Oral Health-related Attitudes Research Articles

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

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

Impact of Parents' Oral Health Literacy on Their Own and Their Children's Oral Health in Chinese Population.

BackgroundOral health literacy (OHL) has been recognized as a component of oral health disparities; however, the precise relationship between literacy and oral health outcomes has not been established. To explore the role of parents' OHL for their own subjective oral health, related behavior, and for the proxy assessment of their child's oral health, oral health-related behavior.MethodsSurvey data were collected from 406 parents of 4- to 7-year-old children in Beijing, China. The background characteristics, oral health assessment, oral health-related behavior, knowledge and attitudes, and diet-related questions of parents and their children were surveyed by a questionnaire. OHL was assessed with the Hong Kong Rapid Estimate of Adult Literacy in Dentistry (HKREAL-30) Scale and a revised version that asked the respondents to indicate if they understood the words (HKREALD-30-Understand).ResultsThe HKREALD-30 responses correlated with the HKREALD-30-Understand responses. The higher the parents' HKREALD-30-Understand scores, the better they described the health of their own teeth and gums, the greater their child's diet was influenced by the protein, sugar and calories of the food, and the more positive their oral health-related attitudes were. The higher the parent's HKREALD-30 scores, the healthier they described their child's teeth and gums.ConclusionsBoth the HKREALD-30 and HKREALD-30-Understand Scores correlate with parents' self and proxy oral health-related responses. Chinese parents could understand that the word would add predictive value to the prediction of how parents' oral health literacy affects their own oral health care, children's oral health and other related aspects.

Oral Health-Related Knowledge, Attitudes and Behaviours of Arab Dental Students: Multi-National Cross-Sectional Study and Literature Analysis 2000-2020.

Dental students are the future leaders of oral health in their respective communities; therefore, their oral health-related attitudes and behaviours are of practical value for primary disease prevention. The present study aimed to evaluate oral health-related knowledge, attitudes, and behaviours of dental students in Arab countries and explore the potential sociodemographic predictors of their oral health outcomes. A multi-centre, cross-sectional study was conducted during the academic year 2019/2020 in three Arab countries: Lebanon, Syria, and Tunisia. The study used a validated Arabic version of the Hiroshima University Dental Behavioural Inventory (HU-DBI) composed of original twenty items that assess the level of oral health-related knowledge, attitudes, and behaviours, and four additional dichotomous items related to tobacco smoking, alcohol drinking, problematic internet use, and regular dental check-up The HU-DBI score ranges between 0 and 12. A total of 1430 students took part in this study, out of which 60.8% were females, 57.8% were enrolled in clinical years, 24.5% were tobacco smokers, 7.2% were alcohol drinkers, and 87% reported internet addiction. The mean HU-DBI score was 6.31 ± 1.84, with Lebanon having the highest score (6.67 ± 1.83), followed by Syria (6.38 ± 1.83) and Tunisia (6.05 ± 1.83). Clinical students (6.78 ± 1.70) had higher HU-DBI scores than their preclinical peers (5.97 ± 1.86). The year-over-year analysis revealed that dental public health and preventive dentistry courses had significantly and positively impacted the undergraduate students’ knowledge, attitudes, and behaviours. The gender-based differences were not statistically significant, with a modest trend favouring males, especially oral health behaviours. Tobacco smoking, alcohol drinking, and problematic internet use were associated with lower HU-DBI scores. In the Arab world, the economic rank of the country where the dental students live/study was weakly correlated with the students’ mean HU-DBI score.

Evaluating an Oral Health Education Intervention in Chinese Undocumented Migrant Mothers of Infants in Northern Ireland.

Background: Poor oral health remains a significant dental public health challenge for ethnic minority and immigrant groups living in the UK. This study aimed to evaluate a culturally appropriate community-based home visiting oral health education intervention for Chinese, undocumented migrant mothers to promote their infants’ oral health, by focusing on their oral health related knowledge, attitudes, and behaviors. Methods: A convenience sample of 36 Chinese mothers with babies aged less than eight weeks were recruited in South-East region of Belfast. The local Chinese community was consulted to assist with the development of the intervention. The oral health education intervention was provided to 19 intervention group mothers through home visits and telephone calls during mothers’ first postpartum year. They were also provided with unlimited social support during the intervention period. Mothers’ oral health related knowledge, attitudes, and behaviors regarding baby toothbrushing and sugar snacking were measured at eight weeks, six months, and 12 months. Results: A higher proportion of Chinese intervention group mothers had improved knowledge about baby toothbrushing at 12 months compared with control group mothers (χ2 = 14.12: p = 0.004). Significantly, more intervention group mothers’ oral health related attitudes were enhanced regarding baby toothbrushing and sugar snacking compared with control group mothers. Conclusion: This community-based oral health education intervention has shown effects in mothers’ self-reported knowledge, attitudes, and behaviors in the intervention group when the community based and culturally appropriate home-visiting program improved the mothers’ oral health related knowledge, attitudes, and behaviors.

