Parental influence on children's oral health-related behavior

OBJECTIVE: The aim of this study was to determine whether there are differences between oral health-related knowledge, attitudes, beliefs and behaviors of children and their parents, and to identify the family-related factors associated with children's poor or good oral health-related behavior. MATERIAL AND METHODS: The data were gathered by means of questionnaires from 11-12-year-old schoolchildren and their parents who replied without having knowledge of the answers of the others. Differences between subgroups of children were analyzed by cross-tabulation, and the factors related to children's good or poor oral health-related behavior by logistic regression analyses. RESULTS: Parents of children who reported good oral health-related behavior had better knowledge and more favorable behaviors than those of other parents. Predictors for a child's poor oral health-related behavior were the child's poor knowledge, male gender, the parent's frequent consumption of sweets, and the parent's infrequent use of xylitol gum. When a less strict threshold for the child's poor oral health-related behavior was used, more predictors entered the model: the parent's unfavorable use of fluoride toothpaste; among girls, the parent's lack of knowledge; and among children whose mother's occupation level was high, the parent's infrequent use of xylitol gum. The parents of children whose oral health behavior was favorable were more likely to have a high level occupation and favorable oral health-related behaviors. CONCLUSIONS: Oral health-related knowledge of children and their parents seems to be associated with children's oral health-related behavior. Parents' behaviors, but not attitudes, were associated with children's oral health behavior.     

Caregivers' oral health literacy and their young children's oral health-related quality-of-life

Abstract

Objectives: To investigate the association of caregivers' oral health literacy (OHL) with their children's oral health related-quality of life (C-OHRQoL) and explore literacy as a modifier in the association between children's oral health status (COHS) and C-OHRQoL. Methods. This study relied upon data from structured interviews with 203 caregivers of children aged 3–5 from the Carolina Oral Health Literacy (COHL) Project. Data were collected for OHL using REALD-30, caregiver-reported COHS using the NHANES-item and C-OHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS). This study also measured oral health behaviors (OHBs) and socio-demographic characteristics and calculated overall/stratified summary estimates for OHL and C-OHRQoL. Spearman's rho and 95% confidence intervals (CI) were computed as measures of correlation of OHL and COHS with C-OHRQoL. To determine whether OHL modified the association between COHS and C-OHRQoL, this study compared literacy-specific summary and regression estimates. Results. Reported COHS was: excellent—50%, very good—28%, good—14%, fair—6%, poor—2%. The aggregate C-OHRQoL mean score was 2.0 (95% CI: 1.4, 2.6), and the mean OHL score 15.9 (95% CI: 15.2, 16.7). There was an inverse relationship between COHS and C-OHRQoL: ρ = ?0.32 (95% CI: ?0.45, ?0.18). There was no important association between OHL and C-OHRQoL; however, deleterious OHBs were associated with worse C-OHRQoL. Literacy-specific linear and Poisson regression estimates of the association between COHS and C-OHRQoL departed from homogeneity (Wald χ ² p < 0.2). Conclusion: In this community-based sample of caregiver/child dyads, a strong correlation was found between OHS and C-OHRQoL. The association's magnitude and gradient were less pronounced among caregivers with low literacy.     

Changes in children's oral health-related behavior, knowledge and attitudes during a 3.4-yr randomized clinical trial and oral health-promotion program

The aim of our study was to compare the changes in children's oral health-related behavior, knowledge, and attitudes obtained using an oral health-promotion approach, a risk-strategy and promotion approach, and reference area, and to report changes in the behavior of children between the experimental and the control groups of a randomized clinical trial (RCT). The study population consisted of all fifth and sixth graders who started the 2001–2002 school year in Pori, Finland ( n  = 1,691), where the RCT and program of oral health promotion were implemented for 3.4 yr. Children with at least one active caries lesion were randomly assigned to experimental ( n  = 250) and control ( n  = 247) groups. Children in Rauma ( n  = 807) acted as the reference. Changes in children's self-reported behavior, knowledge, and attitudes were compared between groups. The subjects in the oral health-promotion group and in the risk-strategy and promotion group in Pori tended to show greater improvement in most of their oral health-related behaviors than those in the reference group, and children in the RCT experimental group showed greater improvement in most of their oral health-related behaviors than those in the RCT control group. Children can be helped to improve their oral health-related behavior by intervention, including oral hygiene and dietary counseling, or by implementing a multilevel-approach oral health-promotion program.     

