Oral Health Beliefs Research Articles

The relationship between self-efficacy and oral health status of older adults

ObjectivesThe objectives of this study were to determine the relationship between reported self-efficacy and dental status in older adults, identify factors which might influence self-efficacy and, their willingness to pay (WTP) for preventive care. MethodsParticipants aged 60–90 years of age living in Singapore were recruited. All participants completed an oral health questionnaire and a clinical examination. Details of participants’ socio-economic status and educational attainment were collected, and participants also answered a range of questions related to self-efficacy, oral health attitudes, beliefs and dental attendance patterns. Participants were asked to indicate their willingness to pay for preventive care using contingent valuation. The clinical examination recorded decayed, missing and filled teeth [DMFT], root caries, periodontal attachment loss, bleeding on probing index, occlusal status and, denture wearing status. Associations between self-efficacy, self-report and clinical variables were assessed using Kendall's Tau B coefficient. Results614 participants [mean age 68.07 (5.99) years] were recruited. There was a high level of dental awareness and nearly 70% of the participants reported visiting a dentist once or twice a year. Self-efficacy was associated with levels of bleeding on probing and self-reported satisfaction with oral health. Nearly 60% of participants were not willing to pay for preventive advice from an oral healthcare professional. ConclusionOlder adults with a high level of self-efficacy had good gingival health, with low reported levels of bleeding on probing. Participants with low reported self-efficacy had higher disease levels and were less satisfied with their oral health. Clinical SignificanceSelf-efficacy in relation to oral hygiene practices is variable, and participants with low self-efficacy had higher gingival bleeding scores. However, willingness to pay for preventive advice is low, and further work is required to increase the value proposition of preventive care to older adults.

Influence of small-group experiential learning of integrated traditional Chinese and Western medicine on the oral health knowledge, beliefs, and behaviors of elderly patients with diabetes.

This study aimed at the oral health problems of elderly patients with diabetes. A training course of integrated traditional Chinese and Western medicine was constructed, helping patients improve their oral health quality of life. A randomized controlled prospective experimental study was conducted. A total of 190 elderly patients were divided randomly into an observation group and a control group with 95 cases in each. The control group received regular health education, while the observation group was based on the control group to implement the integrated experiential learning of traditional Chinese and Western medicine in small groups. The oral health knowledge, attitude, behavior, and blood glucose control status along with the oral health quality of life of the two groups were compared before the intervention and at 3-month postintervention. Three months after the intervention, the fasting blood glucose control and the 2-h postprandial blood glucose/glycosylated hemoglobin levels in the observation group were significantly better than in the control group, and the difference was statistically significant (p<0.05). The oral health quality of life in the observation group was significantly better than in the control group, and the difference was statistically significant (p<0.05). The small-group experiential learning model of integrated Chinese and Western medicine can promote the transformation of knowledge-beliefs-behaviors in elderly patients with diabetes, which is conducive to controlling blood sugar levels and improving the quality of oral health.

Child-, Family-, and Community-Level Facilitators for Promoting Oral Health Practices among Indigenous Children.

Despite the preventive nature of oral diseases and their significance for general wellbeing, poor oral health is highly prevalent and has unfavourable ramifications for children around the world. Indigenous children in Australia experience disproportionate rates of early childhood caries compared to their non-Indigenous counterparts. Therefore, this paper aims to collate parental experiences and generate an understanding of facilitators for Indigenous childhood oral health. This project aggregated stories from parents of Indigenous children across South Australia who were participants in an early childhood caries-prevention trial. This paper explores facilitators for establishing oral health and nutrition behaviours for Indigenous children under the age of three through reflexive thematic analysis. Fisher-Owens’ conceptual model for influences on children’s oral health is utilised as a framework for thematic findings. Child-level facilitators include oral hygiene routines and regular water consumption. Family-level facilitators include familial ties, importance of knowledge, and positive oral health beliefs. Community-level facilitators include generational teaching, helpful community resources, and holistic health care. Recommendations from findings include the following: exploration of Indigenous health workers and elder participation in oral health initiatives; inclusion of Indigenous community representatives in mainstream oral health discussions; and incorporation of child-level, family-level, and community-level facilitators to increase support for efficacious oral health programs.

