Children's Oral Health Outcomes Research Articles

Association between neighborhood disadvantage and children's oral health outcomes in urban families in the Chicago area.

The prevalence of childhood caries in urban Chicago, compared with national and state data, indicates that neighborhood context influences oral health. Our objective was to delineate the influence of a child's neighborhood on oral health outcomes that are predictive of caries (toothbrushing frequency and plaque levels). Our study population represents urban, Medicaid-enrolled families in the metropolitan Chicago area. Data were obtained from a cohort of participants (child-parent dyads) who participated in the Coordinated Oral Health Promotion (CO-OP) trial at 12 months of study participation (N = 362). Oral health outcomes included toothbrushing frequency and plaque levels. Participants' neighborhood resource levels were measured by the Area Deprivation Index (ADI). Linear and logistic regression models were used to measure the influence of ADI on plaque scores and toothbrushing frequency, respectively. Data from 362 child-parent dyads were analyzed. The mean child age was 33.6 months (SD 6.8). The majority of children were reported to brush at least twice daily (n = 228, 63%), but the mean plaque score was 1.9 (SD 0.7), classified as "poor." In covariate-adjusted analyses, ADI was not associated with brushing frequency (0.94, 95% CI 0.84-1.06). ADI was associated with plaque scores (0.05, 95% CI 0.01-0.09, p value = 0.007). Findings support the hypothesis that neighborhood-level factors influence children's plaque levels. Because excessive plaque places a child at high risk for cavities, we recommend the inclusion of neighborhood context in interventions and policies to reduce children's oral health disparities. Existing programs and clinics that serve disadvantaged communities are well-positioned to support caregivers of young children in maintaining recommended oral health behaviors.

Associations between Maternal Education and Child Nutrition and Oral Health in an Indigenous Population in Ecuador.

The global nutrition transition has increased the prevalence of childhood dental caries. Greater understanding is needed of the impact of social determinants-including maternal education-on child oral health. This is a cross-sectional analysis of a convenience sample of families of 458 indigenous Ecuadorian children aged 6 months through 6 years from 2011-2013. Data was collected by mother interviews and child dental and anthropometric examinations. Multivariate logistic and Zero-Inflated-Poisson regression analyses assessed associations between years of maternal education and maternal-child oral health practices and child oral health outcomes. Each additional year of maternal education was significantly (p < 0.05) associated with some healthier practices including greater likelihood of mothers and children drinking milk daily (OR 1.20; 95% CI 1.08, 1.34); and less healthy practices including greater likelihood of bottle-feeding children with sugary liquids (OR 1.14; 95% CI 1.06, 1.22) and to older age, giving children sweets daily, calming children with a bottle or sweets, and less likelihood of helping brush their children's teeth (OR 0.93; 95% CI 0.88, 0.98). Each year of maternal education had a small but statistically non-significant influence on increasing the odds of children being among those who are cavity-free (OR 1.03; 95% CI 0.92, 1.16). Interventions to improve health outcomes should focus not just on maternal education but also address social and commercial determinants of health through nutrition and oral health education, as well as policies to reduce sugar and ensure universal access to oral health care.

Relationship of family related factors with dental caries prevalence in 5 years old children of different schools of Hyderabad.

Introduction: The habits children have included in life; continues to make the choices they make as adults. According to social learning theory these habits are derived through supervision, learning and modelling. For a child, most significant are primarily father and mother and their immediate family members. All these factors have the collective ability to influence the child's oral health outcomes.
 Objective: To examine the dental caries rate in 5 year’s old school children and influence of their family related habits and socio demographic factors on child’s dental caries experience and their oral health behavior.
 Methodology: This study conducted upon sample of 600 school children selected through random sampling from primary private and Government primary schools of Qasimabad Hyderabad Sindh during period of October 2015 to December 2015. 
 Results: shows that out of 600 children 330 (55%) were boys and 270 (45%) were girls. Boys 245 (40%) were affected from caries and 85 (14%) were free from caries. In relation to parental education; 44 (7.3%) child boys whom parents were highly educated were found affected by caries 44(7.3%), while 3 (0.5%) boys were free from caries. Girls whose parents were highly educated affected by caries were 44(7.3%), caries free were 12(2%) Boys whose parents have incomplete secondary education/ vocational school were affected by caries 162(27%) and caries free were 82(13.6%). Girls whose parents have incomplete secondary / vocational school were affected by caries 145 (24.1%). Boys whose parents were having low level of education affected by caries were 39(6.5%) while caries free were 0 (0%). Girls whose parents have low level of education were affected by caries were 69 (11.5%) while caries free were 0 (0%) .
 Conclusion: Life style choices are the habits that are formed in childhood and dictated as in adult hood. Thus, assessing family related risk factor regarding oral health is essential when conducting preventive treatment programs for children because education on oral hygiene maintenance and regular preventive dental health checkups are very important in order to prevent oral diseases.
 Key words: Dental Caries, primary dentition.

