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Hunsrisakhun J, Naorungroj S, Tangkuptanon W, Wattanasit P, Pupong K, Pithpornchaiyakul S. Impact of Oral Health Chatbot With and Without Toothbrushing Training on Childhood Caries. Int Dent J 2024:S0020-6539(24)01541-7. [PMID: 39443262 DOI: 10.1016/j.identj.2024.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 09/10/2024] [Accepted: 09/21/2024] [Indexed: 10/25/2024] Open
Abstract
OBJECTIVES Standalone oral health chatbots targeting young children's oral health are rare. The aim of this research was to compare the effectiveness of a standalone chatbot and a combination chatbot with in-person toothbrushing training for caregivers in improving young children's oral health. METHODS A randomised, parallel, 2-group pretest-posttest design was employed with 320 caregiver-child pairs (aged 6-42 months). Group I (160 pairs) used the 21-Day FunDee (modified) chatbot along with in-person toothbrushing training, whilst Group II (160 pairs) used only the 21-Day FunDee Plus chatbot. Oral examination assessed plaque levels and caries, whilst a self-administered questionnaire evaluated oral hygiene care, dietary practices, and oral health perceptions based on the protection motivation theory (PMT). Data were analysed using 2-way repeated-measures analysis of variance, a t test, and chi-square measures for group comparisons. RESULTS The majority of caregivers were Muslim mothers. No significant differences were observed between groups at the baseline, 3-month, and 6-month follow-ups in mean dmft (Group I: 4.16, 4.64, and 5.30 vs Group II: 4.30, 5.54, and 5.82), mean plaque scores (Group I: 0.72, 0.53, and 0.55 vs Group II (0.84, 0.52, and 0.59), and most dietary habits. However, significant improvements were found within groups from baseline to follow-ups in plaque reduction, toothbrushing practices, overall knowledge score, PMT perceptions, proper tooth brushing, fluoride toothpaste usage, and dietary behaviours (frequency of bottle feeding, frequency of nocturnal bottle feeding, proportion of children who went to bed without consuming anything after cleaning their teeth before bedtime). The significant differences between groups were found in self-efficacy at all time points, but only at the 6-month evaluation for percentage of fluoride toothpaste and overall PMT perceptions. CONCLUSIONS Both interventions were comparable in preventing caries, reducing plaque, improving feeding practices, increasing parental involvement in tooth brushing, and enhancing knowledge. The standalone chatbot 21-Day FunDee Plus presents a viable alternative for promoting oral health in young children.
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Affiliation(s)
- Jaranya Hunsrisakhun
- Improvement of Oral Health Care Research Unit, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Supawadee Naorungroj
- Department of Conservative Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | | | - Pissamai Wattanasit
- Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | | | - Samerchit Pithpornchaiyakul
- Improvement of Oral Health Care Research Unit, Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
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Karande PH, Shetty VB, Vinay V, Bhor KB, Ambildhok KA, Shaw AK. Comparative Evaluation of Oral Health and Behavior Changes in Children after Motivational Interviewing and Traditional Method of Oral Health Education among Mothers: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023; 16:464-473. [PMID: 37496945 PMCID: PMC10367297 DOI: 10.5005/jp-journals-10005-2594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023] Open
Abstract
Aim To analyze the effectiveness of motivational interviewing (MI) compared to traditional health education among mothers in improving children's oral health and behavioral changes. Review methods The search strategy was framed using relevant MeSH terms and free text terms in PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Directory of Open Access Journals (DOAJ), Cochrane Library, and Google Scholar for the articles published in the English language between 1st January 2000 and 31st December 2020. Only randomized controlled trials, non-randomized controlled trials, and clinical trials comparing MI with traditional health education were included. Cochrane risk of bias (ROB) tool was used for the quality assessment of the included studies, and Review Manager 5.3 software was used for computing results. Results A total of 9 studies were included for qualitative synthesis and 5 for quantitative synthesis from an initial search of 3,708 articles. The cumulative mean difference for dental caries was -1.03 [95% confidence interval (CI)-1.37-0.70] p < 0.00001, for frequency of toothbrushing Pooled odds ratio was 1.69 (95% CI-0.68-4.25) p = 0.26 and for in-between snacking was 0.83 with (95% CI-0.48-1.44) p = 0.51. A significant difference was present in dental caries among children with mothers in the MI group, while no difference was present in in-between snacking and frequency of toothbrushing between both the groups. Conclusion Motivational interviewing (MI) prove to be significantly effective in reducing newer dental caries for shorter duration; however, long-term effectiveness could not be assessed. Clinical significance Motivational interviewing (MI) can be considered an effective and feasible method for oral health education to mothers, which will, in turn, improve the oral health of their children. Protocol registration International prospective register of systematic reviews (PROSPERO) under registration code. CRD42021224278. How to cite this article Karande PH, Shetty VB, Vinay V, et al. Comparative Evaluation of Oral Health and Behavior Changes in Children after Motivational Interviewing and Traditional Method of Oral Health Education among Mothers: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023;16(3):464-473.
