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

Perspectives on Dental Caries: A Cross-Sectional Study among Parents of Primary School Children in Saudi Arabia

Background:

Dental caries is one of the most prevalent chronic childhood diseases affecting many people worldwide. Many people do not recognize the early signs of dental caries or its causes, which is crucial for the prevention and early intervention of the disease and consequently less-invasive and cheaper treatment options.

Objective:

This study aimed to evaluate the perspectives of parents about the meaning, causes, and early signs of dental caries, the association of tooth discoloration with decay, and the effect of different socio-demographic variables on the knowledge of patients regarding caries.

Methods:

Questionnaires were distributed to parents of primary school children in the region of Madinah, Saudi Arabia. Meaning of dental caries, early signs, causes of tooth discoloration related to decay, and the effect of different socio-demographic variables were calculated. Multiple linear regression analysis was carried out to identify significant predictor variables associated with caries knowledge scores.

Results:

There was a total of 2690 respondents. The majority had average caries knowledge scores. Lighter shades of tooth discoloration were reported to be associated with stains and warranted home care only, while darker shades were associated with caries and yielded a necessity for a visit to the dentist. Different socio-demographic variables had an effect on the caries knowledge of the parents.

Conclusion:

There is a need for increased knowledge about the early signs of dental caries among parents. Delayed recognition of signs of dental caries has a detrimental effect on the teeth of children and leads to seeking dental care at the later stages of the disease process. Community-oriented programs are fundamental for improving caries knowledge, its clinical presentations starting from its early signs, causes, and prevention.

Perspectives on Dental Caries: A Cross-Sectional Study among Parents of Primary School Children in Saudi Arabia

Background:

Dental caries is one of the most prevalent chronic childhood diseases affecting many people worldwide. Many people do not recognize the early signs of dental caries or its causes, which is crucial for the prevention and early intervention of the disease and consequently less-invasive and cheaper treatment options.

Objective:

This study aimed to evaluate the perspectives of parents about the meaning, causes, and early signs of dental caries, the association of tooth discoloration with decay, and the effect of different socio-demographic variables on the knowledge of patients regarding caries.

Methods:

Questionnaires were distributed to parents of primary school children in the region of Madinah, Saudi Arabia. Meaning of dental caries, early signs, causes of tooth discoloration related to decay, and the effect of different socio-demographic variables were calculated. Multiple linear regression analysis was carried out to identify significant predictor variables associated with caries knowledge scores.

Results:

There was a total of 2690 respondents. The majority had average caries knowledge scores. Lighter shades of tooth discoloration were reported to be associated with stains and warranted home care only, while darker shades were associated with caries and yielded a necessity for a visit to the dentist. Different socio-demographic variables had an effect on the caries knowledge of the parents.

Conclusion:

There is a need for increased knowledge about the early signs of dental caries among parents. Delayed recognition of signs of dental caries has a detrimental effect on the teeth of children and leads to seeking dental care at the later stages of the disease process. Community-oriented programs are fundamental for improving caries knowledge, its clinical presentations starting from its early signs, causes, and prevention.

Promoting healthy weight for all young children: a mixed methods study of child and family health nurses' perceptions of barriers and how to overcome them

BACKGROUND

Childhood obesity is a global health concern. Early intervention to help parents adopt best practice for infant feeding and physical activity is critical for maintaining healthy weight. Australian governments provide universal free primary healthcare from child and family health nurses (CFHNs) to support families with children aged up to five years and to provide evidence-based advice to parents. This paper aims to examine factors influencing the child obesity prevention practices of CFHNs and to identify opportunities to support them in promoting healthy infant growth.

METHODS

This mixed methods study used a survey (n = 90) and semi-structured interviews (n = 20) with CFHNs working in two local health districts in Sydney, Australia. Survey data were analysed descriptively; interview transcripts were coded and analysed iteratively. Survey and interview questions examined how CFHNs addressed healthy infant feeding practices, healthy eating, active play and limiting sedentary behaviour during routine consultations; factors influencing such practices; and how CFHNs could be best supported.

