Parental knowledge, attitudes and cultural beliefs regarding oral health and dental care of preschool children in an Indian population: a quantitative study

Knowledge and Attitudes of Parents about Oral Health in the Primary Dentition Stage in a Peruvian High Andean City

Children's oral health depends on parents' knowledge and attitudes. The primary dentition stage, in particular, plays a crucial role in the comprehensive development of children. Therefore, the objective was to evaluate parents' knowledge and attitudes about oral health in the primary dentition stage in Chachapoyas (Amazonas, NW Peru). A questionnaire was administered to 409 parents from 15 educational institutions, and the data were analyzed using multinomial logistic regression. Among the surveyed parents, 75.3% could identify at least one habit harmful to their children's teeth (such as excessive sugar consumption) and one of its effects (such as dental caries). Additionally, 77.5% reported that their children presented some dental problem, more frequent in the peripheral areas than in the city's center. Gender (odd ratio, OR = 0.484; p = 0.037), educational level (OR = 2.144; p = 0.043), and type of health insurance (OR = 2.627; p = 0.044) of the parents influenced awareness of taking care of their children's primary dental health. The geographic location of the school (1.729 < OR < 2.079; p ≤ 0.011) and family income (OR = 3.504; p = 0.028) influenced parents' identification of the different harmful effects of children's habits. Factors such as low socioeconomic status and never taking the child to the dentist increased the risk of dental problems (p < 0.05). It is suggested that peripheral areas, like rural areas, lack the same oral health programs and access to treatment as central urban areas, leading to disparities in parental knowledge and attitudes.

Exploring Jordanian children and parents' awareness, behavior, and perception of pediatric oral health

BACKGROUND

To evaluate children's and parents' practice and attitude toward oral hygiene and their knowledge about oral hygiene.

METHODS

This cross-sectional questionnaire-based study was conducted on randomly selected children who were seen in the Pediatric dentistry clinic in different Royal Medical Services hospitals. A modified questionnaire was used to gather information from the child or parents to gather the child's demographic data and evaluate the children's and parents' practice and attitude toward oral hygiene, their knowledge about oral hygiene, information about the parent and family, and oral examination, the questionnaire questions' reliability and validity were assessed by test-retest and Cronbach's Alpha test.

RESULTS

Three hundred seventy four patients were included, and the average age was 5.06 ± 3.58 SD years. Children's and parents' practice toward oral hygiene was inadequate where the majority (83.3%) brush their teeth occasionally, change their toothbrushes infrequently, apply toothpaste inappropriately, and less than half (47.2%) clean their tongue after teeth brushing. A significant number (73%) of candidates were aware that oral health has a significant role in their general health and can prevent dental problems. Participants agreed that maintaining a healthy mouth is an individual responsibility. The majority of participants came from large family size (the average family members 6.1 ± 1.7 SD) who live below the poverty line.

CONCLUSION

Our study demonstrated that awareness of oral health status in children below the age of 12 was poor. Although their oral knowledge was good their attitude and behavior were inadequate. These findings urge the need for expanded, well-organized, preventive educational programs that include school's syllabus, house visits, and hospitals for parents and children alike.

Dentist Mothers' Attitudes, Challenges and Facilitators in the Oral Health Promotion of Their Young Children

Twice daily parental supervised brushing (PSB) is recommended for the effective oral hygiene of children with toothpaste including fluoride. This cross-sectional study aimed to identify dentist mothers' attitudes, challenges, and facilitators in the oral health promotion of their young children. An online questionnaire was prepared and distributed to dentists via e-mail with a link to the form. Of all the mothers, 46.50% started brushing their children's teeth after the eruption of the first primary teeth. Nearly 50% of the mothers thought that they should brush their children's teeth until at least the age of 7-8 years old. In terms of the main barriers to toothbrushing, 52.9% said children could fall asleep at home or in the car, while 27.5% of all mothers reported being tired as the main barrier to toothbrushing. Although dentist mothers have sufficient knowledge to promote oral and dental health, they do not always have ideal attitudes and behaviors and they may encounter various barriers regarding themselves and their children in practical applications. Providing oral care for young children goes beyond 'knowledge' and is sometimes 'challenging'; however, it could be 'possible' by developing and implementing the most appropriate solution strategies suitable for each unique family and child.

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.

Factors affecting the use of dental services among Arab children in Israel: a qualitative study

BACKGROUND

In 2010, Israel reformed its hitherto dominantly privately financed dental services and included preventative and restorative dental care for children in the publicly-funded basket of healthcare services. A survey conducted by Brookdale Institute, found that only 67% of low-income Israeli-Arab children were using the new service (compared to 85% of Jewish children) while the majority of others continue using privately funded services. The aim of this study is to explore and explain Israeli-Arab children's low utilization of publicly-funded preventive and restorative dental care.

METHODS

A qualitative study designed to describe and understand the parents' motivations and choices. As a preliminary stage, eight semi-structured interviews were conducted with directors of HMO dental departments and Israeli-Arab dentists. In the second stage, ten one-on-one interviews with parents, and five focus group discussions with 55 parents held on February-March 2017. All discussions in the focus groups were conducted in Arabic and each group was moderated by one of the research team accompanied by another person who documented and recorded the discussion. All interviews and discussions were recorded, transcribed in full and translated into Hebrew.

RESULTS

The prevalent attitude is that one goes to the dentist only when there is a serious problem. The importance of preventive care is not appreciated. A childhood fear of the drill is very remembered and passed onto the children. Social and cultural factors such as kinship with service providers (GPs and dentists) influence the choice and utilization of health services. Economic barriers are still existing since even the small co-payment is daunting to low-income parents of large families. Provision of the public service is inadequate in some Arab villages.

CONCLUSIONS

The extension of Israel's National Health Insurance Law's basket of services to include dental care for children, while important, is not sufficiently embraced by Israeli Arab children. The remaining barriers include poor living conditions, low educational level that requires very clear sharing of information about the new service, and the resistance of cultural and social traditions. Public dental services providers should focus on conveying relevant oral health messages to the parents too, either through their children or directly.

Parental recall bias in observational studies: Child dental service use

BACKGROUND

Parents are frequently used to recall events of exposure and disease as a proxy for their children in observational health research.

AIM

To assess the validity of parental recall of children's utilisation of dental services.

