Awareness of Lebanese Pediatricians regarding Children's Oral Health

Oral Health Knowledge, Attitudes, and Clinical Practices of Pediatricians and Pediatric Residents: A Cross-Sectional Study

Background Pediatricians are the first line in the provision of healthcare for children. They can make an important contribution to the oral health of their patients because they usually see children and parents early and frequently in life. This study aims to assess the pediatricians' and pediatric residents' oral health knowledge, attitudes, and practices with patients. Methods A structured English survey was developed based on previous surveys in the literature. It collected data on oral health knowledge, attitudes, and practices. Pediatricians were visited and invited to take the survey. A link to the survey was sent via email to all pediatric residents. An oral health practice score was created based on participants' responses to the practice questions, and a linear regression assessed its predictors. Frequencies of oral health knowledge, attitudes, and practices were presented and compared between both groups by the chi-square test. Results A total of 218 pediatricians and residents were surveyed. The oral health knowledge was low overall, but it was higher among pediatricians, 10.0±1.9, compared to the residents, 8.2±2.5 (P<0.001). The attitude ranged from 66.3% agreeing with the statement "Limited time with patients makes it difficult to integrate oral health into primary care practice" to 87.4% agreeing with the statement "Primary healthcare physicians should know their local dentists to facilitate dental referral and treatment." Overall, pediatricians practice positive oral health behaviors more than pediatric residents, and higher knowledge levels predicted more positive oral health practices. Conclusion Despite acknowledging their important role in promoting oral health, pediatricians' and future pediatricians' knowledge is poor, and their participation in oral health continues to be limited. The potential for the non-dental workforce to greatly improve children's oral health is underexploited. The healthcare system should seek to integrate medical and dental practices better. Incorporating oral health into residency programs and providing continuous education courses are strongly encouraged.

Assessment of knowledge, attitude, and behavior related to children's oral health in pediatricians and students in the pediatric field in Iran: a cross-sectional study

Background

Pediatricians have an important role to play in motivating and instructing parents on oral health in children. The aim of this study was to assess knowledge of, attitude to, and behavior regarding oral health care in children among pediatricians and students in the pediatric field in Iran.

Methods

This cross-sectional study included all students in the pediatric field (those who had started a residency or fellowship) and practicing pediatricians in provincial centers and universities (61 setting centers) throughout Iran in the course of 2021. Participants completed an online questionnaire assessing details of the parameters of knowledge of, attitude to, and behavior toward oral health for each individual. A convenience sampling technique was used to gather the study sample. All data were coded for each of the parameters. The data were analyzed by one-way ANOVA (Analysis of Variance)/Tukey and Pearson's correlation tests and path analysis.

Results

Out of 582 participants who visited the website, a total of 217 completed the entire questionnaire (participation rate of 37.2%). On the attitude parameter, 84.8% of participants scored above 75% of the possible attainable score, while only 37.9% and 48.1% of them had adequate knowledge and behavior for the possible score, respectively. Specialists had a higher mean score on behavior and knowledge than residents (P=0.001). There was a significant correlation between the scores on attitude and behavior (r=0.42, P<0.001), attitude and knowledge (r=0.19, P=0.005), and behavior and knowledge (r=0.25, P<0.001). Nearly all of the participants, 216 (99.5%), felt the need for the principles of dentistry to be included in the curriculum.

Conclusions

Pediatricians showed a favorable attitude to oral health, but their knowledge of and behavior in the field was inadequate. Improvement of pediatricians' interest and performance in oral health in children should be encouraged through the inclusion of these parameters in the curriculum for students of the pediatric field. Implementing training programs for practical pediatricians or incorporating independent theoretical and clinical courses offered by pediatric dentists in dental school departments into the field curriculum of the students in the pediatric field is recommended.

An interdisciplinary intervention program to prevent early childhood caries in the Dominican Republic

Objective

The principal aim of this randomized clinical trial (RCT) was to test the effectiveness in the prevention of Early Childhood Caries (ECC) through an educational intervention program with the use of a printed guide for pediatricians and parents both designed by pediatric dentists.