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目的了解济南市小学生家长对口腔保健知识的认知程度,为济南市儿童口腔保健预防工作提供基线资料。方法 2009年1—5月对济南市10所小学2860名学生家长进行问卷调查,所得数据采用SPSS软件统计分析。结果家长对各种口腔保健知识的认知水平不同,在所调查的问题中,对刷牙的作用、频繁进食甜食饮料等易致龋坏等知识认知水平非常高,对六龄牙的重要性的认识也处于较高水平,但对于氟化物、窝沟封闭防龋、乳牙龋坏应及时治疗及咬合诱导知识等认知明显偏低,相关知识知晓率差异有统计学意义(P<0.05)。随家长文化水平及经济收入的提高,家长对部分口腔保健知识的掌握有明显提高(P<0.05)。不同年龄家长对部分口腔保健知识的掌握有明显差异(P<0.05)。结论济南市儿童家长口腔保健知识认知水平存在明显差异,部分家长口腔保健知识缺乏,保健意识不强,应加强针对性的口腔宣传与教育工作。     

口腔健康教育对泰州市城区小学生口腔卫生知识和口腔健康行为改变的影响

目的了解口腔健康教育对小学生口腔卫生知识和行为习惯的影响,为开展口腔疾病预防和制定学校口腔卫生工作政策提供依据。方法采用随机整群抽样方法,抽取泰州市海陵区6所小学2～3年级4 000名学生进行3个月的口腔健康教育,并在教育前后分别进行问卷调查,比较口腔卫生知识和行为习惯的变化。结果口腔健康教育后小学生的口腔健康基本知识、对窝沟封闭的认识、口腔健康行为的改变等17项内容均高于教育前,差异均有统计学意义(P<0.01)。结论泰州市小学生口腔健康教育应有计划、长期进行。     

儿童乳牙患龋状况及其家庭口腔健康行为的差异

目的研究家庭口腔健康行为对辽宁省城乡儿童乳牙患龋状况的影响。方法采用多阶段、分层、等容量、随机抽样的方法,运用世界卫生组织《口腔健康调查基本方法》诊断标准对辽宁省城乡792名5岁儿童进行乳牙龋病检查,并随机抽取50%受检者的家长进行问卷调查。结果1）辽宁省5岁儿童乳牙患龋率为73.86%,龋均（dmft）为4.38;其中城市儿童乳牙患龋率为64.14%,农村儿童乳牙患龋率为83.59%,城乡之间儿童乳牙患龋率具有统计学差异（P<0.01）。2）口腔健康行为分析表明,农村儿童进食糖果、巧克力、糖水、碳酸饮料、果汁等的频率高于城市。城市儿童开始刷牙时间、频率、用含氟牙膏的比例均高于农村。城市家长普遍学历高,收入多,儿童定期检查和采取预防措施的人数高于农村。结论辽宁省,尤其是农村地区应加强对家庭口腔健康行为的教育。     

河北省宣化地区6岁儿童家长口腔基本保健知识认知情况现状调查

目的　通过了解6岁儿童家长口腔基本保健知识认知情况,为儿童临床口腔工作提供理论依据。方法　以本地区4所幼儿园的500名6岁儿童家长为研究对象,采用自行设计的调查问卷,以不记名方式了解其对口腔基本保健知识的掌握情况。结果　500名被调查对象中在首次就诊原因,监督孩子刷牙及选择专业儿童牙医方面不同学历家长之间存在明显差异（P<0.05）,大专以上学历家长知识知晓率高于大专以下学历家长;其余调查项目均无统计学差异。结论　宣化地区6岁儿童家长口腔基本保健知识较缺乏,专业儿童口腔医生在临床工作中应加强儿童口腔卫生防治工作。     

广西12岁儿童口腔健康行为抽样调查报告

目的 了解广西12岁儿童口腔健康行为、口腔卫生服务利用等情况。方法 采用多阶段分层等容量随机抽样的方法 抽取429名广西壮族自治区12岁城乡常住儿童进行集体自答式问卷调查。结果 广西93.71%(402/429)12岁学生每天刷牙,其中仅32.17%(138人)每天刷牙2次以上,城市刷牙情况好于农村(P<0.001)。调查前12个月口腔科就诊率为16.55%(71人),51.52%(221人)学生从没看过牙。口腔科就诊的主要原因是急、慢性牙疼。结论 广西大部分12岁儿童口腔健康行为仍较差,未能充分利用现有的口腔卫生资源,口腔健康教育有待加强。?     