Oral health belief and satisfaction after scaling experience with comprehensive dental hygiene care

Oral health belief and satisfaction after scaling experience with comprehensive dental hygiene care

Cross-sectional study of oral health care service, oral health beliefs and oral health care education of caregivers in nursing homes

ObjectivesTo assess oral care beliefs and oral hygiene procedures among nursing home personnel to identify strengths and weaknesses in managing oral care. MethodsA cross-sectional study in two nursing homes using an oral health care questionnaire including the Nursing Dental Coping Belief Scale. ResultsA total of 109 health personnel participated. Oral care was seldomly achieved twice a day and dental supplies were not guaranteed. Registered nurses found the oral health of residents more acceptable than did allied health personnel with less oral care education, who mostly delivered daily care. Conversely, nursing staff with oral care education had lower dental coping beliefs, suggesting a lack of self-reliance in controlling oral health outcomes. ConclusionDental supplies should be part of nursing care equipment. Educational programs could increase positive oral health beliefs and enhance the quality of care in these settings, particularly among those who are accountable for oral care.

Longitudinal Association of Health Literacy with Parental Oral Health Behavior.

Background:Prior studies suggest that parents with limited health literacy (HL) may be less likely to engage in oral health practices known to protect children's oral health. Earlier work has relied on cross-sectional data, however, so it is unclear whether HL influences parental behavior or is merely correlated with it.Objective:We sought to clarify the impact of HL on subsequent adherence to parental oral health practices.Methods:This secondary analysis used survey data from a randomized controlled trial designed to reduce dental decay in American Indian children (N = 579). We used path analysis to test a theoretical framework developed to clarify the mechanisms through which HL might influence parental oral health behavior. The framework proposed that HL (1) has a direct effect on parental oral health knowledge, beliefs (i.e., self-efficacy, perceived susceptibility, perceived severity, perceived barriers, perceived benefits), and behavior; (2) has an indirect effect on beliefs through knowledge; and (3) has an indirect effect on behavior through knowledge and beliefs. To test expectations regarding the temporal precedence of the constructs, we examined the association of HL at baseline with knowledge at the 12-month time point, beliefs at 24 months, and behavior at 36 months.Key Results:HL had significant direct effects on knowledge and specific beliefs (i.e., self-efficacy, perceived susceptibility, perceived barriers), but not on behavior. HL had significant indirect effects on beliefs—except perceived susceptibility—through knowledge. HL had significant indirect effects on behavior, through knowledge and beliefs. Both HL and knowledge had significant total effects on subsequent parental oral health behavior.Conclusions:HL influenced behavior measured 3 years later through its impact on parental oral health knowledge and beliefs. Our results highlight the importance of addressing HL in development of oral health promotion efforts aimed at protecting the teeth of young Native children. [HLRP: Health Literacy Research and Practice. 2021;5(4):e333–e341.]Plain Language Summary:It is unclear whether HL influences how parents care for their children's teeth. We analyzed data from a project to reduce dental decay in children. We found that HL impacted parents' oral health knowledge, beliefs, and behavior at later points in time. This suggests that HL may influence development of knowledge and beliefs that support positive behavior.

Understanding the oral health beliefs and behaviours among the tribal population of Chamarajanagar district, Karnataka

Background: Regardless of the improvements in the field of healthcare, there is a section of people who live away from civilization known as ‘indigenous people’ or ‘tribals’. Information regarding oral health status is instrumental in the planning and implementation of oral health policies and programmes related to promotion of oral health. The aim of the study was to understand the oral health beliefs and behaviour of the tribal population of Chamarajanagar district.Methods: A cross‑sectional survey of 256 tribals of Chamarajanagar district was conducted. A modified WHO oral health questionnaire (2013) was utilized to collect the data. The recorded data was statistically analysed using the Statistical Package for the Social Sciences version 24.Results: Based on the age-category, majority of them belonged to the age group of 35-44 years. All the participants belonged to the sub-caste of Soligas. The results showed that the perceived barriers for seeking oral health care are high and poor utilization of the oral health care services were observed, but the participants had good knowledge regarding oral health which increases the cues for action.Conclusions: The results of the study suggest that the participants might have favorable compliance for oral health promotional programs.