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Affiliation(s)
- Purnima H Karande
- Department of Public Health Dentistry, Sinhgad Dental College & Hospital, Pune, Maharashtra, India
| | - Vittaldas B Shetty
- Department of Public Health Dentistry, Sinhgad Dental College & Hospital, Pune, Maharashtra, India
| | - Vineet Vinay
- Department of Public Health Dentistry, Sinhgad Dental College & Hospital, Pune, Maharashtra, India
| | - Ketaki B Bhor
- Department of Public Health Dentistry, DY Patil (Deemed to be University) School of Dentistry, Nerul, Navi Mumbai, Maharashtra, India
| | - Kadambari A Ambildhok
- Department of Public Health Dentistry, Sinhgad Dental College & Hospital, Pune, Maharashtra, India
| | - Amar K Shaw
- Department of Public Health Dentistry, Bharati Vidyapeeth Dental College and Hospital, Pune, Maharashtra, India
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Manek S, Jawdekar AM, Katre AN. The Effect of Motivational Interviewing on Reduction of New Carious Lesions in Children with Early Childhood Caries: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023; 16:112-123. [PMID: 37020773 PMCID: PMC10067999 DOI: 10.5005/jp-journals-10005-2497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Background Preventive therapies rely on effective behavior change. Motivational interviewing (MI), has been the most recent advancement in behavior therapies that have been successful in tobacco cessation. The effectiveness of MI needs to be evaluated in caries prevention. Objectives To evaluate the effectiveness of MI on the reduction of new carious lesions in children with early childhood caries (ECC). Materials and methods The two authors independently searched data from Cochrane Library, PubMed, Google Scholar, J gate, and Quintpub. Selection criteria-interventional studies written in the English language with MI as an intervention, a mean follow-up period of atleast 2 years, ECC with decayed, missing, and filled primary teeth/decayed, missing, and filled primary surfaces (dmft/dmfs) as the outcome measures, in the age group of 0-6 years. We excluded cross-sectional studies. Information regarding methods, participants, interventions, outcome measures, and results were extracted. A risk of bias assessment within and across studies was conducted. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were applied to generate quality evidence. Results Six studies with a total of 2,663 participants were included in the review, and meta-analysis was conducted on 4; 3 studies had a high risk of bias. A mean reduction of 2.16 (-5.06, 0.75) was observed with MI as an intervention. A sensitivity analysis revealed a mean reduction of 3.64 (-5.77, -1.51) in favor of MI. Conclusion There is some evidence with moderate certainty that MI is beneficial in the reduction of new carious lesions in children with ECC. How to cite this article Manek S, Jawdekar AM, Katre AN. The Effect of Motivational Interviewing on Reduction of New Carious Lesions in Children with Early Childhood Caries: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023;16(1):112-123.
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Affiliation(s)
- Shivangi Manek
- Department of Pediatric and Preventive Dentistry, Dr G.D. Pol Foundation's Y.M.T. Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Ashwin M Jawdekar
- Vice Principal, Bharati Vidyapeeth Deemed to be University Dental College & Hospital, Belpada, Navi Mumbai 400614 (India)
| | - Amar N Katre
- Department of Pediatric and Preventive Dentistry, Dr G.D. Pol Foundation's Y.M.T. Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Ahn E, Kim SM. The cost- effectiveness of early dental visit in infants and toddlers focused on regional deprivation in South Korea: A retrospective cohort study. PLoS One 2022; 17:e0269770. [PMID: 35696402 PMCID: PMC9191701 DOI: 10.1371/journal.pone.0269770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background The aims of this study are to evaluate the cost-effectiveness of early dental visits (EDVs) and to investigate how regional deprivation impacts the economic evaluation. Methods This study used the South Korea National Health Insurance database, which included medical claim data and voluntary-based oral examination data. The subjects of this study included whole participants for oral examinations for infants and toddlers of the National Health Insurance Corporation. A retrospective cohort study was designed and measured all oral treatments, costs, and number of visits for 208,969 children (experimental group, 101,768; non- experimental group, 107,201) who underwent oral examination for infants and toddlers from 2007 to 2014. The cost-effectiveness was measured using the incremental cost-effectiveness ratio, and the T-health index was used as the measurement for effectiveness. In addition, the difference in the effect according to the level of regional deprivation was confirmed. Results The findings of this study showed that EDVs were cost-effective and that children who participated in EDVs had better oral health (T-health-2 index difference 0.32 point in most deprived regions) and needed 5 USD less costly dental treatments than those who did not have EDVs. The cost-effectiveness of EDVs varied according to the level of regional deprivation and was the highest in the most deprived regions. Conclusions The study findings suggested that the provision of oral examination for infants and toddlers was a cost-effective dental policy. Additionally, EDVs were more effective in children who resided in the most deprived regions, a finding that will lead to the development of policy intervention to improve dental care despite spatial inequality for disadvantaged population groups. Regarding the distribution of dental hospitals/clinics, incentive based dental polices for either dental providers or patients are needed that will assure the delivery of dental care despite spatial inequality.
