Use Of Bottles Research Articles

Penatalaksanaan early childhood caries Management of early childhood caries

Early childhood caries (ECC), also known as milk bottle caries is a syndrome of severe tooth decay, occurs ininfants and children, is an infectious disease that develops rapidly and lead to health problems in children. Thissyndrome can be caused by inappropriate use of bottles. Most cases of untreated ECC to children aged 20 months.At this stage many children need serious treatment, because this will result in trauma to both the children andparents. The most common treatment ECC and other dental diseases have been included in each treatment ofdisease. Efforts to educate families about dental hygiene and practice start a diet, the high rate of recurrence of anyevidence of disease ranging from tooth decay to the failure of the treatment plan resulted in the need for specialattention to this disease. This paper is expected to be a good input for a dentist in the treatment of ECC

Relação de escolaridade, faixa etária e profissão de mães com a oferta de chupeta e mamadeira a seus filhos

OBJETIVO: avaliar a relação do grau de escolaridade, faixa etária e a profissão das mães com a oferta de chupeta e mamadeira a seus filhos MÉTODO: participaram deste estudo 190 mães de crianças entre 0 e 10 anos de idade, com idades de 20 a 45 anos que responderam a um questionário com questões fechadas a respeito de profissão, nível de escolaridade e uso de chupeta e mamadeira de seus filhos RESULTADOS: não foi observada diferença significante entre o grau de escolaridade quanto ao uso de chupeta (p= 0,915). O uso de mamadeira foi significantemente maior nos filhos de mães com ensino superior (p= 0,0124). Não houve diferença significante quanto à faixa etária das mães e a presença desses hábitos nos filhos (chupeta: p=0,427; mamadeira: p=0,427); e, entre mães que trabalham em casa e que trabalham fora de casa (chupeta: p=0,061; mamadeira: p=0,798). Não houve diferença entre mães que trabalham na área da saúde e em outras áreas (chupeta: p=0,339; mamadeira: p=0,455) CONCLUSÃO: as mães com nível superior de escolaridade oferecem significantemente mais mamadeira aos seus filhos, o que não ocorreu quanto ao uso de chupeta. Não foi observada diferença significante quanto ao uso de chupeta e mamadeira em relação à faixa etária e profissão de mães.

Storage bottle material and cleaning for determination of total mercury in seawater

Accurate determinations of trace levels of mercury (Hg) in water require scrupulously clean sampling equipment and storage bottles. To avoid Hg contamination during storage, it has been presumed that water samples must be stored in either glass or Teflon bottles cleaned with a rigorous method, such as submersion in hot acid. These cleaning procedures are hazardous, and use of Teflon bottles can be cost prohibitive for major oceanographic programs. We investigated the suitability of alternative cleaning procedures and bottle materials for storage of seawater containing sub‐picomolar levels of Hg. We found that a simple technique with detergent, dilute acid, and bromine monochloride removes Hg from all bottle materials tested, which included FEP Teflon, glass, polycarbonate (PC), low‐density polyethylene (LDPE), and fluorinated polyethylene (FLPE). The technique is effective for bottles that are either new or used previously for trace‐level oceanographic samples (total Hg < 10 pM). Stability of seawater Hg levels differed dramatically among storage bottle materials during a 74‐ week test. Hg in seawater stored in LDPE, FLPE, and FEP bottles increased within 15 weeks of storage at room temperature. In contrast, Hg levels in seawater stored in PC bottles were increased modestly only after 74 weeks of storage and those in glass bottles were unchanged throughout the test. We recommend future use of this new cleaning method and encourage greater use of glass and PC bottles for storage of waters containing low levels of Hg.

The influence of social status on pre-school children’s eating habits, caries experience and caries prevention behavior

To assess the prevalence of Early Childhood Caries (ECC) in a county in Northern Hesse and to correlate this parameter to various independent variables. Additionally to investigate the relationship between preventive measures and the socioeconomic status (SES). In spring 2006, 1,082 preschool children were examined. According to WHO-criteria d(3+4)mft scores were recorded. Information about eating habits and preventive measures were collected by structured questionnaires. To compare the mean caries scores and preventive measures of various subgroups, non-parametric tests were performed. Variables associated with caries were included in a binary stepwise backward logistic regression analysis. The mean d(3+4)mft score amounted to 1.88. Children with high SES had significantly less caries than children with low SES. Significant positive and negative associations of feeding practices and preventive measures to d(3+4)mft scores were observed. Differences between feeding practices and preventive measures were dependent on SES. Long-term use of baby bottles at night is the most important factor of ECC. Differences in feeding practices and preventive measures in the various SES groups are evident but not that significant as supposed.