DESIGN

Parents in the Longitudinal Study of Australian Children (LSAC) were asked to recall their children's overall dental service use in the previous year and whether the study child had received fillings or extractions due to decay in the previous 2 years. True positives were identified through parents who correctly recalled child dental service utilisation with actual dental treatment received in a linked dataset.

RESULTS

Of the 10 090 participants from the LSAC, 1290 study children had linked dental treatment data eligible for inclusion in this study. The absolute true-positive rate for parental recall of dental service use in the previous year was 82% (n = 1263). Overall true-positive percentages were lower for recall of fillings (40%) and extractions (7%) in the previous 2 years. Increasing number of recall days was associated with the rate of true-positive recall adjusted for other factors in all three models.

CONCLUSION

Accuracy of parental recall for tooth fillings and extractions was low. The use of parental recall for specific dental treatment over a time span of 2 years in further research is not recommended.

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.

Oral and Dental Health Knowledge and Attitudes among Parents of Children

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

Parent-reported toothbrushing behaviour in the Portuguese preschool population

PURPOSE

Study toothbrushing behaviours and associated factors in a Portuguese preschool population.

METHODS

The study population was the parents of children attending Portuguese kindergartens. The data on sociodemographic and toothbrushing behaviours, at home and at school, were collected by an online questionnaire. The data analysis was performed using Chi-square, Fisher, Mann-Whitney and Kruskal-Wallis tests (α = 0.05).

RESULTS

The sample included 711 parents. Most of the children brushed their teeth at home at least twice-a-day (65.3%), with the help of an adult (62.9%). The majority of the children did not brush their teeth at school (71.2%); however, only 9.9% of the parents reported that they don't/wouldn't authorise it. Considering both toothbrushing, at home and at school, 75% of the children brushed their teeth twice-a-day. However, only 7.8% of the children performed all the correct toothbrushing related procedures. Toothbrushing at school was more frequent in private kindergartens (p < 0.001). A higher level of education was associated with non-authorisation of toothbrushing at school (p = 0.019) and with performing the correct toothbrushing related procedures (p = 0.007). Attending an oral health professional appointment was also associated with performing the correct toothbrushing related procedures (p = 0.005).

CONCLUSION

Toothbrushing twice-a-day was frequent in the studied population, however, the percentage of children who brushed at school was low, as well as the percentage of children who performed all the correct toothbrushing related procedures. Toothbrushing at school was more likely in private kindergartens. Performing correct toothbrushing related procedures was more frequent in children who had a previous oral health appointment and whose parents had a higher education level.

Evaluation and Comparison of Oral Health Status between Spanish and Immigrant Children Residing in Barcelona, Spain

The present study aimed to evaluate and compare the level of oral health among Spanish and immigrant children residing in Barcelona, Spain. Oral health status was evaluated in 1400 children aged 3 to 14 years between September 2018 and June 2019. Multiple variables (dental caries lesions, exodontia, trauma, malocclusions, gingivitis, fillings, stainless steel crowns in primary dentition, and pit and fissure sealings in permanent dentition) were compared in both populations. Statistically significant differences (p < 0.001) were found in the prevalence of caries in the primary dentition, which was higher in the immigrant group (62.3%) than in the Spanish group (42.6%). For the permanent dentition, the prevalence of dental caries lesions was 12.2% in Spanish children and 16.4% in immigrant children, showing statistically significant differences (p = 0.026) between the two groups. The prevalence of fillings in the primary dentition was 14.6% in Spanish and 12.5% in immigrant children (p = 0.253). Regarding the permanent dentition, the number of fillings was also higher in the Spanish population (6.8%) compared to the immigrant population (3.5%), again evidencing statistically significant differences (p = 0.006). Our findings suggest a better oral health status in Spanish children than in immigrant children.

Parental Knowledge and Awareness of Fluoride Varnish Application on Their Children - A Cross-Sectional Study

Introduction

Fluoride varnishes are forms of topical fluoride that are applied on the surfaces of teeth to prevent from dental caries. It contains sodium fluoride, which is the active ingredient in the varnish and the concentration is about 22,600 ppm. Fluoride can promote enamel remineralization which protect against dental caries and it can be professionally applied by dentists and physicians for infants and young children.

Methods

In this, cross-sectional study, a close-ended survey containing 14 items was given to 399 randomly assigned parents in Jeddah, Saudi Arabia. The questionnaire included demographic data and items to assess the general knowledge about fluoride and fluoride varnish. The responses were coded and statistical analysis was performed.

Results

About 65.3% of males and 47.4% females were not sure if fluoride application was safe for their children, however, 67.2% of the population revealed that tooth pastes were one among the fluoride sources for their children. Pearson’s correlation test showed high statistical significance between the parents’ educational background and awareness level of fluoride varnish was of with p-value-0.000 and correlation coefficient (r-value-0.427).

Conclusion

The lack of awareness among parents on an important caries-control measure warrants the implementation of special awareness programs on fluorides and its benefits in young children.

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

Tooth decay remains one of the most common diseases in children, although it is a preventable injury and despite significant advances that has been made in terms of attention and care for oral hygiene. Several studies have shown the association between prevalence of tooth decay in children and parents’ incorrect oral care habits, with a low educational level and a low socioeconomic background. The question that arises concerns the actual oral hygiene knowledge of mothers, fathers, family members or caregivers of young patients; therefore, the aim of this review is to investigate the genesis of gaps in the topic. A literature search was conducted through the Scopus and PubMed search engine and ended in May 2022; only studies from the past 20 years were included. Current evidence suggests that parents and caregivers still have little knowledge about their children’s oral health: there is not enough awareness about the importance of preventing oral diseases, due to poor attention to good oral hygiene but also lack of information from health professionals and institutions. In the future, all the professionals involved in the pregnant woman’s care should increase parents’ knowledge, solve their doubts, collect and compare data in order to design effective intervention programs.

Malocclusion and esthetic perception among young adults in Riyadh Region of Saudi Arabia

Aim:

To assess the malocclusion and esthetic perception among young adults in Riyadh region.

Methodology:

A total of 667 subjects aged above 6 years were included in this study. Link containing questionnaires were sent through social media, email, and WhatsApp. Questions were related to the effect of malocclusion on oral health such as dental caries, gum disease, difficulty in tooth brushing, perception of their teeth in the way of alignment, and smile personality.