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Affiliation(s)
- Eunsuk Ahn
- Department of Dental Hygiene, Daejeon Institute of Science and Technology, Daejeon, Republic of Korea
| | - Sun-Mi Kim
- Department of Dental Hygiene, Wonkwang Health Science University, North Jula, Republic of Korea
- * E-mail:
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Leske AM, Mustchin C, Clarke-Errey S, Satur J, Bhujel N, Rajan S. Motivational interviewing versus conventional caries prevention strategies in high-caries-risk children and families: a non-randomised trial. Br Dent J 2022:10.1038/s41415-022-4341-4. [PMID: 35676460 DOI: 10.1038/s41415-022-4341-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/30/2021] [Indexed: 11/09/2022]
Abstract
Background This study compared the effectiveness of motivational interviewing (MI) and conventional caries prevention (CCP) for primary (caries increment) and secondary outcomes (caries intensity, gingival health, caregiver-reported oral health-related knowledge, behaviours and attitudes) over 12 months.Methods High-caries-risk children and caregivers received CCP or MI with comprehensive dental care. Fidelity was monitored using MI treatment integrity code 4.2.1. Caries increment, intensity and gingival health were measured at baseline, six and twelve months. Readiness Assessment of Parents Concerning Infant Dental Decay questionnaires recorded oral health-related knowledge, behaviours and attitudes.Results In total, 86 caregiver-child dyads (CCP = 51; MI = 35) were recruited. The mean difference (95% confidence interval [CI]) in caries increment (ΔdICDAS1-6mfs + DICDAS1-6MFS) was significantly higher with MI compared to CCP at six (MI 2.3 [1.2, 3.5] vs CCP 0.6 [0.1, 1.0]; p <0.001) and twelve (MI 4.3 [2.5, 6.0] vs CCP 1.2 [0.6, 1.8]; p <0.001) months. Multivariate analysis with CCP as reference group, odds ratio (95% CI) for new/progressed caries (Δdecayed, missing and filled surface score [permanent] + decayed, missing and filled surface score [primary] >0) at six and twelve months were 18.2 (4.0, 81.7); p <0.001 and 12.6 (3.3, 47.8); p <0.001, respectively. The MI group reported positive behaviours and attitudes.Conclusions CCP was more effective in reducing caries increment when behaviour change technique was incorporated into the preventative strategies as per current paediatric dentistry guidelines.
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Affiliation(s)
- Amanda M Leske
- Paediatric Dentistry, Melbourne Dental School, The University of Melbourne, Australia
| | - Claire Mustchin
- Oral Health Therapy, Melbourne Dental School, The University of Melbourne, Australia
| | - Sandy Clarke-Errey
- Statistical Consulting Centre, School of Mathematics and Statistics, The University of Melbourne, Australia
| | - Julie Satur
- Oral Health Therapy, Melbourne Dental School, The University of Melbourne, Australia
| | - Nabina Bhujel
- Paediatric Dentistry, Guy´s and St Thomas´ NHS Foundation Trust, UK
| | - Sadna Rajan
- Paediatric Dentistry, Melbourne Dental School, The University of Melbourne, Australia; King´s College London, London, UK.
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Khan SDAA, Al-Garni M, Khurim MNA, Alkhathami ES, Sayhab BHA, Salaah FMA, Qshanin KNA. Assessment of Children's Oral Health-Related Knowledge and Self-Efficacy in Expectant Mothers of Najran, Saudi Arabia. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Mortazavi S, Kazemi A, Faghihian R. Impact of Motivational Interviewing on Parental Risk-Related Behaviors and Knowledge of Early Childhood Caries: A Systematic Review. Int J Prev Med 2021; 12:167. [PMID: 35070200 PMCID: PMC8724630 DOI: 10.4103/ijpvm.ijpvm_600_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/12/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Behavior is important in dental disease etiology, so behavioral interventions are needed for prevention and treatment. Motivational interviewing (MI) has been proposed as a potentially useful behavioral intervention for prevention of early childhood caries. METHODS Studies have evaluated the effectiveness of MI on reduction of the risk-related behaviors for early childhood caries (ECC) compared to dental health education (DHE) The aim of this systematic review was to assess the scientific evidence on MI applied to change parental risk-related behaviors. The potentially eligible studies involved the assessment of caries-related behaviors in caregivers receiving MI. Electronic search of English published literature was performed in February 2020 in the Scopus, Cochrane, PubMed, and Embase databases. Assessment of risk of bias was done by the Cochrane risk of bias tool. RESULTS Of 329 articles retrieved initially, seven were eligible for inclusion in this review. Four studies evaluated the behavior of tooth brushing and four studies assessed the cariogenic feeding practice, while only one study investigated the behavior of checking teeth for pre-cavities. Moreover, two studies examined dental attendance for varnish fluoride use and oral health-related knowledge. It was not possible to perform a meta-analysis. CONCLUSIONS Generally, results support the application of MI to improve the "dental attendance behavior for fluoride use" and participants' knowledge. However, the results were inconclusive for other behaviors. We need further and better designed interventions to completely evaluate the impact of MI on specific ECC-related behaviors.
