Will the role of family influence dental caries among seven-year-old children?

The present study analyzed the prevalence of dental caries as well as associations of dental health and family competence among 7-year-old children and their families. Dental caries status was the outcome variable of the 7-year prospective follow-up study. Pre-tested questionnaires were used to gather data individually from the parents at six points in time (at the public maternity health-care clinic during the mother's pregnancy and at childbirth, at the well-baby clinic at 18 months, and at ages 3, 5, and 7 years). Clinical examinations at dental health-care clinics were used to record dental status indicators of the child at ages 3, 5, and 7 years. A child had caries more often when the mother did not regard it as important to teach a healthy lifestyle right from birth; when the mother undervalued consistent action in child-rearing; when the father preferred merely to explain the causes and consequences during child-rearing (giving no examples); when the father had several new carious teeth per year; when the child consumed sweets several times a week; or when the child's toothbrushing was infrequent. The child's daily dental health behaviors and a strong influence of family competence emerged in the final logistic regression analysis. Dental and well-baby clinic staff members need to discuss consistency in child-rearing with the parents and there is a need for modeling adult dental health behaviors at the time of the mother's pregnancy if the child's future preventive dental health is to function properly.     

The potential role of breast-feeding and other factors in helping to reduce early childhood caries

Objectives: Dental caries is the most common chronic disease in US children. Early childhood caries (ECC) is particularly virulent and can interfere with a child's ability to eat, grow, speak, and communicate. Studies on whether breast‐feeding or bottle‐feeding are more likely to reduce ECC have proven inconclusive. Methods: The study population included 175 children, aged 1 to 5, receiving dental care at the Hughes Spalding Children's Hospital in Atlanta, GA. Participation included a dental exam, chart data abstraction, and a personal interview with the mother. Results : Too few exclusively breast‐fed children prevented the adequate study of breast‐feeding. However, children exclusively bottle‐fed for at least 1.5 years had more decayed or filled tooth surfaces than children breast‐fed part of that time but well short of a year. No bottle at night nor juice at irregular times, the mother's brushing of her child's teeth, and adequate dental care in the mother seemed to reduce ECC. Conclusions : Our results suggest measures that might reduce ECC risk. Medical providers must discuss oral health with new mothers and educate them on the important role they play in keeping their babies' teeth healthy.     

Oral health of young children in Mississippi Delta child care centers: a second look at early childhood caries risk assessment

Objectives: To identify the predictors of early childhood caries and urgent dental treatment need among primarily African‐American children in child care centers in the Delta region of Mississippi. The purpose of this study was to replicate predictors of caries and urgent dental treatment needs that were identified in an earlier study conducted in Delta child care centers and to assess additional caries risk factors not collected in the original study. Methods: Children in 19 child care centers were examined by the dentists, and the parents provided data on oral health practices, oral health history, and on children's oral health‐related quality of life (QOL). The dentists also assessed visible plaque and tested levels of mutans streptococci. Predictors of caries and treatment need among children 24 to 71 months of age were examined using logistic regression. Results: Two parent predictors of caries identified in the earlier study (parent flossing and soft/sugary drink consumption) were not predictive in the current study. Parent history of abscess continued to predict their child's urgent need for treatment. Young children's level of salivary mutans streptococci, maxillary incisor visible plaque, and parents' reports of child oral health‐related QOL measures predicted the presence of both caries and urgent treatment need. Some expected predictors, such as frequency of child's toothbrushing, were not predictive of caries. Conclusions: Parental abscess and parent's report of the child's oral health‐related QOL are risk indicators for poor oral health outcomes that could be used by nondental personnel to identify young children in need of early preventive intervention and dental referral.     

Family characteristics and caries experience in preschool children. A longitudinal study from pregnancy to 5 years of age

Wigen TI, Espelid I, Skaare AB, Wang NJ. Family characteristics and caries experience in preschool children. A longitudinal study from pregnancy to 5 years of age. Community Dent Oral Epidemiol 2011; 39: 311–317. © 2010 John Wiley & Sons A/S Abstract – Objective: The purpose of the study was to explore associations between family status, family income, family size, mother’s age at child birth, mother’s education and parents’ national background and caries experience in 5‐year‐old children. Method: This study is based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and the Public Dental Services. A total of 1348 children were followed from pregnancy to the age of 5 years. Questionnaires were completed by mothers twice during pregnancy and when the children were 3 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. Results: Caries experience in the 5‐year‐old children was low; 89% had no caries experience (d_3–5 mft = 0). In multiple logistic regression having one or both parents of non‐western origin (OR 3.4, CI 1.6–7.3), having had a change in family status from pregnancy to 5 years of age (OR 2.0, CI 1.1–3.4) and having mother with low education (OR 1.9, CI 1.3–2.8) were statistically significant risk indicators for having caries experience at the age of five. Conclusion: Family characteristics in pregnancy and early life were associated with caries experience in 5‐year‐old children. Primary care personnel meeting young children with one or several of these characteristics should consider referring the child to dental personnel to enable early initiation of health‐promoting activities.     

