Parental perception of oral health status of children in mainstream and special education classrooms

Oral health status, behavior, and practices among hearing impaired children attending a specialized school in Jordan

AIMS

To assess the oral health status and related factors among hearing impaired schoolchildren.

METHODS

A cross-sectional study among 115 hearing impaired schoolchildren enrolled at the School of the Deaf in Jordan. The World Health Organization (WHO) methodology and criteria were applied to collect data on caries, gingival bleeding. The WHO classification modified by Andreasen et al. was used to record traumatic dental injuries (TDIs). Sociodemographic data, oral health practices, and oral health related quality of life information were collected using a structured questionnaire.

RESULTS

The prevalence of caries among the study sample was 84.3%, the dominating component was untreated dental caries. Mean decayed, missing, filled primary teeth (dmft) was 8 in the primary dentition and 3.62 in the mixed dentition, mean Decayed, Missing, Filled permanent Teeth (DMFT) was 1.38 in the mixed dentition and 2.87 in the permanent. The overall mean of gingival bleeding percentage among the whole study sample was 70.38%. the prevalence of TDIs was of 11.3% and mostly caused by falls.

CONCLUSIONS

The prevalence of dental caries and caries experience, rate of gingival bleeding and dental trauma in children with hearing impaired individuals are high compared to figures observed in studies conducted among Jordanian schoolchildren with normal hearing. Dental diseases impact the quality of life of these individuals.

Type 1 Diabetes Mellitus Patients' Self-perception of Periodontal Diseases

OBJECTIVES

 The study aimed to evaluate type 1 diabetes mellitus (T1DM) patients' self-perceived periodontal health status and to identify the association between periodontal disease (PD) and DM.

MATERIALS AND METHODS

 This cross-sectional study included 113 T1DM children between 3 and 18 years old from the Universiti Teknologi MARA and the University of Malaya. Periodontal health parameters, including plaque index, gingival index, probing pocket depth, simplified basic periodontal examination, and clinical attachment loss, were recorded. Self-perceived periodontal health status was assessed with questionnaires.

STATISTICAL ANALYSIS

 Statistical analysis was performed to evaluate the sensitivity of the questionnaire and the relationship between T1DM and periodontal parameters.

RESULTS

 The median age was 11.4 years. Half of them (50.4%) were females. A total of 83.5% rated their oral condition as good, whereas 27.5% reported a history of gingival bleeding. Clinical examination revealed that 48.7% had healthy gingiva, whereas 47.8% had gingivitis. The question "Do you have bleeding when brushing, flossing, or eating food?" showed good accuracy in the evaluation of PD (p < 0.001).

CONCLUSION

 The questionnaire has a high potential to be used by medical professionals in identifying T1DM patients at risk of PD to guide nondental health care providers in making appropriate referrals to dental services.

Family Influences on the Dental Caries Status of Children with Special Health Care Needs: A Systematic Review

Oral health is a likely source of health inequalities in children with special health care needs (CSHCN), according to multiple studies. This systematic review aimed to explore the evidence of family influence—as well as family features, such as societal variables and parents’ perspectives—on these children’s dental caries status. Embase, Ebsco, Scopus, PubMed, and Web of Science databases were all searched. All cross-sectional research published on the variables of family impact ranging from 2010 to 2021 were considered. The DMFT and dmft index was utilised for the report data of dental caries, whereas the National Heart, Lung, and Blood Institute (NHLBI) was used for the purposes of assessing quality. Of the 3861 records identified, 14 were eligible. Further, most of the studies had a caries prevalence of over 50%, (p-value < 0.005). Family influences imparted a significant relationship and association towards the dental caries status of the demographic being studied. The influences on the children included tooth brushing behaviour, parents’ education level, parents’ occupation level, diet pattern, dental visit, snacking frequency, parents’ psychological status, family size, and parents’ knowledge towards oral health. Future research should further explore the family functioning domains, specifically among the CSHCN population. This study was registered on PROSPERO, number CRD42021274923.

Changes in Parental Perceptions of Their Care of Their Children's Oral Health From Age 1 to 4 Years

Introduction: In this 3-year longitudinal study, parent/child attended 3 dental visits and in between, parents were called every 4 months and asked if their child had visited the dentist and if fluoride varnish had been applied. Methods: Objectives were to assess changes in parents’ perceptions of how well they do in taking care of their children’s teeth and/or gums across these 3 time points (at age 1, 2.5, and 4 years), assess differences in parents’ perceptions of how well they do taking care of their children’s teeth and/or gums versus taking care of their children’s medical health, and determine factors associated with parental perceptions of how well they do in taking care of the children’s teeth and/or gums longitudinally. Results: Participant pairs (1325) were enrolled and over time there was a significant improvement in parental perceptions of their job taking care of their children’s teeth and/or gums, increasing from 86% perceiving it to be excellent/very good/good at their child’s 1 year of age to 92% at child’s age 4 years. The estimated odds of parents perceiving they provided excellent/very good/good versus fair/poor care for the children’s teeth and/or gums were higher for those who cleaned and checked inside the children’s mouth and/or gums daily (odds ratio 4.74) or took their children to the dentist yearly or twice yearly (odds ratio; 2.73). Conclusions: Parents’ perceptions of the care of their children’s teeth and/or gums improved over time. Parents consistently perceived that they provided better medical care than dental care for their child.