口腔健康行为的影响因素

个体的口腔健康行为直接影响到个体的口腔健康状况。而个体的口腔健康行为受个体因素、家庭因素和社会因素等的影响。口腔健康教育和口腔健康促进就是通过改善人群的口腔健康行为,达到改善人群的口腔健康状况的根本目的。所以,只有深刻认识口腔健康行为的各种影响因素,才能为更好地实施口腔健康教育和口腔健康促进提供依据。本文对口腔健康行为的影响因素作一综述。     

Influence of children's oral health-related quality of life on school performance and school absenteeism

Objective: This study assessed the relation of child oral health‐related quality of life with school performance and school absenteeism. Methods: We followed a cross‐sectional design with a multistage random sample of 312 12‐year‐old schoolchildren living in Brazil. The participants completed the child perceptions questionnaire (CPQ_11–14) that provides information about psychological factors, while their parents or guardians answered questions on their socioeconomic status measured by parents' education level and household income. A dental examination of each child provided information on the prevalence of caries and dental trauma. Data on school performance, which included the results of baseline Brazilian language (Portuguese) tests, and school absenteeism (school days missed) were obtained from the school register. Multilevel linear regression was used to investigate the association among psychological and socioeconomic status and children's school performance. Results: In the multiple model, after adjusting for individual covariates, being a girl was associated with higher school performance (P < 0.05), whereas low household income (P < 0.05), higher mean of CPQ_11–14 (P < 0.05), and higher school days missed (P < 0.001) were identified as individual determinants of lower school performance. When the school‐level covariates were included in the model, the association between subjects' level characteristics and school performance still persisted. Conclusion: Children's school performance and absence were influenced by psychological and socioeconomic conditions.     

3～6岁儿童家长口腔保健知识的门诊调查

目的 调查儿童口腔门诊3～6岁儿童家长口腔保健知识的认知情况与需求,以期有针对性地对儿童口腔疾病的教育指导提供基础资料。方法 于南京医科大学附属口腔医院儿童口腔科门诊对3～6岁初次就诊的200名儿童的家长进行口腔保健知识的认知与需求问卷调查。结果 参与本调查的家长口腔保健知识总得分为8.152±1.807分。分析结果发现受检家长的年龄、文化程度及与儿童亲属关系和口腔保健知识的得分有密切关系。参与调查的家长对口腔保健知识需求的内容主要是窝沟封闭的相关知识与氟化物的使用等,获取知识的主要途径是医疗机构发放或微信接收宣传资料。结论 3～6岁儿童家长的口腔保健知识有待提高,应丰富口腔健康宣教的内容与形式,并且针对性地开展口腔健康宣教。     

上海市5岁本地和外来儿童患龋状况和口腔健康行为的调查

目的分析上海市5岁本地和外来儿童患龋状况和口腔健康行为的差异,为设计口腔卫生服务项目和相关政策制订提供信息支持。方法采用分层等容量随机抽样方法,调查上海市共575名5岁儿童口腔健康状况,并对家长进行相关问卷调查。结果 5岁乳牙患龋率为65.74%,龋均为3.35,本地儿童明显低于外来儿童(P<0.05)。5岁儿童龋失补充填构成比为12.57%,本地和外来儿童有显著差异(P<0.01)。外来儿童睡前进食甜食的比例高于本地儿童(P<0.05)。外来儿童每天刷牙2次及以上的仅占19.44%,明显低于本地儿童(P<0.01)。从没看过牙的外来儿童比例比本地儿童更高(P<0.01)。结论上海外来儿童患龋状况和口腔健康行为均比本地儿童差,未来需加强对外来儿童的口腔保健力度,有针对性地采取防治措施及健康教育,提高儿童口腔健康整体水平。     

Gender differences in child-related and parent-related determinants of oral health-related lifestyle among 11- to 12-year-old Finnish schoolchildren

Objective. The aim of this study was to ascertain whether child-related and parent-related characteristics were associated differently with oral health-related lifestyle among boys and girls. Material and methods. The study population consisted of 5th and 6th graders and their parents in Pori, Finland. There were 1691 children ranging in age between 11 and 12 years. The data were gathered by questionnaires. For the analyses, we grouped children and parents within three lifestyle groups: favorable, moderate and poor. Differences in child-related and/or parent-related characteristics between boys and girls were analyzed with logistic regression analyses; those with a favorable lifestyle comprised the healthy lifestyle group, and those with a moderate or poor lifestyle the unhealthy lifestyle group. Results. Oral health-related lifestyle was healthy more often among girls than among boys. In both genders, those who considered toothbrushing important for pleasing authorities more often had a healthy lifestyle. Girls who considered toothbrushing important for health and appearance were more likely to have a healthy lifestyle than those who did not. The effect of parents’ oral health-related lifestyle was slightly stronger among boys than among girls. Among girls, however, high occupational level of father was indicative of healthy lifestyle. Conclusions. Among girls and boys, there are similarities and differences in factors related to oral health-related lifestyle. The parents’ model is important for both, but the effect is stronger among boys than among girls. Among girls, attitudes on health and appearance are positively associated with a health-related lifestyle.     