Associations between dental care approachability and dental attendance among women pregnant with an Indigenous child: a cross-sectional study

BackgroundOral health during pregnancy is vital for both mother and child. Indigenous Australians face many barriers in accessing dental care. Service approachability is one of the key domains in accessing health services. There is little empirical evidence of the association between service approachability and dental care attendance or oral health outcome. The aim of this study is to examine the relationship between dental service approachability on dental care attendance and self-reported gum disease among South Australian women pregnant with an Aboriginal child.MethodsFour hundred and twenty-seven women pregnant with an Aboriginal child completed questionnaires in both metropolitan and regional health settings in South Australia in 2011. Four variables related to approachability of dental services: (1) perception of need; (2) service-related health literacy; (3) oral health beliefs and; (4) trust and expectation of dental service. The association between service approachability-related factors, dental utilisation and self-reported gum disease during pregnancy were assessed using Generalised Poisson regression models, after adjusting for age, remoteness, employment status and education. Estimates were presented as adjusted prevalence ratios (APR).ResultsMost participants (85.8%) reported a need for dental care, had positive oral health beliefs (88.3%) and had expectations towards dental care (86.2%). Dental service utilisation during pregnancy was low (35.7%). Many participants (78.0%) expressed knowing what to do if they needed dental care, while most (39.8%) doubted that dental care would be available the next day. Poor health service literacy was identified as a risk factor for non-optimal dental attendance (APR = 0.86, 95%CI 0.74–0.99). Perceived need for dental care was positively associated with self-reported gum disease (APR = 1.24, 95%CI 1.06–1.45).ConclusionInability to navigate the dental care system was a risk factor for poor dental attendance among South Australian women pregnant with an Aboriginal child. Perceived need for dental care was associated with gum disease.

A new comprehensive oral health literacy scale: development and psychometric evaluation

BackgroundIt has been widely accepted that oral health status is related to oral health literacy. The need to measure oral health literacy has led to the development of measurement instruments. This study aimed to develop a comprehensive instrument for adults and to examine its reliability and validity in China.MethodsA three-step design process was used. First, a literature review and expert panel discussion were used to draw up a 37-item pool covering oral health knowledge, belief, practice, skill, and functional oral health literacy. The Delphi method was used to delete and modify questions in the item pool. The draft instrument was evaluated by nine experts and the consensus among them was calculated using the content validity index. The scale was then used to conduct a psychometric study among 370 participants from community health centers in Beijing. Construct validity, discriminant validity and concurrent validity were examined. The Cronbach’s alpha coefficient, and test–retest methods were used to assess reliability.ResultsThe final scale included 30 items across four dimensions. The item–level content validity index was 0.90. Exploratory factor analysis extracted four fixed factors, and the result of the Kaiser–Meyer–Olkin and Bartlett’s tests was 0.752, with the model explaining 35.21% of the total variance. The four dimensions were associated with oral health knowledge, perceptions of oral health issues, oral health practice and skills, and functional oral health literacy. The mean score of the lowest 27% was significantly lower than the highest 27% (P < 0.01), suggesting adequate discriminant validity. The associations between comprehensive oral health literacy scores and educational level, income and self-reported literacy level were significant (P < 0.001), showing adequate overall concurrent validity. Internal consistency and test–retest reliability were acceptable, with a Cronbach’s alpha of 0.72 and a total test–retest reliability coefficient of 0.979.ConclusionsInitial testing of the comprehensive oral health literacy instrument suggested that it is a valid and reliable instrument to evaluate individuals’ oral health literacy, with four dimensions for evaluating knowledge, belief, skills, and functional oral health literacy.

