The role of parental anxiety, depression, and psychological stress level on the development of early-childhood caries in children

Examining Caregiver- and Family-Level Psychosocial Influences on Child Oral Health Behavioral Outcomes in Racially and Economically Minoritized Urban Families

OBJECTIVES

Understanding the pathways linking caregiver- and family-level psychosocial factors and child oral health behaviors is critical for addressing oral health disparities. The current study examined the associations between caregiver psychosocial functioning and family chaos and child toothbrushing behaviors in children at high risk for poor oral health outcomes.

METHODS

Data were drawn from the baseline wave of the CO-OP Chicago Cohort Study (U01DE030067), a longitudinal study on child/caregiver dyads exploring oral health behaviors and caries development in young children (N = 296 dyads; child mean age = 5.36, SD = 1.03; caregiver mean age = 33.8 years, SD = 6.70; caregiver race = 43% Black; caregiver ethnicity = 55% Latinx). The oral health behavioral outcomes included child toothbrushing frequency, child plaque levels, and caregiver assistance with child toothbrushing. The data included demographics; caregiver depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, social functioning, social support, and resilience; and family-level household chaos.

RESULTS

Multiple regression models indicated that greater household chaos was significantly related to lower caregiver assistance with child toothbrushing (p = 0.0075). Additionally, caregiver anxiety and PTSD symptoms as well as number of children in the home significantly predicted higher levels of household chaos (p < 0.01). Notably, 18% of caregivers reported clinically significant PTSD. The relationships between caregiver-level psychosocial factors and child oral health behaviors were not significant.

CONCLUSIONS

The results suggest household chaos may play an important role in child oral health behaviors and highlight the importance of investigating family-level factors for understanding and addressing child oral health risk.

Emotional symptoms, dietary patterns and dental caries: A cross-sectional study in adolescents

OBJECTIVES

This study investigates the relationship between emotional symptoms and dental caries in adolescents and the role of dietary patterns as mediating variables.

METHODS

This cross-sectional study used a multistage stratified random sample of schools, in Jiangsu, with a sample of 17,997 adolescents aged 11-19. Measures included emotional symptoms, dental caries, toothbrushing frequency, and dietary patterns. Logistic and Poisson regression models were conducted to test mediation hypotheses.

RESULTS

The decayed, missing, and filled teeth index (DMFT) was related to depressive symptoms following adjustment for other variables (incidence rate ratios [IRR] = 1.09; p < 0.05), but not to anxiety symptoms level (IRR = 1.02; p > 0.05). The link between depressive symptoms and DMFT had a partial mediation impact on toothbrushing frequency (a, b, c' all p < 0.05). Sugary foods, but not fried foods, partially mediated the link between depressive symptoms and caries when toothbrushing frequency was adjusted.

CONCLUSION

There are direct and indirect associations between emotional symptoms and caries; the latter may be due to changes in oral health behaviours that increase the risk of caries.

The Longitudinal Reciprocal Relationships of Tooth Brushing Behaviors Between Underserved Children and Their Caregivers

BACKGROUND

Tooth brushing is effective in preventing early childhood caries. However, it is unclear how children's and caregiver's tooth brushing are reciprocally related.

PURPOSE

The current study investigated whether the longitudinal relationships between children and caregiver tooth brushing are moderated by a caregiver-targeted child oral health intervention and caregiver depression.

METHODS

Secondary analysis of a randomized clinical trial that tested whether caregiver-targeted oral health text messages (OHT) outperformed child wellness text messages (CWT) on pediatric dental caries and oral health behaviors (n = 754, mean child age = 2.9 years, 56.2% Black, 68.3%

RESULTS

Within-participants analyses revealed that caregiver tooth brushing at Months 4 and 12 positively predicted their child's tooth brushing at Months 12 and 24 for caregivers in the OHT condition with low depressive symptoms (i.e., moderation by depressive symptoms and condition). Similarly, children's tooth brushing at Month 4 positively predicted caregiver tooth brushing at Month 12 for caregivers in the OHT condition with low depressive symptoms. There were no significant associations among participants in the CWT condition, regardless of depressive symptoms.

CONCLUSIONS

Child and caregiver tooth brushing have reciprocal influences, but only for those in the OHT condition with low depressive symptoms.