Dental fear and oral health and family characteristics of Finnish children

Objectives: Our aim was to describe the occurrence of dental fear among Finnish children of different ages and to ascertain how oral health and family characteristics are associated with dental fear. Methods: The subject groups were aged 3, 6, 9, 12, and 15 years in two middle‐sized cities, and the 1474 participants were distributed over fairly equal samples of each age. A questionnaire given to each child to be filled out at home enquired about social background, oral hygiene habits, diet, and dental fear. Oral health status was examined clinically and radiographically by two calibrated dentists. Multiple logistic regression analyses were performed for each age group in order to study the associations between dental fear and selected factors. Results: Dental fear was higher among 12‐ and 15‐year‐old children than among the younger ones. Pain, drilling, and local anesthesia were reported to be the most frightening aspects. Excluding the 12‐year‐olds, children whose family members reported dental fear were more likely to report dental fear than children whose family members did not report dental fear. Six‐ and 12‐year‐olds who had experienced caries were more likely to report dental fear than were caries‐free children. Among 6‐year‐olds, father's education modified the effect of a child's caries experience on child dental fear. Frequent intake of sugary items and a limit on eating candies to only one day per week were associated with higher dental fear. Conclusions: Fear of dental treatment is still fairly common among Finnish children, and the factors associated with it differ with the age of the child.     

Validity of single-item parental ratings of child oral health

Objective. The aim of this study was to assess the validity of single-item parental ratings of child oral heath. Methods. Data were collected during a study to assess the impacts of dental injury. Clinical examinations of children aged 11–14 years were undertaken that included measures of trauma, decay, treatment needs, and fluorosis. Children with trauma and a group of trauma-free children were followed-up. Parents were mailed a questionnaire along with a questionnaire for the child that contained a short form of the Child Perceptions Questionnaire 11–14 (CPQ11–14). Bivariate analyses examined associations between parents’ ratings of their child's oral health, measures of dental disease, clinically defined treatment needs, and scores on the CPQ11–14. Logistic regression was used to see if the associations observed remained after controlling for access to dental care variables. Results. Complete data were collected from 370 children and their parents. Parental ratings showed significant associations with most of the clinical indicators used and CPQ11–14 scores. Similar results were obtained when the data were analysed for subgroups defined by household income and mother's education. These associations remained after controlling for access to dental services. Conclusion. The data suggest that single-item parental ratings of child oral health have adequate construct validity.     

Dental health behavior in fathers of young families in Finland

The purpose of this study was to examine dental health behavior in young fathers by means of a questionnaire for subjective evaluation of dental status, frequency of caries and visits to the dentist. Cariogenic diet was estimated by the consumption of sweets, confectionery and soft drinks. The participation rate 18 months after the birth of the family's first child was 73.1%. The mean age of the respondents was 28.1 yr (range 17–49; SD 4.6). When background factors were considered, it was observed that cariogenic diet was more often mentioned by participants from the lower social groups. The standard of the wife's knowledge level was an important indicator of dental care behavior in the fathers. If the wife's knowledge level was high, the father assessed the future condition of his child's teeth as good.     

Parental anxiety as a possible predisposing factor to child dental anxiety in patients seen in a suburban dental hospital in Nigeria

Summary. Introduction. The aim of this study was to determine the relationship between parents’ anxiety level and that of the child patient. Methods. The Short Form of the Dental Anxiety Survey Schedule was administered to 81 children who were attending the dental clinic for the first time. The Dental Anxiety Scale was also used to collect relevant information from the parents. Results. There was no statistically significant correlation between the anxiety level of the mother (r = ?0·02, P = 0·82) or the father (r = ?0·59, P = 0·62) and that of their child. However, bivariate analysis showed a closer association between the anxiety levels of the mother and the child (P = 0·055) compared to that between the father and the child (P = 0·475) although this was again found not to be statistically significant. Conclusion. Assessment and management of the anxiety level of the mother may be needed in some cases, both to manage the child effectively and to break the cycle of dental care anxiety in families.     