Results:

54.1% of participants said malocclusion can cause dental caries, 63.3% said it will lead to gum disease, and 72% were of the opinion that it will make tooth brushing difficult. 27.9% of study subjects were not happy with the alignment of their teeth. None of the responses were found to be statistically significant according to age (P > 0.05). Most of the questions were statistically significant according to gender (P < 0.05).

Conclusion:

Majority of study subjects had good knowledge about malocclusion and oral health. Perception about esthetics was more among women than men. More than 90% of subjects thinks beautiful smile is a part of personality.

Feeding Practices and Early Childhood Caries in Korean Preschool Children

Objectives

This study aimed to investigate the association between feeding practices and early childhood caries using representative Korean national survey data.

Methods

Data of 2772 children (aged 1-3 years) from the fourth to seventh Korean National Health and Nutrition Examination Surveys (2007-2018) were analysed. Data on decayed-filled teeth (dft) were obtained, and early childhood caries was determined as dft ≥1. Chi-squared test was performed to examine the experiencing of dental caries by participant characteristics, whilst analysis of variance was performed to compare the difference in dft values amongst the 3 groups (breast-feeding, mixed-feeding, and formula-feeding groups). Logistic regression analysis was performed to evaluate the association between feeding practice and early childhood caries.

Results

Comparison of the mean dft values amongst the 3 groups showed the highest value in the breast-feeding group. Multiple logistic regression analysis results showed that the likelihood of experiencing dental caries was significantly lower in the mixed-feeding group than in the breast-feeding group, whereas no significant difference was seen between the formula-feeding and breast-feeding groups. The likelihood of early childhood caries was higher in the group that introduced weaning food at ≥6 months than that at 4- to 6-month age, whilst the introduction of cow's milk and use of nutritional supplements had no significant association with the likelihood of early childhood caries.

Conclusions

Breast-feeding and delayed introduction of weaning food were associated with a higher likelihood of early childhood caries.

The Meaning and Purpose of Primary Tooth Disposal Rituals: Implications for Pediatric Dental Professionals

Rituals for disposing of exfoliated primary teeth exist in virtually all cultures around the globe, suggesting an important psychological and social function for young children and parents. Despite the importance of these rituals, and the role they may play in children's interactions with dental professionals, the meaning and purpose of primary tooth disposal traditions has not yet received adequate attention in pediatric dentistry. The overarching goal of this perspective was to draw attention to the meaning and purpose of primary tooth disposal rituals and show how, with a greater understanding of these rituals, dental professionals could improve the interactions they have with their young patients. To achieve this goal, we first summarize findings from prior research on how primary tooth disposal rituals are primarily practiced as a rite-of-passage to ease the transition from early to later childhood, to counteract anxiety, trauma, or pain experienced by children of tooth-shedding age, and to honor spiritual or religious beliefs that are thought to protect the child and aid their healthy development. Second, we articulate how, by understanding the significance and diversity of these traditions, practitioners can potentially improve their ability to prevent dental anxiety, increase their cultural competence to engage with increasingly diverse pediatric patient populations, and ensure more timely primary oral care. Finally, we provide a two-pronged approach, centered around the pillars of Education and Communication, to improve overall patient care built on knowledge of these rituals and cultural practices.

Facilitators and barriers to home-based toothbrushing practices by parents of young children to reduce tooth decay: a systematic review

OBJECTIVES

Parental supervised toothbrushing (PSB) is a collection of behaviours recommended by national guidance to improve oral health. This systematic review aimed to identify the barriers and facilitators to PSB.

MATERIALS AND METHODS

Studies investigating parental involvement in home-based toothbrushing in children under 8 years old and the impact on tooth decay were included. Electronic databases, references and unpublished literature databases were searched. The Theoretical Domains Framework (TDF) was used to code barriers/facilitators to PSB.

RESULTS

Of the 10,176 articles retrieved, 68 articles were included. Barriers and facilitators were found across all 12 TDF domains. Barriers included an inadequate toothbrushing environment and resources, knowledge of what PSB entails and child behaviour management. Facilitators were increased oral health knowledge, the adaption of the social environment to facilitate PSB and positive attitudes towards oral health. When only high-quality articles were synthesized, knowledge was not a common barrier/facilitator.

CONCLUSIONS

There are a comprehensive range of barriers/facilitators to PSB acting across all domains and at multiple levels of influence. This review identifies the most popular domains, thus informing the focus for supporting resources to supplement oral health conversations.

CLINICAL RELEVANCE

PSB is a complex behaviour. Practitioners need to understand and be able to explore the wide range of potential barriers and have practical suggestions to enable PSB. This review provides pragmatic examples of different barriers and facilitators and emphasises the importance of listening to parents and exploring their story to identify the barriers and solutions that are relevant to each family.

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

Introduction

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

Aim and objective

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

Materials and methods

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

Results

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

Conclusion

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

How to cite this article

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

Maternal knowledge on early childhood caries and barriers to seek dental treatment in Jordan

Purpose

To assess maternal knowledge, attitudes and beliefs of Early Childhood Caries (ECC) risk factors and to determine barriers in seeking dental treatment among children with ECC.

Methods

A total of 600 mothers of healthy children, aged 3–5 years, with ECC attending maternity and child health centres in Jordan completed a questionnaire using face-to-face interviews. ECC was diagnosed clinically by the chief investigator, based on the diagnostic criteria suggested by American Academy of Paediatric Dentistry (AAPD), and caries was recorded using dmft index.

Results

The majority of the children had poor oral health status (99.2%) with a dmft index of 6.04 (± 1.2). Less than third (25.7%) of the mothers believed that their child had poor oral health with more than half (53.3%) not being aware that their child had dental caries. Most of the mothers had poor knowledge, attitudes and beliefs regarding their children’s oral health (82%). Participants` oral health knowledge was significantly associated with mothers` level of education and profession (p < 0.05). In addition, there was delay in seeking dental treatment for their children by the majority (65.9%) of mothers. Maternal profession, family income and time needed to reach a nearby health centre were found to be significant barriers in seeking dental treatment (p < 0.05).

Conclusion

The majority of the mothers of children in Jordan with ECC had poor knowledge about their children’s oral health status. Moreover, seeking dental treatment was delayed by a large number of mothers of children with ECC.