4-Nonylphenol, bisphenol-A and triclosan levels in human urine of children and students in China, and the effects of drinking these bottled materials on the levels

4-Nonylphenol (4-NP), bisphenol-A (BPA) and triclosan (TCS) are three industrial chemicals used widely in daily products. This study investigated 4-NP, BPA and TCS levels in urine samples of 287 children and students aged from 3 to 24years old in Guangzhou, China. Total (free and conjugated) amounts of 4-NP, BPA and TCS in the urine samples were detected using gas chromatography–mass spectrometry with negative chemical ionization. The detection rates of 4-NP, BPA and TCS were 100%, 100% and 93% respectively, given the detection limits of 3.8, 0.5 and 0.9ng/L respectively. Data for 4-NP, BPA and TCS were presented in both creatinine-adjusted (microgram per gram creatinine) and unadjusted (microgram per liter) urinary concentrations. The geometric mean (GM) concentrations of urinary 4-NP, BPA and TCS were 15.92μg/g creatinine (17.40μg/L), 2.75μg/g creatinine (3.00μg/L) and 3.55μg/g creatinine (3.77μg/L) respectively. Multiple regression models considering age, gender, preferred drinking bottle and log-transformed creatinine were used to calculate the adjusted least square geometric mean (LSGM). Among these subjects, the females had higher LSGM concentrations of 4-NP, BPA and TCS than the males; and the only statistically significant difference was found for the LSGM concentrations of triclosan (p=0.031). Participants who reported to use ceramic cups more frequently had significantly lower LSGM concentrations of BPA than those who used plastic cups (p=0.037).Meanwhile, a three-week test of using polycarbonate bottles and ceramic cups to drink bottled water and boiled tap-water was carried out among 12 graduate students of 25years old. The GM concentrations of urinary BPA at the end of the first week after using ceramic cups to drink bottled water were 7.16μg/g creatinine, then decreased significantly to 3.49μg/g creatinine after the second week of using ceramic cups to drink boiled tap-water (p<0.05), and finally increased to 4.15μg/g creatinine after the third week of using polycarbonate bottles in drinking boiled tap-water. The results indicate that in daily life the use of polycarbonate bottles or drinking of bottled water is likely to increase the ingestion of BPA, resulting in an increase in urinary BPA levels.

Prevalence of non-communicable diseases in Brazilian children: follow-up at school age of two Brazilian birth cohorts of the 1990's

BackgroundFew cohort studies have been conducted in low and middle-income countries to investigate non-communicable diseases among school-aged children. This article aims to describe the methodology of two birth cohorts, started in 1994 in Ribeirão Preto (RP), a more developed city, and in 1997/98 in São Luís (SL), a less developed town.MethodsPrevalences of some non-communicable diseases during the first follow-up of these cohorts were estimated and compared. Data on singleton live births were obtained at birth (2858 in RP and 2443 in SL). The follow-up at school age was conducted in RP in 2004/05, when the children were 9-11 years old and in SL in 2005/06, when the children were 7-9 years old. Follow-up rates were 68.7% in RP (790 included) and 72.7% in SL (673 participants). The groups of low (<2500 g) and high (≥ 4250 g) birthweight were oversampled and estimates were corrected by weighting.ResultsIn the more developed city there was a higher percentage of non-nutritive sucking habits (69.1% vs 47.9%), lifetime bottle use (89.6% vs 68.3%), higher prevalence of primary headache in the last 15 days (27.9% vs 13.0%), higher positive skin tests for allergens (44.3% vs 25.3%) and higher prevalence of overweight (18.2% vs 3.6%), obesity (9.5% vs 1.8%) and hypertension (10.9% vs 4.6%). In the less developed city there was a larger percentage of children with below average cognitive function (28.9% vs 12.2%), mental health problems (47.4% vs 38.4%), depression (21.6% vs 6.0%) and underweight (5.8% vs 3.6%). There was no difference in the prevalence of bruxism, recurrent abdominal pain, asthma and bronchial hyperresponsiveness between cities.ConclusionsSome non-communicable diseases were highly prevalent, especially in the more developed city. Some high rates suggest that the burden of non-communicable diseases will be high in the future, especially mental health problems.