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Affiliation(s)
- Shiva Mortazavi
- Department of Pediatric Dental, Research Center, Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azam Kazemi
- Faculty of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reyhaneh Faghihian
- Department of Pediatric Dental, Research Center, Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Community-based interventions to reduce dental caries among 24-month old children: a pilot study of a field trial. BMC Oral Health 2021; 21:637. [PMID: 34893041 PMCID: PMC8665609 DOI: 10.1186/s12903-021-01999-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 11/30/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Early childhood caries (ECC) is the most common dental disease among children worldwide, leading to many difficulties on child's growth. As WHO mentioned, educational interventions in addition to interprofessional collaboration are needed to achieve proper ECC prevention. In present study we've aimed to evaluate the effectiveness of some oral health promotion interventions to reduce dental caries among 24-month old children. METHODS A field trial study was conducted amongst 439 mothers from pregnancy up to 24 months after delivery in Public Health Centers in Varamin, Tehran, Iran. Participants were allocated to intervention (n = 239) and control groups (n = 200). Demographic, socioeconomic status and dental care behavior data were collected using a questionnaire. The content of our study intervention consisted of nutritional and behavioral oral health-related messages. Mothers received messages via either of four methods (A: comprehensive method including all other methods together (n = 74), B: group discussion by dentists (n = 59), C: face to face education by primary health care providers (n = 53), and D: social network (n = 53). The control group received routine maternal and oral health care. To assess the effectiveness of interventions on promoting children's oral health, the oral health-related behaviors data, the number of decayed teeth (d), and being caries free at the age of two were considered. RESULTS Among the 436 examined children, with a mean age of 23.7 months, 48.2% were male. The frequency of using finger toothbrush increased from 53.4% to 89.8% in all intervention groups. The mean (SD) of decayed teeth at 24 months in intervention and control group were 0.36 (0.93) and 1.61 (2.61), respectively. All the four intervention groups, except social network, had more chance of being caries free compared to control group (P value < 0.05). Analysis showed that children in comprehensive intervention group had a higher chance of being caries free compared to all other groups, after adjustment for covariates. CONCLUSIONS Performing oral health interventions could help the prevention of dental caries in newborn children. Also, using a combination of different methods of sending messages can have the best results in promoting oral health.
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Affiliation(s)
- Marzie Deghatipour
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Ghorbani
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Mokhlesi
- Present Address: Dental Research Center, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahla Ghanbari
- Deputy for Health Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Namdari
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Aliakbari E, Gray-Burrows KA, Vinall-Collier KA, Edwebi S, Marshman Z, McEachan RRC, Day PF. Home-based toothbrushing interventions for parents of young children to reduce dental caries: A systematic review. Int J Paediatr Dent 2021; 31:37-79. [PMID: 32333706 DOI: 10.1111/ipd.12658] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dental caries is the most prevalent preventable condition in children. A key preventive home-based oral health behaviour is the adoption and maintenance of parental supervised toothbrushing until 8 years of age. AIM To examine interventions promoting parental supervised toothbrushing practices to reduce dental caries in young children (<8 years old). DESIGN Interventions promoting parental involvement in home-based toothbrushing in children under 8 years old and their impact on caries were subjected to review. Electronic databases (MEDLINE, EMBASE, PubMed, Web of Science, PsycINFO, Scopus, and the Cochrane Library), references, and unpublished literature databases were searched for relevant literature. RESULTS Of the 10 176 articles retrieved, forty-two articles were included. The Theoretical Domains Framework was used to code intervention content, with the main domains addressed being knowledge (41/42), skills (35/42), and environmental context and resources (22/42). Sufficient descriptions of the intervention development, delivery, and evaluation were lacking, with only 18 studies being underpinned by theory. Twenty-nine studies explored the impact on caries yielding mixed results. CONCLUSIONS There are few interventions targeting home-based oral health behaviours underpinned by theory and methodological rigour in their development and evaluation. This demonstrates a clear need for future interventions to be guided by complex intervention methodology.
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Affiliation(s)
- Elnaz Aliakbari
- Specialist in Paediatric Dentistry, Clarendon Dental Spa, Leeds, UK
| | - Kara A Gray-Burrows
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, UK
| | | | - Sakina Edwebi
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, UK
| | - Zoe Marshman
- Faculty of Medicine, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | - Peter F Day
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, UK
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Faghihian R, Faghihian E, Kazemi A, Tarrahi MJ, Zakizade M. Impact of motivational interviewing on early childhood caries: A systematic review and meta-analysis. J Am Dent Assoc 2020; 151:650-659. [PMID: 32854867 DOI: 10.1016/j.adaj.2020.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The authors aimed to assess the scientific evidence on motivational interviewing for the clinical reduction of early childhood caries compared with traditional dental health education. METHODS Search terms were selected on the basis of Medical Subject Headings and non-Medical Subject Headings terms. The main key words were motivational interviewing, early childhood caries, and education. Potentially eligible studies involved the clinical assessment of caries rate in children whose parents or caregivers received motivational interviewing as an intervention. The authors assessed the risk of bias using the Cochrane risk-of-bias tool. In March 2019, the authors performed an electronic database search of literature published in English within the following databases: Scopus, Cochrane, PubMed, and Embase. RESULTS Of 329 articles retrieved initially, 14 were eligible for inclusion in the systematic review and 3 articles contributed to the meta-analysis. For statistical analysis, the mean difference of continuous data was analyzed at a 95% confidence interval using the random-effects model. CONCLUSIONS Overall, the evidence presented in this review was limited. Although the results of the meta-analysis showed that motivational interviewing is as effective as dental health education in controlling early childhood caries, we need more and better designed and reported interventions to assess its impact on early childhood caries accurately.