Oral health behavior and attitudes among students of health and non-health oriented studies

Introduction: Unhealthy behavior such as neglecting to brush and floss, using tobacco and alcohol, and inadequate nutrition can adversely affect dental health. The frequency of dental visits is also of great importance in the early detection of different oral disorders. Our aim was to assess oral health behavior and attitudes among students of the 1st year of two health and non-health oriented studies of University of Sarajevo.
 Methods: We included 119 students of the 1st year of Faculty of Health Studies and 108 students of the 1st year of Faculty of Architecture of the University of Sarajevo. A self-administered questionnaire was used, comprising demographic data, data on oral hygiene habits, dental attendance pattern, a number of extracted teeth as well as problems with the appearance, comfort, and social life due to teeth problems.
 Results: Faculty of Architecture students significantly more often visit their dentist (χ2 = 24.174, df = 5, p = 0.00). Faculty of Health Studies students have significantly more extracted teeth (χ2 = 35.54, df = 4, p = 0.001). Dental health habits were significantly better at the students Faculty of Architecture (χ2 = 16.391, df = 2, p = 0.001). No significant difference between the groups about about avoiding encounters due to teeth and dentures problems.
 Conclusion: Oral health related attitudes may be better in students of non-health oriented studies, however, these results have to be confirmed by more investigations and larger studies.

Complex interrelations between self-reported oral health attitudes and behaviors, the oral health status, and oral health-related quality of life.

PurposeThe purpose of this study was to develop and test a moderated mediation model that was able to describe the relationships between oral health-related attitudes and behaviors, oral health status (OHS), and oral health-related quality of life. The hypothesized relations corresponded to research questions such as “is a person’s oral health predicted by the actions that person takes in order to prevent oral health conditions?” and “do individuals with better oral health also have higher levels of oral health-related quality of life?”.Materials and methodsA cross-sectional correlational study with selected predictor variables was conducted in Cluj-Napoca, Romania, among 191 participants, enrolled in the fourth and sixth years of study at the Dentistry School of the Medicine and Pharmacology, University of Cluj-Napoca. Participants completed the Hiroshima University Dental Behavior Inventory (HUDBI) questionnaire targeting specific behavior and attitude with respect to their dental self-care, Oral Health Impact Profile (OHIP) short questionnaire for measuring oral health-related quality of life, and the current OHS was assessed objectively using Decayed, Missing, Filled Teeth/Surfaces (DMFT) index. Statistical analyses were done using structural equation modeling software.ResultsOur research showed relevant associations between HUDBI, DMFT, and OHIP. The relationship between HUDBI and OHIP was mediated by DMFT. Furthermore, HUDBI worked as a moderator between DMFT and OHIP. Thus, our study revealed a case for moderated mediation, which is usually ignored in similar research.ConclusionThe “straightforward” causality between oral health-related behavior and the actual OHS must be considered with caution, as well as their impact on the oral health-related quality of life. Further research is needed to investigate the interaction between variables, the strength of the interrelations and the magnitude of their interactions, and the confidence that can be placed in these measurements, with respect to the general population and/or those lacking domain-specific education.

Prenatal Oral Health Counseling by Primary Care Physicians: Results of a National Survey.