Evaluating mechanisms of change in an oral hygiene improvement trial with older adults

BackgroundThis paper compares the relationship between theoretically-driven mechanisms of change and clinical outcomes across two different interventions to improve oral hygiene of older adults participating in a group randomized trial.MethodsSix low-income senior residences were paired and randomized into two groups. The first received a face to face counseling intervention (AMI) and the second, a peer-facilitated health campaign (three oral health fairs). Both were based on Fishbein’s Integrated Model. 331 participants were recruited at baseline and 306 completed the post-assessment one month after intervention. Clinical outcomes were Gingival Index (GI) and Plaque score (PS), collected by calibrated dental hygienists. Surveys obtained data on patient background characteristics and ten mechanisms of change including oral health beliefs, attitudes, norms and behaviors. GLMM was used to assess the effects of time, intervention arm, participant characteristics, intervention mechanisms and differences between the two interventions over time in relation to outcomes.ResultsAt baseline, both groups had similar background characteristics. Both groups improved significantly in outcomes. Overall GI scores changed from baseline mean of 0.38 (SD = .032) to .26 (SD = .025) and PS scores changed from baseline mean of 71.4 (SD = 18%) to 59.1% (SD = 21%). T-tests showed that fears of oral disease, oral health intentionality, oral health norms, worries about self-management of oral health, flossing frequency and sugar control improved significantly in both interventions from baseline to post intervention. Oral health self-efficacy, perceived risk of oral health problems, oral health locus of control and brushing frequency improved significantly only in the counseling intervention. GLMM models showed that the significant predictors of GI improvement were intentionality to perform oral hygiene, locus of control, and improvement in frequency of brushing and flossing in association with the counseling intervention. Predictors of PS improvement were worries about oral hygiene self-management and fear of oral diseases, in association with the counseling intervention. In the reduced final models, only oral health locus of control (predicting GI) and fears of oral diseases (predicting PS) were significant in association with the counseling intervention. Locus of control, a key concept in oral hygiene interventions including the IM was the main contributing mechanism for GI improvement. Fear, an emotional response, drove improvement in PS, reinforcing the importance of cognitive/emotional mechanisms in oral hygiene interventions.ConclusionsThough both groups improved in outcomes, GI and PS outcomes improved more in response to the counseling intervention than the campaign. The counseling intervention had an impact on more mechanisms of change than the campaign. Improvements in intervention mechanisms across both interventions however, suggest a closer examination of the campaign intervention impact on outcomes over time.Trial Registration: Clinicaltrials.gov NCT02419144, first posted April 17, 2015.

Poor dental health in British Army Infantry recruits reduces their quality of life: A cross‐sectional survey and retrospective analysis of health records

AbstractIntroductionOral Health‐Related Quality of Life (OHRQoL) is a determinant of an individual's wellbeing and can be affected by dental disease. For military recruits, adverse OHRQoL may result in poor performance, and has safety implications. The aim of this study was to determine the incidence of dental extractions and dental health of a sample of new Infantry recruits.MethodElectronic healthcare recordings of tooth extraction incidence were compared to recruits from the general military population. Clinical dental examinations and patient questionnaires were used to determine the prevalence and impact of caries using the PUFA (Pulp exposure, Ulceration, Fistula, Caries) criteria. The association between caries and PUFA lesions with self‐reported oral health behaviours and beliefs was explored.ResultsThe incidence of tooth extraction was 2.4 times higher in new Army Infantry recruits than recruits in the general UK military population. 211 recruits were assessed, with a 100% response rate. 135/211 (64%) had caries, and 37/21117.5% had a PUFA lesion at the time of inspection. Sleep loss was significantly more likely in those with PUFA lesions than those without (OR 5.62, p &lt; 0.0001).ConclusionsThose military Infantry recruits with caries and PUFA lesions had worse OHRQoL than those that did not. This was evidenced by poorer sleeping patterns and an inability to perform tasks at work. Treatment of dental disease through extractions was higher in Army Infantry recruits and will likely reduce the number of days taken off sick, but its effect on overall OHRQoL cannot yet be substantiated.

Influence of Parental Health Literacy on Change over Time in the Oral Health of American Indian Children.