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Yazdani R, Mohebbi SZ, Fazli M, Peighoun M. Evaluation of protective factors in caries free preschool children: a case-control study. BMC Oral Health 2020; 20:177. [PMID: 32586302 PMCID: PMC7318423 DOI: 10.1186/s12903-020-01154-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 06/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing the proportion of caries-free children following the WHO's global target has led to more desirable welfare and a higher level of quality of life for children. In the present study, we aimed to evaluate the factors contributing to a caries-free condition in preschool children as a basic action towards the global goals of children's oral health. METHODS This was a case-control study evaluating the protective factors contributing to dental caries free in 4-6-year-old children in Tehran/Iran in 2017. 500 preschool children and their mothers were selected from 22 randomly selected preschools and were enrolled in the study. The participants were divided into two case (caries-free) and control (with dental caries) groups. The data were collected using two data gathering tools; the child oral examination form and the mother's valid questionnaire. The latter included three domains; socio-demographic factors, behavioral oral health measures, and feeding practices and dietary habits. The criteria for caries detection were cavities in the enamel and dentine. A logistic regression model was applied to identify caries-free protective factors (P < 0.05). RESULTS Among 230 caries-free and 270 non-caries-free children who participated in the study, boys were more caries-free (P = 0.001). The protective factors against dental caries that were identified in the study were dental check-up as the cause of dental visit, being the first child in the family, the fewer sessions night feeding of the child's, family's house ownership, and parent's university education (P < 0.05). CONCLUSIONS Dental health can be achieved by considering protective factors like the regular dental check-up and socio-economic factors. Communities are invited to pay close attention to these important protective factors as far as they can increase the proportion of caries-free among preschool children especially in countries with developing oral health care systems.
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Affiliation(s)
- Reza Yazdani
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Simin Zahra Mohebbi
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Fazli
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Peighoun
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Goyal A, Grover A, Gauba K, Gupta A, Mehta N, Dutta S, Pandey RM, Joshi A, Thakur JS, Mohanty U, Dhaliwal RS. A community-based pragmatic, controlled trial for preventing and reducing oral diseases among 1-6-year-old children visiting Anganwadi centers, under the Integrated Child Development Scheme, India. BMC Public Health 2019; 19:1626. [PMID: 31796028 PMCID: PMC6892135 DOI: 10.1186/s12889-019-7874-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 10/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early childhood caries (ECC) has reached epidemic proportions affecting millions of children worldwide. Its prevention becomes imperative owing to the significant morbidity and financial implications involved with its treatment. The Integrated Child Development Scheme (ICDS), launched in India to provide mid-day meals, pre-school education and primary healthcare to children, can be utilised to counsel and deliver oral health education to mothers. The purpose of the study is to compare the effect of an oral health care package (OHCP) with usual care on the change in dental disease status among 1 to 3-year-old children at Anganwadi centres (AWC) in periurban areas of Chandigarh and rural areas of Cuttack, Orissa over a follow-up period of three years. METHODS Two geographically distant ICDS blocks would be selected at each of the two study sites and would be randomly allocated to intervention and control group. Closely located AWCs under each of the selected blocks shall constitute the study setting. OHCP would be delivered to the mothers of the 1-6-year-old children enrolled in the AWCs of the experimental group whereas mothers under control group would receive usual care advice available at the AWCs. DISCUSSION ECC prevention had conventionally focused upon testing effectiveness of programs targeting behaviour change among the caregivers and children, but surprisingly minimal efforts have been made to seek translation of these efforts into reduction of ECC at the community level. The present study has two components; testing effect of altering maternal and child behavioral aspects on ECC incidence through cohort follow up of 1-3-year-old children for three consecutive years and cross-sectional follow up of all available 1-6-year old children at the selected AWCs at regular intervals to look for change in prevalence of ECC at community level. In other regions of the world surveys of ECC prevalence before and after the intensive educational programs have shown a significant reduction in ECC prevalence. A similar decline can be anticipated through this program. TRIAL REGISTRATION This trial has been prospectively registered at Clinical Trials Registry, India (CTRI/2019/02/017556, 08 February 2019).