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Key Words

• Child health
• Depressive symptoms
• Family health
• Oral health

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MESH Headings

• Child
• Humans
• Child, Preschool
• Toothbrushing
• Caregivers
• Dental Caries
• Oral Health
• Child Health

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Grants

• UH3DE025492 National Institute for Dental and Craniofacial Research

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Affiliation(s)

Romano Endrighi Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
Michelle Henshaw Office of Global & Population Health and Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
William G Adams Department of Pediatrics, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
Erin Montion Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
Hannah Park Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
Belinda Borrelli Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA

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Adolescents' views on oral health care and promotion in Norway: everyday practices, recommendations, and future visions

Introduction

In this study, we aimed to understand adolescents' perspectives on oral health care and promotion. Our research was conducted in the context of Norway's oral health care system, where societal factors like income and education influence health disparities. Despite free public dental care for all residents younger than 19 years, challenges persist in promoting oral health among adolescents, a group whose oral health behavior and literacy remain largely unexplored.

Materials and methods

A thematic analysis of an anonymized dataset from 80 adolescents aged 12-20 years was conducted.

Results

Five central themes were recognized: (1) Feeling fresh vs. feeling indifferent: A broad spectrum of attitudes; (2) Bridging gaps, building habits: Collaborative efforts in oral care; (3) "Create good experiences at the dentist so people come back again"; (4) Requested qualities in oral health promoting solutions; (5) Reminder tools for everyday use. Taken together, these themes highlight adolescents' oral health practices and resources, recommendations for dental clinics, and visions for future oral health promotion.

Discussion

Based on the results, the discussion highlights a need for tailored oral health promotion and ideas to reach adolescents in meaningful and effective ways. Reflections on the theme of social inequalities are provided.

Parental stress and dental caries experience in adolescents: analysis of data from a birth cohort study in Pelotas, Southern Brazil

PURPOSE

Analyze the association between parental stress and dental caries experience in adolescents in southern Brazil using data from the Pelotas 2004 Birth Cohort.

METHODS

Interviews and oral health examinations for the determination of the main exposure and outcome of the study were performed in the homes of the adolescents. The outcome was dental caries experience in the permanent dentition analyzed using the Decayed, Missing and Filling Surfaces (DMFS) index. The main exposure was parental stress measured using the Parenting Stress Index-Short Form administered to the parents of the adolescents. Demographic/socioeconomic characteristics, oral health characteristics and oral health-related quality of life were considered potential confounding factors. Negative binomial regressions estimated mean ratios (MR) and 95% confidence intervals (CI).

RESULTS

Nine hundred ninety-six adolescents were evaluated at 12 and 13 years of age. The prevalence of dental caries experience in the adolescents was 36.9% (95% CI: 33.8-40.0) and 15.1% (95% CI: 12.8-17.3) of the parents had parental stress. After adjusting for confounding factors, parental stress was associated with a higher mean number of decayed, missing and filling surfaces in the adolescents (MR = 1.10; 95% CI: 1.01-1.26; p = 0.045).

CONCLUSION

Adolescents of parents with parental stress have more dental caries experience compared to those whose parents do not have parental stress.

Patterns in Oral Hygiene and Dietary Habits in School Children during the COVID-19 Pandemic

Aim

To assess oral hygiene and dietary patterns in school children participating in a school-based preventive oral health program during the COVID-19 pandemic.

Materials and methods

In this cross-sectional study, an anonymous questionnaire exploring oral hygiene and dietary patterns during the COVID-19 pandemic was completed by parents of school children. Data were compared among different schools, school years, and between genders using nonparametric tests. Associations among further nominal and categorical variables related to oral hygiene and dietary habits were also assessed using the chi-square test.

Results

Only 26% (n = 32) of parents reported that their children brushed their teeth the recommended amount of twice or more per day during the pandemic. In addition, 17.2% of the parents reported less brushing than before the pandemic. A total of 40 parents (32.8%) reported that their child consumed unhealthy beverages once a day or more. Comparison between genders revealed that male participants were drinking significantly unhealthier than female (p = 0.038). Sugary foods were consumed once a day or more by 63.1% of children. No significant differences were found between public and church schools. Significant direct associations were found between changes in dietary habits and brushing frequency (p = 0.017), between parental concern regarding the interruption of the school program and decreased brushing frequency (p = 0.005), and negative changes in dietary habits (p = 0.013).

