Stages and transitions in the development of tooth brushing skills in children of Mexican immigrant families: a qualitative study

Early childhood caries and parents' challenges in implementing oral hygiene practices: a qualitative study

BACKGROUND

Early childhood caries (ECC) is highly prevalent with significant long-term consequences. Parents are primarily responsible for the oral health practices of their children. Parents' health beliefs, attitudes, and cultural factors influence oral health practices.

AIM

To explore and understand the perceptions and challenges faced by the parents of the children with ECC in performing routine oral hygiene practices for their children.

DESIGN

We conducted a qualitative description study with the parents of children with ECC. Data were collected through five focus groups using culturally appropriate, semi-structured, open-ended questions and probes. Focus groups were audiotaped, and field notes were taken, which were transcribed verbatim after each focus group session. Data were analyzed using content analyses.

RESULTS

A vast majority of the participants were aware of the significance of oral hygiene. However, they faced challenges in implementing proper home hygiene practices at home and lacked knowledge about the type of toothpaste and toothbrush to be used for their children.

CONCLUSION

The parents of the children with ECC face a severe knowledge gap, which is interfering with the selection of proper oral hygiene aids for their children. They also face barriers in implementing oral hygiene routines for their children, in spite of awareness that tooth brushing is important.

Comparison of Efficacy of Different Supervision Methods of Toothbrushing on Dental Plaque Scores in 7-9-year-old Children

Background and objectives

The efficiency of mechanical plaque control in children not only depends on the type of oral aids they use but also on the instructions, training, and motivation given to them. To compare the efficiency of different methods of personal supervision of toothbrushing in reducing the dental plaque levels in 7-9-year-old schoolchildren.

Materials and methods

A parallel designed double-blinded randomized study was conducted in a private school in Jeddah, Saudi Arabia from September 2018 to December 2018. The children were allocated randomly into two groups based on the type of supervision given. Plaque scores examination was carried out at four intervals as baseline, 7th day, 14th day, and 90th day.

Results

Plaque scores reduced after 7 days in all groups, even though there was no statistically significant difference observed. At the final examination of plaque scores (90th day), there was a highly statistically significant reduction observed in group I and II compared to group III where the reduction was less evident.

Conclusion

Supervision of toothbrushing in the correct way was effective in reducing the plaque scores. Our study benefited both parents and children in understanding the correct method of brushing and the importance of plaque control.

How to cite this article

Pullishery F, Abuzenada BM, Alrushnudi NM, et al. Comparison of Efficacy of Different Supervision Methods of Toothbrushing on Dental Plaque Scores in 7-9-year-old Children. Int J Clin Pediatr Dent 2021;14(2):263-268.

Toothbrushing Performance and Oral Cleanliness after Brushing in 12-Year-Old Children

Objectives:

Nationwide prevention programs in Germany aim to promote oral health. The group prevention program starts in kindergarten and ends when the children are about 12 y old. While in a recent study, toothbrushing behavior of 12-y-old children was analyzed, the present study’s objective was to examine the children’s ability to achieve oral cleanliness and to analyze how toothbrushing behavior and compliance with the toothbrushing recommendations taught in the group prevention programs predict oral cleanliness.

Methods:

Twelve-year-old randomly selected children (N = 174) were asked to brush their teeth to the best of their abilities, and simultaneously a video was recorded for behavioral analyses. Plaque levels were measured before and immediately after toothbrushing. In addition, dental status and gingival bleeding were assessed.

Results:

After brushing to the best of their abilities, there was plaque on 50% (±24.72%) of all measured sites at the gingival margin (Marginal Plaque Index). Regression analyses revealed approximately 22% of the variance of marginal plaque on the outer surfaces to be explained by the time brushed by circular movements (β = −0.41;P < 0.001) and the number of sextants brushed for at least 7.5 s (β = −0.171; P < 0.05). Circular movements explained most additional variance (ΔR² = 0.113; P < 0.001). With respect to inner surfaces, none of the behavioral aspects explained any variance of oral cleanliness.