RESULTS

CFHNs frequently advised parents on breastfeeding, introducing solid foods, and techniques for settling infants. They spent less time providing advice on evidence-based formula feeding practices or encouraging physical activity in young children. Although nurses frequently weighed and measured children, they did not always use growth charts to identify those at risk of becoming overweight or obese. Nurses identified several barriers to promoting healthy weight gain in infants and young children, including limited parental recognition of overweight in their children or motivation to change diet or lifestyle; socioeconomic factors (such as the cost of healthy food); and beliefs and attitudes about infant weight and the importance of breastfeeding and physical activity amongst parents and family members.

CONCLUSIONS

CFHNs require further education and support for their role in promoting optimal child growth and development, especially training in behaviour change techniques to increase parents' understanding of healthy infant weight gain. Parent information resources should be accessible and address cultural diversity. Resources should highlight the health effects of childhood overweight and obesity and emphasise the benefits of breastfeeding, appropriate formula feeding, suitable first foods, responsiveness to infant feeding cues, active play and limiting screen time.

Determinants for early introduction of complementary foods in Australian infants: findings from the HSHK birth cohort study

OBJECTIVE

The purpose of this study was to examine the timing of introduction of complementary (solid) foods among infants in South Western Sydney, Australia, and describe the maternal and infant characteristics associated with very early introduction of solids.

METHODS

Mother-infant dyads (n = 1035) were recruited into the "Healthy Smiles Healthy Kids" study by Child and Family Health Nurses at the first post-natal home visit. Data collected via telephone interviews at 8, 17, 34 and 52 weeks postpartum included timing of introduction of solids and a variety of maternal and infant characteristics (n = 934). Multiple logistic regression was used to identify factors independently associated with the risk of introducing solids very early, which for the purpose of this study was defined as being before 17 weeks.

RESULTS

The median age of introduction of solids was 22 weeks. In total, 13.6% (n = 127) of infants had received solids before 17 weeks and 76.9% (n = 719) before 26 weeks of age. The practice of introducing solids early decreased with older age of the mother. Compared to women < 25 years of age, those who were 35 years or older were 72% less likely to introduce solids very early (OR = 0.28, CI95 0.14-0.58). Single mothers had more than twice the odds of introducing solids before the age of 17 weeks compared to married women (OR = 2.35, CI95 1.33-4.16). Women who had returned to work between 6 to 12 months postpartum were 46% less likely to introduce solids very early compared with those who were not working at the child's first birthday (OR = 0.54, CI95 0.30-0.97). Women born in Vietnam and Indian sub-continent had lower odds of introducing solids very early compared to Australian born women (OR = 0.42, CI95 0.21-0.84 and OR = 0.30, CI95 0.12-0.79, respectively). Infants who were exclusively formula-fed at 4 weeks postpartum had more than twice the odds of receiving solids very early (OR = 2.34, CI95 1.49-3.66).

CONCLUSIONS

Women who are younger, single mothers, those not working by the time of child's first birthday, those born in Australia, and those who exclusively formula-feed their babies at 4 weeks postpartum should be targeted for health promotion programs that aim to delay the introduction of solids in infants to the recommended time.

Predictors of Early Introduction of Core and Discretionary Foods in Australian Infants-Results from HSHK Birth Cohort Study

