Association between family factors and children's oral health behaviors--a cross-sectional comparative study of permanent resident and migrant children in large cities in China

Healthy Food, Healthy Teeth: A Formative Study to Assess Knowledge of Foods for Oral Health in Children and Adults

Eating patterns characterised by low intakes of processed carbohydrates and higher intakes of fat- and Vitamin D-rich foods are associated with protection against dental caries. The aim of this formative study was to evaluate the extent to which the knowledge of children and adults of foods for oral health reflects dietary guideline advice, and the evidence base for foods associated with increased and decreased caries burdens. Using a novel card-sorting task, the participants categorised foods according to their knowledge of each food for oral health. There were no differences between children and adults in the categorisation of fresh, minimally processed foods. Fish, chicken, and red meat were categorised as healthy by significantly fewer children than adults. High-sugar foods were correctly characterised as unhealthy by nearly all participants. More children categorised breakfast cereals as healthy than adults. There were no statistically significant differences between children and adults for the categorisation of brown or wholegrain breads categorised as healthy. The alignment of the participants’ beliefs with dietary guideline recommendations suggests education through health promotion initiatives is successful in achieving knowledge acquisition in children and adults. However, recommendations to increase the intake of refined carbohydrates inadvertently advocate foods associated with increased caries burdens.

Dental caries and associated factors among adolescents aged 12 to 15 in Jiangxi Province, China

BACKGROUND

The purpose of this survey was to examine the association of general characteristics, oral health knowledge, attitudes, behavior, and dental caries status among adolescents in Jiangxi Province and to provide a basis for future prevention of dental caries among middle school students.

METHODS

A total of 8,160 adolescents aged 12 to 15 years were invited to participate in this survey by a stratified random cluster sampling method from 30 schools in five counties in Jiangxi Province. A self-administered questionnaire was used to understand their basic characteristics, including oral health behaviors, knowledge, and attitudes. Chi-square tests were used to compare dental caries status and general characteristics. Univariate and multivariate logistic regression analyses were used to study the effects of oral health knowledge, attitudes, and behavior on dental caries.

RESULTS

The prevalence of dental caries in permanent teeth was 25.8 percent, and the mean DMFT score of 12- to 15-year-old adolescents was 0.48 ± 1.04. The prevalence in rural areas was higher than that in urban areas (P < 0.001). The prevalence was higher in girls than in boys (P < 0.001). No significant age differences were observed (P > 0.05) in the prevalence of dental caries. The multivariate logistic regression analysis indicated that the variables associated with dental caries were tooth brushing frequency, use of toothpaste, frequency of sugary milk intake, smoking, and oral health attitudes.

CONCLUSIONS

This study revealed that adolescent oral health behaviors and attitudes were associated with dental caries. It is important to implement targeted oral disease prevention and control measures among adolescents.

Are parents' education levels associated with either their oral health knowledge or their children's oral health behaviors? A survey of 8446 families in Wuhan

Background

Children aged 6–7 years are in the early mixed dentition, which is a period of high prevalence of dental caries and other dental diseases and a critical period for the formation of oral health behaviors. Therefore, good oral hygiene habits of children and oral health knowledge of parents are very important. This study sought to explore the relationship between children’s oral health behaviors, parental oral health knowledge, parental choices of pit and fissure sealants, and parents’ education levels based on a large-scale sample size for the first time, and to compare the influences of parental education levels between parents.

Methods

Families of the first and second graders of primary schools in Wuhan Hongshan District were included in this study. A total of 8446 questionnaires were collected to obtain comprehensive information on children’s oral health behaviors, parents’ oral health knowledge and parents’ pit and fissure sealants-related choices. The relationship between these outcome variables and parents’ education levels were studied using logistic regression analysis and chi-square test.

Results

Parents who reported good educational background had more favorable oral health knowledge than those of other parents, and their children had better oral hygiene behaviors. Four indicators of five measures to children’s oral health behaviors were significantly associated with mother’s education level (P < 0.05), and three of them were related to father’s education level (P ≤ 0.01). Moreover, seven indicators of eight measures to parents’ oral health knowledge were significantly related to mother’s education level (P < 0.05) and four of them were affected by the father’s (P < 0.05). In addition, parents with higher educational attainments paid more attention to the completeness of medical facilities, the environment of dental practice, the distance to treatment sites, and took less concern of children’s willingness when choosing the pit and fissure sealants sites.

Conclusions

In families with children at the early mixed dentition stage, parents with higher education levels tend to have better oral health knowledge and more oral health care needs, such as pit and fissure sealants. In addition, children of parents who have better educated parents tend to perform better oral hygiene practices.

The disparity in caries and sealants between migrant and native children in Shanghai: A cross-sectional study

OBJECTIVE

To investigate the disparity in dental caries between native and migrant children in Shanghai, China.

METHODS

Between 2013 and 2015, a random cluster sample of native and migrant children aged 5, 9, 12 and 15 years was collected from each district in Shanghai. Oral examination was performed following the World Health Organization (WHO) method, and findings were reported as decayed-missing-filled teeth of primary dentition (dmft) and permanent dentition (DMFT).