Clinical significance

Within the limitations of this study, the present significant findings observed during the pandemic support the importance of school programs in promoting oral hygiene and healthy dietary habits of children.

How to cite this article

Agius A-M, Gatt G, Cortes ARG, et al. Patterns in Oral Hygiene and Dietary Habits in School Children during the COVID-19 Pandemic. Int J Clin Pediatr Dent 2023;16(2):205-210.

Associations between oral habits, dental anxiety, dental service utilization, and maternal mental health status among 6- to 12-year-old children in Ile-Ife, Nigeria

PURPOSE

The current study sought to determine the associations between maternal mental health and oral habits, dental anxiety, and dental service utilization of 6- to 12-year-old children in Ile-Ife, Nigeria.

METHODS

Data were obtained from a household survey involving 1411 mothers and their 6- to 12-year-old children. Data collected were the confounding (maternal age, child's age at last birthday, sex at birth and socioeconomic status), independent (maternal psychological distress, and depression status) and dependent (child's non-nutritive oral habits, dental anxiety level, and most recent dental visit) variables. Bivariate analyses were conducted to test the associations between the dependent and independent variables. After controlling for confounding variables, the associations between the dependent and independent variables were determined using multivariable linear and logistic regression analyses.

RESULTS

Overall, 479 (33.9%) reported one oral habit, 189 (13.4%) reported two and 99 (7.0%) children reported three or more oral habits. Only 25 (1.7%) children reported a dental visit in the year preceding the study. Higher maternal psychological distress was associated with higher dental anxiety in children (AOR: 0.094; 95% CI - 0.080 to - 0.293; p < 0.001). There was no significant association between maternal psychological distress, child's non-nutritive oral habits, and the child's most recent dental visit. There was also no association between maternal depression and the child's non-nutritive oral habits, dental anxiety level, and most recent dental visit.

CONCLUSION

Maternal psychological distress was a significant risk indicator for dental anxiety, but not for dental service utilization or non-nutritive oral habits among children in Ile-Ife, Nigeria. Maternal educational status was also associated with dental anxiety. Further research is needed to elucidate the study's findings.

Smaller putamen volumes are associated with greater problems in external emotional regulation in depressed adolescents with nonsuicidal self-injury

The functions of nonsuicidal self-injury (NSSI) consist of social and emotional aspects (Social influence, Sensation seeking, Internal and External emotion regulation). Previous studies have indicated that dysfunction in reward-related brain structures especially the striatum might drive this habitual behavior. However, no studies to date have investigated the associations between striatum and different functions for adolescents engaging in NSSI behaviors. Here, we recruited 35 depressed adolescents with recent NSSI behaviors and 36 healthy controls and acquired structural brain images, depressive symptoms, social, academic and family environments assessments, in addition to NSSI functions in patients only. Subcortical volumes and cortical thickness were estimated with FreeSurfer. Mixed linear regressions were performed to examine associations between striatal structures (caudate, putamen, nucleus accumbens, pallidum) and NSSI functions, with age, sex, total intracranial volume, hemisphere and depression severity included as covariates. Effect of environmental factors and potential associations with cortical thickness and other subcortical volumes were also tested. We found that, among the four functions, external emotional regulation represented the main function for NSSI engagement. Increased external emotion regulation was significantly associated with smaller putamen volume. No environmental factors biased the association with putamen. No associations with other cortical or subcortical regions were observed. Our findings suggested that smaller putamen might be a biomarker of NSSI engagement for depressed adolescents when they regulated frustrated or angry emotions. The results have potentially clinical implications in early identification and brain intervention of NSSI in youth.

Oral community health worker-led interventions in households with average levels of psychosocial factors

Introduction

Household-level psychosocial stress levels have been linked to child tooth brushing behaviors. Community health worker (CHW) interventions that target psychosocial factors in high-risk communities have been associated with changes in health behaviors.

Aim

Observe changes in psychosocial factors over time and an association between psychosocial factors and CHW intervention dose amongst urban Chicago families.

Patients and methods

Participants (N = 420 families) were recruited from 10 community clinics and 10 Women, Infants, or Children (WIC) centers in Cook County, Illinois to participate in a clinical trial. Research staff collected participant-reported psychosocial factors (family functioning and caregiver reports of depression, anxiety, support, and social functioning) and characteristics of CHW-led oral health intervention visits (number, content, child engagement) at 0, 6, and 12 months. CHWs recorded field observations after home visits on household environment, social circumstances, stressors, and supports.

