Caries increment in children aged 3-5 years in relation to parents' dental attitudes: Oslo, Norway 2002 to 2004

Abstract – Objectives: To assess the relationship between parents’ dental attitudes and the caries increment in their children from the age of 3 to 5 years. Methods: Data based on parental questionnaires and dental examinations were collected from children participating in a follow‐up study from age 3 years (n = 354) in 2002 to 5 years (n = 304) in 2004. The children were categorized as western‐native (WN) and immigrants (IM). The items used were significantly related to caries experience in a multicentre study [ 1 Community Dent Health, vol. 21, pp. 121–30]. The responses to attitudinal items were weighted as positive if they would promote good dental health, and negative if not. Composite attitudinal variables relating to hygiene, diet and indulgence were calculated as a summation of the weighted responses to selected items. Regression analyses (bivariate and multiple) were performed to assess associations during the period between the attitudinal predictors/other control variables and caries increment (Δd_3‐5mfs). Results: Bivariate logistic regression analyses revealed that ‘Attitude to Diet’ and ‘Parental Indulgence’ were clearly related to caries increment. The more exposed children were to negative parental attitudes, the higher the OR. ‘Attitude to Diet’ also persisted in a multiple logistic regression model, showing a higher OR value than caries experience. ‘Immigrant Status’ was the most potent predictor of caries increment. Parents were found to be more indulgent among IM than among WN groups. Conclusion: Parental dental attitudes are clearly shown to be associated with caries increment in early childhood. The relationship is of such strength that it deserves to be taken into account in future preventive dental strategies.     

A longitudinal study of oral health in immigrant children in Sweden

Children immigrating into Sweden from Finland and Southern Europe (Greece, Yugoslavia and Turkey) were subjected to a longitudinal study on caries activity and gingival condition. For each immigrant child a Swedish "twin" of the same sex and age was used as a control. Out of 124 pairs originally examined, 75 were reexamined after a 2 1/2-year stay in Sweden. The study showed that on arrival in Sweden the Finnish children had more caries and a higher Gingival Index (GI) than the controls and that they acquired more carious lesions during their stay in this country. Their GI, however, did not develop less favorably than that of the Swedish controls. The South-European children did not seem to have more carious lesions than the Swedish controls on arriving, nor did they seem to acquire more carious lesions during the period of observation. Their GI was higher at the first examination but the change in this index ran parallel with that of the controls. It was concluded that the children immigrating from Finland should be considered a risk group with regard to oral health.     

Caries and background factors in Norwegian and immigrant 5-year-old children

Wigen TI, Wang NJ. Caries and background factors in Norwegian and immigrant 5‐year‐old children. Community Dent Oral Epidemiol 2010; 38: 19–28. © 2009 John Wiley & Sons A/S Abstract – Objectives: The purpose of this study was to assess the caries status of 5‐year‐olds in a low caries area, and study associations between dental caries and parent‐related factors: parents’ education, national origin, oral health behaviours and attitudes. Methods: The material consisted of 523 children and was a stratified random sample. Clinical and radiographic examination was performed in 2007. Enamel and dentine caries were recorded at surface level. Parents filled in questionnaires regarding socioeconomic status, their own oral health behaviours and attitudes. Results: Most participants (66%) had no caries experience and 16% had enamel caries only. Dentine caries experience was present in 18% of the children, and 5% had dentine caries experience in five or more teeth. Surfaces with enamel caries constituted half of all surfaces with caries experience. In multiple logistic regression, statistically significant risk indicators for the child having dentine caries experience at the age of five were: having one or both parents of non‐western origin (OR = 4.8), both parents (OR = 3.0) or one parent (OR = 2.1) with low education, parental laxness about the child’s tooth brushing (OR = 2.8), parents’ brushing their own teeth less than twice a day (OR = 2.2) and having parents with frequent sugar intakes (OR = 1.8). Conclusion: Caries prevalence in 5‐year‐olds was strongly associated with parent‐related factors signifying that information on parents’ socioeconomic status, dental behaviours and attitudes should be considered when planning dental services for young children. Our results suggest that the real high risk group is non‐western children whose parents have low education.     