Conocimiento, actitud, práctica, percepciones y barreras para el cuidado dental en salud bucal entre los padres libios

Aim: To assess parental oral health knowledge, attitude, practice (KAP), perceptions of their children's oral health status, and explore the barriers to dental care utilization among Libyan parents living in Malaysia. Material and Methods: A cross-sectional study was conducted among Libyan parents of children aged 1- 7 years old who lived in Malaysia. A 63-items questionnaire was constructed, validated, and pretested. Six hundred self-administered questionnaires were distributed Data were analyzed using IBM SPSS version 22.0. A generalized Linear Model was used to test the possible relationships between KAP scores and different sociodemographic factors. A significant level for all the statistical tests was predetermined at p?0.05. Results: A total of 381 questionnaires were included, of which fathers' responses constituted 189 (49.6%), and mothers' responses constituted 192 (50.4%). Most of the parents exhibited good oral health knowledge (77.2%), positive attitudes (86.4%), and were adherent to good oral health practice (78.7%) with mean values of 10.6 (SD=1.8), 9.5 (SD=1.5), and 7.9 (SD=1.4) respectively. Gender, age, and income had statistically significant relationships (p<0.05) with KAP scores. The majority (81.1%) of parents rated their child's oral health as good. More than one-third of parents (35.7%) perceived no need for dental care, and 18.6% perceived no need to treat the primary teeth as they will be replaced. Conclusion: Good Knowledge and positive attitudes towards oral health are not necessarily translated into favorable practices. The lack of perceived need and low value attributed to primary teeth created barriers to seek dental care services among the majority of surveyed parents. Attention must be directed to behavior change strategies rather than providing oral health education alone to improve the children's oral health outcomes.

Association between mother's behaviour, oral health literacy and children's oral health outcomes: A cross-sectional study.

Parents' infant and early childhood oral health knowledge is of paramount importance, because oral health behaviours are the exclusive domain of parents during the early years of life. Studies exploring the association between mother's behaviour, oral health literacy and children's oral health outcomes are scarce. To evaluate the association between mother's behaviour, oral health literacy and children's dental caries experience. A cross-sectional study was conducted among one hundred pre-school children aged 2-6 years and their mothers from pre-schools in Bangalore, India. Data regarding their demographics, mother's knowledge, attitude and practice (KAP) was collected through a questionnaire. Mother's oral health literacy was assessed with Rapid Estimate of Adult Literacy in Dentistry-30 (REALD-30) scale. Caries experience of the children was recorded using Decayed Missing Filled Teeth (DMFT) Index. Data was entered into excel sheet and analysed using statistical package for SPSS 22.0. : The mean KAP, REALD-30 and DMFT scores were 13.17 ± 4.57, 17.68 ± 5.85, 2.61 ± 2.21, respectively. In this study, REALD-30 score negatively correlated with DMFT score and positively correlated with KAP score. In a linear regression, KAP and REALD-30 scores showed a highly significant association with dental caries. Mother's behaviour and oral health literacy influenced caries experience of the children. Therefore, improving the behaviour and oral health literacy of the mothers is the key to influence child's oral health.

Impact of Parents' Sense of Coherence on Children's Oral Health-Related Behaviors and Dental Caries Experience among Newcomers.

To examine the relationship between parents' sense of coherence (SOC) and children's oral health outcomes among newcomers (immigrants to Canada). Immigrant parents with children aged 1-12 years who lived in Canada for 10 years or less were recruited. Outcome variables included children's caries experience (DMFT/dmft) and oral health-related behaviors (frequency of toothbrushing, sugar intake, and dental visits). Parents SOC was measured. Among 274 parents: mean (SD) age 34.92 (6.35) years; 57% post-secondary education; 38% monthly income below $2000; and 41% living in Canada for less than five years. Children: mean (SD) age 4.5 (2.9) years; 55% born in Canada; 42% dental coverage; 52% untreated caries. The mean (SD) of parents' SOC was 59.1 (12.03). Sense of coherence scores were not significantly associated with children's caries experience and oral health behaviors. Parent's SOC was relatively low among newcomers and not associated with children's oral health outcomes.

Is parental oral health literacy a predictor of children's oral health outcomes? Systematic review of the literature.