Results

Participants across the cohort reported levels of psychosocial factors consistent with average levels for the general population for nearly all measures. Psychosocial factors did not vary over time. Social functioning was the only measure reported at low levels [32.0 (6.9); 32.1 (6.7); 32.7 (6.9); mean = 50 (standard deviation)] at 0, 6, and 12 months. We did not observe a meaningful difference in social functioning scores over time by exposure to CHW-led intervention visits (control arm, 0, 1, 2, 3, and 4 visits). Field observations made by CHWs described a range of psychosocial stress related to poverty, language barriers, and immigration status.

Conclusion

The unexpectedly average and unchanging psychosocial factors over time, in the context of field observations of stress related to poverty, lack of support, immigration status, and language barriers, suggests that our study did not adequately capture the social determinants of health related to oral health behaviors or that measurement biases precluded accurate assessment. Future studies will assess psychosocial factors using a variety of instruments in an attempt to better measure psychosocial factors including social support, depression, anxiety, functioning, trauma and resilience within our urban population. We will also look at neighborhood-level factors of community distress and resilience to better apply the social ecologic model to child oral health behaviors.

[Prevalence, intensity, and efficacy of dental caries treatment in pre-school children living in the town of Khimki]

THE AIM OF THE STUDY

Was to assess the prevalence, intensity, and treatment efficacy of dental caries in children aged 3 to 6 years residents of the town of Khimki, Moscow region. The number of decayed, filled, and missed due to caries teeth was registered. The parents were interviewed in order to reveal dental caries treatment experience as well as reasons for negative experience, age of the first dental office visit and the reasons for it.

RESULTS

The incidence of dental caries in 3-6 years old living in Khimki is 52%. The prevalence and incidence unsurprisingly grow with age as well as the number of children having the experience of toothache and early extractions. The vast majority of children including these with positive dental treatment experience have untreated carious lesions. The difference of decayed teeth between children having negative and positive treatment experience in statistically insignificant (p=0.57), and the number of filling is equally small in both subgroups (p=0.99). This means even cooperative children who underwent dental treatment have untreated (or previously treated but having no fillings - in 22.6% of treatment cases) cavities.

CONCLUSION

The dental caries intensity growth outpaces the possibilities of the Khimky dental service resulting in the low number of caries-free previously treated children (17.9% of all treated). All this dictates the necessity for dental caries prevention programs and implementation of new models for dental care organization in preschool children.

36 Months' Clinical Performance of Primary Incisors Restorations Depending on the Type of Restorative Technique Used: A Randomized Controlled Trial

Background: Depending on the stage of the disease and the child’s age, different types of interventions can be used to treat early childhood caries. As a result, there is not enough clinical evidence to show that one kind of restoration is better than another. The objective of this longitudinal study was to compare the results of 36 months of clinical performance of primary incisors restorations using an incremental layering technique with the ceram.x^® SphereTECTM nanoceramic composite (Dentsply) or a full coverage technique with transparent strip crowns (Frasaco GmbH) with the same composite in children with or without biological caries risk factors. Methods: 80 patients (females 42/52.5%) were included in the study. A total of 160 restorations were performed. Restorations were evaluated at baseline and at 6, 12, 24, and 36 months, according to modified Ryge criteria. Conclusion: Restorations with both techniques were clinically highly successful and showed similar clinical performance at postoperatively regardless of the presence of biological factors of caries risk.

Relationship Between Maternal Dental Anxiety and Children's Dental Caries in the Eastern Province of Saudi Arabia

Purpose

Dental anxiety is a barrier to dental care utilization and is associated with poor oral health outcomes. The aim of the study was to assess the relationship between dental anxiety of mothers and dental caries of their children in the Eastern Province, Saudi Arabia.

Methodology

A cross-sectional study was conducted on a sample of mother-child pairs (N= 199) in Dammam, AlKhobar, and Dhahran, Saudi Arabia. Dental caries experience among children was determined using dmft/DMFT indexes following the World Health Organization's guidelines. Maternal dental anxiety was assessed by using the Modified Dental Anxiety Scale (MDAS).