Prolonged Bottle Use and Obesity at 5.5 Years of Age in US Children

To examine the association between prolonged bottle use and the risk of obesity at 5.5 years of age. Data from the Early Childhood Longitudinal Study, Birth Cohort were analyzed for 6750 US children born in 2001. The outcome was obesity (body mass index ≥ 95 th percentile) at 5.5 years, and the exposure was parental report of the child using a bottle at 24 months. The prevalence of obesity at 5.5 years was 17.6%, and 22.3% of children were using a bottle at 24 months. The prevalence of obesity at 5.5 years was 22.9% (95% CI, 19.4% to 26.4%) in children who at 24 months were using a bottle and was 16.1% (95% CI, 14.9% to 17.3%) in children who were not. Prolonged bottle use was associated with an increased risk of obesity at 5.5 years (OR, 1.33; 95% CI, 1.05 to 1.68) after controlling for potential confounding variables (sociodemographic characteristics, maternal obesity, maternal smoking, breastfeeding, age of introduction of solid foods, screen-viewing time, and the child's weight status at birth and at 9 months of age). Prolonged bottle use was associated with obesity at 5.5 years of age. Avoiding this behavior may help prevent early childhood obesity.

Caries experience associated to social and preventive factors in children of a pastoral community from Limeira-SP

Aim: To evaluate caries experience and prevalence associated to social and preventive factors in 3-6-year-old children of a Pastoral Community from Limeira, Brazil. Methods: A cross-sectional study was carried out through an epidemiologic research about the oral conditions of 110 children registered at the Children’s Pastoral Community from the city of Limeira, SP, Brazil. Intraoral examination was performed by a trained dentist and the parents/caregivers filled out a questionnaire in order to outline the children’s profile with respect to gender, parental education and oral health. Results: Differences related to gender were not detected (p= 0.3404). The most frequent periods of breastfeeding were 0 to 2 months (36.36%) and 2 to 6 months (35.45%), corresponding to 71.81% of the cases. The time bottle feeding pointed to two most frequent categories: 1) more than 12 months (35.45%) and 2) between 2 and 6 months (22.63%). Regarding parental education, the majority of the sample has not completed primary school (38.32%). It was observed a larger number of decayed teeth in male children (63.39%). Caries experience was significantly higher in children who were breastfed for only 2 months of life (41.96%). Children that did not use baby bottle or did not use a baby bottle for more than 1 year presented a smaller dmft, corresponding to 29.17% and 28.33%, respectively. Time of use of bottle and pacifier presented a significant association (p<0.05). Conclusions: The implementation of adequate strategies and actions is needed to reinforce oral health conditions in risk groups.

Difficulties in the use of medicine packaging

Abstract A postal questionnaire sent to a large group of the general public asked about difficulties encountered in the use of liquid medicine bottles, eye-drop containers, ointment/cream tubes and inhalers. Liquid medicine bottles and ointment/cream tubes were the most widely used, with eye-drop bottles having been used by approximately half of the respondents. Only 16 per cent had used inhalers. The use of eye-drop bottles and ointment/cream tubes caused the greatest number of difficulties for the majority of users. Other than with inhalers, those aged under 40 years reported the greatest number of difficulties with medicine containers. It is suggested that new medicine containers be designed to overcome the large number of difficulties reported by the general public.

A study considering the force required for broken glass bottles to penetrate a skin simulant

Injuries and assaults related to alcohol consumption are a growing concern in many countries. In such cases, the use of impulsive weapons, an object from the immediate environment, such as a glass bottle, is not uncommon. This current study utilises a material testing system to measure the force required to push a broken glass bottle into a skin simulant with the displacement of the bottle into the skin simulant being recorded simultaneously, using a linear variable differential transformer (LVDT). From this data, load versus displacement plots were produced. Multi-detector computed tomography (MDCT) was also used to analyse bottle wall thickness to determine if a relationship could be found between force required for penetration and bottle wall thickness. The forces required for the penetration of the skin simulant ranged from 9.8 to 56.7 N. The range was found to be independent of bottle type with the variation in force for penetration being attributed to the varying fracture points, with some fractures presenting a sharper point on first contact with the skin. Although the dangers associated with the use of broken bottles as weapons is apparent, there is a paucity of information in this area in the current English literature, which this study has addressed. The results of this study also highlight the risks of attempting reconstructions of broken bottle stab events.