The scientific evidence regarding the association between parental oral health literacy (OHL) and children's oral health is unclear. To evaluate the scientific evidence concerning the association between parental OHL and children's oral health outcomes. Eight databases were searched. Studies that evaluated oral health outcomes among children and measured parental OHL through a validated tool were included. Two independent reviewers selected studies, extracted data and analysed the risk of bias. Eleven studies were included. Most (n=6) had a high risk of bias. Most studies evaluating dental caries found association between lower parental OHL and higher prevalence/experience of dental caries. Poor oral health-related quality of life was associated with decreased parental OHL (P<0.05). Studies diverged on the association between OHL and the number of filled, extracted teeth, and dental visits. There was no association between children's tooth brushing frequency, use of toothpaste, oral health claim, oral health expenditures and parental OHL. The literature was inconclusive regarding the association between night bottle feeding, negative parental perception of the child's oral health and OHL. Low parental OHL was associated with dental caries among their children. It is too soon to assume an association between OHL and the remaining outcomes.

The Impact of Maternal Self-Efficacy and Oral Health Beliefs on Early Childhood Caries in Latino Children.

Latino children experience one of the highest rates of early childhood caries requiring interventions based on valid conceptual frameworks. The Health Belief Model has relevance as a predictor of compliance with health recommendations based on perceptions of a health condition and behaviors to avoid the condition. The model encompasses four perceptual constructs (susceptibility, severity, benefits, barriers) and, for complex conditions, includes self-efficacy as an extended model. This study evaluated individual (self-efficacy and health beliefs) and cultural (acculturation status) level factors and the inter-relationship to determine if items assessed for the Extended Health Belief Model (EHBM) were valid measures of maternal factors. A cross-sectional study was conducted with 100 mother-child dyads at the Dental Center of Children's Hospital Colorado, Aurora, CO, USA. Participating mothers completed a survey in English or Spanish with items from the Basic Research Factors Questionnaire encompassing sociodemographic characteristics, oral health knowledge and behavior, and psychosocial measures including the EHBM. Language preference was a proxy for maternal acculturation. Children were examined to measure decayed, missing, and filled tooth surfaces. Internal consistency reliability of each subscale was evaluated using Cronbach's alpha. Convergent validity was assessed using linear regression to evaluate the association of the EHBM subscales with oral health-related measures and language preference. The benefits and self-efficacy scales reflected good reliability. Maternal education was the strongest predictor of health beliefs with significant associations for barriers, benefits, and susceptibility. Perceived benefits increased with each additional year in the household. There was a significant association between maternal oral health knowledge and higher perceived benefits and increased self-efficacy, and the same was found for higher knowledge of dental utilization which was also associated with children perceived as having increased susceptibility to early childhood caries. Less acculturated participants perceived more barriers to behavioral adherence and fewer barriers as knowledge increased. As dental utilization knowledge improved for Spanish-speaking participants, they perceived greater benefits from adherent oral health behavior compared to English-speaking participants. Items assessed for the EHBM were valid as measures of maternal factors influencing children's oral health outcomes in a Latino population.

Racism and Oral Health Outcomes among Pregnant Canadian Aboriginal Women.

This study assessed links between racism and oral health outcomes among pregnant Canadian Aboriginal women. Baseline data were analyzed for 541 First Nations (94.6%) and Métis (5.4%) women in an early childhood caries preventive trial conducted in urban and on-reserve communities in Ontario and Manitoba. One-third of participants experienced racism in the past year determined by the Measure of Indigenous Racism Experience. In logistic regressions, outcomes significantly associated with incidents of racism included: wearing dentures, off-reserve dental care, asked to pay for dental services, perceived need for preventive care, flossing more than once daily, having fewer than 21 natural teeth, fear of going to dentist, never received orthodontic treatment and perceived impact of oral conditions on quality of life. In the context of dental care, racism experienced by Aboriginal women can be a barrier to accessing services. Programs and policies should address racism's insidious effects on both mothers' and children's oral health outcomes.

Oral health, nutritional knowledge, and practices among pregnant women and their awareness relating to adverse pregnancy outcomes

Introduction: Oral health is often neglected by pregnant females, and physicians should evaluate and educate pregnant women regarding the routine dental checkups to prevent complications. Periodontitis is associated with preterm birth and low birth weight babies, and high levels of cariogenic bacteria in the oral cavity of the mother leads to dental caries in infants. Most of the pregnant women are unaware of periodontal diseases during pregnancy because of lack of knowledge. Aims and Objectives: The aim of the study was to assess the oral health-related awareness and practice among pregnant women in Bilaspur city. In addition, we assessed the knowledge of mothers towards nutrition during pregnancy because adequate prenatal nutrition is one of the most important environmental factors affecting the health of pregnant women and their babies. Materials and Methods: The study was a cross-sectional study. A total of 446 samples were selected by convenience sampling technique. A questionnaire containing 12 questions related to knowledge and practices pertaining to oral health and 12 questions related to diet and nutrition along with sociodemographic data were used for collecting information. Analysis were conducted using the Statistical Package for the Social Sciences (SPSS) for Windows (version 20.0, SPSS Inc., Chicago IL, USA). Results: Majority of women (74%) were not aware about periodontal diseases, which is common during pregnancy. Only 44.9% were aware which period was safe for dental treatment, and 33.4% were aware that exposure to high dose radiation is dangerous to the baby. A total of 50.1% experienced bleeding from gums during pregnancy; 99.8% maintained their oral hygiene by brushing twice daily and 96.8% visited dentist twice yearly. Concerning nutritional awareness, pregnant patients were aware of the meaning of food (40.1%) and the importance of food (45.5%), balanced (47%), and healthy diet (43.9%). They had adequate knowledge regarding requirement of food for proper functioning of the body (59.9%) as well as for fighting infections (67.2%). Knowledge regarding sources of carbohydrates/proteins, iron, zinc, vitamin A and iodine was low in our patients. Conclusion: The results suggest that knowledge and practices of pregnant women should be improved for better pregnancy outcomes. It requires proper coordinated effort between oral health and prenatal communities for maternal and child's oral health outcomes. Nutritional education programs should be carried out by medical centres, which should be directed towards women in rural areas.

