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.     

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.     

Psychosocial factors and early childhood caries among low-income African-American children in Detroit

Objectives: This study sought to advance knowledge of the social determinants of oral health, by examining how several specific maternal health beliefs, behaviors, and psychosocial factors relate to young children's early childhood caries (ECC) status in a lower‐income African–American population. Methods: Data were collected by the Detroit Dental Health Project (NIDCR grant), a population‐based study of 1021 African–American families with at least one child under 6 years of age and living in 39 low‐income Census tracts in Detroit, Michigan. Analyses were limited to 719 children aged 1–5 years and their biological mothers, and conducted in SUDAAN to account for the complex sampling design. Survey data included health belief scales on mothers’ self‐efficacy, feelings of fatalism, knowledge about appropriate bottle use and children's oral hygiene needs, brushing habits, psychosocial measures of depressive symptoms (CES‐D), parenting stress, and availability of instrumental social support. The child's age, dental insurance status, dental visit history, and 1‐week brushing frequency were also included in the model. Children's ECC status, based on a dental examination, was the main outcome. The dental team used the International Caries Detection and Assessment System (ICDAS) criteria for caries detection. Each child was classified as either caries‐free or having ECC or severe ECC (S‐ECC) based on the case definition of ECC proposed by an expert panel for research purposes with preschool‐aged children. Results: The dental team followed a specific examination protocol and established reliable and consistent ratings of ECC based on the ICDAS criteria. The inter‐rater reliability kappa was 0.83 overall, and the intra‐rater reliability kappa was 0.74 overall. One‐third of the children had ECC, and 20% had severe ECC. Age of the child and lower parenting stress scores were each positively associated with ECC, while higher education and income were protective. Maternal oral health fatalism and knowledge of children's hygiene needs were associated with ECC among preschool‐aged children. ECC was higher among younger children who had past restorative care. Conclusions: These findings call attention to the high prevalence of ECC in this population and the need to consider psychosocial as well as traditional risk factors in developing interventions to reduce oral health disparities.     

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.     

Comparison between regional micropush-out and microtensile bond strength of resin composite to dentin

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.     

An examination of racial/ethnic disparities in children's oral health in the United States

Objective: To assess the extent factors other than race/ethnicity explain apparent racial/ethnic disparities in children's oral health and oral health care. Methods: Data were from the 2007 National Survey of Children's Health, for children 2‐17 years (n = 82,020). Outcomes included parental reports of child's oral health status, receiving preventive dental care, and delayed dental care/unmet need. Model‐based survey‐data‐analysis examined racial/ethnic disparities, controlling for child, family, and community/state (contextual) factors. Results: Unadjusted results show large racial/ethnic oral health disparities. Compared with non‐Hispanic White people, Hispanic and non‐Hispanic‐Black people were markedly more likely to be reported in only fair/poor oral health [odds ratios (ORs) (95% confidence intervals) 4.3 (4.0‐4.6), 2.2 (2.0‐2.4), respectively], lack preventive care [ORs 1.9 (1.8‐2.0), 1.4 (1.3‐1.5)], and experience delayed care/unmet need [ORs 1.5 (1.3‐1.7), 1.4 (1.3‐1.5)]. Adjusting for child, family, and community/state factors reduced racial/ethnic disparities. Adjusted ORs (AORs) for Hispanics and non‐Hispanic Blacks attenuated for fair/poor oral health, to 1.6 (1.5‐1.8) and 1.2 (1.1‐1.4), respectively. Adjustment eliminated disparities for lacking preventive care [AORs 1.0 (0.9‐1.1), 1.1 (1.1‐1.2)] and in Hispanics for delayed care/unmet need (AOR 1.0). Among non‐Hispanic Blacks, adjustment reversed the disparity for delayed care/unmet need [AOR 0.6 (0.6‐0.7)]. Conclusions: Racial/ethnic disparities in children's oral health status and access were attributable largely to socioeconomic and health insurance factors. Efforts to decrease disparities may be more efficacious if targeted at social, economic, and other factors associated with minority racial/ethnic status and may have positive effects on all who share similar social, economic, and cultural characteristics.     