A Causative Approach to Demographic and Socioeconomic Factors Affecting Parental Ratings of Child Oral Health

INTRODUCTION

Many studies have investigated associations between demographic, socioeconomic status (SES), behavioral, and clinical factors and parental ratings of child oral health. Caries experience, pain, missing teeth, malocclusions, and conditions and treatments likely to negatively affect the child or family in the future have been consistently associated with poorer parental ratings. In contrast, effect sizes for associations between demographic and SES indicators (race/ethnicity, country of birth, family structure, household income, employment status, and parental education levels) and parental ratings vary greatly.

OBJECTIVES

The primary objectives of this study were to estimate effect sizes for associations between demographic and SES variables and parental ratings of child oral health and then to consider possible causal implications.

METHODS

This article uses a nationally representative data set from 24,664 Australian children aged 5 to 14 y, regression analyses guided by a directed acyclic graph causal model, and sensitivity analyses to investigate effects of demographic and SES factors on parental ratings of oral health.

RESULTS

One in 8 children had oral health rated as fair or poor by a parent. Indigenous children, older boys, young children with a migrant parent, children from single-parent families, low-income households and families where no parent worked full-time, and children whose parents had lower education levels were much more likely to receive a fair or poor parental oral health rating in crude and adjusted models.

CONCLUSION

This cross-sectional study helps to clarify inconsistent findings from previous research and shows many demographic and SES variables to be strong determinants of parental ratings of child oral health, consistent with the effects of these variables on other health outcomes. Sensitivity analyses and consideration of the potential for chance and bias to have affected these findings suggest that many of these associations may be causal.

KNOWLEDGE TRANSFER STATEMENT

Based on regression analyses driven by a directed acyclic graph causal model, this research shows a strong impact of demographic and socioeconomic determinants on parental ratings of child oral health, consistent with associations between these variables and other oral and general health outcomes. Many of these associations may be causal. We demonstrate the value of causal models and causal thinking when analyzing complex multilevel observational data.

Short-term impact of an oral health program for adults with cerebral palsy

AIM

To evaluate the impact of an oral health program for institutionalized individuals with cerebral palsy (CP) and their caregivers, after 2 and 6 months.

METHODS

Sixty-two CP individuals in four homes were selected for intervention group (n = 31) and control group (n = 31). An oral hygiene practices questionnaire was applied to all caregivers at the baseline. Both groups received awareness sessions, practical demonstration of toothbrushing and adaptive techniques with role-play. In the study group, individual oral hygiene monitoring was also performed in the first 2 months. A gingival and an oral hygiene indexes were performed at the beginning, after 2 and 6 months of intervention.

RESULTS

There was a significant reduction of gingival (p < 0.001) and oral hygiene (p < 0.001) indexes at 2 and 6 months in the intervention group with the most significant reductions at 2 months. Caregivers reported opening the mouth (84.6%) and swallowing toothpaste (61.5%) as the most important difficulties in performing toothbrushing.

CONCLUSION

It was found that frequent and individualized monitoring of plaque control was essential to reduce dental plaque and gingivitis levels and that awareness sessions were not enough to produce clinically significant result.

Factors Associated With Parents' Perceptions of Their Infants' Oral Health Care

INTRODUCTION

Parents have an important role ensuring their infants receive oral and medical health care. Their decisions affect the well-being of their children.

METHODS

This study used data collected from a longitudinal, prospective study with the aim of developing and validating a caries risk assessment tool. The objectives of this study are to (a) compare parents' perceptions of how well they do in taking care of the infants' teeth and/or gums versus how well they do in taking care of the infants' medical health and (b) determine factors associated with parental perceptions of how well they do in taking care of the infants' teeth and/or gums.

RESULTS

A total of 1323 parent/infant pairs were enrolled in the study at Duke University, Indiana University, and the University of Iowa. Through a survey, 283 (21%) of the parents perceived they did an excellent job of both taking care of both the infant's oral and medical health, while 861 (65%) perceived the care of their infant's medical health was better than their care of the teeth and/or gums. In the multivariable model, parents who perceived they provided excellent/very good/good care for the infants' teeth and/or gums were more likely to brush the infant's teeth daily, use toothpaste daily, clean inside the infant's mouth and/or gums daily, and not let the infant have something other than water after brushing and prior to bedtime. Also, those with infants having Medicaid or State Insurance, parents not eating sugary snacks frequently, and parents getting dental checkups at least annually were likely to perceive that they provided excellent/very good/good care for their infant's teeth and/or gums.