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Affiliation(s)
- Ashima Goyal
- Oral Health Sciences Centre, PGIMER, Chandigarh, India.
| | - Ashoo Grover
- Indian Council of Medical Research, New Delhi, India
| | - Krishan Gauba
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Arpit Gupta
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Nishant Mehta
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Sourabh Dutta
- Division of Neonatology, Department of Pediatrics, PGIMER, Chandigarh, India
| | - R M Pandey
- Department of Biostatistics, AIIMS, New Delhi, India
| | - Ashish Joshi
- Foundation of Healthcare Technologies Society, New Delhi, India
| | - J S Thakur
- Community Medicine and School of Public Health, PGIMER, Chandigarh, India
| | - Utkal Mohanty
- Department of Community Dentistry, SCB Dental College & Hospital, Cuttack, Odisha, India
| | - R S Dhaliwal
- Indian Council of Medical Research, New Delhi, India
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Calcagnile F, Pietrunti D, Pranno N, Di Giorgio G, Ottolenghi L, Vozza I. Oral health knowledge in pre-school children: A survey among parents in central Italy. J Clin Exp Dent 2019; 11:e327-e333. [PMID: 31110611 PMCID: PMC6522113 DOI: 10.4317/jced.55378] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/18/2019] [Indexed: 11/30/2022] Open
Abstract
Background The aim of this survey was to evaluate the knowledge and awareness of parents about potential oral health risk factors and correct management of oral hygiene of their preschool children. Material and Methods The participation to the survey was proposed to all parents of 3-5 year aged children attending a kindergarten in Campobasso. A self-administered questionnaire was completed to obtain information regarding demographic and education variables, knowledge about caries and its transmission, infant feeding practice, maternal oral health during pregnancy, parents and children’s oral hygiene habits and risk behaviors (e.g., sharing cutlery, tasting of baby food, nightly using of baby bottles or pacifier), oral health prevention and role of school. Results Overall, the parents of 101 children consented to fill the questionnaire. Data analysis showed that only 24% of respondents was aware of the potential vertical transmissibility of cariogenic bacteria through contaminated saliva. It is still a common trend from 61% of parents tasting food of their child. On 101 children, 30% used pacifier and 17% used baby bottle with milk during night and among these children 41% for more than 2 years. Parents reported no toothbrushing for 57% of the children in their first 3 years of life. Conclusions From this survey, independently on parents education, it emerges as still nowadays parents are not fully trained and informed about the management of their child’s oral hygiene and as it’s necessary a parental oral health promoting program to control children oral health risk status, starting from school. Key words:Oral health, pre-school children, dental caries, oral prevention.
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Affiliation(s)
- Francesca Calcagnile
- DDS, PhDing. Department of Oral and Maxillo-facial Sciences, Sapienza University of Rome
| | - Daniela Pietrunti
- RDH. Department of Oral and Maxillo-facial Sciences, Sapienza University of Rome
| | - Nicola Pranno
- DDS, PhDing. Department of Oral and Maxillo-facial Sciences, Sapienza University of Rome
| | - Gianni Di Giorgio
- DDS, PhD. Department of Oral and Maxillo-facial Sciences, Sapienza University of Rome
| | - Livia Ottolenghi
- DDS. Department of Oral and Maxillo-facial Sciences, Sapienza University of Rome
| | - Iole Vozza
- RDH. Department of Oral and Maxillo-facial Sciences, Sapienza University of Rome
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Zacharias S, Kahabuka FK, Mbawalla HS. Effectiveness of Randomized Controlled Field Trial Instructing Parents to Supervise Children on Tooth Brushing Skills and Oral Hygiene. Open Dent J 2019. [DOI: 10.2174/1874210601913010076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Educating parents on supervision of tooth brushing ensures effective plaque removal, healthy gums and attainment of tooth brushing skills.
Objective:
To evaluate the effect of educating parents about children’s tooth brushing supervision on their own knowledge and act of supervision, their children’s tooth brushing skills, plaque score and gingival health.
Methods:
Two arms cluster randomized controlled field trial among 8-9 years primary school pupils and their parents. The intervention trial was an educational leaflet on step by step supervision of children during tooth brushing. The outcomes were; improved tooth brushing skills, oral hygiene status and gingival health, parental awareness and supervision of children’s tooth brushing. Data processing and statistical analysis was done using SPSS version 20.0. Frequency distribution for proportions, cross tabulations with Chi-square and adjusted binary logistic regression were performed.
Results:
A total of 237 pupils were followed to completion of the study. The odds of parents being aware and supervising children during tooth brushing were higher in the intervention group at follow-up 4.5 (1.5, 13.4) and 2.4 (1.3, 4.5) respectively. The unadjusted odds for good oral hygiene following intervention was 3.1 (1.4, 6.9) and that of tooth brushing skills 61.8 (7.7, 498.6). On adjusting with parental awareness and supervision of children during tooth brushing, odds of having tooth brushing skills increased to 88.2 (9.2, 847.4).
Conclusion:
Providing education to parents on children tooth brushing supervision effectively improved children’s tooth brushing skills, plaque score and gingival health emanating from awareness and act of supervision improvements revealed on their part.