Maternal Knowledge Regarding Feeding Practices and its Effect on Occlusion of Primary Dentition in Children: A Cross-sectional Study

Background

Infant feeding practices are an important factor influencing malocclusion in deciduous dentition, which can have long-lasting negative outcomes on oral health-related quality of life. Hence, knowledge, attitudes and cultural practices of mothers are vital in prevention of this.

Objective

The present study was carried out to assess the mother's knowledge about feeding practices and its influence on primary dentition.

Materials and methods

The current study was a cross-sectional study of 187 mothers of 3- to 5-year-old children identified with malocclusion, conducted in the pedodontics department of tertiary care teaching dental hospital in South India.

Results

Majority of the mothers were graduates (31.6%) or undergraduates or postgraduates (42.8%). The duration of breastfeeding was 0–3 months in 9.1%, 3–6 months in 23%, 6–12 months in 30.5%, and >12 months in 37.5%. Bottle-feeding was reported by 21.4%. Only 52.4% of the mothers were aware about caries, and 66.2% were aware of malocclusion. The prevalence of malocclusion was 63.6% in study population, and the prevalence of caries was 30.5%. The most common type of malocclusion was overjet seen in 20.9% of study subjects. The proportion of children with crowding, open bite, and crossbite was 17.1, 15, and 10.7%, respectively. There was a gradually increasing trend in malocclusion awareness with increasing educational status of the mother which was statistically not significant (p value = 0.119). The proportion of malocclusion was highest in children who received breastfeeding between 3 months and 6 months and was highest (69.8%) in children who received bottle-feeding for more than 12 months. None of the factors had shown a statistically significant association with malocclusion in study population.

Conclusion

The prevalence of malocclusion is high in children, and mothers’ awareness regarding malocclusion is poor.

Clinical significance

There is a need to educate mothers about proper feeding practices to prevent dental malocclusion.

How to cite this article

Duraisamy V, Pragasam AX, Vasavaih SK, et al. Maternal Knowledge Regarding Feeding Practices and its Effect on Occlusion of Primary Dentition in Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2020;13(1):31–34.

Parents' knowledge about the effects of oral hygiene, proper nutrition and fluoride prophylaxis on oral health in early childhood

Introduction: Health education, as one of the important aspects of preventive dentistry, plays an important role in promoting good oral health. The aim of this study was to determine and define the influence of parents' knowledge about the effects of oral hygiene, proper nutrition and fluoride prophylaxis on oral heath in early childhood. Methods: The survey was conducted in four pedagogical-education institution on Kosovo and Metohia, Serbia. The study included 403 parents of children, aged between 3-6 years. Parents were asked to fill a questionnaire about oral hygiene, nutrition and fluoride prophylaxis. Results: Parents from urban (64.8%) and parents from rural (63.5%) areas were informed that the teeth should be brushed at least twice a day. Only 3.4% parents from urban and 3% parents from rural were informed how often should a child toothbrush be changed. Awareness about nutrition showed that parents from rural areas were better informed than parents from urban areas. Parents from urban (31.4%) and rural (31.7%) areas belived that tooth decay may be caused by prolonged breastfeeding. Awareness about fluoride prophylaxis in preventive and pediatric dentistry was poor. Conclusion: The study showed that parents knowledge about the impact of oral hygiene, nutrition and fluoride on the oral health in early childhood is not good.

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

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

Perception of Saudi parents towards the problems related to primary dentition of their children residing in Riyadh city

Background:

The parental awareness and perceptions help in early recognition of problems in deciduous dentition, which will help us plan better preventive measures. Hence, the present study was conducted to evaluate the perceptions of Saudi parents residing in Riyadh towards the problems related to primary dentition of their children.

Materials and Methods:

A cross-sectional study was conducted on the patients attending private dental institution in Riyadh city. Information about demographic details, questions related to maintenance of primary teeth, and future implications of poor primary dentition health were collected. Descriptive statistics and Chi-square test were used for the analysis. The level of significance was set at P < 0.05.

Results:

A total of 1773 male and females filled up the survey form, which comprised of 28% males and 72% females, and maximum parents (68%) were university graduates. Overall better responses were in females and parents having more children.

Conclusion:

Over all mothers had a higher level of knowledge and positive attitude towards their children's oral health as compared to fathers. Developing and strengthening optimistic outlook among parents towards oral health especially primary dentition is utmost important.

Parental Knowledge and Acceptance of Different Treatment Options for Primary Teeth Provided by Dental Practitioners

Background: Parents have an influence on dental treatment options for young children regarding type of care provided. The aim of this study was to assess parents' knowledge and acceptance of different treatment options for primary teeth provided by dental practitioners for their children.

Materials and Methods: In this descriptive, cross-sectional study, caregiver/child dyads (n = 476) were recruited from patients at Pediatric Dental Clinics, Jordan University of Science and Technology. The data collection questionnaire to parents included: 1-demographic data 2-parental knowledge and practices regarding child's oral hygiene, caries and caries prevention 3-parental knowledge and acceptance of different treatment options for primary teeth including two given clinical scenarios (ICDAS-5 molar requiring intra-coronal restoration, ICDAS-6 molar requiring pulp therapy and stainless steel crown) with pictures before and after treatment. Afterwards, the child underwent a dental examination to record dmft/DMFT, gingival and plaque indices. Data was analyzed using SPSS, significance was set at P ≤ 0.05.

Results: Children's ages were 2–12 years (mean/SD 6.97 ± 2.5); with 255/53.6% males, 221/46.4% females. There were (166) children 2–5 years in primary dentition; (108/166) 65% had ECC, and (n = 62/166) 37.4% had S-ECC, and (310) 6–12 years in mixed dentition; (278/310) 89.7% had caries. Scaling and extraction were the highest known and accepted treatments for primary teeth by parents (35.5 and 30.1%, respectively), while nitrous oxide/oxygen sedation was the least (3.6%). Parental educational level was significant for composite restorations, fluoride gel application and pulp therapy (P = 0.03, 0.02, and 0.03, respectively) and age above 40 for amalgam restorations (P = 0.04). In both scenarios, most parents preferred to leave any care decision in hands of the dentists with no effect of educational level (P > 0.05). There were 81.5% parents who reported that their children's dental status was good, however, 78.4%/42.8% children had an average dmft/DMFT score 5.34/2.32 and mean PI/GI scores 0.88 ± 0.20/0.17 ± 0.23.