The Pacific Islands Families Study: Oral Health of Pacific Children Living in New Zealand

Research has demonstrated that Pacific children are less likely to be cavity-free than children from other ethnic groups living in New Zealand. This paper describes their oral health practices (tooth brushing, flossing) and oral health outcomes (toothaches, dental treatment). The maternal interview in the Pacific Islands Families (PIF) longitudinal study (n = 1000) included questions about the oral health practices and outcomes in nine-year-old Pacific children. The prevalence of child oral health outcomes and the influence of individual lifestyles and socio-demographic variables on these outcomes will be discussed. Findings revealed the significant impact of extensive sweet consumption and irregular tooth brushing on child oral health. The overriding socio-demographic and environmental factors will also be considered, as well as the way these factors affect access to oral health care and attitudes towards prevention.

Maternal self-report of oral health in six-year-old Pacific children from South Auckland, New Zealand

To examine maternal and socio-demographic factors associated with oral health practices and experiences in six-year-old Pacific children. The longitudinal Pacific Islands Families (PIF) study is following a cohort of Pacific children born in Auckland, New Zealand in 2000. At approximately six years postpartum maternal reports (n = 1001) on child oral health practices and experiences of fillings and extractions were gathered. Forty-five per cent of mothers reported that their child had experienced fillings or extractions. After adjusting for confounding factors, we found that Tongan children were almost twice as likely to have their teeth filled or extracted than Samoan children (OR, 1.93; 95%, 1.34-2.77). Differences between Samoan children and children of other ethnic groups were not significant. Children of mothers who had secondary qualifications were significantly less likely to have their teeth filled or extracted compared to children of mothers who had postsecondary qualifications (OR, 0.634; 95%, 0.44-0.90). Prolonged duration of breastfeeding was associated with an increased likelihood of filling or extraction experience. In terms of maternal oral hygiene, maternal tooth brushing frequency of less that once a day was significantly associated with increased odds of fillings and/or extractions in their children (OR, 1.35; 95% CI, 1.02-1.79). Children who were sometimes supervised for tooth brushing were significantly more likely to have fillings or extractions than children who were not provided supervision. These findings highlight the role of cultural factors and maternal hygiene in child oral health outcomes and suggest that health promotion efforts should encompass the whole family and embrace a culturally appropriate approach.

Impact of Caregiver Literacy on Children's Oral Health Outcomes

The objective of this study was to examine the relationship of primary caregivers' literacy with children's oral health outcomes. We performed a cross-sectional study of children who were aged < or =6 years and presented for an initial dental appointment in the teaching clinics at the University of North Carolina at Chapel Hill School of Dentistry. Caregiver literacy was measured using the Rapid Estimate of Adult Literacy in Dentistry (REALD-30). The outcome measures included oral health knowledge, oral health behaviors, primary caregiver's reports of their child's oral health status, and the clinical oral health status of the child as determined by a clinical examination completed by trained, calibrated examiners. Among the 106 caregiver-child dyads enrolled, 59% of the children were male, 52% were white, and 86% of caregivers were the biological mothers. The bivariate results showed no significant relationships between literacy and oral health knowledge (P = .16) and behaviors (P = .24); however, there was an association between literacy and oral health status (P < .05). The multivariate analysis controlled for race and income; this analysis revealed a significant relationship between caregiver literacy scores and clinical oral health status as determined by using a standardized clinical examination. Caregivers of children with mild to moderate treatment needs were more likely to have higher REALD-30 scores than those with severe treatment needs (odds ratio: 1.14 [95% confidence interval: 1.05-1.25]; P = .003). Caregiver literacy is significantly associated with children's dental disease status.

Impact of Caregiver Literacy on Children's Oral Health Outcomes

Impact of Caregiver Literacy on Children's Oral Health Outcomes