Conclusion:

Despite regular group prevention measures, 12-y-old children show limited skills to clean their teeth adequately. Furthermore, none of the recommended behaviors relates to oral cleanliness after toothbrushing at inner surfaces. As a consequence, it is necessary to explore further which behavioral sequences effectively improve oral cleanliness.

Knowledge Transfer Statement:

This study illustrates that children’s compliance to toothbrushing recommendations is not necessarily related to toothbrushing effectiveness. Clinicians should therefore assess the effectivity of recommendations individually and provide individual guidance for improvement.

[Social determinants of the health of international migrant children in Chile: qualitative evidence.]

OBJECTIVE

To explore the social determinants of health (SDH) of international migrant children, from the perceptions of caregivers, health workers and local authorities in eight municipalities in Chile.

MATERIALS AND METHODS

A secondary analysis of data was conducted from a qualitative study that took place between 2014 and 2017. The original study involved semi-structured interviews and focus groups. The secondary thematic analysis of data included all emerging issues related to international migrant children and their living conditions, including use of health services.

RESULTS

Findings were grouped according to the model of social determinants of health, which allow a reflection on living conditions of international migrant children and their health situation.

CONCLUSIONS

This research shows the impact of SDH on international migrant children in Chile, highlighting relevant issues around this group.

Effectiveness evaluation of Contra Caries Oral Health Education Program for improving Spanish-speaking parents' preventive oral health knowledge and behaviors for their young children

OBJECTIVES

To determine the effectiveness of the Contra Caries Oral Health Education Program (CCOHEP) for improving low-income, Spanish-speaking parents' oral health knowledge and behaviors for their young children. Mexican American children in the United States suffer disproportionately high prevalence and severity of early childhood caries, yet few evaluated, theory-based behavioral interventions exist for this population. CCOHEP is a theory-based curriculum consisting of four 2-h interactive classes designed for and by Spanish speakers and led by designated community health educators (promotoras). Topics included children's oral hygiene, caries etiology, dental procedures, nutrition, child behavior management, and parent skill-building activities.

METHODS

Low-income Spanish-speaking parents/caregivers of children aged 0-5 years were recruited through community services in an agricultural city in California. Survey questions from the Oral Health Basic Research Facts Questionnaire measuring oral health-related behaviors and knowledge were verbally administered before, immediately after, and 3 months after attendance at CCOHEP. Five questions measured aspects of parental toothbrushing for their children (frequency, using fluoridated toothpaste, brushing before bed, not drinking or eating after nighttime brushing, adult assistance), three questions measured other oral health behaviors, and 16 questions measured oral health-related knowledge. Analyses of within-person changes between pre- and post-tests and again between post-test and 3-month follow-up consisted of McNemar's test for binary outcomes and sign tests for ordinal outcomes.

RESULTS

Overall, 105 caregivers participated in CCOHEP (n = 105 pretest, n = 95 post-test, n = 79 second post-test). At baseline, all parents self-reported doing at least one aspect of toothbrushing correctly, but only 13% reported performing all five aspects according to professional guidelines. At post-test, 44% of parents reported completing all aspects of toothbrushing according to professional guidelines (P < .001). Statistically significant improvements were seen in 4 aspects of toothbrushing (P ≤ .008) between pretest and post-test (all but adult assistance). The second post-test showed 3 of these improvements were maintained, while adult assistance and the other reported behaviors improved (P ≤ .008). Between pretest and post-test, checking child's teeth monthly and frequency of sweet drinks consumption improved (P ≤ .008), while frequency of eating sweet foods did not change. Knowledge was high at baseline (mean 12.8 of 16), but 6 knowledge items improved significantly between pretest and post-test. Improvements were maintained at second post-test.

CONCLUSIONS

Contra Caries Oral Health Education Program improved low-income Spanish-speaking parents' oral hygiene knowledge and self-reported behaviors for their young children, and change was sustained 3 months after the end of the intervention. Future, more rigorous evaluation of the intervention is recommended.