Early introduction of complementary foods can have a detrimental impact on children's long-term health. This study examined the timing and determinants of early introduction of core and discretionary foods among infants in Sydney, Australia. Mothers (n = 1035) from an ongoing population-based birth cohort study were interviewed at 8, 17, 34 and 52 weeks postpartum. The outcome was 'age at which particular core and discretionary food items were first introduced'. Multivariable logistic regression models were used to investigate family and infant-related determinants of early introduction of core (<17 weeks of age) and discretionary foods (<52 weeks of age). Of the 934 mother-infant dyads interviewed, 12% (n = 113) of infants were introduced core foods before 17 weeks of age (median: 22). Mothers working part-time (adjusted odds ratio (OR): 3.42, 95% confidence interval (CI): 1.54-7.62) and those exclusively formula-feeding their babies at four-weeks postpartum (adjusted OR 3.26, 95% CI: 1.99-5.33) were most likely to introduce core foods early. Ninety-five percent (n = 858) of infants were introduced discretionary foods before 52 weeks of age (median: 28). Low socio-economic status was significantly associated with early introduction of discretionary foods (adjusted OR: 3.72, 95% CI: 1.17-11.78). Compliance with infant feeding guidelines related to core foods was better; however, discretionary foods were introduced early in most infants.

Lessons learnt in recruiting disadvantaged families to a birth cohort study

BACKGROUND

Dental decay in early childhood can be prevented by a model based on shared care utilising members of primary care team such as Child and Family Health Nurses (CFHNs) in health promotion and early intervention. The aims of this study were to identify the facilitators and barriers faced by CFHNs in recruiting research participants from disadvantaged backgrounds to a birth cohort study in South Western Sydney, Australia.

METHODS

Child and Family Health Nurses recruited mothers-infants dyads (n = 1036) at the first post-natal home visit as part of Healthy Smiles Healthy Kids Study, an ongoing birth cohort study in South Western Sydney. The nurses (n = 19) were purposively selected and approached for a phone based in-depth semi-structured interview to identify the challenges faced by them during the recruitment process. Interviews were audio-recorded, subsequently transcribed verbatim and analysed by thematic analysis.

RESULTS

The nurses found the early phase of parenting was an overwhelming stage for parents as they are pre-occupied with more immediate issues such as settling and feeding a newborn. They highlighted some key time-points such as during pregnancy and/or around the time of infant teething may be more appropriate for recruiting families to dental research projects. However, they found it easier to secure the family's attention by offering incentives, gifts and invitations for free oral health services. The use of web-based approaches and maintaining regular contact with the participants was deemed crucial for long-term research. Cultural and linguistic barriers were seen as an obstacle in recruiting ethnic minority populations and the need for cultural insiders in the research team was deemed important to resolve the challenges associated with conducting research with diverse cultures. Finally, nurses identified the importance of inter-professional collaboration to provide easier access to recruiting research participants.

CONCLUSIONS

This study highlighted the need for multiple time-points and incentives to facilitate recruitment and retention of disadvantaged communities in longitudinal research. The need for cultural insiders and inter-professional collaboration in research team are important to improve research participation.

Adaptation of child oral health education leaflets for Arabic migrants in Australia: a qualitative study

BACKGROUND

The purpose of this study was to gain an in-depth understanding of Arabic-speaking mothers views on the usefulness of existing oral health education leaflets aimed at young children and also to record their views on the tailored versions of these leaflets.

METHODS

This qualitative study was nested within a large ongoing birth cohort study in South Western Sydney, Australia. Arabic-speaking mothers (n = 19) with young children were purposively selected and approached for a semi-structured interview. Two original English leaflets giving advice on young children's oral health were sent to mother's prior to the interview. On the day of interview, mothers were given simplified-English and Arabic versions of both the leaflets and were asked to compare the three versions. Interviews were audio-recorded, subsequently transcribed verbatim and analysed by thematic analysis. Ethical approval was obtained from Human Research Ethics Committees of the former Sydney South West Area Health Service, University of Sydney and Western Sydney University.

RESULTS

Mothers reported that simplified English together with the Arabic version of the leaflets were useful sources of information. Although many mothers favoured the simplified version over original English leaflets, the majority favoured the leaflets in Arabic. Ideally, a "dual Arabic - simplified English leaflet" was preferred. The understanding of key health messages was optimised through a simple layout and visual images.