Conclusion: Parental knowledge and acceptance about dental treatment options for primary dentition was generally low. Parental education and age had an impact on parental knowledge and practices regarding child's oral hygiene, caries and caries prevention, and some treatment options. There was an overrated parental opinion of their child's teeth status despite the high dmft/DMFT and PI.

Effectiveness of an integrated perinatal oral health assessment and promotion program on the knowledge in Indian pregnant women

BACKGROUND

Oral health during pregnancy plays a crucial role in the overall health and well-being of pregnant women. Evidence shows that most young children acquire cariogenic organisms from their mothers. Poor maternal knowledge about oral diseases combined with inappropriate feeding can lead to severe caries among young children. The aim of study was to assess the oral health status of pregnant women and to evaluate the gain in their knowledge after educational session in an antenatal setting.

MATERIALS AND METHODS

It is a pre- and post-intervention study carried out on the pregnant women (n = 198) attending an antenatal clinic in a tertiary care hospital. A specially designed semi-structured 14-point questionnaire was used to assess the pre- and post-knowledge and attitude to the oral health. Each participant was educated for self and infant oral care with the help of a specially prepared colored printed booklet. Kruskal-Wallis test was used to explore the associations between the age, education and socioeconomic class and knowledge; Wilcoxon signed-rank test was used to compare pre- and post-knowledge score.

RESULTS

Median preoral health knowledge-attitude score was found to be 4 (0-8) and was found to be associated with the level of education (P = 0.014) and socioeconomic class (0.019). There was a significant improvement in the median postknowledge score to 7 (2-10) (P < 0.001) following oral health educational session in all categories.

CONCLUSIONS

An integrated preventive oral health checkup and educational program to pregnant women can benefit the dental health of the women and children. Prenatal care workers can be involved to disseminate the oral health awareness to pregnant women during antenatal visits.

Parents Knowledge and Awareness of their Children’s Oral Health in Riyadh, Saudi Arabia

Objective:

To assess the parents’ knowledge and awareness of their children’s oral health in Riyadh, Saudi Arabia.

Methods:

The study was a cross-sectional analytical study of Saudi parents. A self-administered questionnaire was collected from 324 parents in public parks and malls. In addition to the demographic questions, parents’ knowledge about the number of primary teeth, tooth brushing, best time of dental visits, the meaning of plaque and calculus, the importance of fluoride, the relationship between primary and permanent teeth and the effect of oral health on general health were questioned. Data analysis included descriptive statistics and one-way analysis of variance and Bonferroni tests to assess differences in the mean number of correct answers among demographic categories. A p-value of 0.05 was set at a significant level.

Results:

The percentages of correct answers ranged from 26% to 75% depending on the type of questions. Only 26-28% could identify the number of primary teeth and the duration of teeth brushing. About one-third of parents knew the time of the first dental visit and the definition of plaque and calculus. Between 63-75% of parents believed that primary teeth can affect permanent teeth and mouth problems can affect general health. On average, 59.2% of participants provide incorrect answers about their children’s oral health. The numbers of correct answers were significantly increased by increasing education and income.

Conclusion:

Parents' knowledge and awareness of oral health among Saudi parents were poor. Special attention should be given to parents with low socioeconomic status who need to be educated about children oral health more.

Is there a relationship of negative oral health beliefs with dental fear and anxiety regarding diverse dental patient groups? A systematic review and meta-analysis

OBJECTIVES

This systematic review and meta-analysis aimed to critically appraise the evidence on the relationship of oral health beliefs with dental fear and anxiety in distinct patient groups.

MATERIALS AND METHODS

Observational studies were retrieved by Cochrane, Embase Search, Portal BVS, Clinical Trials, Ovid, Open Gray, PubMed, Scopus, and Web of Science, and they were manually checked for the inclusion of additional articles of interest. The assessment of quality of studies was performed by the application of three different versions of the Newcastle-Ottawa Scale, for cohort, case-control, and cross-sectional studies. Only studies with low or unclear/moderate risk of bias contributed to meta-analyses, regarding the analysis of random effects of mean differences of dental beliefs scores between dental fear/anxiety and control groups, and the correlation of dental beliefs with dental fear and anxiety measures.

RESULTS

Of 276 articles initially retrieved, 10 were included in the systematic review, while only 6 studies with unclear/moderate risk of bias were considered in meta-analyses. The mean difference of dental beliefs effects was higher in patients with dental fear and anxiety compared to controls (1.20; 95% CI 0.27-2.14; P = 0.01). Additionally, a moderate positive correlation was observed between dental beliefs and dental fear measures (r = 0.54, 95% CI 0.47-0.60;P< 0.001).

CONCLUSIONS

Based on these results, the presence of negative health beliefs is directly related to the increase of dental fear and anxiety; however, these findings are supported in studies with unclear/moderate risk of bias.

CLINICAL RELEVANCE

Dental fear and anxiety is an important obstacle for the access of dental treatment and patient-dentist relationship, leading to inadequate oral health levels.

Parental attitudes about acquiring a dental home for preschool children: a new concept in the Arab state of Qatar

OBJECTIVE

The purpose of the study was to assess parental perceptions and acceptability of a dental home for their preschool children, a new concept in the state of Qatar.

METHODS

A cross-sectional prospective study was conducted at Hamad Medical Corporation, in the state of Qatar. Parents of infants and children <5 years of age were offered an interview survey.

RESULTS

A total of 309 questionnaires were completed (response rate =98%). More than 90% of the participants believed that oral health and dentition affected total-body well-being. Only 18% of parents stated that their children had excellent oral health. Interestingly, more than two-thirds of children had not had a routine dentist visit in the 12 months preceding the interview. Reasons for not having such visits included long appointment times (17.4%), the perception that dental care was expensive (15.5%), the notion that deciduous teeth did not need care (9%), the impression that insurance did not cover dental procedures (8%), unawareness of location of dental centers (4%), the child did not want to go (4%), the notion that children are difficult to handle during a dental procedure (3%), a combination of these factors (33.5%), and other factors (5%). When asked what factors would encourage them to enrol a dental home for their children, almost 20% mentioned speedy appointments followed by dentists specialized in pediatrics (14.3%), child-friendly atmosphere (12%), low cost (12%), close to home (5.7%), none (2.7%), others (2%), and all of the above (32.3%).