容器の使用状況を考慮した緑茶・コーヒー飲料のLCA マイボトルの使用に着目して

容器の使用状況を考慮した緑茶・コーヒー飲料のLCA マイボトルの使用に着目して

Radiographic position of the hyoid bone in children with atypical deglutition

The persistence of childlike deglutition after the replacement of deciduous teeth is described as atypical deglutition. This condition has been attributed to sucking action without nutritive purposes, use of a feeding bottle, oral respiration, and anatomical abnormalities. Among the possible anatomical alterations, the hyoid bone, as a result of being the origin or the insertion of several muscles involved in swallowing, may have its position altered in cases of atypical deglutition. The aim of the present study was to evaluate the position of the hyoid bone using lateral teleradiographs, among patients with atypical deglutition during the stage of mixed dentition. Using cephalometric analysis on lateral teleradiographs, the distances of H-MP (hyoid to mandibular plane) and H-T (hyoid to tuber) were measured in two groups: the experimental group with atypical deglutition and the control group normal deglutition. Both groups included subjects in mixed dentition stage. Measurements from the groups were compared using Mann-Whitney U-test and a P-value <0.05 was considered as an indication of statistical significance. The average distance of the H-MP variable was 11.69 mm for the control group and 16.14 mm for the experimental group, with a statistically significant difference (P = 0.016). The average distance of the H-T variable was 2.26 mm for the control group and -5.89 mm for the experimental group, with significant difference (P < 0.001). There was no correlation among the variables studied. Cephalometric analysis of the H-MP distance revealed a mean difference of approximately 5 mm between the two groups, and the difference was more than 7 mm for H-T distance. Distances of H-MP and H-T based on radiographic measurements were greater in individuals with atypical deglutition than in control group and there was no correlation between these two parameters.

열처리 및 나이신·유카추출물 첨가에 의한 김치의 미생물 증식 저해

For extension of storage period of cabbage-kimchi, effects of heat treatment as well as nisin or yucca extract were examined on the growth of microbes. Firstly, when kimchi was heated at various temperatures in polyethylene plastic bottle or membrane pouch, the optimum inhibitory condition giving no sensory change was at for 30 min in a plastic membrane pouch and this treatment made a reduction of in total microbes. The result showed that use of plastic bottle was inefficient due to low heat transfer rate. Interestingly, pasteurization of seasoning pastes at for 30 min separately from cabbage resulted in better inhibitory effect reducing of total bacteria and of lactic acid bacteria, and this operation was regarded as a promising inhibitory method. Secondly, when nisin and yucca extract were separately added in kimchi, microbial growth was inhibited during storage period and their inhibition effects were enhanced at lower temperature.

Oral Health Literacy among Female Caregivers

The aim of this study was to investigate the association of female caregivers’ oral health literacy with their knowledge, behaviors, and the reported oral health status of their young children. Data on caregivers’ literacy, knowledge, behaviors, and children’s oral health status were used from structured interviews with 1158 caregiver/child dyads from a low-income population. Literacy was measured with REALD-30. Caregivers’ and children’s median ages were 25 yrs (range = 17-65) and 15 mos (range = 1-59), respectively. The mean literacy score was 15.8 (SD = 5.3; range = 1-30). Adjusted for age, education, and number of children, low literacy scores (< 13 REALD-30) were associated with decreased knowledge (OR = 1.86; 95% CI = 1.41, 2.45) and poorer reported oral health status (OR = 1.44; 95% CI = 1.02, 2.05). Lower caregiver literacy was associated with deleterious oral health behaviors, including nighttime bottle use and no daily brushing/cleaning. Caregiver oral health literacy has a multidimensional impact on reported oral health outcomes in infants and young children.