Objectives Limited information exists on the extent oral health is addressed in the context of prenatal care. This study sought to investigate characteristics of primary care physicians (PCP) who provide oral health counseling to pregnant women. Methods The study relied upon data from the 2013 Survey of PCP on Oral Health. Provision of oral health counseling to pregnant women (sometimes vs. rarely/never) was the primary outcome. Covariates included respondents' demographic and practice characteristics, oral health-related training, knowledge, attitudes, preparedness and clinical behaviors. The analytical strategy included bivariate tests and multivariable Poisson regression modeling, accounting for the survey design; inference was based upon marginal effects estimation. Results Two-thirds of PCP (233 out of 366 respondents) reported providing oral health counseling to pregnant women. In bivariate comparisons, female PCP, PCP with oral health-specific instruction during medical training, favorable oral health-related attitudes, behaviors, preparedness, and knowledge were more likely to provide counseling (p < 0.05). Multivariable analyses confirmed the independent associations of female gender [marginal effect = + 9.7 percentage points (p.p.); 95% confidence interval (CI) = 0.0-19.0], years in practice (- 0.4 p.p. for each added year; 95% CI = - 0.09 to 0.0), oral health continuing education (+ 13.2 p.p.; 95% CI = 2.6-23.8), preparedness (+ 23.0 p.p.; 95% CI = 16.9-29.0) and oral health counseling of adult patients with other conditions (+ 8.8 p.p.; 95% CI = 4.6-13.3) with prenatal oral health counseling. Conclusions for Practice A considerable proportion of PCP nationwide counsel pregnant patients on oral health. Provider attributes including education and preparedness appear as promising targets for interventions aimed to enhance pregnant women's oral health and care.

The family's influence on the oral health of children. A peek behind the front door

The prevention of dental caries seems fairly easy. The disease can largely be avoided by the daily removal of dental plaque using fluoride toothpaste and the control of sugary intakes. Most parents have sufficient knowledge and motivation to adhere to this prevention advice with respect to their children. Actual practice, however, proves quite difficult because parents experience barriers in implementing the advice. This article provides an overview of the most important family-related factors that influence children's oral health behaviour and dental caries experience. Factors include oral health-related attitudes of the parents, the way that parents deal with their children and communicate with them (parenting practices) and the organisation of daily life within the family (family functioning). It's important for oral health care providers to engage in conversations with parents to identify possible barriers. Tailored advice can then be given to help them improve their oral health behaviour.

History of Orthodontic Treatment, Treatment Needs and Influencing Factors in Adolescents in Croatia.

The aim of this study was to assess the orthodontic treatment needs of adolescents in Zagreb, Croatia, in relation to their orthodontic treatment history, caries experience and socio-demographic parameters. The study sample comprised 1,289 adolescents from 12 randomly selected public schools in Zagreb, Croatia. The subjects were 15-18 years old (mean age 16.3±1.4), and 51% of them were girls. The Dental Aesthetic Index (DAI), the sum of the numbers of decayed, missing and filled teeth (DMFT index), and a questionnaire (covering socio-demographic issues, oral health-related attitudes and behaviours) were employed in this study. The data was analyzed by means of Chi-square test, analysis of variance, and multiple logistic regression models. The DMFT score was higher in adolescents with no orthodontic history (5.2±3.7) than in those who were under orthodontic treatment at the time of the research (4.5±3.2; p=0.043). More than 60% of the adolescents have never undergone any orthodontic treatment, around 24% previously undergone treatment and 15% were under treatment at the time of the research. Overall, 85% of the adolescents' orthodontic appliances were removable, and the girls were more often under orthodontic treatment. One fifth of the studied population had severe or very severe malocclusion. Adolescents with previous orthodontic treatment were more often interested in better teeth alignment, changes in their teeth positioning and continuing orthodontic treatment. Multiple logistic regression model demonstrated that previously treated adolescents, in comparison with their untreated peers, were on average older (p=0.002), were less satisfied with the appearance of their teeth (p=0.001), they had higher malocclusion severity (p=0.046), and fewer dental caries (p<0.001), changed toothbrushes more often (p=0.012), and their mothers attained higher education (p<0.001). Although many adolescents received orthodontic treatment, the severity of their malocclusion was still somewhat high, and they were more often dissatisfied with their treatment outcome. Mothers' educational level was found to be the most important socio-demographic predictor for children's involvement in orthodontic treatment. The caries experience increased in comparison with the Croatian national survey data from 1999.

Oral health-related resources - a salutogenic perspective on Swedish 19-year-olds.

The aim was to explore health-oriented resources among 19-year-olds and, specifically, how these resources interact with oral health-related attitudes and behaviour. To represent individuals with various psychosocial environments and socioeconomic areas, the participants were selected from different geographical locations of the Public Dental Service clinics in the county of Jönköping, Sweden. A structured questionnaire was distributed, including the instrument 'sense of coherence', for description of the study group, followed by a semi-structured thematized interview. The qualitative method used for sampling and analyses was grounded theory. Data sampling and analysis were performed in parallel procedures and ended up in a sample of ten informants (five women). In the analysis of interview data, a core category was identified, 'Resources of Wealth and Balance in Life - a Foundation for Healthy Choices', describing the central meaning of the informants' perceptions of resources with an essential beneficial impact on oral health. The core category was built on five themes, which in turn had various subthemes, describing different dimensions of resources interacting with beneficial oral health-related attitudes and behaviour: 'Security-building Resources and Support', 'Driving force and Motivation', 'Maturity and Insight', 'Health Awareness' and 'Environmental influences.' The results elucidate personal and environmental health-oriented resources with influence on oral health-related attitudes and behaviours of young individuals. Such beneficial recourses should be recognized by dental personnel to promote oral health.