CONCLUSION

Counseling by primary-care physicians can increase dental home acceptability in the state of Qatar, especially that access to health care is easy in our community.

Knowledge, Attitudes, and Practices of Mothers of Preschool Children About Oral Health in Qatar: A Cross-Sectional Survey

Health-related behaviors are influenced by knowledge and awareness, with oral health being no exception. It is well-known that oral diseases are influenced by social determinants. There is an association between the oral health knowledge of mothers and the status of their children's oral health. In Qatar, the knowledge and practices of oral health in preschool children have not been previously reported. The aim of this study was to assess the knowledge, attitude, and related practices of mothers of preschool children about oral health in Qatar. A total of 400 questionnaires were distributed by the principals of kindergarten to mothers of children attending 16 government kindergartens in Qatar. The questionnaire included 38 close-ended questions grouped into nine categories, addressing different aspects of knowledge and practices related to early childhood oral health. The questionnaire was constructed in English, before being translated into Arabic, which is the local language in Qatar. The questionnaire instrument was pre-tested on mothers with demographic characteristics matching the main population. These participants were not included in the main study. The questionnaire study was associated with a clinical epidemiological study to assess dental caries and enamel defects of the sampled children. The dmft caries index (decayed, missing and filled teeth) was used for that purpose according to the World Health Organization criteria. For the questionnaire administered to mothers with clinical survey variables, a binary logistic regression analysis was performed to determine the associations between the measures of oral health status (dmft, Dental index) and mothers' oral health knowledge and practices. A total of 48% mothers thought that children should have their teeth brushed from the age of three years and 42% chose younger than two years as a starting age for brushing. More than half (54%) of the mothers thought that children should not have their teeth flossed. In general, no significant statistical association was found between dmft and any other variables, except for whether or not the child had visited the dentist. Logistic regression analyses were performed to determine the association between the measures of oral health status (dmft, DI) and mothers' oral health knowledge and practices. After controlling for the other independent variables included in this model, the test of the model was not statistically significant, which indicated that none of the variables represent a significant risk for occurrence of caries. The only exception was whether or not the child had visited the dentist (odds ratio = 2.51, 95% confidence interval 1.091⁻5.774). Despite the existence of good knowledge of oral health care, there were deficiencies in the oral health care provided to children. This may reflect that seeking dental care is either not very important or it is challenging to obtain access to a child-friendly dentist in the public health system in Qatar. The results of this study suggest that there is a need for an oral health promotion program to fill the gaps in knowledge for mothers regarding oral health care for young children.

Risk Determinants of Dental Caries and Oral Hygiene Status in 3-15 Year-Old Recent Immigrant and Refugee Children in Saskatchewan, Canada: A Pilot Study

This study aimed to identify the risk determinants of caries and record oral hygiene status in recent immigrant and refugee children residing in Saskatoon and Regina, Saskatchewan, Canada. Convenience samples of 133, 3-15 year-old recent immigrant and refugee children, and 86 adult guardians were recruited. Clinical examination of children and survey of their guardians explored the presence of at least one decayed tooth in the child's mouth; and the knowledge, attitudes, behaviors, among other aspects in adult participants. Refugee children had statistically significant higher decayed, missing, filled teeth (DMFT) scores (mean dmft/DMFT score 5.80 ± 4.24) than immigrant children (mean dmft/DMFT score 3.52 ± 3.78 (p < 0.001). Adult immigrants had significantly higher proficiency in English language, knowledge about preventive components like fluoride and dental floss compared to refugee adults. The results of this study confirm the poorer state of oral health among refugee and immigrant children compared to Canadian children.

Parents' Attitude towards the Use of Fluorides and Fissure Sealants and its Effect on their Children's Oral Health

OBJECTIVES

To characterize the attitudes of Israeli parents towards caries preventive measures.

STUDY DESIGN

participating parents completed a 21-item questionnaire on their demographics, dental history, attitudes and satisfaction from fluorides and fissure sealants.

RESULTS

One hundred parents (average age 41.62±4.9 years, 85 females) participated. Most of the parents (88% of the mothers and 84% of the fathers) had an academic education. Most of the parents (54%) had a favorable attitude towards the use of fluoridated gels, while only 37% of them had a positive opinion regarding fluoridated water. The satisfaction levels were very high regarding fissure sealants, fluoridated mouth rinses and fluoridated gels (78.1%, 73.6% and 72.5% respectively). The satisfaction from fluoridated water was split almost equally (50.8% were 'pleased' and 49.2% 'not pleased'). The main source for parental oral health knowledge was the dentist (83%). Parents' attitude towards caries preventive measures was significantly correlated to their gender, dental experience, level of education and the number of children in the family.

CONCLUSIONS

positive attitude towards caries preventive measures was found among parents with higher awareness for preventive oral health measures and among bigger families. Mothers were more positive about fissure sealants than fathers. Mothers with up to 12 years of education tended to have a positive opinion regarding water fluoridation.

Effects of nutrition and hygiene education on oral health and growth among toddlers in rural Uganda: follow-up of a cluster-randomised controlled trial

OBJECTIVE

To examine the effect of a nutrition and hygiene education intervention on oral health behaviour and whether early onset of caries was related to child growth in rural Uganda.

METHODS

Follow-up study of a cluster-randomised controlled trial conducted between October 2013 and January 2015. Data were available from 399 mother/child pairs (203 in the intervention and 198 in the control group) of the original trial (78%) when the children were 36 months old. Oral health behaviour was evaluated using questionnaires. Photographs of the maxillary anterior teeth were examined for unmistakably carious lesions, and 115 water samples from the study area were analysed for fluoride concentration.

RESULTS

The frequency of cleaning of the child's teeth at 36 months was about twice as high in the intervention as in the control group (84.3% vs. 46.6%; P = 0.0001). Cavitated carious lesions occurred more frequently in the control than the intervention group (27.8% vs. 18.2%; P = 0.04). Extraction of 'false teeth' (ebiino), a painful and crude traditional operation, was profoundly reduced in the intervention group (8.9% vs. 24.7%; P = 0.001). There was no evidence of association between the occurrence of caries and child growth.

CONCLUSIONS

The education intervention improved oral hygiene practices and reduced the development and progression of caries and extraction of ebiino. Early childhood caries was not clearly associated with child growth.