Results

The mean ages of mothers and children were 33.98 ± 5.41 and 6.74 ± 2.29 years, respectively. The mean dmft score was 4.3 ± 3.99 in primary dentition and the mean maternal dental anxiety score was 13.89 ± 5.33. Ninety-two percent of mothers had low to extreme dental anxiety and only 8% reported no dental anxiety. Dental caries experience in primary teeth was higher in children of dentally anxious mothers (mean dmft 4.45 ± 3.92) than the children of mothers who were non-anxious (mean dmft 2.56 ± 4.59) (P=0.07). The mean maternal anxiety score was significantly higher in children with untreated decay in primary dentition (14.49 ± 5.08) than those with sound primary dentition (12.24 ± 5.67) (P = 0.008). The study also found a statistically significant correlation between maternal dental anxiety and untreated decay in the primary dentition (Pearson's r =0.171, P = 0.015).

Conclusion

Dental anxiety was highly prevalent among mothers in the present study. There was a significant relationship between maternal dental anxiety and untreated decay in the primary dentition. Awareness should be raised among dentally anxious mothers to reduce the burden of dental caries in their children.

Early childhood caries: Are maternal psychosocial factors, decision-making ability, and caries status risk indicators for children in a sub-urban Nigerian population?

OBJECTIVE

Early childhood caries (ECC) is caries in children below the age of 72 months. The aim of the study was to determine the association of maternal psychosocial factors (general anxiety, dental anxiety, sense of coherence, parenting stress, fatalism, social support, depressive symptoms, and executive dysfunction), decision-making abilities, education, income and caries status with the prevalence and severity of ECC among children resident in Ile-Ife, Nigeria.

METHODS

A dataset of 1549 mother-child (6-71-months-old) dyads collected through examinations and a household survey, using validated psychometric tools to measure the psychosocial factors, were analyzed. The DMFT for the mothers and the dmft for the child were determined. The association between maternal psychosocial factors, education, income, and decision-making ability, the prevalence of maternal caries, and the prevalence of ECC was determined using logistic regression analysis.

RESULTS

The prevalence of maternal caries was 3.3%, and the mean (standard deviation-SD) DMFT was 0.10 (0.76). The ECC prevalence was 4.3%, and the mean (SD) dmft was 0.13 (0.92). There was no significant difference between the prevalence and severity of maternal caries and ECC by maternal age, education, income, or decision-making abilities. There was also no significant difference in maternal caries, ECC prevalence and ECC severity by maternal psychosocial factors. The only significant association was between the prevalence of caries in the mother and children: children whose mothers had caries were over six times more likely to have ECC than were children with mothers who had no caries (AOR: 6.67; 95% CI 3.23-13.79; p < 0.001).

CONCLUSION

The significant association between ECC and maternal caries prevalence suggests that prenatal oral health care for mothers may reduce the risk for ECC.

The intergenerational interplay of adversity on salivary inflammation in young children and caregivers

Systemic inflammation links exposure to early childhood adversity to later disease. The associations among adversity and disease risk might in part operate through poor oral hygiene and subsequent periodontal inflammation, which can be measured in saliva. Few studies, however, have examined the association between adversity and salivary inflammation in young children. Further, there is a dearth of literature investigating adverse experiences and salivary inflammation in children and caregivers together, limiting our understanding of the intergenerational, dual effects of adversity on inflammation for both members of the caregiver-child dyad. This study tested child and caregiver adversity and their associations with an inflammatory composite (i.e., IL-6, IL-1β, IL-8, TNF-α) and CRP in 93 preschool-age children and their caregivers. Caregivers reported on their child's experiences of adversity, as well as on their own adverse experiences, using a comprehensive questionnaire synthesized from previous checklists for complete coverage of possible adverse events. Results showed that caregivers' salivary inflammatory markers (i.e., IL-6, IL-1β, IL-8, TNF-α, and CRP) were not significantly correlated with the same five inflammatory markers in children's saliva. Among children, adversity was associated with significantly higher levels of the inflammatory composite, though not CRP. This association was amplified among children whose caregivers also experienced more adversity during adulthood. Among caregivers, childhood adversity and adulthood adversity were each independently associated with significantly higher levels of the inflammatory composite and CRP. The association between caregivers' own childhood adversity and inflammation was amplified among caregivers whose children also experienced more adversity during their childhoods. These findings provide preliminary evidence for the possible dual role of young children's and caregivers' adverse experiences in contributing to salivary inflammation for both members of the dyad, suggesting possible implications for systemic inflammation and future disease.