In cross-sectional studies, parental health literacy (HL) is associated with children’s oral health. It is unclear, however, whether HL influences pediatric outcomes. We examined the relationship of HL with change over time in parental oral health knowledge, beliefs, and behaviors, as well as pediatric oral health outcomes. We used longitudinal data from a study designed to reduce dental decay in American Indian children (N = 579). At baseline and annually for three years, parents answered questions assessing HL; oral health knowledge, beliefs, and behaviors; and pediatric oral health status. The number of decayed, missing, and filled tooth surfaces (dmfs) was computed based on annual dental evaluations. Linear mixed models showed that HL was significantly associated with all constructs, except dmfs, at their reference time points and persistently across the three-year study period. HL predicted change over time in only one variable, parents’ belief that children’s oral health is determined by chance or luck. HL is strongly associated with oral health knowledge, beliefs, behaviors, and status prospectively but is not a key driver of change over time in these oral health constructs.

An exploration of the oral health beliefs and behaviors of people living with HIV in Mangalore, India: a qualitative study

IntroductionPeople living with HIV (PLWHIV) have increased oral healthcare needs due to an increase in the prevalence of oral and dental diseases. Their oral health is influenced by psychosocial, behavioral and biologic factors. The aim of this study was to explore and obtain a deeper understanding of the oral health beliefs and behaviors of PLWHIV that could potentially affect their oral health.MethodsWe have used the Health Belief Model (HBM) and qualitative methods using in-depth interviews with 16 PLWHIV. Content analysis of the transcribed data was done. The data was grouped under the constructs of the HBM.FindingsThe perceived susceptibility to oral diseases and awareness on the importance of good oral health was low. Regular tooth brushing and traditional methods for oral hygiene maintenance were considered beneficial. Regular dental visits were not considered important. Psychosocial issues, time and financial constraints were the barriers. Participants believed that information on oral health should be provided by the health providers in hospitals and dental clinics. ConclusionThe findings on the oral health beliefs and behaviors support the need for education on oral health and preventive healthcare practices among PLWHIV. Oral health promotion should include behavioral change as one of its components.

Parental Ethnic Identity and Its Influence on Children's Oral Health in American Indian Families.

Objectives: To examine the relationship between ethnic identity and oral health knowledge, beliefs, behavior, and outcomes in American Indian families. Methods: Secondary data were analyzed for 579 parent–child dyads in a randomized controlled trial aimed at reducing early childhood caries in a Northern Plains tribal community. Data included demographic characteristics; parental ethnic identity; oral health knowledge, beliefs, and behavior; and parental/pediatric oral health outcomes. Ethnic identity was assessed using two measures: perceived importance of tribal identity and tribal language proficiency. We examined the association of baseline ethnic identity with baseline and longitudinal oral health measures. Results: At baseline, importance of tribal identity was significantly associated with several oral health beliefs, and one’s locus of control measure (external-chance). Baseline scores on importance of tribal identity were also associated with one’s oral heath belief (perceived severity), the same locus of control measure, and oral health knowledge and behavior over the three years of study follow up. Tribal language proficiency was not associated with any study measures at baseline, although it was associated with parental oral health status over the three years. Conclusions: Ethnic identity was associated with a range of oral health constructs expected to influence American Indian children’s oral health.

Pathways Through Which Health Literacy Is Linked to Parental Oral Health Behavior in an American Indian Tribe.

Health literacy (HL) is the "ability to find, understand, evaluate and put information to use to improve decision making and, ultimately, improve health and quality of life." Parents with limited HL are less likely to follow recommended parental oral health behaviors. We tested a theoretical framework designed to clarify mechanisms through which HL may influence parental oral health behavior. The framework proposed that HL: (a) has a direct effect on parental oral health knowledge, beliefs (i.e. self-efficacy; perceived susceptibility, severity, benefits, barriers), and behavior; (b) influences beliefs indirectly through knowledge; and (c) influences behavior indirectly through knowledge and beliefs. We analyzed cross-sectional data from a randomized controlled trial designed to reduce dental decay in American Indian children (N = 521). Parents completed survey questions assessing sociodemographic characteristics, HL, and parental oral health knowledge, beliefs, and behavior. Path analysis was used to test the framework. HL exerted significant direct effects on knowledge and beliefs but not behavior. HL had significant indirect effects on all beliefs through knowledge. Significant indirect effects of HL on behavior occurred through self-efficacy (estimate: 0.99, 95% CI: 0.42, 1.83, p = .005), perceived barriers (estimate: 0.73, 95% CI: 0.29, 1.43, p = .010), knowledge to self-efficacy (estimate: 0.57, 95% CI: .31, 0.98, p = .001), and knowledge to perceived barriers (estimate: 0.24, 95% CI: 0.09, 0.47, p = .012). HL exerted an indirect effect on parental oral health behavior, with knowledge, self-efficacy, and perceived barriers being the primary constructs linking HL to behavior.