The influence of dental attendance on change in oral health-related quality of life

Crocombe LA, Brennan DS, Slade GD. The influence of dental attendance on change in oral health–related quality of life. Community Dent Oral Epidemiol 2012; 40: 53–63. © 2011 John Wiley & Sons A/S Abstract – Background: Few longitudinal studies have investigated the association between dental attendance and oral health–related quality of life (OHRQoL). These studies were limited to older adults, or to study participants with an oral disadvantage and did not assess if dental attendance had a different effect on OHRQoL for different people. Objective: This project was designed to test whether routine dental attendance improved the OHRQoL of survey participants and whether any patient factors influenced the effect of dental attendance on change in OHRQoL. Methods: Collection instruments of a service use log book and a 12 month follow‐up mail self‐complete questionnaire were added to the Tasmanian component of the National Survey of Adult Oral Health 2004/06. The dependent variable was change in OHIP‐14 severity and the independent variable was dental attendance. Many putative confounders/effect modifiers were analysed in bivariate, stratified and three‐model multivariate analyses. These included indicators of treatment need, sociodemographic characteristics, socioeconomic status, pattern of dental attendance and access to dental care. Results: None of the putative confounders were associated with both dental attendance and the change in mean OHIP‐14 severity. The only statistically significant interaction for change in OHIP‐14 severity was observed for dental attendance by residential location (P < 0.01). In multivariate analysis, there was a statistically significant association of dental attendance with change in mean OHIP‐14 severity. It also showed that the difference in association of attendance between Hobart, the capital city of Tasmania, and other places was statistically significant based on the interaction between residential location and attendance (P < 0.05). Conclusion: The effect of dental attendance on OHRQoL was influenced by a patient's residential location.     

Measuring parental perceptions of child oral health-related quality of life

OBJECTIVES: The aim of this study was to develop and evaluate the P-CPQ, a measure of parental/caregiver perceptions of the oral health-related quality of life of children. This forms one component of the Child Oral Health Quality of Life Questionnaire (COHQOL). METHODS: An item pool was developed through a review of existing child health questionnaires and interviews with parents/caregivers of children with pedodontic, orthodontic, and orofacial conditions. The resulting 47 items were used in a study in which 208 parents/caregivers provided data on their frequency and importance. The 31 items rated the most frequent and important were selected for the final questionnaire (P-CPQ). The P-CPQ validity and reliability were assessed by a new sample of 231 parents, 79 of whom completed two copies for the assessment of test-retest reliability. RESULTS: The P-CPQ discriminated among the three clinical groups included in the expected direction. Within-group analyses using clinical data provided some evidence that scores were associated with the severity of the condition. The P-CPQ also showed good construct validity. It had excellent internal consistency reliability with a Cronbach's alpha of 0.94 and demonstrated perfect test-retest reliability (ICC=0.85). CONCLUSION: The study provides data to indicate that the P-CPQ is valid and reliable.     

上海市残障儿童及家长口腔健康知、信、行调查分析

目的: 调查分析上海市残障儿童口腔健康行为及家长的口腔健康知识、态度,为设计针对残障儿童的口腔公共卫生服务项目和制订有关政策提供依据。方法: 采用分层整群抽样方法,对上海市1 381名残障儿童家长进行相关问卷调查。数据采用SPSS 21.0软件包进行处理。结果: 残障儿童家长口腔健康知识知晓率为67.21%,78.98%的残障儿童家长对口腔健康持积极态度。13.61%的残障儿童经常在睡前吃甜食,只有45.98%的残障儿童每天刷牙2次及以上,42.65%的残障儿童使用含氟牙膏,88.12%的残障儿童从未使用过牙线,49.75%的残障儿童从未看过牙。结论: 上海市残障儿童口腔健康行为有待改善,家长口腔健康知识水平较低,应对家长开展个性化口腔健康教育,并加强郊区口腔健康宣教工作。