Usefulness of a psychometric questionnaire in exploring parental attitudes in children's dental care

In this methodological study we investigated the usefulness and reliability of a questionnaire designed to capture 4 aspects of parental dental attitudes: dental knowledge, child oral health behavior, perceived importance of dental related aims, and parental responsibility. The study was undertaken in a group of 140 parents of schoolchildren aged 8-12 years from four comprehensive schools in Sweden. Test-retest reliability, quantified by the intraclass correlation coefficient (ICC) or by Cohen's kappa, varied from acceptable to excellent for different aspects of the questionnaire. The knowledge and responsibility-taking sections were also answered by a group of dental experts who showed a high level of internal agreement. Expert profiles, to which the parental assessments could be compared, were created. Exploration of the 4 aspects showed that this group of parents commonly had a multifocal view on the etiology and prevention of caries. Correlations between their knowledge assessments and the assessments made by the expert group varied from moderately negative to strongly positive. The parents revealed a high degree of dental-related motivation and responsibility, particularly according to oral health behaviors. In conclusion, the results indicate that this 4-part psychometric questionnaire might be a suitable instrument in investigations of priority and responsibility-taking as new aspects of parental dental attitudes, along with dental knowledge and child oral health behaviors.     

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.     

Income gradients in oral health according to child age

This study aimed to confirm whether the well‐known income disparities in oral health seen over the life course are indeed absent in 9‐ to 11‐yr‐old children, and to explore the role of access to dental care in explaining the age‐profile of the income gradient in child oral health. We used data from the 2007 United States National Survey of Children's Health. Income gradients in parental reports of children's decayed teeth or cavities, toothache, broken teeth, bleeding gums, and fair/poor condition of teeth were assessed in stratified analyses according to age of child (1–5, 6–8, 9–11, 12–14, and 15–17 yr), using survey logistic regression to control for family‐, parental‐, and child‐level covariates. Health insurance status and use of preventive dental care were the indicators for children's access to dental care. The adjusted ORs for the effect of family income on having decayed teeth or cavities, toothache, and fair/poor condition of teeth were not significant in 9‐ to 11‐yr‐old children. Different age‐patterns were found for broken teeth and bleeding gums. The attenuation of the income gradients in having decayed teeth or cavities, toothache, and fair/poor condition of teeth, previously seen in 9‐ to 11‐yr‐old children, was also seen in 15‐ to 17‐, 12‐ to 14‐, and 6‐ to 8‐yr‐old children, respectively, after controlling for children's access to dental care. This study supports the attenuation of income inequalities in oral health in 9‐ to 11‐yr‐old children. Access to dental care could attenuate income gradients in oral health in other age groups.     

Family composition and children's dental health behavior: evidence from Germany

Objective: To assess whether children's dental health behavior differs between family compositions of either natural parents or birth mothers together with stepfathers. Methods: We use data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) public use file. This is the first nationally representative sample on child health in Germany and particularly contains variables for dental attendance, tooth care, and eating behavior of 13,904 children below 14 years of age. A series of zero‐inflated Poisson, ordinary least squares, binary, and ordered logistic regression models was set up in order to identify whether family composition is a significant explanatory variable for children's dental health behavior. Results: Family composition turned out as a significant parameter for some aspects of children's dental health behavior. Specifically, children who grow up in families with a birth mother and a stepfather have only half the probability to access dental services but, once seeking treatment, the number of visits is significantly higher in comparison with children raised by their natural parents. Moreover, children growing up in such a patchwork family setting consume a higher amount of sugary foods and drinks. This appears mainly attributable to differential consumption habits for juices, cookies, and chocolate. Conclusions: Children who grow up in settings other than the nuclear family may develop different dental health behaviors than children who grow up with both natural parents, albeit more research is needed to identify the extent to which such behavioral changes lead to variations in caries occurrence.     

Oral health status of mississippi delta 3- to 5-year-olds in child care: an exploratory study of dental health status and risk factors for dental disease and treatment needs

OBJECTIVES: For poor and minority young children, disparities exist in dental health and treatment. In rural impoverished areas, institutions that reach young children and potentially offer access to care are limited. In the current Mississippi Delta study, child care centers were examined as potential venues for oral health intervention and research, and potential risk factors for dental caries and treatment urgency in high-risk preschool children were explored. METHODS: Child care centers were selected and attending children recruited. Data on oral health practices were collected from surveys of center directors and parents/caregivers. Children were examined for caries and treatment urgency at centers by dentists. Bivariate and multivariate analyses with a 0. 05 alpha were used to examine data. RESULTS: A total of 346 preschool children at 15 participating centers were examined: 46% were female, 68% minority. Minority children and those with public insurance were more than twice as likely to have caries and urgent treatment needs as non-minorities or those with private insurance. The odds of children having caries were half as great if parents reported using floss and nearly twice as great if the parent had experienced a dental abscess. For every soft drink the parent consumed daily, the odds of dental caries for children increased by 44%. CONCLUSIONS: Conducting oral health exams and research in child care venues was possible, yet presented challenges. The combined use of two parental variables, reported soft drink consumption and abscess history, appears promising for caries prediction. Implementation of oral health programs and research in child care venues merits further exploration.     