Dental health and parental attitudes in Finnish immigrant preschoolchildren in the north of Sweden

Abstract The aim of the present study was to investigate the dental health of 100 Finnish 4-6-year-old children in Luleå, in the north of Sweden, and to compare data with those from a matched control group of Swedish children of the same age, sex and social background. The study also included altitudes to dental health among the parents. The clinical examination included registration of decayed, extracted and filled teeth and surfaces (deft and defs), gingival bleeding points (GBI) and presence of open bite or crossbite. Posterior bitewings were taken. Data concerning among other things oral habits, dietary habits and fluoride prophylaxis were taken. A questionnaire about the parents' attitudes to their own and their children's dental health as well as their opinion about the dental care received by their children was filled in. The results showed that the average defs in the Finnish group was 12.2 compared to 6.4 in the Swedish group. The percentage of children with a defs >12 was 43% in the Finnish group and 19% in the Swedish. The mean GBI% was 11.2% in the Finnish and 8.2% in the Swedish group. The results showed a statistically significant difference in toothbrushing frequencies between the groups, and a tendency to better dietary habits in the Swedish group. There were no differences in the use of fluoride tablets or fluoridated toothpaste. Forty-seven percent of the Finnish parents were denture wearers compared to 10% of the Swedish. The attitudes to dental health among the Finnish parents differed from those in the Swedish group. This difference in attitudes together with language problems were the factors found that could explain the difference in dental health between the immigrant group and the Swedish group.     

Parental knowledge, beliefs and behaviours for oral health of toddlers residing in rural Victoria

BACKGROUND: Little is known about the oral health of children under the age of four years. The determinants of early childhood caries (ECC) in this young age group are also not well understood despite a growing recognition that early interventions may deliver the greatest benefits. The aim of this study was to examine the oral health-related knowledge, attitudes and reported behaviours of parents of children aged 12-24 months living in rural areas of Victoria, Australia. METHODS: A robust theoretical model was utilized to identify oral health-related behaviours and their antecedent and reinforcing conditions within the context of this specific population group. Two hundred and ninety-four parent/child dyads were recruited through their maternal and child health nurses as part of a larger intervention trial. Parents completed a self-report questionnaire. RESULTS: Knowledge regarding risk and protective factors amongst parents was variable and sometimes at odds with contemporary evidence. Knowledge of the role of early infection with S. mutans was very low, with high levels of behaviours that may promote early transmission reported. Tooth cleaning was reported by most parents at least sometimes, however a large proportion lacked confidence and this was significantly related to the frequency of the cleaning. Parents were confused about the fluoride status of their water supplies. Most parents believed fluoride toothpaste reduced the risk of ECC but did not know whether it should be used with toddlers. CONCLUSIONS: The results of this study have implications for efforts to prevent dental decay in this very young age group. Health care professionals other than dentists need support to provide information and promote confidence with regard to optimal fluoride exposure. Attention should also be given to the contribution of early contact with particular bacteria in oral health education and promotion programmes.     

东莞市12岁儿童龋病现状及其行为影响因素分析

目的:研究东莞市城乡12岁儿童恒牙龋病现状及其行为影响因素,分析两者之间的关系,为东莞市儿童口腔卫生保健工作提供科学依据。方法:采用多阶段、分层、整群、随机抽样的方法,抽取东莞市12岁城乡常住人口604人,检查全口恒牙龋病的患病状况并用问卷调查的方式收集全部受检儿童口腔健康行为等相关因素。结果:东莞市12岁儿童患龋率和龋均分别是40.89%和1.47。Logistic回归分析显示:口腔保健知识掌握越多的儿童其患龋率越低,食用水果的频率越高,儿童患龋率也相应增加。结论:东莞市12岁儿童患龋水平较高,口腔卫生行为较差,口腔保健知识掌握情况是致龋最为重要的影响因素,食用水果的频率是危险因素。     