Oral health attitudes and caries-preventive behaviour of Czech parents of preschool children

To characterize the oral health-related attitudes and behaviour of Czech parents of preschool children. A representative sample of 796 parents was recruited for the cross-sectional questionnaire survey. Study data were collected using a validated questionnaire with 44 attitudinal items related to different aspects of caries prevention. The data were analyzed by explorative factor analysis, extracted factors were subjected to reliability analysis and Kruskal-Wallis ANOVA was used to test differences in the factor scores in respondents with different levels of education and self-perceived SES. The factor analysis extracted 3 factors, labelled "Toothbrushing - perceived significance and parental efficacy" ; "External caries control" and "Internal caries control". They explained 28.9% of the data variability. The comparison of the factor scores in groups with different SES and education of mothers showed highly significant differences. For all three factors, median values of the aggregated Likert scale increased with increasing SES and education of the mother. The parents report that they are aware of their responsibility for the prevention of tooth decay in their children. In caries prevention they concentrate on toothbrushing. Dietary measures do not seem to be of similar importance to them. The increasing self-perceived SES of the family and the education level of the mother have a significantly positive effect on the caries-preventive attitudes of the parents. Based on the study results, the message to the public health sector in the Czech Republic should include the need to highlight the importance of a non-cariogenic diet and the role of fluorides in caries prevention.

Effect of dental education on peruvian dental students' oral health-related attitudes and behavior

This study evaluated the effect of dental education on oral health-related attitudes and behavior of students in a five-year dental program in Peru. A survey using the Hiroshima University-Dental Behavioral Inventory (HU-DBI), which consists of twenty dichotomous responses (agree-disagree) regarding oral health behavior and attitudes, was completed by Year 1 and Year 5 dental students at the Universidad Inca Garcilaso de la Vega in Lima, Peru. A total of 153 Year 1 students and 120 Year 5 students responded to the Spanish version of the HU-DBI questionnaire. The data were analyzed using chi-square tests and logistic regression analyses. Compared to the Year 1 students, the Year 5 dental students were more likely to agree with questions such as think I can clean my teeth without using toothpaste (OR=0.24, 95% CI: 0.10-0.58); have used a dye to see how clean my teeth are (OR=0.19, 95% CI: 0.10-0.36); and have had my dentist tell me that I brush very well (OR=0.34, 95% CI: 0.17-0.69). Overall, the data showed that the curriculum in this dental school in Peru resulted in more positive oral health-related attitudes and behavior among Year 5 dental students compared to those of Year 1 dental students.

Effect of Dental Education on Peruvian Dental Students’ Oral Health–Related Attitudes and Behavior

This study evaluated the effect of dental education on oral health-related attitudes and behavior of students in a five-year dental program in Peru. A survey using the Hiroshima University-Dental Behavioral Inventory (HU-DBI), which consists of twenty dichotomous responses (agree-disagree) regarding oral health behavior and attitudes, was completed by Year 1 and Year 5 dental students at the Universidad Inca Garcilaso de la Vega in Lima, Peru. A total of 153 Year 1 students and 120 Year 5 students responded to the Spanish version of the HU-DBI questionnaire. The data were analyzed using chi-square tests and logistic regression analyses. Compared to the Year 1 students, the Year 5 dental students were more likely to agree with questions such as "I think I can clean my teeth well without using toothpaste" (OR=0.24, 95% CI: 0.10-0.58); "I have used a dye to see how clean my teeth are" (OR=0.19, 95% CI: 0.10-0.36); and "I have had my dentist tell me that I brush very well" (OR=0.34, 95% CI: 0.17-0.69). Overall, the data showed that the curriculum in this dental school in Peru resulted in more positive oral health-related attitudes and behavior among Year 5 dental students compared to those of Year 1 dental students.