Perception and Practices of Nomadic Women in a Rural Community in Southwestern Nigeria to Their Children's Oral Health

Introduction Nomads move from one settlement to another, thus it has been difficult to have adequate documentation about their oral health and that of their children. Aim To investigate the perception and practices of nomadic Fulani women toward their children's oral health. Methodology A cross-sectional study was conducted among 197 Fulani women using a structured interviewer administered questionnaire. Results Perceived causes of tooth decay included tooth germs/worms (23.9%) and sugar (5.1%), and 32.0%, 15.2%, and 5.1%, respectively, self-medicated children with antibiotics, traditional concoctions/herbs, and analgesics for tooth decay. Two fifths (40.1%) attributed bleeding gums to tooth germs/worms. Polyurethane foam (46.7%), toothbrush (32.0%), finger (18.8%), and wooden twigs (2.5%) were aids used for cleaning children's teeth. Conclusions These mothers have suboptimal oral health knowledge, attitudes, and practices toward their children's oral health. There is a need for urgent intervention among this group of people.

Reasons for extraction in primary teeth among 5-12 years school children in Haryana, India- A cross-sectional study

Background

Due to high prevalence of oral diseases extraction of primary teeth is a common and a major concern in developing countries. These teeth are given least importance as they are believed to shed off automatically, thus leading to serious problems like crowding and malocclusion.

Material and Methods

A cross sectional study was carried out among children aged 5 to 12 years among 1347 children. The data was recorded on a prestructured questionnaire. Reasons for extraction of teeth were based on Kay and Blinkhorn criteria.

Results

20.4% children were having tooth loss due to various reasons. The main reason for extraction was found to be caries in 64.3% followed by trauma in maxillary teeth among 43.02% of children.

Conclusions

Presence of early loss of primary teeth result in occlusal disturbances and space loss among children. Hence, proper treatment regimens must be followed by the dental professionals and should be the need of the hour.

Key words:Extraction, children, primary teeth, caries.

What do expectant mothers need to know about oral health? A cohort study from a London maternity unit

Objective:

To determine the oral health knowledge of pregnant women and to report their future plans to provide dental care for their expected child.

Design and setting:

Prospective cohort study; Ultrasound maternity services at St Thomas’ Hospital, London, 2014. Pregnant women attending for a routine ultrasound scan completed a questionnaire.

Results:

Women did not know that milk, dried fruit or fruit juices can cause caries. Most women knew about the benefit of fluoridated toothpaste, dental floss and sugar-free chewing gum, but only a minority knew about fluoride varnish. Most pregnant women planned to read or seek advice before purchasing their child’s first toothpaste. There was no difference regarding knowledge of prevention tools (diet and fluoride supplements) for dental caries (P>0.05) between first-time mothers and those who had children already. Though the latter knew more about toothpaste dose and timing of starting toothbrushing (P<0.05).

Discussion:

Oral health knowledge among pregnant women was deficient with respect to the cariogenicity of prolonged night-time milk feeding, dried fruits and fruit juice consumption. There was also limited knowledge of the benefit of fluoride varnish and timing of starting toothbrushing.

Conclusions:

Oral health knowledge amongst pregnant women is still deficient in many aspects. In this study population the need to improve maternal knowledge was shown.

Parental preference for fluoride varnish: a new concept in a rapidly developing nation

OBJECTIVE

The objective of this study was to investigate parental preference for fluoride varnish in a country where the average percentage of dental caries in young children is up to ~73%. Consequently, the aim of this study, despite being a pilot, was to create a nationwide project in the State of Qatar to promote oral health in children.

METHODS

A cross-sectional perspective study was conducted at Hamad Medical Corporation in Qatar. Parents of children aged ≤5 years were offered an interview survey. A total of 200 questionnaires were completed (response rate =100%). The study was conducted between December 1, 2014 and March 30, 2015, and included all children aged >1 year and <5 years who came to the outpatient clinics for well-child and sick visits. We also included children who were admitted to the inpatient wards.

RESULTS

The mean age of participant children was 2.8±1.1 years. When inquiring regarding parents' knowledge and awareness of dental health, we found that >90% of families were aware that dental health affects the health of the whole body. The study showed that ~70% of parents were not aware of the existence of fluoride varnish, but would allow a health provider to apply fluoride varnish. Furthermore, ~80% of parents would not stop brushing their child's teeth and would not skip dentist appointments if varnish was to be applied. Approximately 40% of parents conveyed some concerns regarding the safety of fluoride varnish, despite being considered as a new concept. The main concern was that the child might swallow some of the fluoride. Another important concern expressed by parents was the availability of the fluoride varnish in all clinics.

CONCLUSION

The robust positive attitude of parents in this sample suggests that introducing fluoride varnish is feasible and acceptable in our community. Actions to augment fluoride varnish acceptability in the developing world, such as focusing on safety, could be important in the disseminated implementation of fluoride varnish.

Evaluation of parental awareness regarding their child's oral hygiene

OBJECTIVES

To determine parental awareness about their child's oral hygiene and its associated factors.

METHODS

In this cross-sectional study, 396 parents and their 3- to 6-year-old children were selected by randomized cluster sampling from Shiraz kindergartens in 2013. Parents completed a questionnaire on their perception of their child's oral hygiene. The children received a dental examination, and their dental cleaning status was determined using Simplified Debris Index. Parental awareness was determined by comparing parents' perception of their child's oral hygiene with the results of the dental examination. Associations between demographic factors and parental awareness were evaluated.

RESULTS

Sixty per cent of the parents were aware of their child's teeth cleaning status. Higher percentage of parents with university degree (P < 0.001) and parents whose child did not have a previous dental visit (P < 0.001) were aware. Also, more aware mothers were employed compared with homemakers (P = 0.002). Children of aware parents had lower dmft (P < 0.001) and better oral hygiene (P = 0.001) than those of unaware parents. Parents who perceived overall oral health status of their child as good (P < 0.001) as well as those who believed that their child did not have any cavities (P < 0.001) were more likely to be aware of their child's teeth cleaning than those who perceived otherwise.

CONCLUSION

Many parents were not aware of their child's oral hygiene. Educational interventions should be provided to young families to increase parental knowledge and skills that help them recognize their child's dental needs. The interventions are more necessary for low socioeconomic parents and for the parents of children with poor oral hygiene.

