The influence of social support, oral health beliefs and health behaviours on dental caries in children living in deprived neighbourhoods.

Abstract

This study assessed the influence of social support, oral health beliefs and health behaviours on dental caries incidence among children living in underprivileged neighbourhoods. Data from a cohort study with 12-year-old schoolchildren (N=312) selected from public schools in Manaus, Brazil, and their parents or guardians was analyzed. Socioeconomic characteristics, sex, oral health beliefs, social support (SSA questionnaire), oral health-related behaviours (sugar consumption, frequency of toothbrushing, use of fluoride toothpaste) and dental caries (DMFT index) were assessed at age 12 years. Dental caries incidence over 12 month period was registered according to the number of new cavitated teeth. The hypothesis was that socioeconomic disadvantage, lower social support, unfavourable oral health beliefs, and inadequate behaviours would increase the risk of dental caries incidence Statistical analysis was conducted using confirmatory factor analysis and structural equation modeling. Unfavourable oral health beliefs indirectly predicted higher dental caries incidence (β = 0.041) via sugar consumption and frequency of toothbrushing. Unfavourable oral health beliefs directly predicted higher sugar consumption (β = 0.148) and lower frequency of toothbrushing (β = -0.218). Lower frequency of toothbrushing directly predicted higher dental caries incidence (β = -0.140). Sex (β =-0.017) and social support (β =-0.016) were indirectly linked to dental caries incidence. Our findings suggest that incidence of dental caries in socially underprivileged children results from the complex relationships between social support, oral health beliefs and oral health behaviours.