RESULTS

A total of 10 150 children were examined, and 33.6% of them were migrants. Migrant children had a higher prevalence of deciduous caries than native children (the 5-year-old age group, 67.8% vs 63.0%, P = 0.024; the 9-year-old age group, 75.9% vs 66.1%, P < 0.001), and higher dmft values were found in migrant children. But with respect to permanent teeth, no statistical differences were found between the two groups in caries prevalence or DMFT. After controlling for potential confounders by logistic regression, migrant children showed a higher risk of deciduous caries (odds ratio 1.42, 95% confidence interval 1.25-1.61, P < 0.001) but not of permanent caries. Migrant children exhibited relatively lower deciduous Restorative Care Index (RCI). However, 9- and 15-year-old migrant children had a higher permanent RCI than their native counterparts.

CONCLUSIONS

Dental caries prevalence in migrant children was higher in the deciduous teeth but not in the permanent teeth compared to that in their native counterparts. School-based dental public health services may contribute to reducing the disparity in dental health status between migrant and native children.

Oral health status among newly arrived refugees in Germany: a cross-sectional study

Background

The objectives of this study were to determine the status of oral health among newly arrived refugees in Germany and to explore their knowledge, attitude and practices on oral hygiene.

Methods

All participants (n = 386) were adults, 18–60 years of age, coming from Syria and Iraq and registered as refugees in Germany within one year prior to the enrollment in the study. Clinical oral assessments in addition to a survey on knowledge, attitude and practice were carried out. The survey was conducted through a questionnaire translated into Arabic.

Results

Eighty seven point 5 % of the participants had untreated caries. The mean DMFT score was 6.38 with DT, MT and FT showing mean scores of 4.00, 1.46 and 0.92 respectively. Seventy nine percent had bacterial plaque in all six sextants, 60 % had calculus in at least three sextants and 6 % showed various magnitudes of enamel fluorosis. DMFT score was significantly associated with age (Regression Coefficient 0.031, P-value < 0.001) and with education (Regression Coefficient − 0.019, P-value 0.037) and females had significantly less missing teeth (Regression Coefficient-0.398, P-value 0.001) compared to males. The participants had in general high levels of knowledge and attitude on oral hygiene. The findings however showed a gap between their knowledge and practice.

Conclusions

The findings show high prevalence of untreated caries and poor oral hygiene among newly arrived refugees in Germany. The study recommends to lay emphasis on motivation in oral health promotion campaigns among refugees and to provide them with adequate guidance, preferably in their native language, on how to access oral health care in the host country.

Oral health knowledge, behaviors and parental practices among rural-urban migrant children in Guangzhou: a follow-up study

BACKGROUND

Despite the growing number of rural-urban migrant children in China, follow-up observation on the oral health of migrant children is still scarce. This study described the changes of oral health knowledge, behaviors and parental practices in migrant children over a period of one year. Possible factors affecting changes were also investigated.

METHODS

The study used purposive sampling to select five private schools of migrant children in Guangzhou. A total of 1900 students in Grades 3 and 4 were recruited. A self-administered questionnaire was used in November 2011 to understand their basic situations, including oral health knowledge, behaviors and parental practices. A final survey was conducted in April 2013 to detect any changes.

RESULTS

The mean accuracy of oral health knowledge was 53.17% and 59.42% in 2011 and 2013, respectively (p < 0.001). For migrant children, the total score of oral hygiene, dietary habits and parental practices increased at the follow-up evaluation (p < 0.05). Children with less oral health knowledge were more likely to achieve significantly positive changes in score of knowledge (p < 0.001) in the final survey. Migrant children who had worse performance on oral hygiene (beta estimate = 0.68, p < 0.001), dietary habits (beta estimate = 0.58, p < 0.001) and good parental practices in the baseline survey were more likely to obtain beneficial changes. No significant associations between demographic characteristics and changes of oral health knowledge and behaviors (p > 0.05) were observed.

CONCLUSION

Oral health knowledge, behaviors and parental practices among migrant children significantly improved at the follow-up assessment. However, the overall situation was still poor. Positive and effective health education and prevention programs tailored to rural-urban migrant children with varying levels of oral health knowledge, behaviors and parental practices will be needed.

Gender differences in the pathways of family factors influencing children's oral health behaviours: a cross-sectional study of primary school students in Beijing, China

OBJECTIVE

Research on what family factors influence children's oral health behaviours (COHB) in developing countries is limited, and there have been no path analyses accounting for gender differences in these factors. Thus, our study evaluated gender differences in COHB including the influencing pathways of family factors in China.

MATERIALS AND METHODS

Through multistage cluster sampling, 915 pairs of mothers and children from six public elementary schools in Beijing completed self-administered questionnaires regarding COHB, parents' modelling behaviours (PMB), parents' controlling behaviours (PCB), parents' oral health knowledge and attitudes (PKA), and children's oral health knowledge and attitudes (CKA). The influencing factors were analysed using path analysis.

RESULTS

Compared with boys, girls showed significantly better performance in drinking less carbonated drinks regularly (8.6% vs. 16.9%). For both genders, PMB shad a significant direct influence on COHB, while PKA had an indirect influence through PMB. In the boys' model, PKA indirectly influenced COHB through CKA. In the girls' model, socioeconomic status had a positive direct effect on COHB.

CONCLUSIONS

The gender differences were not as large as expected. Given that slightly different influential factors for COHB exist between boys and girls, interventions should take note of the similarities and differences in pathways.