CONCLUSIONS

Parents who provide good infant oral health care are more likely to perceive they provide good care and more likely to have better personal dental health behaviors. This agrees with previous studies concerning older children.

Waiting times before dental care under general anesthesia in children with special needs in the Children's Hospital of Casablanca

Introduction

Oral diseases may have an impact on quality of children's life. The presence of severe disability requires the use of care under general anesthesia (GA). However, because of the limited number of qualified health personnel, waiting time before intervention can be long. Aim: To evaluate the waiting time before dental care under general anesthesia for children with special needs in Morocco.

Methods

A retrospective cohort study was carried out in pediatric dentistry unit of the University Hospital of Casablanca. Data were collected from records of patients seen for the first time between 2006 and 2011. The waiting time was defined as the time between the date of the first consultation and intervention date.

Results

127 children received dental care under general anesthesia, 57.5% were male and the average age was 9.2 (SD = 3.4). Decay was the most frequent reason for consultation (48%), followed by pain (32%). The average waiting time was 7.6 months (SD = 4.2 months). The average number of acts performed per patient was 13.5.

Conclusion

Waiting times were long, it is necessary to take measures to reduce delays and improve access to oral health care for this special population.

Racial/ethnic disparities in provision of dental procedures to children enrolled in Delta Dental insurance in Milwaukee, Wisconsin

OBJECTIVES

Most studies on the provision of dental procedures have focused on Medicaid enrollees known to have inadequate access to dental care. Little information on private insurance enrollees exists. This study documents the rates of preventive, restorative, endodontic, and surgical dental procedures provided to children enrolled in Delta Dental of Wisconsin (DDWI) in Milwaukee.

METHODS

We analyzed DDWI claims data for Milwaukee children aged 0-18 years between 2002 and 2008. We linked the ZIP codes of enrollees to the 2000 U.S. Census information to derive racial/ethnic estimates in the different ZIP codes. We estimated the rates of preventive, restorative, endodontic, and surgical procedures provided to children in different racial/ethnic groups based on the population estimates derived from the U.S. Census data. Descriptive and multivariable analysis was done using Poisson regression modeling on dental procedures per year.

RESULTS

In 7 years, a total of 266,380 enrollees were covered in 46 ZIP codes in the database. Approximately, 64 percent, 44 percent, and 49 percent of White, African American, and Hispanic children had at least one dental visit during the study period, respectively. The rates of preventive procedures increased up to the age of 9 years and decreased thereafter among children in all three racial groups included in the analysis. African American and Hispanic children received half as many preventive procedures as White children.

CONCLUSION

Our study shows that substantial racial disparities may exist in the types of dental procedures that were received by children.

Avaliação da saúde de crianças em creches de cidade do sul do Brasil

OBJETIVO: Analisar a avaliação da saúde de crianças de creches públicas e privadas de uma cidade do Sul do Brasil feita por seus responsáveis e investigar sua associação com fatores socioeconômicos, demográficos e aqueles relacionados ao estado de saúde. MÉTODOS: Estudo transversal com amostragem em duplo estágio (n=589). A coleta de dados incluiu medidas antropométricas e questionário com variáveis infantis e do responsável. A avaliação do responsável sobre a saúde infantil foi coletada como muito boa, boa, regular, ruim ou muito ruim. Para a análise, as duas primeiras categorias foram agrupadas e as três últimas indicaram saúde negativa. As razões de prevalência brutas e ajustadas e seus respectivos intervalos de confiança de 95% (IC95%) foram calculadas por meio da regressão de Poisson, com ajuste para delineamentos complexos. RESULTADOS: Foram avaliadas 531 crianças (90,2%) com idades de 1,5 meses a 7,5 anos, a maioria de creches públicas (75,9%). Apenas 8,1% (IC95% 5,8 - 10,4) tiveram sua saúde classificada como regular. Crianças hospitalizadas no ano anterior, as de raça negra, amarela ou indígenas, que ficavam mais de 20 horas por semana na creche e com consumo alimentar considerado "pequeno" pelos pais apresentaram maior prevalência de saúde classificada como regular. Pais que relataram consumir bebidas alcoólicas avaliaram como pior a saúde de seus filhos. CONCLUSÕES: A maioria dos responsáveis avaliou positivamente a saúde de seus filhos. Cor da pele, hospitalizações e consumo alimentar foram variáveis independentemente associadas à pior avaliação de saúde infantil pelos responsáveis.