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Thwin KM, Zaitsu T, Ueno M, Kawaguchi Y. Effects of oral health education in Myanmar preschool children and guardians. ACTA ACUST UNITED AC 2018; 9:e12346. [PMID: 29873195 DOI: 10.1111/jicd.12346] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 03/09/2018] [Indexed: 12/01/2022]
Abstract
AIM The aim of the present study was to investigate the effects of oral health education on preschool children's oral health status and habits, and their guardian's oral health knowledge. METHODS A 1-year interventional study was conducted for 201 preschool children from January 2016 to January 2017. A questionnaire survey and clinical oral examination were performed at baseline and at 1-year follow up. A 30-min oral health education session was given to children and their teachers and guardians separately by a dentist every 6 months. The impact of health education was evaluated by assessing the changes in guardians' questionnaires and children's oral health status during the 1-year period. RESULTS The mean oral health knowledge scores of guardians significantly increased from 8.0 ± 2.0 at baseline to 9.0 ± 2.5 at 1-year follow up (P < .001). Most oral health habits, except drinking water after eating, significantly improved at 1-year follow up. Significant decreases in debris score (P = .008) and gingival score (P < .001) were found. CONCLUSION Comprehensive oral health education was shown to improve guardians' knowledge of oral hygiene, and oral health habits and status of their children. It is necessary to adopt a comprehensive oral health-promotion program involving oral health-care professionals, parents, and teachers.
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Affiliation(s)
- Kaung Myat Thwin
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Zaitsu
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masayuki Ueno
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoko Kawaguchi
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Chang CP, Barker JC, Hoeft KS, Guerra C, Chung LH, Burke NJ. Importance of Content and Format of Oral Health Instruction to Low-income Mexican Immigrant Parents: A Qualitative Study. Pediatr Dent 2018; 40:30-36. [PMID: 29482680 PMCID: PMC5830177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE This study's purpose was to explore how content and format of children's oral health instruction in the dental clinic is perceived by parents and might affect parents' knowledge and behaviors. METHODS Thirty low-income Mexican immigrant parents of children age five years and under were recruited from dental clinics in 2015 to 2016. In-person qualitative interviews in Spanish about their children's and their own experiences of dental care and home oral hygiene practices were conducted, digitally recorded, translated, and transcribed. Data analysis involved iteratively reading text data and developing and refining codes to find common themes. RESULTS Twenty-five of 30 parents recalled receiving oral hygiene instruction, and 18 recalled receiving nutrition instruction and were included in analyses. The format and effectiveness of instruction varied. More engaging educational approaches were recalled and described in more detail than less engaging educational approaches. As a result of oral hygiene and nutritional instruction, most parents reported changing their oral hygiene home behaviors for their children; half aimed to reduce purchasing sugary foods and drinks. CONCLUSIONS Most parents recalled receiving oral hygiene and nutrition instruction as part of their child's dental visit and reported incorporating the instruction and recommendations they received into their children's home routine.
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Affiliation(s)
- Corissa P Chang
- Dental student, School of Dentistry, University of California, in San Francisco, Calif., USA
| | - Judith C Barker
- Professor, in the Department of Anthropology, History and Social Medicine, University of California, San Francisco, and at the Center to Address Disparities in Children's Oral Health (CAN DO), in San Francisco, Calif., USA
| | - Kristin S Hoeft
- Assistant professor, in the Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, and at CAN DO, in San Francisco, Calif., USA;,
| | - Claudia Guerra
- Staff research associate, Department of Anthropology, History and Social Medicine, and Division of General Internal Medicine, School of Medicine, University of California, in San Francisco, Calif., USA
| | - Lisa H Chung
- Associate professor, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, and at CAN DO; in San Francisco, Calif., USA
| | - Nancy J Burke
- Professor, Department of Anthropology, History and Social Medicine, University of California, San Francisco, and at the Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced, Calif., USA
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Basir L, Rasteh B, Montazeri A, Araban M. Four-level evaluation of health promotion intervention for preventing early childhood caries: a randomized controlled trial. BMC Public Health 2017; 17:767. [PMID: 28969655 PMCID: PMC5625785 DOI: 10.1186/s12889-017-4783-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/21/2017] [Indexed: 11/12/2022] Open
Abstract
Background Early childhood caries (ECC) is the most common dental disease among children, which can affect children’s primary teeth during their teething. This study evaluates an intervention for preventing early childhood caries in a pediatric population in Ahvaz, Iran. Method The population of this study (IRCT2017070210804N10) consists of 104 women with 12 to 36 months of age without dental caries referred to a health care center in Ahvaz, Iran. The children were randomly assigned to either an experimental or control group in equal numbers. First, the demographic information of participants was collected through a questionnaire containing components of perceived threat, health literacy, and oral health behaviors using a valid and reliable questionnaire. The ECC status of the children was established by a dentist. Control group received “standard well baby care”. The experimental group received standard well baby care in addition to educational interventions, including lecture and group discussion. After 6 months, the participant completed the questionnaire for the second time, and the children’s teeth were reexamined. Data were analyzed using SPSS version 15 at a significance level of p < 0.05. Results The mean ages of women and children were 31 ± 6.68 years and 18 ± 7.21 months, respectively. Before the intervention, no significant difference was documented between the groups for the study variables, p > 0.05. However, after the intervention, a significant difference was observed between the perceived threats (41.15 ± 4.46 in the experimental group and 38.26 ± 4.21 in the control group, p = 0.001), health literacy (20.98 ± 2.15 in the experimental group and 19.76 ± 2.70 in the control group, p = 0.01), oral health behaviors (7.75 ± 2.30 in the experimental group and 6.15 ± 2.65 in the control group, p = 0.01), and the incidence of ECC (13% in the experimental group and 35% in the control group,p = 0.001). Conclusion This intervention had positive effects on the perceived threat, health literacy, and health behaviors; and the intervention could reduce the incidence of ECC. The finding of this study provided a suggestion for evidence-based decision-making processes regarding ECCs prevention programs. Trial registration IRCT2017070210804N10 (retrospectively registered)
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Affiliation(s)
- Leila Basir
- Department of Pediatric Dentistry, School of dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bita Rasteh
- School of dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Montazeri
- Mental Health Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
| | - Marzieh Araban
- Social Determinants of Health Research center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Department of Health Education and Promotion, Public Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Kabil NS, Eltawil S. Prioritizing the Risk Factors of Severe Early Childhood Caries. Dent J (Basel) 2017; 5:E4. [PMID: 29563410 PMCID: PMC5806985 DOI: 10.3390/dj5010004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/15/2016] [Accepted: 12/20/2016] [Indexed: 11/21/2022] Open
Abstract
Severe early childhood caries remains the most common chronic disease affecting children. The multifactorial etiology of caries has established a controversy about which risk factors were more significant to its development. Therefore, our study aimed through meticulous statistical analysis to arrange the "well agreed upon" common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program. The study prioritized or reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to three or more, night feeding, child self-employed brushing, mother's caries experience, two siblings, on demand feeding, once/day sugary food, sharing utensils, one sibling, male gender, father's education, late first dental visit, brushing time, mother's education, no dental visit, decreased brushing frequency, and no night brushing.