Abstracts for the International Symposium on Dental Hygiene, Cape Town, South Africa, August 14–17, 2013

Objectives: The aim was to explore health oriented resources among 19-year olds and in specific how these health oriented recourses interacts with oral health related attitudes and behaviors.Method ...

Neighborhood Social Capital, Neighborhood Attachment, and Dental Care Use for Los Angeles Family and Neighborhood Survey Adults

We tested the hypothesis that neighborhood-level social capital and individual-level neighborhood attachment are positively associated with adult dental care use. We analyzed data from the 2000-2001 Los Angeles Family and Neighborhood Survey that were linked to US Census Bureau data from 2000 (n = 1800 adults aged 18-64 years across 65 neighborhoods). We used 2-level hierarchical logistic regression models to estimate the odds of dental use associated with each of 4 forms of social capital and neighborhood attachment. After adjusting for confounders, the odds of dental use were significantly associated with only 1 form of social capital: social support (adjusted odds ratio [AOR] = 0.85; 95% confidence interval [CI] = 0.72, 0.99). Individual-level neighborhood attachment was positively associated with dental care use (AOR = 1.05; 95% CI = 1.01, 1.10). Contrary to our hypothesis, adults in neighborhoods with higher levels of social capital, particularly social support, were significantly less likely to use dental care. Future research should identify the oral health-related attitudes, beliefs, norms, and practices in neighborhoods and other behavioral and cultural factors that moderate and mediate the relationship between social capital and dental care use.

Influence of oral health related behavior on oral health of adolescents in Belgrade

Introduction. Adolescence is a period of intensive physical, psychological and emotional changes that might affect existing oral health related habits and result in developing risky behaviors. The aim of the present study was to investigate oral health attitudes and behavior and their relation to dental caries experience in the group of adolescents from Belgrade. Material and Methods. This cross-sectional study included 404 high-school students grade one from Belgrade. Two trained and calibrated dentists conducted clinical examination in classrooms to determine oral health status of adolescents (DMFT index and visual signs of gingivitis). Modified Serbian version of Hiroshima University Dental Behavior Inventory (HU-DBI) questionnaire with three additional questions was used to collect data on oral health behavior and attitudes. Results. Mean HU-DBI score was 6.22?1.45 for males and 6.28?1.45 for females (p&lt;0.05). Dental visits at least once in a year reported 67.3% adolescents, more often girls (p&lt;0.05). Only emergency dental visits reported 47.1% of adolescents. Majority of respondents reported brushing teeth twice a day or more (86.2%), girls more often than boys (p&lt;0.001). Only 13.4% reported regular flossing and 30.3% daily use of mouth rinses. Mean DMFT score was 5.84?0.20 with 45% of untreated decayed tooth. Unfavorable oral health related attitudes and behavior were related to poorer oral health status of adolescents. Conclusion. Poor oral health of adolescents is influenced by their inadequate attitudes and habits. Program of oral health promotion for adolescents that would target knowledge, attitudes and skills development should be implemented to enhance adolescents? oral self-care regime and oral health outcome.

The health-promoting prison: can it improve oral health? An evaluation of an Oral Health Improvement Project for high-security prisoners

The aim of the evaluation was to examine the impact of an Oral Health Improvement Project on the oral health-related knowledge, attitudes and behaviours of prisoners in this high-security gaol. Prisoners in a high-security prison that had adopted a health-promoting prison agenda were invited to take part. Prisoners in locations where the Project had been active acted as the intervention group and those in other settings where there was no formal involvement with the Project acted as controls. All consenting prisoners were asked to complete questionnaires to assess their Project awareness, oral health-related knowledge, attitudes and behaviours. The data were subjected to Chi-squared tests, t-tests, correlation analysis and ANCOVA. Fifty-nine intervention and 48 control group prisoners completed questionnaires. Intervention group prisoners were more Project-aware (F[1,97] = 6.98, p = 0.01) and more knowledgeable about oral health (F[1,97] = 12.02, p = 0.001) when controlling for duration of current imprisonment. No significant associations between intervention group status and oral health-related attitudes or behaviours were found. Increased reported smoking and poorer dietary habits were significantly explained by duration of current imprisonment. This evaluation highlights the difficulties in changing health-related attitudes and behaviours in the prison setting. It also demonstrates the need for effective deployment of the health-promoting prison approach to improve the oral health of prisoners.