Longitudinal study of dental health behaviors and other caries predictors in early childhood

This longitudinal study of 231 preschoolchildren from a medium sized Norwegian town had three aims: firstly, to examine the children's early dental behavior, secondly to study the variation of dental health behavior according to mother's education, mother's dental health, and her dental attendance pattern, and thirdly to identify any behavioral or social predictors of dental caries in 36-month-old children. Data were collected at health centers, using precoded questionnaires and examinations, when the children were 6, 18, and 36 months old. Data about the mothers were collected at the maternity ward. At 36 months of age, 80% of the children were caries free. Favorable dental behaviors were related to toothbrushing and use of fluorides. These behaviors were so well established and consistent at all ages that they can be regarded as norms for this community. The most unfavorable and inconsistent behavior was related to sugar consumption. Dental health education could be most usefully applied to this area, where the greatest potential for improvement in behavior exists. A relationship was found between the children's caries experience and the number of missing teeth of the mother, her dental attendance pattern and her level of education. None of the social or behavioral variables tested had a strong enough association with caries experience to justify their use as caries predictors in this age group.     

Oral health status of children seen at a paediatric neurology clinic in a tertiary hospital in Nigeria

The study was carried out to determine oral health status and oral health needs of children presenting at the paediatric neurology clinic of the University College Hospital, Ibadan, Nigeria. Diagnosis of each child's disability was performed by the Consultant Paediatric Neurologist. Data on socio-demographic characteristics and previous history of trauma to the orofacial structures for each child were obtained and intraoral examinations were done using WHO guide lines. Sixty-one children were diagnosed within the period of study and highest proportion (44.3%) had epilepsy while 41.0% had cerebral palsy. Prevalence of dental caries and trauma were 11.5% and 39.3% respectively while 72.1% had good oral hygiene. Despite the relatively good oral health of the children under study, periodic dental recall appointments will be beneficial in order to supervise and evaluate oral health when early detection and prevention of lesions can be instituted.     

CHANGES IN PARENTAL SATISFACTION AND ORAL HEALTH-RELATED QUALITY OF LIFE OF PRESCHOOL CHILDREN AFTER RECEIVING ATRAUMATIC RESTORATIVE TREATMENT WITH OR WITHOUT PRIOR SILVER DIAMINE FLUORIDE APPLICATION

ObjectiveTo investigate the short-term and long-term changes in parental satisfaction and oral health-related quality of life (OHRQoL) of preschool children after receiving atraumatic restorative treatment (ART) with or without prior silver diamine fluoride (SDF) application.MethodsIn a randomized controlled trial, preschool children with cavitated dentine caries lesions in their primary teeth were randomly assigned into two groups to receive either application of SDF solution or placebo (tonic water) on the caries lesions 10 weeks before receiving ART restorations. The information on parental satisfaction and OHRQoL of the children were collected through self-completed questionnaires at baseline, the 6-month and the 24-month follow-up. A five-point scale, from 1 (very dissatisfied) to 5 (very satisfied), was used by parents to indicate their satisfaction with their child's dental conditions. A higher parental satisfaction score indicates that parents were more satisfied with their child's dental condition. In addition, the Chinese version of Early Childhood Oral Health Impact Scale (ECOHIS) was adopted to assess the children's OHRQoL, and a higher ECOHIS score indicates greater negative impacts of oral health on the child's OHRQoL.ResultsA total of 194 children participated in this study, with 101 and 93 children receiving SDF and placebo application before ART restorations, respectively. After placement of ART restorations, at 6-month and 24-month follow-up, parental satisfaction scores with their child's dental health status were significantly higher compared with those at baseline (P <.001) indicating the parents were more satisfied at follow-ups. Regarding OHRQoL, no statistically significant changes were found in the child impact section (CIS), family impact section (FIS) and total ECOHIS scores in both study groups at the 6-month follow-up. In contrast, at the 24-month follow-up, the CIS (P = .025) and total ECOHIS scores (P = .015) of the children in the control group were significantly higher than those at baseline (greater negative impacts), but not the FIS score.ConclusionIn this study, after one-off placement of ART restorations irrespective of prior SDF application, short-term and long-term parental satisfaction with their child's dental health status was improved, but not the children's OHRQoL.     