Early Feeding Practices and Severe Early Childhood Caries in Four-Year-Old Children from Southern Brazil: A Birth Cohort Study

The aim of this study was to investigate the relationship between feeding practices in the first year of life and the occurrence of severe early childhood caries (S-ECC) at 4 years of age. A birth cohort study (n = 500) was conducted in children who were born within the public health system in São Leopoldo, Brazil. Feeding practices were assessed using standardized methods at 6 and 12 months of age. A total of 340 children were examined at 4 years of age. S-ECC was defined as recommended by an expert panel for research purposes: ≧1 cavitated, missing or filled smooth surfaces in primary maxillary anterior teeth or d₁₊ mfs ≧5. Poisson regression with robust variance was used in order to determine the early feeding practices which represent risk factors for the occurrence of S-ECC at 4 years of age. The multivariable model showed a higher adjusted risk of S-ECC for the following dietary practices at 12 months: breastfeeding ≧7 times daily (RR = 1.97; 95% CI = 1.45–2.68), high density of sugar (RR = 1.43; 95% CI = 1.08–1.89), bottle use for liquids other than milk (RR = 1.41; 95% CI = 1.08–1.86), as well as number of meals and snacks >8 (RR = 1.42; 95% CI = 1.02–1.97). Mother’s education ≤8 years was also associated with the outcome. The present study identified early feeding practices which represent risk factors for caries severity in subsequent years. These findings may contribute to developing general and oral health interventions, with special attention to families with low maternal education.

Snacking Habits and Caries in Young Children

Dental caries is caused by a combination of infection and diet. This disease, if left untreated, may lead to pain, and impair the quality of life, nutritional status and development of young children. The objective was to investigate the association between snacking and caries in a population at high risk of dental caries. American preschool children (n = 1,206) were recruited in the offices of paediatricians. Data on sociodemographic characteristics, oral hygiene, breast-feeding, use of bottle and snacking were collected by questionnaire. Plaque presence, the number of teeth and their caries status (deft) were scored. The children sampled were 61% Black, 27% White and 10% Asian. Of the 1- to 2-, 2- to 3- and 3- to 4-year-old children, 93.8, 82.4 and 77.3% were caries free, and their mean caries scores were 0.16, 0.58 and 0.93, respectively. Multivariate partial least squares (PLS) modelling revealed plaque presence, lowest income, descriptors for tooth exposure time (number of teeth and age) and cariogenic challenge (total intake of sugar-containing snacks and chips/crisps, and chips intake with a sugar-containing drink) to be associated with more caries. These differences were also found in univariate analyses; in addition, children who continued breast-feeding after falling asleep had significantly higher deft values than those who did not. PLS modelling revealed that eating chips clustered with eating many sweet snacks, candies, popcorn and ice cream. We conclude that, in addition to the traditional risk indicators for caries – presence of plaque, sugar intake and socioeconomic status –, consumption of chips was associated with caries in young children.

Office-Based Intervention to Reduce Bottle Use Among Toddlers: TARGet Kids! Pragmatic, Randomized Trial

The goal was to determine whether an office-based, educational intervention for parents of 9-month-old children could reduce bottle use and iron depletion at 2 years of age. Between January 2006 and 2007, 251 healthy, 9-month-old infants attending a routine health maintenance visit were assigned randomly to intervention or control groups. Parents in the intervention group were introduced to a 1-week protocol to wean their children from the bottle. Iron depletion (ferritin levels of <10 microg/L) and bottle use at 2 years were assessed. A total of 201 children were monitored to 2 years of age (follow-up rate: 81%). Rates of iron depletion (10 [10%] of 102 children vs 13 [13%] of 99 children; P = .42) and milk consumption of >16 oz (16 [16%] of 102 children vs 17 [17%] of 99 children; P = .7) were not significantly different between the 2 groups at 2 years of age. However, children in the intervention group started using a cup 3 months earlier (9 vs 12 months; P = .001), were weaned from the bottle 4 months earlier (12 vs 16 months; P = .004), and were more than one-half as likely to be using a bottle at 2 years of age (15 [15%] of 102 children vs 39 [40%] of 99 children; P = .0004). This simple intervention administered during a health maintenance visit did not result in a decrease in iron depletion at 2 years of age but did result in a 60% reduction in prolonged bottle use.