CONCLUSIONS

There is a need to tailor oral health education leaflets for Arabic-speaking migrants. Producers of dental leaflets should also consider a "dual Arabic - simplified English leaflet" to improve oral health knowledge of Arabic-speaking migrants. The use of simple layout and pictures assists Arabic-speaking migrants to understand the content of dental leaflets.

Determinants of breastfeeding initiation among mothers in Sydney, Australia: findings from a birth cohort study

Background

Breastfeeding has short-term and long-term benefits for both the infant and the mother. The objective of this study was to identify the incidence of breastfeeding initiation among women in South Western Sydney, and the factors associated with the initiation of breastfeeding.

Methods

Child and Family Health Nurses recruited mother-infant dyads (n = 1035) to the Healthy Smiles Healthy Kids birth study in South Western Sydney, an ethnically and socio-economically diverse area, at the first post-natal home visit. A sample of 935 women completed a structured, interviewer-administered questionnaire at 8 weeks. Multivariate logistic regression analysis was used to identify those factors independently associated with the initiation of breastfeeding.

Results

In total, 92% of women (n = 860) commenced breastfeeding in hospital. Women who completed a university degree were more likely to initiate breastfeeding compared to those who did not complete high school (AOR = 7.16, 95% CI 2.73, 18.79). Vietnamese women had lower odds of breastfeeding initiation compared to Australian born women (AOR = 0.34. 95% CI 0.13, 0.87). Women who had more than one child were less likely to breastfeed than those who had one child (AOR = 0.38, 95% CI 0.19, 0.79). Women who gave birth via a caesarean section were less likely to breastfeed their baby compared to those who had a vaginal delivery (AOR = 0.27, 95% CI 0.14, 0.52). Women who drank alcohol during pregnancy had 72% lower odds to breastfeed compared to those who did not drink alcohol during pregnancy (AOR = 0.28, 95% CI 0.11, 0.71). Women who reported that their partner preferred breastfeeding were more likely to initiate breastfeeding (AOR = 11.77, 95% CI 5.73, 24.15) and women who had chosen to breastfeed before pregnancy had more than 2.5 times the odds of breastfeeding their baby compared to those women who made their decision either during pregnancy or after labour (AOR = 2.80, 95% CI 1.31, 5.97).

Conclusions

Women with lower levels of education, who consume alcohol during pregnancy, have more than one child, and make infant feeding decision after becoming pregnant, and those born in Vietnam should be targeted when implementing breastfeeding promotion programs. Further, women who deliver by caesarean section require additional breastfeeding support post-delivery and it is important to include fathers in breastfeeding related decisions and encourage them to participate in antenatal programs.

Evaluation of the knowledge and attitude of expectant mothers about infant oral health and their oral hygiene practices

Background:

Mothers play a crucial role in developing and maintaining their infants’ oral hygiene. Maternal oral health, their knowledge and attitude toward infant oral health are strong indicators of their infant's oral health status.

Aim:

The aim of this study is to evaluate the knowledge and attitude of expectant mothers about infant oral health and their oral hygiene practices.

Settings and Design:

This was a cross-sectional questionnaire-based survey conducted among expectant mothers in Mangalore city, India.

Materials and Methods:

Three hundred expectant mothers fulfilling the inclusion and exclusion criteria were randomly selected based on convenience method over a period of 1 month. The data were collected using a self-administered questionnaire addressing the various aspects of expectant mothers’ knowledge and attitude about infant oral health and their own oral hygiene practices. The analysis was done using SPSS version 16.0.

Results:

The overall score revealed that majority of the expectant mothers had poor knowledge and attitude toward infant oral health and followed poor oral hygiene practices. Expectant mothers’ educational qualification, trimester, and the number of pregnancy had a significant role in their knowledge, attitude, and oral hygiene practices.

Conclusion:

Implementation of educational programs to motivate expectant mothers and bring out awareness about the importance of oral health and their implications must be emphasized.