Oral Health and Dental Service Utilization of Foreign Residents and Multicultural Families in Korea: a scoping review

Background: Research on oral health and dental service utilization of foreign residents and multicultural families in Korea will play an important role as a fundamental data for establishing future oral health policies in the multicultural society.Objective: In this scoping review, previous studies on oral health and dental service utilization of foreign residents and multicultural families in Korea were reviewed, and the studies were classified according to research participants and research purposes. The variables related to oral health and dental service utilization and socio-demographic factors were also analyzed. Through this systematic review of literature, the limitations of existing research and future research directions were suggested.Design: Korean databases such as Korean Medical Database (KMbase), DBpia, Research Information Sharing Service (RISS), Korean studies Information Service System (KISS), and National Assembly Library were investigated to collect data regarding oral health and dental service utilization. Afterretrieving the references, the title and the abstract of the literature were reviewed and their relevance was screened. Full text screening was conducted and a total number of 42 studies were selected, which met the inclusion criteria.Results: After careful review and analysis of 42 studies, the following results were obtained: (a) the research participants were married migrant women, multicultural children and adolescents, foreign workers, and foreign students (four types), of whom the most frequent was marriage migrant women (45.5%) and (b) the research purposes were oral health behavior, oral health status, dental service utilization, oral health belief, oral health knowledge, and oral health education (six types), of which the most frequent was oral health behavior (39.7%).Conclusion: This research takes a systematic approach to exploring research participants, purposes, variables related to oral health and dental service utilization, and demographic variables of foreigners and multicultural families residing in Korea. According to the findings, the most published research topic of research participants was 'marriage migrant women' and oral health behavior has the highest number of publications in research purposes.

Association of Acculturation and Latino Parents' Oral Health Beliefs and Knowledge.

The purpose of our study was to explore the association of acculturation and Latino parent behavioral and psychosocial characteristics. A cross-sectional survey was conducted with 197 parent-children triads. Participating parents completed survey questions encompassing oral health knowledge, behaviors and beliefs from a validated oral health instrument. The mean score for acculturation in this sample was 3.8, where acculturation was dichotomized to a categorical variable. The bivariate associations between the independent variables (caregiver psychosocial factors and socio-economic factors (SES) factors) and acculturation (more/less acculturated) were conducted using logistic regression analysis, and for the final model a multivariate logistic regression model was used. In the bivariate analyses, less acculturated parents reported lower oral health knowledge (p = 0.02), higher social support (p = 0.028) and chronic stress (p = 0.015) and lower perceived susceptibility to dental caries in their children (p = 0.039). The bivariate analysis demonstrated that less acculturated parents had less education and employment (p < 0.0001) than more acculturated parents. The multivariate logistic model demonstrated that social support (p = 0.028), chronic stress (p = 0.015) and health beliefs as barriers to access dental care (p = 0.039) were higher in less acculturated parents compared to more acculturated parents. Less acculturated parents demonstrated lower oral health knowledge, higher stress and more barriers to accessing oral health care for their children. Oral health interventions for Latino families should incorporate strategies that include consideration of parental oral health beliefs.

Oral health knowledge and practices in the Kaski District of Nepal.