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Affiliation(s)
- Noha Samir Kabil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo 11566, Egypt.
| | - Sherif Eltawil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Oral & Dental Medicine, Cairo University, Giza 12613, Egypt.
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Rigo L, Dalazen J, Garbin RR. Impact of dental orientation given to mothers during pregnancy on oral health of their children. EINSTEIN-SAO PAULO 2016; 14:219-25. [PMID: 27462897 PMCID: PMC4943357 DOI: 10.1590/s1679-45082016ao3616] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/09/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the perception of mothers about oral health of their children, as well as to check the influence of demographic variables, perception and preventive practice in oral health of mothers regarding guidance received during pregnancy. METHODS Quantitative and cross-sectional field study, with a non-probability sample formed by all mothers who attended the primary healthcare unit of Ijuí (RS), Brazil, from January to July 2014, comprising a sample of 79 women. Self-applied questionnaires were given to these mothers. Data analysis was carried out using descriptive and inferential statistics, the χ2 test at a significance level of 5%. RESULTS The mothers who received dental orientation during pregnancy had greater perception of oral health of their children. The mean age of mothers was 26 years, most of them attended high school education (32.9%) and worked outside the home (60.8%). There was a statistically significant relation between the outcome variable, dental orientation during pregnancy, and the independent variables: schooling level of mothers, occupation, baby's first visit to the dentist, duration of breastfeeding, beginning of baby's tooth brushing and knowledge about dental decay (p<0.005). CONCLUSION Mothers with higher schooling levels and who worked outside the home had more knowledge about oral care, because they received dental orientation during pregnancy. The dental guidance during pregnancy influences the mother in the procedures adopted with their children, as to early oral hygiene, first dentist appointment, duration of breastfeeding, knowledge about the factors that lead to dental decay. OBJETIVO Analisar a percepção das mães em relação à saúde bucal de seus filhos, bem como verificar a influência das variáveis demográficas, de percepção e prática preventiva em saúde bucal das mães, na orientação odontológica recebida durante a gestação. MÉTODOS Pesquisa de campo com abordagem quantitativa e delineamento transversal. A amostragem foi não probabilística com todas as mães que frequentaram o posto de saúde do município de Ijuí (RS), de janeiro a julho de 2014, compondo uma amostra de 79 mulheres. Foram distribuídos questionários autoaplicativos às mães participantes da pesquisa. A análise dos dados foi feita através de estatística descritiva e inferencial, pelo teste do χ2 com nível de significância de 5%. RESULTADOS Mães que receberam orientação odontológica durante a gestação tiveram maior percepção sobre a saúde bucal de seus filhos. A média de idade das mães foi 26 anos, e a maioria delas frequentou o ensino médio completo (32,9%) e trabalhava fora de casa (60,8%). Houve uma relação estatisticamente significativa entre a variável desfecho, orientação odontológica durante a gestação e as variáveis independentes: escolaridade das mães, ocupação, primeira visita do bebê ao dentista, tempo de amamentação natural, início da escovação do bebê e conhecimento sobre a cárie dentária (p<0,005). CONCLUSÃO As mães com maior nível de escolaridade e que trabalhavam fora de casa tinham mais conhecimento sobre atenção odontológica, pois receberam orientação odontológica na gestação. A orientação odontológica recebida na gestação influencia as mães nos procedimentos adotados com seus filhos, em relação ao início da higienização bucal, primeira consulta ao dentista, tempo de amamentação, o conhecimento sobre os fatores que levam ao aparecimento da cárie dentária.
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Affiliation(s)
- Lilian Rigo
- Faculdade Meridional, Passo Fundo, RS, Brazil
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