Disposal of human milk donated to a human milk bank before and after measures to reduce the amount of milk unsuitable for consumption

To evaluate the causes of disposal of donated human milk and the impact of the measures taken to reduce the amount of milk unsuitable for consumption. A quasi-experimental, observational, comparative study was conducted with different populations of external donors in 2006 and 2008. In 2006, a simple form was used to record the criteria for disposal of the donated milk. We also interviewed the donors to find the reason of changes in the milk. In 2008, a checklist containing comprehensive guidance for milk collection and pre-storage was handed out to the donors. Next, we continued to survey the disposal criteria after the intervention using the same form administered in 2006. A case was defined as all bottles of milk of the same donor discarded per day. Data were analyzed by calculations based on comparison of proportions for 2006 and 2008. Twenty-four percent of the milk collected was discarded in 2006, while in 2008 only 10.5% of the milk was discarded. There was significant reduction in the disposal of milk for the items: cigarette odor; forgetting the milk outside the refrigerator, inside it or on its door; problems with the freezer; frequent opening of the refrigerator and freezer; expiration date; and unidentified cases. However, there was a significant increase in milk disposal for first milk collection without guidance; use of inappropriate bottle; milk transportation from work to home; and indirect guidance. The use of the step-by-step checklist had a positive impact on the reduction of the volume of donated milk discarded and changed the frequency of the causes of disposal, eliminating some of these causes.

Infectious Diseases in the Athlete: An Overview

In the USA, organized sports include not only professional athletes, but also high school students, collegians, and a large but imprecise number of persons participating in community-based leagues and other recreational programs. Infectious diseases represent a significant problem in all competitive sports. While not considered as serious a problem as concussions or frequent musculoskeletal injuries, infectious diseases account for significant loss of playing time and have been associated with outbreaks among teams. 1 The physician must not only treat the individual athlete, but also take the necessary precautions to contain the spread of communicable diseases to other team members, coaches, trainers, and other staff and relatives. Groups of athletes are often at an increased risk of transmission because they are confined to close quarters with teammates in the locker room, at practice, through dormitory living, and during travel. Given the athlete’s expectation to return to play as soon as possible, accurate diagnosis and aggressive treatment of illnesses are essential. Participation and return to play decisions are determined by the nature of the infection, the risk of transmission, and the demand placed on the athlete during practice and competitions. Infectious diseases can occur via person-person transmission such as in the case of herpes gladiatorum in wrestlers 2 or methicillin-resistant Staphylococcus aureus skin infections where skin to skin contact and/or shared personal items (common source) are implicated 3-5 or via a common source transmission as in the case of an enteroviral meningitis outbreak associated with shared use of water bottles 6 or a norovirus outbreak from a common food source (tainted turkey sandwiches from a catered box lunch), which infected a college football team, who then subsequently infected the opposing team via person to person contact. 7 The risk of transmission of blood-borne pathogens (hepatitis B and C or human immunodeficiency virus (HIV)) during sporting events from bleeding wounds or exudative skin lesion of an infected athlete

Urban Mexican‐American mothers’ beliefs about caries etiology in children

Caries is a severe condition which disproportionately affects Latino children in the US. This study sought contextual understanding of urban, low-income Mexican-American mothers' beliefs, perceptions, knowledge and behavior surrounding causes of caries. In urban San José, CA, a qualitative study was conducted with a convenience sample of Mexican-American mothers of young children about their beliefs and knowledge about the causes of caries. Audio-taped in-depth interviews with open-ended questions, primarily in Spanish, were translated to English and then transcribed verbatim. Texts were independently read and thematically analyzed by two researchers. Even while expressing uncertainty, all 48 mothers mentioned specific causes of caries, most frequently citing candy or juice consumption (85%), poor oral hygiene (65%) and use of the bottle (52%). Mothers rarely recognized cariogenic foods beyond candy, did not know or perform recommended oral hygiene routines, and demonstrated confusion and uncertainty about exactly how baby bottles are detrimental to teeth. Nearly half of these mothers also mentioned secondary cavity causes, such as genetics, lack of calcium, not going to the dentist or lack of fluoride. Mothers did not mention the role of bacteria. While mothers recognized that oral hygiene can counteract the detrimental effects of candy consumption, they did not recognize its beneficial effects in other contexts. Nor did they know about other preventive activities. Mothers recognized the three major important factors causing caries: sugar consumption, poor oral hygiene and bottle use. However, their knowledge is limited in depth and specificity which restricts development of caries prevention behaviors. More comprehensive education is needed, including about caries prevention (oral hygiene) behaviors, which could lead to an increased sense of self-efficacy with respect to their children's oral health.