Parental stress as a predictor of early childhood caries: a systematic review

AIM

The aim of this study was to systematically review the literature to answer the question: Are parental stress associated with early childhood caries (ECC)?

METHODS

Electronic databases including MEDLINE (via Pubmed), Scopus and SciELO were searched. Cross-sectional and case-control studies that investigate the association between parental stress and ECC were included. The Newcastle-Ottawa scale was used to assess the risk of bias of the included articles.

RESULTS

Out of 498 articles identified in initial research, 7 articles met the inclusion criteria; five were cross-sectional and two were control-case in design. A statistically significant correlation between ECC and total parental stress as well as a higher level of carious activity associated with total parental stress was reported in four studies. In two studies, no significant relationship between stress and ECC was found (P > 0.05) and in one study, parental stress was inversely associated with children's ECC status with better dental outcomes significantly associated with a higher level of parenting stress.

CONCLUSION

Despite the fact that the heterogenicity of the following data precluded conclusions to be drawn, it was obvious that parenting stress or some of its domains may influence the development of carious lesions in young children.

Impact of maternal and child dental anxiety on oral health-related quality of life of 5-6-year-old preschool children

BACKGROUND

There is a lack of evidence with regards to the association between both maternal and child dental anxiety and the mother's perception of her child's oral health-related quality of life (COHRQoL). The aim of this study was to investigate the association of maternal and child dental anxiety with COHRQoL and the effect of demographic factors as moderators in this relationship. In addition, the association between child's dental caries experience and the COHRQoL was also assessed.

METHODS

A cross-sectional study was conducted involving 1150, 5-6 year-old preschool children in Selangor, Malaysia. Mothers answered a questionnaire on socio-economic status, the Malay-Modified Dental Anxiety Scale to assess maternal dental anxiety, and the Malay-Early Childhood Oral Health Impact Scale to assess COHRQoL. Child's dental anxiety was assessed using the Malay-Modified Child Dental Anxiety Scale via a face-to-face interview prior to oral examination to assess dental caries. Data were analysed using structural equation modelling to assess the relationship between maternal and child dental anxiety and COHRQoL.

RESULTS

Overall, complete data on 842 mother-child dyads were analysed. The mean scores of total ECOHIS, the child impacts section (CIS), and the family impacts section (FIS) were 17.7 (SD = 4.9), 12.6 (SD = 3.7), and 5.1 (SD = 1.9), respectively. The mean dental anxiety scores for mothers and children were 11.8 (SD = 4.5) and 16.9 (SD = 4.3), respectively. Maternal dental anxiety was associated with the CIS (b = 0.08, p < 0.001), the FIS (b = 0.01, p = 0.001), and the total ECOHIS (b = 0.14, p < 0.001). Maternal education level, income, urban/rural location, and kindergarten type were moderators to the relationship. In addition, there was also a significant relationship between child's dental caries experience and COHRQoL (p < 0.001).

CONCLUSIONS

Maternal dental anxiety and child's dental caries experience have significantly impacted the COHRQoL, the CIS, and the FIS domains. Demographic factors such as maternal education, income, urban/rural location, and kindergarten type acted as moderators that can strengthen or weaken the relationship between maternal dental anxiety and COHRQoL of 5-6-year-old preschool children.

Association between maternal socioeconomic factors, decision-making status, and dental utilization by children with early childhood caries in sub-urban Nigeria

AIM

To determine the association between maternal education, income, and decision-making status and the presence of early childhood caries (ECC) and dental-service utilization among young children.

METHODS

This cross-sectional study was based on data from a household survey of 1,549 mother-preschool-aged-child dyads conducted in Ife Central Local Government Area, Nigeria. The explanatory variables were maternal education, income, and decision-making status (related to healthcare, large household purchases, and visits to family/relatives). Outcome variables were the presence of ECC and the child's history of dental-service utilization. Poisson regression analyses were conducted to identify factors associated with outcomes; the models were adjusted for maternal age, child's socioeconomic status, oral hygiene status, and frequency of sugar consumption.