Oral health attitudes and behaviours of final‐year dental students

Objectives: The objectives of this study of final‐year dental students in 10 classes (1997, 2001—2009) were to examine their self‐reported oral health attitudes and behaviours and describe any trends in these attributes. Participants and methods: Students were surveyed in final semester via an anonymous questionnaire (34 behaviour questions; eight attitude statements). Distributions, trends over time and attitude–behaviour associations were examined. Results: Of 583 students, 459 responded (79%). All tooth‐brushed with fluoride toothpaste; 80% brushed ≥2/day. Overall, 85% flossed; over time flossing behaviour increased significantly (P < 0.05), and those flossing 1—2/day increased (P < 0.005). Over time, significant decreases occurred in those taught toothbrushing (P < 0.001) and flossing (P < 0.05), and in use of mouth rinses (P < 0.05) and tooth cleansing sticks/picks (P < 0.001). Almost all (96%) had received a dental examination; 77% attended a dentist 1—3/year. Between‐meal snacking was common (84%); 71% chewed gum. Although 18% had ever smoked, 5% currently smoked. Most strongly agreed they expected to keep most of their teeth for all their life (76%); their future needs for fillings would be minimal (61%); smoking could adversely affect their teeth or gums (85%); and regular dental attendance was important for their dental health (51%). Congruent attitudes and behaviours favouring oral health were widely held concerning dental attendance, flossing and smoking. Conclusions: Final‐year dental students showed well established, favourable oral hygiene attitudes and behaviours, with evidence to suggest this knowledge was developed whilst in dental school. Despite many ceasing smoking, 5% still smoked. All dental students should receive training in motivational counselling and tobacco cessation to ensure this is included in patient care.     

A comparison of perceived and actual dental needs of a select group of children in Texas.

Dental caries (DMFS) evaluations were made for 150 children in Grades 2 to 7. Three months later, a trained interviewer questioned 120 children from 100 families to determine atitudes toward oral hygiene and dental health on the part of (a) the child, (b) the parent, along with (c) the child's perception of the parent's attitude, and (d) the parent's perception of the child's attitude. Evaluation of the perceived attitudes toward oral hygiene revealed a statistically significant correlation between the child's attitude and the degree of dental health as well as between the attitudes of child and parent. Conclusions were: (1) parents were not accurate in their perception of the dental health habits of their children, (2) children were not performing acceptable routine oral hygiene procedures, (3) children accurately perceived the attitudes of their parents toward dental health, and (4) children's actual dental health behavior as manifested by dental health status was related to the attitudes of their parents.     

Risk indicators of caries experience among young adults

BACKGROUND: Significant gains have been documented on the oral health of Australian children. However, the question remains as to whether improvements have extended to the oral health of young adults. This study aimed to determine the risk indicators associated with oral health status in young adults aged 20-25 years. METHODS: A random sample of young adults was selected from the South Australian electoral roll. Telephone interviews were conducted for 1261 young adults. These provided socio-demographic, health behaviour and dental visiting data. Dental examinations were carried out on 644 subjects by three calibrated examiners in clinical settings. RESULTS: The mean number of tooth surfaces affected by dental caries (DMFS) was 6.05 with the presence of untreated cavitated decayed surfaces (DS) evident in 28.6 per cent. In regression models the risk indicators associated with DS were being on government benefits, unemployed, usually visiting for a problem rather than a check, visiting a public clinic, drinking 5+ acidic drinks per day and being a current smoker. Risk indicators for higher DMFS scores were usually visiting for a problem, visiting a public clinic, being on government benefits and having made a dental visit in the previous 2 years. CONCLUSIONS: Socio-demographic factors, dental visiting patterns and general health behaviours are risk indicators for caries in young adults.     