Materials and methods

After ethical approval, the first step was to design the educational guides, which were based on the information obtained from a focus group with pediatricians (n = 3), phone interviews with mothers to toddlers' (n = 7), and the best evidence available about children's oral health. For the RCT, 309 parents with their 10-12 months old children were randomly allocated to either the intervention or the control group. Parents in the intervention group received oral health education from the pediatricians supported by the printed guides. Parents in both groups received an oral health kit with a toothbrush and toothpaste at the first visit as well as at each 6-month follow-up visit. After 18 months the children were evaluated using ICDAS criteria.

Results

At baseline, data were available from 309 children (49.8% girls). The mean age of the children was of 10.8 months (SD = 0.8) and 69.3% had not had their teeth brushed with toothpaste. After 18 months, a total of 28 (22%) children in the intervention group and 44 (24%) in the control group were clinically examined. Regarding the number of tooth surfaces with caries lesions, the children in the intervention group had a mean of 6.50 (SD = 6.58) surfaces, while the children in the control group had a mean of 5.43 (SD = 4.74) surfaces with caries lesions. This difference was not significant (p = 0.460).

Conclusion

The RCT showed no effectiveness in caries-progression control. Despite this result, this study managed to identify barriers that do not allow pediatricians from offering parents adequate oral health recommendations. With this learning, it is possible to work on collaborative programs with pediatricians that over time likely will increase dental health by controlling for ECC.

Knowledge, perceptions, and behavior regarding children's oral health among Syrian pediatricians: a cross-sectional study

BACKGROUND

Oral health has a direct impact on health-related quality of life (HRQoL). Hence, general health and oral health cannot be separated. Pediatricians play a pivotal role in providing primary care for infants and are the first to interact with them since birth. Therefore, the aim of this study was to evaluate the knowledge, perceptions, and behavior of Syrian pediatricians regarding children's oral health.

METHODS

This was a cross-sectional study. The questionnaire consisted of six main sections and required answers regarding demographic characteristics, knowledge, behavior, perceptions, and training received in oral health. The association between categorical variables was tested with Pearson's chi-square tests and Fishers exact tests using SPSS ver. 23.

RESULTS

The response rate was 43.12% (229/531). Most of the participants (64.02%) got a poor level of knowledge and no significant association was found between knowledge level and years of experience (p = 0.270). The majority of the participants (99.13%) perceived that diet, bacteria, and sugar exposure time are the etiological factors of dental caries. The overwhelming majority of the participants (98.25%) acknowledged the need for further oral health training during residency.

CONCLUSIONS

Most pediatricians reported a poor level of knowledge. It is recommended to update the postgraduate and residency curriculum to equip pediatricians with adequate knowledge regarding children's oral health.

Assessment of Paediatricians' Oral Health Knowledge, Behaviour, and Attitude in the United Arab Emirates

Aim

Paediatricians' oral health knowledge is essential for early detection of disease, appropriate advice, and proper referral. Therefore, this study aimed to evaluate the knowledge, behaviour, and attitude of paediatricians practicing in the United Arab Emirates (UAE) regarding children's oral health. Study Design. Cross-sectional survey.

Methods

A questionnaire consisting of 16 questions was completed after piloting by a sample of randomly selected registered UAE paediatricians. Scores of knowledge (out of 9), behaviour (out of 4), and attitude (out of 3) were calculated. Statistical analysis was performed using Shapiro–Wilk, Mann–Whitney U, and Kruskal–Wallis tests. Statistical significance was set as P < 0.05.

Results

A total of 185 surveys were completed. Nearly half of the paediatricians (95 (51.4%)) identified the appropriate age for child's first dental visit; while 88 (47.6%) believed that the appropriate age to start brushing was after the eruption of the primary molars (2-3 yrs), and 132 (71.4%) believed that the ideal time to give sugary snacks is in between meals. 123 (66.5%) participants said that they would prescribe antibiotics to treat local dental sepsis without fever. Experienced paediatricians and those trained in Western countries had significantly better knowledge about oral health (P values 0.040 and 0.031 consecutively). The scores of attitude, behaviour, and knowledge were correlated, and a positive relationship between the scores of knowledge and behaviour was found (r = 0.241, P=0.001) and between scores of attitude and behaviour (r = 0.197, P=0.007).

