STATISTICAL ANALYSIS

 Descriptive and analytical statistics were employed. For descriptive statistics, frequency of distribution in relation to sociodemographic characteristics and responses to items of the questionnaire were presented. For analytical statistics, associations between independent variables and KAP were employed using Chi-squared tests.

RESULTS

 The overall mean scores of KAP were 60.8%, 65.6% and 72.7%, respectively. Females had significantly higher percentages of correct answers than males (p = 0.001). Only 20% of females had poor knowledge, while it was 40% in males. Parents with university or higher degrees had significantly higher percentage of good attitudes than parents with preparatory or less education (p = 0.05). Areas that necessitated improvement by parents included the following: the amount of toothpaste needed for brushing, signs of tooth demineralization, bacteria that causes tooth decay can be transmitted from mother to her child, and tooth decay can be transmitted by sharing utensils (i.e., spoons, forks).

CONCLUSIONS

 The overall KAP of parents toward ECC was relatively fair. However, certain socioeconomic factors (SEF) seemed to influence each domain, and areas of improvement are needed. Areas of improvement are needed in each domain. Mothers were significantly more knowledgeable than fathers regarding oral health issues of their children. Highly educated parents demonstrated better attitudes than the less educated. Continuous educational programs coordinated by health regulatory bodies should be introduced to improve parents' KAP regarding ECC risk factors and prevention.

Oral Health of Children and Adolescents in the United Arab Emirates: A Systematic Review of the Past Decade

Oral diseases are a universal public health problem with serious health and economic burdens. These diseases are a major concern in the pediatric population specifically. In the United Arab Emirates (UAE), among all the diseases that affect children, oral diseases, particularly early childhood caries, are the most common despite improvement in the provision of oral health services. Enhancing oral health status is one of the key public health goals in the country. This current systematic review aims to summarize the available data on oral health among children and adolescents in the UAE over the past decade (2011-2021). The review was conducted following a predefined protocol and in concordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO, EMBASE via Ovid, the Cochrane Library, and the Index Medicus for the Eastern Mediterranean Region (IMEMR) databases, and the gray literature were searched for original studies reporting on oral health in the pediatric population in the UAE, without applying any language restriction. Twenty-nine studies were included reporting on a total of 43,916 participants; they were mostly cross-sectional, and emirate-based; they were mostly limited by their setting and convenient sampling. Among the general pediatric population, results showed a high prevalence of dental caries across different emirates. Nevertheless, it was difficult to provide a predictable profile of caries, as risk factors were not well-explored and inconsistent across studies. Suboptimal oral hygiene practices were also prevalent, in addition to a low utilization of dental services. Furthermore, included studies showed a high level of oral problems in children with different disease (down syndrome, cerebral palsy, thalassemia, autism…) and special conditions (children in prison nurseries); yet, in general, treatment indices were lower than their healthy counterparts. This review suggests that dental caries is a major pediatric health problem in the UAE. Risk factors included higher consumption of snacks, being in public schools, lower maternal education level, and socioeconomic status. Nevertheless, risk factors were not well-explored and inconsistent across studies. Suboptimal oral hygiene practices and a low utilization of dental services were also identified, in addition to a high level of oral problems in children with different disease coupled with lower treatment indices in comparison with their healthy counterparts. This systematic review provides crucial information for planning and evaluating effective oral health programs, identifies gaps in the recent research in this field, and paves the way for preventive and interventional studies targeting oral health in pediatrics in the UAE. Immediate oral health promotion strategies are needed to address this public health problem early in its course by creating conditions that promote oral health, and increasing uptake of dental services. Intensifying research to draw temporal trends, understand the profile of childhood caries in the UAE, and explore cost-effective national community prevention programs are also needed.

Developing an Instrument to Measure Maternal Knowledge and Attitude of Oral Health on Children Under 3 Years

OBJECTIVE

 Parental knowledge, belief, and attitude about oral health affect children's dental cleaning behavior. Further research on maternal knowledge and attitude about early-age children's oral health has been suggested to identify factors related to pediatric dental and oral health. For that purpose, a measurement instrument is needed. The research aimed to develop an instrument to measure maternal knowledge and attitude about under 3-year-old children's oral health.

MATERIALS AND METHODS

 Using a validity-based approach, we held a series of basic consultation (workshops and interviews) to identify the conceptually different domains. Instrument items were derived from relevant theories. Cognitive interviews were conducted to ensure that the items were properly understood. The items were first tested among the population calibration samples (n = 150). All instrument items were analyzed for reliability and validity.

RESULTS

 In total, 15 items were derived from Bloom's theory of learning and were developed for the knowledge instrument, while 10 others were developed for the attitude instrument. The reliability analysis yielded Cronbach's α scores of 0.620 for the knowledge instrument and 0.565 for the attitude instrument. All items were considered valid based on Pearson's correlation test results.

CONCLUSION

 The instruments on maternal knowledge and attitude about under 3-year-old children's oral health consisted of three dimensions, respectively. Both instruments have been tested and analyzed and therefore are applicable for use.

Assessment of Knowledge and Attitude of Expectant Mothers Regarding Effect of Their Oral Health and Its Influence on the Infant Oral Health

INTRODUCTION

Good oral health during pregnancy and infancy is important for the overall health and well-being of mother and child, respectively.

AIM

To assess the knowledge and attitude of expectant mothers regarding the effect of their oral health and its influence on infant oral health.