Oral health education in school: parents' attitudes and prevalence of caries in children

ABSTRACTIntroductionThe promotion of oral health in children is highly important, as well as parents' motivation to adopt the attitudes necessary for the maintenance of the health of their children.ObjectiveTo evaluate parents' attitudes about their children's oral health and to determine the prevalence of dental caries.Material and methodA cross-sectional analytical study, conducted with parents and preschoolers from the elementary schools in Araçatuba. A formal instrument was used to collect data, in order to evaluate parents' attitudes regarding their children's oral health. A clinical oral exam was performed in order to determine the decayed, missing and filled teeth (dmft) and Index of Oral Health–Simplified (IOH–S). The collected data were analyzed using the SPSS 21.0 software.ResultThe state of the children's oral health was good; the mean of the decayed, missing and filled teeth (dmft) was 0.68 (Standard deviation = 1.70). Most of the children presented a mean index of oral hygiene (IOHS = 1.51, Standard deviation = 0.48). The parents' attitudes related to oral health were not very good. Many of them did not floss their children's teeth; the bottle-fed children did not brush after feeding. The consumption of sugar was associated with the presence of dental plaque in the children (p=0.05). Nevertheless, in most cases, tooth brushing was performed by the parents and was associated with a good dmft index in the children (p=0.04).ConclusionThe state of children's oral health in the present study was good. However, the parents' attitudes in relation to oral health were not good.

Impact of oral hygiene on oral health-related quality of life of preschool children

OBJECTIVES

To assess the impact of oral hygiene of preschool children and parental attitude on children's oral health-related quality of life (OHRQoL).

METHODS

In this cross-sectional study, 396 children of Shiraz kindergartens were selected by a randomized cluster sampling. Children's oral hygiene was assessed using the Simplified Debris Index (DI-S) and a self-made questionnaire about oral hygiene habits. Children's OHRQoL was evaluated by the Farsi version of Early Childhood Oral Health Impact Scale (F-ECOHIS). The effect of oral hygiene determinants on OHRQoL was measured using Pearson and Spearman correlation, independent-sample t-test and anova.

RESULTS

Children's mean DI-S and F-ECOHIS scores were 1.19 (± 0.77) and 19.36 (±8.42), respectively. Only 75% of the children had their teeth brushed once a day or more, and in 28%, toothbrushing had started before 2 years of age. DI-S values (P < 0.001) and frequency of toothbrushing (P < 0.001) had a statistically significant impact on OHRQoL of the children. Children's OHRQoL was also significantly associated with parents' attitude towards the importance of brushing deciduous teeth (P = 0.002).

CONCLUSIONS

Oral health status of preschool children in Shiraz was less than optimal and had a significant impact on their OHRQoL. Therefore, improvement of children's OHRQoL could be achieved by improving their home dental care. Strategies promoting parental attitude about the importance of children's toothbrushing may significantly influence children's oral hygiene and are highly recommended.

Informing a culturally appropriate approach to oral health and dental care for pre-school refugee children: a community participatory study

Background

Pre-school children in families of recently settled refugees often have very high rates of early childhood caries (ECC). ECC is associated with a high level of morbidity and is largely preventable, however effective culturally appropriate models of care are lacking. This study aimed to provide a deeper understanding of the refugee experience related to early oral health by exploring pre-school refugee families (i) understanding of ECC and child oral health, (ii) experiences of accessing dental services and (iii) barriers and enablers for achieving improved oral health. The knowledge gained will be critical to the development of effective early oral health programs in refugee children.

Methods

Community based participatory qualitative methodology using focus groups of resettled refugee families and community refugee nurse interviews. A community reference group was established and a bi-lingual community research associate was employed. Transcripts were analysed for thematic content using NVivo software.

Results

There were 44 participants: eight focus groups (nine countries of origin) and five interviews. Emergent themes were (i) the major influence of parents’ previous experience, including their beliefs about deciduous (baby) teeth, traditional feeding practices and poverty; and a consequent lack of understanding of the importance of early oral health and early dental caries, (ii) the burden of resettlement including prioritising, parenting, learning about new foods and how to assimilate into the community, and (iii) refugees’ difficulties in accessing both information and dental services, and the role of schools in addressing these issues. An Opportunities for Change Model was proposed.

Conclusions

The main implication of the study is the demonstration of how enhanced understanding of the refugee experience can inform improvement in early oral prevention and treatment. The community participatory methodology of the study provided a basis for cross-cultural understanding and has already assisted in translating the findings and raising awareness in the provision of targeted refugee oral health services.

Indicators of child health, service utilization and mortality in Zhejiang Province of China, 1998-2011

Objective

To investigate the levels of primary health care services for children and their changes in Zhejiang Province, China from 1998 to 2011.

Methods

The data were drawn from Zhejiang maternal and child health statistics collected under the supervision of the Health Bureau of Zhejiang Province. Primary health care coverage, hospital deliveries, low birth weight, postnatal visits, breastfeeding, underweight, early neonatal (<7 days) mortality, neonatal mortality, infant mortality and under-5 mortality were investigated.

Results

The coverage rates for children under 3 years old and children under 7 years old increased in the last 14 years. The hospital delivery rate was high during the study period, and the overall difference narrowed. There was a significant difference (P<0.001) between the prevalence of low birth weight in 1998 (2.03%) and the prevalence in 2011 (2.71%). The increase in low birth weight was more significant in urban areas than in rural areas. The postnatal visit rate increased from 95.00% to 98.45% with a significant difference (P<0.001). The breastfeeding rate was the highest in 2004 at 74.79% and lowest in 2008 at 53.86%. The prevalence of underweight in children under 5 years old decreased from 1.63% to 0.65%, and the prevalence was higher in rural areas. The early neonatal, neonatal, infant and under-5 mortality rates decreased from 6.66‰, 8.67‰, 11.99‰ and 15.28‰ to 1.69‰, 2.36‰, 3.89‰ and 5.42‰, respectively (P<0.001). The mortality rates in rural areas were slightly higher than those in urban areas each year, and the mortality rates were lower in Ningbo, Wenzhou, and Jiaxing regions and higher in Quzhou and Lishui regions.

Conclusion

Primary health care services for children in Zhejiang Province improved from 1998 to 2011. Continued high rates of low birth weight in urban areas and mortality in rural areas may be addressed with improvements in health awareness and medical technology.