Changes in oral health related knowledge, attitudes and behaviours following school based oral health education and atraumatic restorative treatment in rural Tanzania

Objectives: The following questions were addressed; to what extent is sugar consumption, tooth brushing, and oral health related attitudes and knowledge subject to change following a combined atraumatic restorative treatment (ART) /oral health education (OHE) program? Are changes in intended sugar avoidance associated with changes in cognitions as specified by the Theory of Planned Behaviour (TPB)? Are changes in oral health related knowledge associated with changes in attitudes and oral health behaviour?Method: A total of 1306 (follow-up prevalence 73.8%) primary school students in Kilwa, Tanzania completed interviews before and after a combined ART/OHE program. Post intervention at 6 months follow-up assessed changes in oral health related knowledge, attitudes, and behaviours. Complete baseline and follow-up interviews were obtained from 221 and 1085 students who received ART/OHE and OHE only at schools, respectively.Results: Improvement was obtained with attitudes towards sugar avoidance, knowledge, and tooth brushing (effect sizes in the range 0.1-0.3). Within individual changes did not differ significantly between students receiving ART/ OHE and OHE only. Change scores of intended sugar avoidance associated in the expected direction with changes in sugar consumption. Attitudes and norms with respect to sugar avoidance deteriorated and improved among subjects who respectively decreased and increased intended sugar avoidance. Tooth brushing increased in students who improved oral knowledge.Conclusion: School based ART/OHE improved pupils’ tooth brushing, knowledge, and attitudes, but had no effect on sugar consumption. This study provided support for the validity of the TPB in predicting changes in intended sugar avoidance and reported sugar intake.

An assessment of oral health promotion programmes in the United Kingdom

Improving oral health and reducing tooth decay is a key area for action, both in the United Kingdom (UK) and overseas. The World Health Organization (WHO) has highlighted the unique advantage schools have in promoting oral health. We summarise current oral health promotion strategies in the United Kingdom and estimate the spread of their use as well as their impact on oral health and influence on the oral health-related knowledge and behaviour in a patient population. A structured overview of published papers, government publications, official government websites and policy reports. A cross-sectional study of patients referred for a tooth extraction in one dental surgery in south-east London. Statistical methods consisted of logistic and ordinal regressions to model the likelihood of exposure to oral health promotion and of obtaining higher levels of knowledge of oral health issues, respectively. Linear regression was used to model the level of oral health and knowledge of oral health issues. We found three main promotion programmes, namely, National Healthy Schools (NHS), Sure Start and Brushing for life plus a small number of local initiatives. Sure Start targets disadvantaged areas, but is limited. In our observational study, 34% of the patients reported exposure to a settings-based oral health education programme: Sure Start (5%), NHS (7%) and other (22%). This exposure was not influenced by age or gender, but an association with education was detected. Although oral health promotion was not found to influence the actual knowledge of oral health issues, it was found to influence some oral health-related attitudes and perceptions. Participation in an oral health promotion programme was found to be significantly associated with the patients' education, their belief that they can prevent oral disease and the subjective perception of their own oral health. The WHO principles need to be embedded across all schools to achieve a true national oral health promotion programme for the United Kingdom. The National Healthy Schools programme provides the perfect platform.

Influence of mothers’ oral health knowledge and attitudes on their children’s dental health

This was to evaluate the influence of mothers' oral health-related knowledge and attitudes on the tooth-brushing behaviour and dental health of their children and to compare the effect of these maternal aspects on child's oral health. In 2005, an oral health study conducted among a random sample of 457 mother and child pairs in Tehran, Iran, used self-administered questionnaires to provide data on mothers' oral health-related knowledge and attitudes and children's tooth-brushing behaviour. Clinical data allowed assessment of dental status of the primary and permanent dentition. Chi-square test and binary logistic regression models were employed. Generally, mothers had extensive knowledge of and positive attitudes towards oral health. Mothers' higher level of oral health knowledge and better attitude scores were associated with children's sound dentition (p<0.05), while only mothers' better attitude was associated with children's twice-daily tooth brushing (p=0.001). The multivariate analyses showed that children of mothers with higher attitude scores were more likely to brush their teeth twice daily (OR = 2.1; 95% CI 1.2 - 3.7) and have sound dentition (OR = 12.4; 95% CI 1.8 - 85.9). The models revealed that mother's knowledge per se had no effect on children's sound dental health, but showed an additive effect with mother's attitudes. Because twice-daily tooth-brushing behaviour and sound dentition in 9-year-olds were associated with their mothers' positive oral health-related attitudes, in developing oral health promotion programs for children and adolescents, the considerable potential of mothers should be a major focus of oral health professionals.