Food insecurity and dental caries in schoolchildren: a cross‐sectional survey in the western Brazilian Amazon

We analyzed the association between food insecurity and dental caries in 7‐ to 9‐yr‐old schoolchildren. We performed a cross‐sectional survey nested in a population‐based cohort study of 203 schoolchildren. The participants lived in the urban area of a small town within the western Brazilian Amazon. Dental examinations were performed according to criteria recommended by the World Health Organization. The number of decayed deciduous and permanent teeth as a count variable was the outcome measure. Socio–economic status, food security, behavioral variables, and child nutritional status, measured by Z‐score for body mass index (BMI), were investigated, and robust Poisson regression models were used. The results showed a mean (SD) of 3.63 (3.26) teeth affected by untreated caries. Approximately 80% of schoolchildren had at least one untreated decayed tooth, and nearly 60% lived in food‐insecure households. Sex, household wealth index, mother's education level, and food‐insecurity scores were associated with dental caries in the crude analysis. Dental caries was 1.5 times more likely to be associated with high food‐insecurity scores after adjusting for socio–economic status and sex. A significant dose–response relationship was observed. In conclusion, food insecurity is highly associated with dental caries in 7‐ to 9‐yr‐old children and may be seen as a risk factor. These findings suggest that food‐security policies could reduce dental caries.     

Assessing the relationship between children's oral health status and that of their mothers

BackgroundThe authors conducted a study to describe the relationship between the oral health of young children and that of their mothers.MethodsUsing data from the Third National Health and Nutrition Examination Survey and a related birth certificate–linked file, the authors compiled a sample of 1,184 mother/child pairs for children aged 2 through 6 years. The authors performed logistic and cumulative logistic regression analyses by using children's caries experience and untreated caries status as dependent variables. They evaluated the mothers' untreated caries status and tooth loss status along with other covariates, including age, race/ethnicity and poverty status.ResultsChildren of mothers who had high levels of untreated caries were more than three times as likely (odds ratio [OR], 3.5; 95 percent confidence interval [CI], 2.0–6.2) to have higher levels of caries experience (treated or untreated dental caries) compared with children whose mothers had no untreated caries. A similar relationship was observed between mothers' tooth loss and caries experience among their children. The children of mothers with high levels of tooth loss were more than three times as likely (OR, 3.3; 95 percent CI, 1.8–6.4) to have higher levels of caries experience compared with children of mothers with no tooth loss; for mothers with moderate tooth loss, the OR was 2.3 (95 percent CI, 1.5–3.5).ConclusionsMothers' oral health status is a strong predictor of the oral health status of their children.Practice ImplicationsPreventive plans for children should be based on a caries risk assessment. The results of this study demonstrate that basic information obtained from the child's mother regarding her oral health status is valuable in helping the dentist determine the child's caries risk.     

Characteristics of African‐American Male Caregivers in a Study of Oral Health in Detroit – A Brief Communication1

Objective: The role of fathers among African‐American men, particularly related to oral health, has received relatively little scholarly attention. This paper describes the characteristics of African‐American men who self‐identified as primary caregiver to an index child participating in the Detroit Dental Health Project. Methods: Of 1,021 caregiver–child pairs recruited to this oral health study, 52 were male. Data were collected at a central site in Detroit on: 1) demographics; 2) social support; 3) oral health beliefs, behaviors, and knowledge; 4) caregivers' and child's oral health. Results: Participants reported good availability of social support and high perceived self‐efficacy to take care of their child's teeth, yet, they possessed limited knowledge on preventing oral health problems. Moreover, male caregivers had high levels of caries, missing teeth, and poor hygiene. Conclusions: Findings may inform the development of effective interventions aimed at male caregivers to improve knowledge and understanding of the caries process, particularly concerning their children.     

Caries in five-year-old children and associations with family-related factors

It is generally understood that the teeth of pre-school-aged children are healthy, but the improvement in the dmft index has halted in the industrialized countries. Those few children who have caries have more of it than before. Little is known of the family-related factors which are associated with this polarization of caries. A representative population-based sample consisted of 1443 mothers expecting their first child. The children were followed at well-baby clinics and public dental health clinics for over five years. The objective was to study the prevalence of dental caries and its predictors in five-year-old children and to assess children's own dental health habits and the meaning of family-related factors in dental health. The findings were based on questionnaire data from parents and on clinical dental examinations of the five-year-old children as completed by 101 public health dentists. In firstborn five-year-old children, dental health was found to be good in 72%, fair in 20%, and poor in 8% of the cases. The final multivariate analysis illustrated that the dmft index > 0 was independently associated with the mother's irregular toothbrushing (OR 2.2; 95% CI 1.4-3.5), annual occurrence of several carious teeth in the father (OR 2.6; 95% CI 1.9-3.6), daily sugar consumption at the age of 18 months (OR 2.4; 95% CI 1.4-4.1), occurrence of child's headaches (OR 3.7; 95% CI 1.5-8.8), parents' cohabitation (OR 3.3; 95% CI 1.5-7.6), rural domicile (OR 2.4; 95% CI 1.2-4.5), and mother's young age (OR 5.0; 95% CI 1.3-19.8). The findings indicated that attention should be paid not only to the child's dental health care but also to that of the whole family. Parents should be supported in their upbringing efforts and encouraged to improve their children's dental health habits. In everyday life, parents function as role models for their children, and therefore, parents' own dental hygiene habits are very meaningful.     