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.     

Relationships Between Caregivers' Responses to Oral Health Screening Questions and Early Childhood Caries

Objective: This study evaluated relationships between caregiver responses to oral health screening questions and caries in young children. Methods: Two samples of caregivers answered identical eight‐item screening questionnaires about their oral health. One sample included children enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) who were 24 to 42 months of age; the other sample included 3‐ to 5‐year‐old children attending a pediatric dental clinic. Using chi‐square and relative risk, questionnaire findings were related to children's caries history based on clinical caries exams. Results: Questions significantly (P < 0.05) related to children's caries in the older sample included caregivers' poorer rating of their oral health, less frequent dental visits, current or recent caries, and history of tooth loss due to caries. However, only questions pertaining to tooth loss were related to caries in the younger sample. Conclusion: Caregivers' reported loss of teeth due to caries was significantly associated with caries development in their children in both samples, and may be a useful means for early identification of children at high risk.     

Usefulness of a psychometric questionnaire in exploring parental attitudes in children's dental care

In this methodological study we investigated the usefulness and reliability of a questionnaire designed to capture 4 aspects of parental dental attitudes: dental knowledge, child oral health behavior, perceived importance of dental related aims, and parental responsibility. The study was undertaken in a group of 140 parents of schoolchildren aged 8-12 years from four comprehensive schools in Sweden. Test-retest reliability, quantified by the intraclass correlation coefficient (ICC) or by Cohen's kappa, varied from acceptable to excellent for different aspects of the questionnaire. The knowledge and responsibility-taking sections were also answered by a group of dental experts who showed a high level of internal agreement. Expert profiles, to which the parental assessments could be compared, were created. Exploration of the 4 aspects showed that this group of parents commonly had a multifocal view on the etiology and prevention of caries. Correlations between their knowledge assessments and the assessments made by the expert group varied from moderately negative to strongly positive. The parents revealed a high degree of dental-related motivation and responsibility, particularly according to oral health behaviors. In conclusion, the results indicate that this 4-part psychometric questionnaire might be a suitable instrument in investigations of priority and responsibility-taking as new aspects of parental dental attitudes, along with dental knowledge and child oral health behaviors.     

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.     

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.     

Socioeconomic and clinical factors associated with caregivers' perceptions of children's oral health in Brazil

Piovesan C, Marquezan M, Kramer PF, Bönecker M, Ardenghi TM. Socioeconomic and clinical factors associated with caregivers’ perceptions of children’s oral health in Brazil. Community Dent Oral Epidemiol 2011; 39: 260–267. © 2010 John Wiley & Sons A/S Abstract – Objectives: We assessed how socioeconomic and clinical conditions could affect parents’ perceptions of their child’s oral health. Methods: A cross‐sectional study was conducted in a sample of 455 children, aged 1–5 years, representative of Santa Maria, a southern city in Brazil. Participants were randomly selected among children attending a National Day of Children’s Vaccination. Clinical examinations provided information on the prevalence of caries, dental trauma, and occlusion. The caregivers’ perception of children’s oral health and socioeconomic status were assessed by means of a questionnaire. A Poisson regression model using robust variance (Prevalence ratio: PR; 95% CI, P ≤ 0.05) was performed to assess the association between the predictor variables and outcomes. Results: Parents were more likely to rate their child’s oral health as ‘poor’ if the former earned a lower income and the latter had anterior open bite and dental caries. Parents of black children with anterior open bite and dental caries were more likely to rate their child’s oral health as ‘worse than that of other children’. Conclusions: Clinical and socioeconomic characteristics are significantly associated with parents’ perceptions of their child’s oral health. Understanding the caregivers’ perceptions of children’s oral health and the factors affecting this could be useful in the planning of public health polices, in view of the inequity in the oral health pattern.     

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.