Parental Perceptions of Oral Health Status in Preschool Children and Associated Factors

<p>The aim of the present study was to evaluate parental perceptions of oral health status in preschool children. A cross-sectional study was carried with 843 Brazilian children between 3 and 5 years of age. Parents/guardians answered a self-administered questionnaire on the health of their children and sociodemographic data. Parental perceptions of their child's oral health were determined by the responses to the following question: "How would you describe your child's oral health?" The Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) was answered by parents/guardians and used to measure the impact of oral health-related quality of life (OHRQoL) on preschool children and their families. Three examiners performed oral exams on the children (K= 0.85-0.90). Descriptive analytical statistics were carried out, followed by logistic regression for complex samples (α=5%). The following variables were significantly associated with parental perceptions of children's oral health: parental perception of general health as poor (OR=18.25; 95% CI: 3.36-98.96), negative impact on family's OHRQoL (OR=13.82; 95% CI: 4.27-44.72), child aged five years (OR=7.40; 95% CI: 1.49-36.63) and the interaction between history of toothache and dental caries (OR=10.02; 95% CI: 1.17-85.61). Thus, parental perceptions of oral health are influenced only by clinical conditions with symptoms, such as dental caries with toothache. Other oral conditions, such as malocclusion or traumatic dental injury, were not associated with parental perceptions of their child's oral health.</p>

Association between parental guilt and oral health problems in preschool children: a hierarchical approach

Background

Dental caries and traumatic dental injury (TDI) can play an important role in the emergence of parental guilt, since parents feel responsible for their child’s health. The aim of the present study was to evaluate the influence of oral health problems among preschool children on parental guilt.

Methods

A preschool-based, cross-sectional study was carried out with 832 preschool children between three and five years of age in the city of Campina Grande, Brazil. Parents/caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The item "parental guilt" was the dependent variable. Questionnaires addressing socio-demographic variables (child’s sex, child’s age, parent’s/caregiver’s age, mother’s schooling, type of preschool and household income), history of toothache and health perceptions (general and oral) were also administered. Clinical exams for dental caries and TDI were performed by three dentists who had undergone a training and calibration exercise (Kappa: 0.85-0.90). Poisson hierarchical regression was used to determine the significance of associations between parental guilt and oral health problems (α = 5%). The multivariate model was carried out on three levels using a hierarchical approach from distal to proximal determinants: 1) socio-demographic aspects; 2) health perceptions; and 3) oral health problems.

Results

The frequency of parental guilt was 22.8%. The following variables were significantly associated with parental guilt: parental perception of child’s oral health as poor (PR = 2.010; 95% CI: 1.502-2.688), history of toothache (PR = 2.344; 95% CI: 1.755-3.130), cavitated lesions (PR = 2.002; 95% CI: 1.388-2.887), avulsion/luxation (PR = 2.029; 95% CI: 1.141-3.610) and tooth discoloration (PR = 1.540; 95% CI: 1.169-2.028).

Conclusion

Based on the present findings, parental guilt increases with the occurrence of oral health problems that require treatment, such as dental caries and TDI of greater severity. Parental perceptions of poor oral health in their children and history of toothache were predictors of greater feelings of parental guilt.

Impact of oral health conditions on the quality of life of preschool children and their families: a cross-sectional study

BACKGROUND

Dental caries, traumatic dental injury (TDI) and malocclusion are common oral health conditions among preschool children and can have both physical and psychosocial consequences. Thus, it is important to measure the impact these on the oral health-related quality of life (OHRQoL) of children. The aim of the present study was to assess the impact of oral health conditions on the OHRQoL of preschool children and their families.