RESULTS

The study recruited 1,549 mother-child dyads, of which 66 (4.3 percent) children had ECC, and 90 (5.9 percent) children had a history of dental-service utilization. Fewer than half (42.3 percent) of the mothers earned between N18,001($49.00) and 60,000 ($168.00) per month. Also, 896 (57.8 percent) reported not making any independent decisions, 152 (9.8 percent) made one of three decisions independently, and 313 (20.2 percent) made two or three decisions independently. In the adjusted model, children of mothers with monthly income higher than N60,000 were more likely to have used dental services than were those whose mother's monthly income was less than or equal to N18,000 (adjusted prevalence ratio = 2.29; 95%CI: 1.30-4.02; P = 0.004). No other maternal factor was associated with ECC.

CONCLUSIONS

Although maternal socioeconomic factors and decision-making abilities were not associated with ECC prevalence, more preschool children whose mothers had high income used dental services.

[Social inequalities in oral health and early childhood caries: How can they be effectively prevented? A scoping review of disease predictors]

BACKGROUND

Early childhood caries represent a major public health problem. In addition to their individual impact, the massive social inequalities in oral health that are at the roots and result from the disease have largely underestimated consequences for the child, his family and the community. In response to the question of "how and where to act?", this scoping review identifies the individual characteristics associated with the disease on which it would be possible to act, using appropriate prevention strategies.

METHODS

This scoping review is aimed at describing and analyzing available data in the literature on the different factors associated with early childhood caries.

RESULTS

The predictors of early childhood caries are represented by mediating (knowledge, attitudes and parents' oral health practices) and moderating (psychosocial parameters, parental health literacy and alcohol consumption) factors. Twenty-eight articles fulfilled the selection criteria, twenty of which studied mediators related to early childhood caries, and fourteen of which dealt with moderators. The lower the parents' level of knowledge and literacy in oral health, the higher a child's dmft index. Additional studies are needed to assess the role of psychosocial parameters.

CONCLUSION

Parents' knowledge and oral health literacy are the key predictors to be preferentially targeted in view of reducing social inequalities in health through actions undertaken on a local scale. The prevention of early childhood caries necessitates a combination of generic and targeted interventions.

Maternal anxiety, social status, and dental caries formation in children: a cross-sectional study

Objective

We sought to evaluate the association of maternal anxiety and social status with caries formation in children.

Methods

Participants comprised 258 pairs of children and their mothers. We collected information regarding age, sex, birth order of children, and mothers’ education and marital status using a questionnaire. The Spielberger Trait Anxiety Inventory was used to determine maternal trait anxiety levels. The children underwent oral examination. Total values for decayed, missing, filled, and total permanent/primary teeth (DMFT/dmft) were evaluated according to standards of the World Health Organization.

Results

No significant relationship was found between the mother's anxiety level and DMFT/dmft scores in their children. A negative correlation was observed between the child’s age and dental caries in children. The sex of the child, mother's education level, and marital status of the mother showed a weak negative correlation with the number of dental caries observed in their children.

Conclusion

Although social, economic, and environmental factors might contribute substantially to the development of dental caries, we failed to demonstrate a clear relationship between maternal anxiety and social status and dental caries in children. We can therefore conclude that biological factors are decisive in the formation of dental caries among children.

Factors Associated with Dental Fear and Anxiety in Children Aged 7 to 9 Years

The aim was to investigate changes in dental fear and anxiety (DFA) and verify factors associated with DFA in children. A longitudinal cohort study that included 160 children aged 7 years was carried out. A questionnaire was completed by parents at two time points and evaluated the immigrant background, maternal education, whether the child had ever had toothache, and whether the parents had dental fear. The oral clinical examination evaluated decayed, extracted, and filled primary teeth (deft). The children’s fear survey schedule dental subscale (CFSS-DS) was used to assess the dental fear of the children. Multilevel mixed-effects logistic regressions analyses were used. The CFSS-DS found that 7% of the children had dental fear at age 7 and mean CFSS-DS was 22.9. At 9 years of age, 8% reported dental fear and the mean increased to 25.4. Parental dental fear, experience of toothache, and report of painful dental treatment and caries development between 7 and 9 years of age were factors that were significantly related to development of DFA. There was a change in DFA between 7 and 9 years of age. Dental fear and anxiety is a dynamic process in growing individuals and is significantly related to painful symptoms and experiences of dental care as well as parental dental fear.