MATERIALS AND METHODS

A cross-sectional study was conducted among expectant mothers. They were randomly selected from those reporting to the Department of Gynecology in Government and Private Hospitals in Durg, Chhattisgarh. A total of 124 closed-ended, self-administered questionnaire were filled by participants, which had 21 items addressing the knowledge and attitude of expectant mothers regarding their oral health and oral hygiene practices; the transmission of bacteria from mother to child; cariogenic food consumption; effect of periodontal disease on infant's teeth and safe trimester for dental treatment. Data were tabulated and subjected to statistical analysis.

RESULTS

Significant differences were found in expectant mothers' knowledge and attitude based on their age (p = 0.02, 0.07), education level (p = 0.001, 0.95), trimester (p = 0.83, 0.43), and number of pregnancies (p = 0.05, 0.10), respectively.

CONCLUSION

The knowledge related to the oral health of pregnant women during pregnancy was found to be low and needs to be improved.

CLINICAL SIGNIFICANCE

Execution of educational programs along with other healthcare professionals to motivate expectant mothers.

HOW TO CITE THIS ARTICLE

Pattanshetti K, Kothari HP, Tiwari J, et al. Assessment of Knowledge and Attitude of Expectant Mothers Regarding Effect of Their Oral Health and Its Influence on the Infant Oral Health. Int J Clin Pediatr Dent 2020;13(5):471-475.

Oral health status and impact on the oral health-related quality of life of Egyptian children and early adolescents with type-1 diabetes: a case-control study

OBJECTIVES

The purpose of the present study is to (1) evaluate the oral health-related quality of life (OHRQoL) among a group of Egyptian children and early adolescents with type-1 diabetes mellitus (T₁DM) aged from 8 to 14 years and the impact of individual, environmental, oral health care and biological independent predictors (2) assess oral health status (OHS) in terms of oral hygiene, caries experience, untreated carious cavities and gingival condition.

MATERIALS AND METHODS

A case-control investigation conducted on eligible 444 participants who have been assigned into four groups (two case groups included 125 children and 97 early adolescents with T₁DM and two matched control groups). The OHRQoL was measured using a validated structured CPQ_8-10 for children and CPQ_11-14 short-form questionnaires for early adolescents. The questionnaire comprised of four parts that represented the study independent variables. Descriptive data were analysed using Mann-Whitney U test for the non-parametric data. Pearson's correlations have been calculated to inspect the interrelation between metabolic disease control and study of different OHS representatives. Log-linear Poisson model regression analyses performed to determine associations between the OHRQoL and independent predictors.

RESULTS

The prevalence of dental caries (DT ≥ 1) in children with diabetes was 49.6% (75.3%). The worse GI mean and median scores were recorded among early adolescents with T₁DM [mean (SD) = 2.24 ± 0.61; median (IQR) = 2.3(1)]. The social well-being of CPQ domains was a prominent concern that negatively affected children and early adolescents' life aspects. A strong correlation between OHRQoL and the level of HbA_1c in the two diabetic groups (r = 0.69 for children's group and 0.74 for the early adolescent group) was observed. The final model of log-linear Poisson regression analysis demonstrated that the odds ratio (OR) of poor OHRQoL among children and early adolescents with poor metabolic control was 1.30 [95% CI 1.18-1.47] and 1.22 [95% CI 1.11-1.38] times more than those with good metabolic control do.

CONCLUSIONS

The overall self-reported OHRQL appears to be adversely affected by T₁DM especially among children and early adolescents with poor metabolic control. Socioeconomic status and oral health care demonstrate a significant impact on the OHRQoL; however, the effect was obvious in the diabetic and non-diabetic groups.

CLINICAL RELEVANCE

1. In Egypt, the number of new cases rises progressively in a retrospective survey to figure out the prevalence of T1DM among children and adolescents. The available data is limited regarding the incidence and prevalence of dental caries and gingival condition among Egyptian children and early adolescents. 2. The present study is a premier study that assesses the OHRQoL and studies the impact of the individual, environmental, biological and oral health care variables. 3. This study highlights the urgent need for improving the oral health status of diabetic children and adolescents and the necessity for qualified oral health education programs for children and parents. There is an intense need to reinforce the role of preventive oral hygiene measures.

Oral health status of pre-school children of incarcerated mothers in United Arab Emirates prison nurseries and oral health knowledge and attitudes of their caregivers

AIM

To evaluate the oral-health of preschool-children of incarcerated-mothers at nine United Arab Emirates (UAE) prison-nurseries and assess the oral-health knowledge and attitudes of the prison nurseries' caregivers.

STUDY DESIGN

Cross sectional comparative study.

METHODS

A total of 128 and 254 preschool children formed the study and control groups respectively. All were examined clinically for dental caries using the dmft score and oral health and hygiene status indices. Knowledge and attitudes of all caregivers (n = 45) at prison nurseries were assessed using an interview questionnaire.

RESULTS

The prevalence of caries was not significantly different between the two groups with 89.9% [mean-dmft 4.97 (± 3.61)] in the study group and 92.1% [mean-dmft 4.48 (± 3.60)] in the controls. Oral-hygiene in the control group was better with 18.2% having good oral-hygiene compared to 6.2% in the study-group. Oral-health knowledge and attitude of the caregivers of prison nurseries were not satisfactory.

CONCLUSIONS

Despite the non-significant difference in the caries prevalence between the study and control groups, oral hygiene and care level of vulnerable-children of incarcerated-mothers were significantly poorer. Prisons' caregivers had poor knowledge and attitude of dental health matters.