METHODS

A preschool-based, cross-sectional study was carried out with 843 preschool children in the city of Campina Grande, Brazil. Parents/caregivers answered the Brazilian Early Childhood Oral Health Impact Scale and a questionnaire addressing socio-demographic data as well as the parent's/caregiver's perceptions regarding their child's health. Clinical exams were performed by three researchers who had undergone a calibration process for the diagnosis of dental caries, TDI and malocclusion (K = 0.83-0.85). Hierarchical Poisson regression was employed to determine the strength of associations between oral health conditions and OHRQoL (α = 5%). The multivariate model was run on three levels obeying a hierarchical approach from distal to proximal determinants: 1) socio-demographic data; 2) perceptions of health; and 3) oral health conditions.

RESULTS

The prevalence of impact from oral health conditions on OHRQoL was 32.1% among the children and 26.2% among the families. The following variables were significantly associated with a impact on OHRQoL among the children: birth order of child (PR = 1.430; 95% CI: 1.045-1.958), parent's/caregiver's perception of child's oral health as poor (PR = 1.732; 95% CI: 1.399-2.145), cavitated lesions (PR = 2.596; 95% CI: 1.982-3.400) and TDI (PR = 1.413; 95% CI: 1.161-1.718). The following variables were significantly associated with a impact on OHRQoL among the families: parent's/caregiver's perception of child's oral health as poor (PR = 2.116; 95% CI: 1.624-2.757), cavitated lesions (PR = 2.809; 95% CI: 2.009-3.926) and type of TDI (PR = 2.448; 95% CI: 1.288-4.653).

CONCLUSION

Cavitated lesions and TDI exerted a impact on OHRQoL of the preschool children and their families. Parents'/caregivers' perception of their child's oral health as poor and the birth order of the child were predictors of a greater impact on OHRQoL.

Diversity considerations for promoting early childhood oral health: a pilot study

Objectives. Several groups in Manitoba, Canada, experience early childhood caries (ECC), including Aboriginal, immigrant, and refugee children and those from select rural regions. The purpose of this pilot study was to explore the views of parents and caregivers from four cultural groups on early childhood oral health and ECC. Methods. A qualitative descriptive study design using focus groups recruited parents and caregivers from four cultural groups. Discussions were documented, audio-recorded, transcribed, and then analyzed for content based on themes. Results. Parents and caregivers identified several potential barriers to good oral health practice, including child's temperament, finances, and inability to control sugar intake. Both religion and genetics were found to influence perceptions of oral health. Misconceptions regarding breastfeeding and bottle use were present. One-on-one discussions, parental networks, and using laypeople from similar backgrounds were suggested methods to promote oral health. The immigrant and refugee participants placed emphasis on the use of visuals for those with language barriers while Hutterite participants suggested a health-education approach. Conclusions. These pilot study findings provide initial insight into the oral health-related knowledge and beliefs of these groups. This will help to inform planning of ECC prevention and research strategies, which can be tailored to specific populations.

Impact of traumatic dental injury on the quality of life of Brazilian preschool children

This study aimed to assess the impact of traumatic dental injury (TDI) on the quality of life of preschoolers and their families. A cross-sectional study was carried out, with a sample of 814 children, aged three to five years old, in Campina Grande, Brazil. Parents/caregivers were asked to complete the Brazilian Early Childhood Oral Health Impact Scale and a questionnaire on socio-demographic data. Oral examinations of the children were performed by three previously calibrated dentists. Bivariate and multiple Poisson regression analyses were performed (α = 5%). The prevalence of negative impact from oral conditions on quality of life was 31.1% among the children and 24.7% among the families. TDI was not associated with a negative impact on quality of life. Parent/caregiver's assessment of the child's oral health (PR = 1.210; 95% CI: 1.027-1.426) and history of toothache (PR = 4.997; 95% CI: 2.943-8.493) remained in the final model for the child section, whereas only a history of toothache (PR = 2.791; 95% CI: 1.801-4.325) remained in the final model for the family section. TDI exerted no negative impact on quality of life in the present sample. A history of toothache was the only variable associated with a negative impact on the quality of life of the preschoolers and their families.