Oral disease is a widespread problem in Nepal. However, up-to-date information on oral health is limited and oral health initiatives may be shaped by assumptions about insufficient oral health knowledge. Furthermore, the influence of socio-demographic factors on oral health in Nepal remains unclear. This study aims to explore the relationship between demographic background and oral health knowledge, attitudes and behaviors in rural Nepal. Secondary analysis of data from a community-based survey on oral health knowledge, beliefs, practices, and access to care among residents ages 12 and above across 4 rural villages in Nepal's Kaski District (Total number = 3,243). Chi-square tests were performed to examine associations among oral health knowledge, attitudes and behaviors and demographic characteristics. Participants reported a baseline knowledge of oral health; 92.4% knew about the recommended tooth-brushing regimen. Participants with higher education and younger age demonstrated better oral health knowledge. Misconceptions about dental treatment causing blindness (23.1%), deafness (11.6%), and mental health problems (14.9%) were reported across all groups. Numerous factors besides knowledge likely determine individual oral health behavior. Future interventions should consider community-based outreach programs and dental care delivery through community Health Posts to build trust in dental care, build on existing knowledge and community experiences, and improve access to preventative care. Up-to-date understanding of oral health knowledge and practices and sociocultural influences on oral health behavior will better focus interventions and policy decisions.

Evaluación de riesgo en Caries de la Infancia Temprana

El objetivo del presente estudio fue realizar una revisión sistemática de la literatura sobre la evaluación de riesgo en caries de Ia infancia temprana (CIT). Para ello fueron localizados por búsqueda electrónica treinta artículos científicos originales que cumplieron con los criterios de inclusión definidos. Los mismos fueron leídos de forma minuciosa para primero ser clasificados en aquellos que cumplen con aspectos básicos del método científico, y aquellos que no; luego, se identificaron en ellos indicadores y factores de riesgo puestos a prueba para verificar su asociación con la enfermedad en cuestión, a su vez, estos fueron clasificados sucesivamente en estadísticamente significativos o no; en aquellos con y sin coherencia en la literatura consultada y en provenientes de estudios longitudinales y transversales. También se determinó el número de estudios incluidos que contemplaron lesiones cavitadas y no cavitadas en la medición de la prevalencia o incidencia de la enfermedad. Resultados: Un total de 103 factores e indicadores de riesgo fueron identificados, de los cuales, solo ocho provienen de los seis estudios correctos en cuanto a los aspectos básicos del método científico establecidos, y se mostraron acordes a los criterios utilizados para determinar su valor relativo como evidencia científica en el proceso de clasificación. 62% de los artículos incluidos contemplaron lesiones cavitadas y no cavitadas. Conclusión: Los indicadores y factores de riesgo que se ajustaron a los criterios establecidos en relación a los padres o encargados son: Historial de Caries; motivo de consulta con el Odontólogo: Necesidad de tratamiento; creencia fatalista sobre salud oral y actitud poco favorable con respecto a la prevención; En tanto que los relacionados a los niños son: Peso del niño/a elevado para la edad; Consumo elevado de bebida carbonatada; A mayor edad; Frecuentar guarderías públicas.

Perception and belief in oral health among Karen ethnic group living along Thai-Myanmar border, Thailand

BackgroundUtilization of oral health services has been low among rural populations in Thailand, especially for minority ethnicity populations living along the borders. The aim of this study was to increase understanding of the determinants of the underutilization of oral health services among these populations.MethodsA qualitative study using in-depth interview and semi-structured interview was conducted among participants of Karen ethnicity living in Mae Tan Sub-district, Thasongyang District, Tak Province, Thailand. The interviews focused on exploring the participants’ perceptions of oral health problems, oral health and hygiene, and oral health-seeking behaviors. The verbatim-transcribed interviews were analyzed using thematic analysis.ResultsA total of 101 participants (50 adults and 51 children) with a Karen ethnic background took part in the interviews. Most participants could not identify oral health problems and did not perceive dental disease as a problem unless there was severe pain that could not be relieved by painkillers. The Karen ethnic community worked as subsistence farmers, and their busy daily activities consisted of farming, going to the forest to hunt and gather, performing housework, and taking care of their children. Dental health was given a lower priority compared with general health. The perceived value of primary teeth was low, which was identified as an underlying factor resulting in delayed oral health care seeking among this population. The participants had relied on self-care throughout their lifetimes, using either traditional medicines or modern painkillers to relieve toothaches. Fear of dental procedures among children was also described as a barrier to seeking dental health care.ConclusionsThis study found that the lifestyle and traditions of Karen people living in this area influence their oral health care and hygiene activities as well as their health-seeking behaviors. Further research should emphasize how to improve oral health promotion by providing necessary services and health education appropriately to Karen ethnic populations living along the Thai-Myanmar border.