Conclusions

The results demonstrated a general lack of knowledge of oral health aspects by UAE paediatricians. Furthermore, continuous education in the subject is recommended.

The knowledge and practice of pediatricians in children's oral health: a scoping review

BACKGROUND

Dental caries is a significant public health problem and one of the most common chronic conditions affecting children. The potential for the non-dental workforce to improve children's oral health is well documented. For well over a decade, there have been calls for pediatricians to address children's oral health, but the incorporation of oral health screening, referral, and oral healthcare in pediatric practice remains underdeveloped. Developing action to strengthen the role of pediatricians' in children's oral health requires an understanding of their current knowledge and practice. In this scoping review, we aimed to comprehensively map what is known about the knowledge and practice of pediatricians regarding children's oral health.

METHODS

Arksey & O'Malley's five-stage review process was used to comprehensively map studies undertaken on pediatrician's knowledge and practice regarding children's oral health. Key search terms were developed and a total of 42 eligible articles are included in the review.

RESULTS

The studies were conducted in 19 countries. The majority (41/42) were quantitative, with over 90% using self-reported surveys. Only four studies used previously validated survey tools, with most adapting questions from previous studies. Observational designs were used in two studies and one used qualitative methods. Sample size ranged from 15 to 862. Oral health knowledge amongst pediatricians was reported to be mostly poor, with many gaps in key areas including age for first dental visit, dental caries and oral health risk assessments. Studies on the translation of oral health knowledge to practice were limited, with wide variation in rates of assessment. Few studies assessed actual practice.

CONCLUSIONS

This scoping review highlights growing international interest in the role of pediatricians in children's oral health. Findings demonstrate that pediatricians have limited knowledge and understanding in critical areas, including; initial clinical signs of dental caries, recommended age for first dental visit, etiology of dental caries and recommended use of fluorides. Barriers for pediatricians include inadequate education and training, time constraints in practice and lack of referral pathways. Development of a validated tool to assess knowledge and practice is needed. This review provides a starting point to guide future research and areas for systematic reviews.

Perception of Dental Caries and Parental Difficulties in Implementing Oral Hygiene for Children Aged Less Than 6 Years: A Qualitative Study

BACKGROUND

Despite extensive prevention programs, dental hygiene remains inadequate, particularly among children under the age of six, and early childhood caries (ECC) are still a concern. Oral hygiene behavior and preventive practices seem difficult to change at a family level.

AIM

The present study aimed to better understand the reasons behind this behavior and to identify the different barriers to the implementation of adequate preventive measures.

METHODS

A qualitative study was conducted in the pediatric dentistry service of the Montpellier University Hospital (France) in 2019. A thematic analysis concerning three domains was performed: family environment, dental literacy, and oral hygiene.

RESULTS

The main barriers encountered by the parents were, respectively, (1) a weakness in the organization of familial life, together with a low-medium family income and a lack of authority, (2) ignorance of the necessity of treating carious primary teeth, and (3) a lack of time for brushing or supervising their children's teeth.

CONCLUSION

These results showed that oral hygiene and primary teeth care could not be easily achieved in the family environment of the participants, and oral health strategies should be focused not only on children but also on their parents.

Pediatricians' view on early childhood caries and oral health in a north region of India: A cross-sectional study

Background:

The majority of oral diseases in children are preventable. The pediatricians owing to the unique position they occupy in child care are invaluable in achieving standard oral and dental healthcare in children. This study was aimed to assess pediatrician's knowledge, attitude, and awareness toward early childhood caries (ECC), oral health, and treatment needs of their patients.

Methods:

A total of 65 pediatricians were randomly selected for the study and were requested to fill out an objective questionnaire pertaining to individual details, approach toward pediatric dentistry, and knowledge level of oral health, without providing any oral health information.

Results:

About 58.5% of pediatricians acknowledged the importance of pediatric dentistry. About 72.7% of pediatricians perform oral examination regularly. Around 17% of pediatricians have knowledge of the ECC. Only 32.3% of pediatricians acknowledged the cariogenicity of medicated syrups.

Conclusion:

This study shows those pediatricians who were surveyed had poor knowledge regarding ECC, oral health, and dental treatment need in children. Pediatricians need to update themselves on recent recommendations.