Comparison of caries detection methods using varying numbers of intra-oral digital photographs with visual examination for epidemiology in children

Background

This was a method comparison study. The aim of study was to compare caries information obtained from a full mouth visual examination using the method developed by the British Association for the Study of Community Dentistry (BASCD) for epidemiological surveys with caries data obtained from eight, six and four intra-oral digital photographs of index teeth in two groups of children aged 5 years and 10/11 years.

Methods

Five trained and calibrated examiners visually examined the whole mouth of 240 5-year-olds and 250 10-/11-year-olds using the BASCD method. The children also had intra-oral digital photographs taken of index teeth. The same 5 examiners assessed the intra-oral digital photographs (in groups of 8, 6 and 4 intra-oral photographs) for caries using the BASCD criteria; dmft/DMFT were used to compute Weighted Kappa Statistic as a measure of intra-examiner reliability and intra-class correlation coefficients as a measure of inter-examiner reliability for each method. A method comparison analysis was performed to determine the 95% limits of agreement for all five examiners, comparing the visual examination method with the photographic assessment method using 8, 6 and 4 intra-oral photographs.

Results

The intra-rater reliability for the visual examinations ranged from 0.81 to 0.94 in the 5-year-olds and 0.90 to 0.97 in the 10-/11-year-olds. Those for the photographic assessments in the 5-year-olds were for 8 intra-oral photographs, 0.86 to 0.94, for 6 intra-oral photographs, 0.85 to 0.98 and for 4 intra-oral photographs, 0.80 to 0.96; for the 10-/11-year-olds were for 8 intra-oral photographs 0.84 to 1.00, for 6 intra-oral photographs 0.82 to 1.00 and for 4 intra-oral photographs 0.72 to 0.98. The 95% limits of agreement were −1.997 to 1.967, -2.375 to 2.735 and −2.250 to 2.921 respectively for the 5-year-olds and −2.614 to 2.027, -2.179 to 3.887 and −2.594 to 2.163 respectively for the 10-/11-year-olds.

Conclusions

The photographic assessment method, particularly assessment of 8 intra-oral digital photographs is comparable to the visual examination method in the primary dentition. With the additional benefits of archiving, remote scoring, allowing multiple scorers to score images and enabling longitudinal analysis, the photographic assessment method may be used as an alternative caries detection method in the primary dentition in situations where the visual examination method may not be applicable such as when examiner blinding is required and in practice based randomised controlled trials (RCTs).

'English leaflets are not meant for me': a qualitative approach to explore oral health literacy in Chinese mothers in Southwestern Sydney, Australia

OBJECTIVES

The aim of this study was to record the views of Chinese mothers living in southwestern Sydney on the value of commonly used dental health education materials that gave behavioural advice on looking after the oral health of young children.

METHODS

This qualitative study was nested within a large cohort study in south-western Sydney. Chinese-speaking mothers (n = 27) with young children were approached for a face-to-face, semi-structured interview at their home. Two dental leaflets in English that gave behavioural advice on monitoring young children's oral health were sent to each mother prior to interview. On the day of the interview, mothers were also given translated versions of the leaflets for comparison. Interviews were recorded and subsequently transcribed verbatim. Transcripts were analysed by thematic coding.

RESULTS

Mothers reported that the leaflets were not tailored to match the different levels of English literacy within the Chinese community, and participants favoured health information material written in their first language with the use of illustrations. However, translations had to take account of the Chinese culture, as some of the advice in the leaflets presented did not reflect Chinese family values. Mothers also felt that the information should be more specific to provide a better understanding of the rationale for changing or implementing a different behaviour.

CONCLUSIONS

Dental health information literature for Chinese people should not be translated directly from those intended for an English-speaking audience, but should reflect Chinese culture-specific advice such as examples of the type and amount of foods to be given during early years of life. Supportive illustrations were also preferred.