Child and family health nurses' experiences of oral health of preschool children: a qualitative approach

Objectives: The objective of this study was to explore Child and Family Health Nurses' work‐related experiences of dental disease in young children. Methods: Child and Family Health Nurses (n = 21) who recruited new mothers to an ongoing birth cohort study that began in South Western Sydney, Australia were invited to take part in a qualitative study. A semi‐structured, in‐depth interview technique was used to explore their experiences of preschool child oral health and how this affects their working lives. Interviews were audio‐recorded, transcribed verbatim, and analyzed using a thematic analysis. Results: The nurses considered dental caries to be a significant health issue for young children and their families. They thought that the burden of dental disease in preschool children was underestimated in disadvantaged and multicultural populations. In addition, they reported that parents were often unaware of the disease process and were ignorant of the relationship between bottle feeding and dental caries. Once the parents were informed about their child's poor oral health, they had feelings of anger, despair, and guilt. Conclusions: This study highlights that oral health problems are a significant segment of the child health problems identified by nurses in their daily work. The nurses perceived the problem of dental caries to be one of a lack of parental knowledge, and families should be educated not only on “what” but also on “how” to feed their children. The primary healthcare team should work collaboratively to educate families in a culturally appropriate way.     

Research defines public dental health promotion in youth

Abstract:  In the Netherlands, Dental Public Health Service workers work in the healthcare delivery system to promote dental health. Since 1994, research has been conducted in Flevoland on the condition of children's teeth. This research has shaped the content of the dental health promotion directed at children in this region. The research comprises two parts: questionnaires for parents and children above the age of 12 and a dental examination of children aged 6 and 12 in the regional primary schools. The dental examination registers the health of the children's teeth. Sound teeth are defined as being free of visible caries and/or restoration. Not sound teeth show at least one case of visible caries and/or restoration. The research results have shown great dental differences between the various schools and between municipalities. The percentage of children with sound teeth ranges between 28 and 100 per school. Based on the final results of the research, an information pack will be disseminated. In the case of high-risk schools the dental health promotion will be conducted more intensively. The Dental Public Health Service workers will give information sessions to groups of parents and children, the dentist and the dental hygienist will provide individual information and prevention. At the child health clinic (consultatiebureau), education will be provided to parents of children ranging in age from 0 to 4. This combined approach has proven to be effective on a large majority of the children. To ensure uniform dental health promotion, information protocols are used in these promotion activities within Flevoland.     

Parental acceptance of restraint methods used for children with intellectual disabilities during dental care

This study evaluated 209 Brazilian parents' acceptance of the use of restraint during dental care for their children with intellectual disabilities. Participants were interviewed end they also watched a video on physical restraint techniques, sedation, and general anesthesia. There was a statistically significant relationship for 22.9% of the parents. The odds ratio revealed that participants were more likely to accept physical restraints for their child when parents were over the age of 35 and from an underprivileged economic class and when the children had previously experienced physical restraints. Dental healthcare professionals should consider the individual needs of each patient and consult with the child's family if there is a need to use restraints.     

Social and behavioural indicators of caries experience in 5-year-old children

Abstract The aim of this study was to investigate the relative influence of socio-economic status and behaviour on dental health of 5-yr-old children. Dental data from a representative sample of 5-yr-old children from Lothian, Scotland, were analysed in combination with reported behavioural data collected by standardised telephone interviews of the mothers. Dental data was established for 520 children. A total of 324 mothers of these children were interviewed giving a response rate in relation to the original sample frame of 62.3%. Caries experience increased with both decreasing toothbrushing behaviour and a more manual occupational status. The relationship between the parent's occupation and the child's dental health was almost two times as large as the relationship between reported toothbrushing behaviour and the child's dental health. Caries experience increased with both increasing sweet consumption and a more manual occupational status. The relationship between the parent's occupation and the child's dental health was almost four times as large as the relationship between reported sweet consumption and the child's dental health. In conclusion, dental health in 5-yr-old children is related to parent's occupation and toothbrushing and sweet consumption. Occupational status is a much stronger factor than behaviours as reported by mothers.