Caries conditions among 2-5-year-old immigrant Latino children related to parents' oral health knowledge, opinions and practices

Objectives : To collect baseline data prior to initiating a community-based, oral health promotion program in an inner city Latino community in Washington DC, populated by Central American immigrants. Methods: In 1995, an oral survey of a convenience sample of children 2–5 years of age ( n = 142) and a survey of the knowledge, opinions and practices (KOP) of their parents ( n = 121) were completed. Clinical data of children were matched with parent respondents of the KOP survey. Data were analyzed for statistical associations using univariate odds ratios, Fisher's exact tests, and multiple logistic regression. Results: Only 53% of the children were caries free. Eighteen percent of all children were in need of immediate dental care and 26% were in need of early or non-urgent dental care. Only 7% of the parents knew the purpose of sealants and 52% knew the purpose of fluorides. Further, only 9% thought that brushing with toothpaste can prevent tooth decay. The strongest predictors of dental caries in this population, after adjusting for child's age and mother's education, were recency of mother's residence in the United States and report of an uncooperative child when attempting toothbrushing. Conclusions: Regimens of caries prevention have been successful in reducing dental decay for a large segment of the US population, yet this disease remains prevalent especially among low socioeconomic groups. The oral health status of the children and the oral health KOP of the parents in this community are disturbingly deficient.     

Dental health knowledge and attitudes among the middle-aged and the elderly in Hong Kong

Abstract Previous studies on adult Hong Kong Chinese have indicated that their level of knowledge of and attitudes toward dental health might be a potential barrier to effective oral preventive efforts. The knowledge and attitudes of elderly Chinese have not previously been studied. The objectives of this study were to describe Hong Kong adults' knowledge of the causes of the two main oral diseases, caries and periodontal disease, and possible preventive measures, and to analyse possible relationships between knowledge and attitudes and selected sociodemographic and utilization variables. Two populations aged 35–44 yr (n= 398) and 65–74 yr (n= 559) were selected for the study, which was conducted as structured interviews. A knowledge score was constructed from questions on caries and periodontal disease development and prevention. Attitudes were measured in the younger group by beliefs and evaluations of those beliefs according to the theory of reasoned action (the higher the score, the more positive the attitude). Knowledge scores were almost normally distributed in the younger respondents, but were heavily skewed toward 0 in the older group. In both age groups, increased level of education and regularity or recency of dental visits were strongly associated with dental knowledge. Women, regular dental care users, and prevention-oriented respondents had higher attitude scores. There was no correlation between knowledge and attitudes. Some improvement in knowledge seems to have taken place, especially on the cause of caries, with fewer 35–44-yr-old respondents claiming lack of knowledge of the causes of caries and gum disease than in a previous study. In the older group, around half of the respondents were unaware of the causes of dental caries and gum disease.     

Oral health status of Canadian-born and immigrant adolescents in North York, Ontario

Studies from a number of countries, including Canada, have demonstrated that the oral health status of immigrants is worse than that of their native-born counterparts and that they make less use of dental services. To date, however, little information is available which documents changes in immigrant oral health following immigration. This paper reports the results of a study conducted in the City of North York, Ontario, that examined the oral health status of Canadian-born and immigrant adolescents aged 13 and 14 years. The former had better oral health than the latter on all parameters assessed and made more use of dental services. Within the immigrant population, there was a signicant association between oral health and time since immigration. Those who had been in Canada 6 or more years were signicantly healthier than those who had arrived within the preceding 2 years. While changing patterns of immigration may account for part of these differences, the data suggest that access to dental public health programs, delivered to students between the ages of 4 and 14 years, have been effective in improving the oral health of those born outside Canada. Since these programs cease at age 13 or 14 years, barriers to accessing the private dental care sector may mean that the residual inequities and inequalities evident in the data widen as these individuals age.