It is widely acknowledged that the behavior of parents, and in particular mothers, affects their children’s health [
Some factors such as maternal education, occupation, age, current knowledge, attitude, and behavior can provide insight for improving their health habits and their children’s health indirectly [
The relationship between dental health of mothers and dental caries in their children can be explained by the influence of faulty dietary and hygiene habits on infants as well as by infection of the child’s mouth by maternal bacteria [
Some studies have examined the association between caregivers’ characteristics and their children’s oral health. These included caregivers’ oral health behaviors and demographic factors [
This report is part of an interventional study to comprise the effectiveness of oral health education using motivational interviewing comparing with traditional education on oral health of preschool children in Iran.
A random sample of over-five-year-old preschool children and their parents were enrolled in the study. Selection of schools was by a clustering method from the list of 160 elementary schools in Kerman, and 22 children randomly enrolled from each school with their parents into the study. The volunteer parents signed an informed consent form, and the study was approved by the local research ethic committee of Kerman University of Medical Sciences. Children and their parents with systemic diseases were excluded and replaced with other children and parents.
Only one of parents who had a more decision-making authority about eating, oral health caring, and taking a nominated child to a physician or a dentist was asked to fill a piloted questionnaire (Cronbach’s alpha = 0.71).
The questionnaire included some demographic characteristics, socioeconomic statuses and oral health behaviors of children and their parents.
Demographic characteristics and oral health behavior of children were asked from their parents.
Oral health status of children was assessed through the following clinical examination. Plaque Index (PI) using the standard plaque index (Loe and Sillnes) [ Gingival health assessment using the standard criteria modified gingival index (MGI) [ dmft index: an estimation of children’s dental status by calculating the decayed, missed, and filled teeth (dmft) using the International Caries Detection and Assessment System (ICDAS) [
Data were analyzed by Minitab statistical software version 16. Regression analysis was used to assess the relationship between dmft of children with some demographic variables and also parental oral health behaviors. Ordinal logistic regression was used to assess the other dental health status variables (PI, GI) versus demographic characteristics and parental oral health behaviors. Correlation analysis evaluated the relationship between oral health behavior variables of parents and those of their children.
From 222 children who participated in the study, 45.7 were boys, and 54.3 were girls. The mean age of parents was 33 years, ranged from 23 years to 45 years.
Eighty-nine percent of respondents were the children’s mothers, 9% were the children’s fathers, and 1.3% was a care giver or grandparents. One hundred and sixty-three parents (73.4%) have experienced mouth disorders during the six months before the study. Table
Oral health indexes of children.
Oral health indexes of children | Frequency | Percent |
---|---|---|
Gingival inflammation index | ||
Sound (0) | 49 | 22.1 |
Moderate (0/1–1/0) | 101 | 45.5 |
Medium (1/1–2/0) | 64 | 28.8 |
Severe (2/1–3/0) | 8 | 3.6 |
Total |
|
|
| ||
Plaque index | ||
Excellent (0) | 4 | 1.8 |
Good (0/1–0/9) | 25 | 11.3 |
Medium (1–1/9) | 72 | 32.4 |
Poor (2-3) | 121 | 54.5 |
Total |
|
|
Adjusted regression analysis of dmft versus demographic and behavioral variables of parents showed that there was a significant relationship between the history of having dental problems in parents and dmft index in their children (
Relationship between sociodemographic and behavioral characteristics of parents and children and dmft of their children.
Dependent variables | Independent variables |
|
Coefficient |
---|---|---|---|
Education of fathers | 0.74 | 0.08 | |
Education of mothers | 0.68 | 0.12 | |
dmft of children | Parental frequency of tooth brushing | 0.48 | −0.25 |
Parental consumption of sweet foods | 0.49 | 0.14 | |
Parental dental visits in the last year | 0.99 | 0.00 | |
Parental history of dental problems | 0.01* | −1.6 |
*significant.
Ordinal Logistic regression analysis showed a significant relationship between plaque index of children with mothers education (
Relationship between characteristics of parents and children with oral health status of children.
Dependent variables in children | Independent variables in parents |
|
Odds ratio | 95% CI | |
---|---|---|---|---|---|
Lower limit | Upper limit | ||||
Plaque index (PI) in children | Education of fathers | 0.25 | 0.86 | 0.67 | 1.11 |
Education of mothers | 0.00* | 1.55 | 1.18 | 2.04 | |
Parental frequency of tooth brushing | 0.49 | 0.89 | 0.64 | 1.24 | |
Parental consumption of sweet foods | 0.20 | 0.88 | 0.72 | 1.07 | |
Parental dental visits | 0.62 | 1.04 | 0.90 | 1.19 | |
Parental history of dental problems | 0.05* | 1.77 | 0.96 | 3.27 | |
| |||||
Gingival index (GI) in children | Education of fathers | 0.69 | 0.95 | 0.75 | 1.21 |
Education of mothers | 0.32 | 1.14 | 0.88 | 1.48 | |
Parental frequency of tooth brushing | 0.76 | 1.05 | 0.77 | 1.43 | |
Parental consumption of sweet foods | 0.31 | 0.91 | 0.76 | 1.09 | |
Parental dental visits | 0.49 | 1.05 | 0.92 | 1.20 | |
Parental history of dental problems | 0.83 | 1.06 | 0.59 | 1.91 |
*significant.
Gingival index of children was not significantly related to other variables which were measured in parents and children (Table
Correlation analysis showed a significant relationship between parental frequency of tooth brushing and child frequency of tooth brushing (
Relationship between oral health behaviors of parents and their children.
Health behaviors of parents | Health behaviors of children |
|
Pearson correlation |
---|---|---|---|
Frequency of tooth brushing | Frequency of tooth brushing | 0.05* | 0.126 |
Frequency of consumption of |
Frequency consumption |
0.00* | 0.28 |
Frequency of dental visits | Frequency of dental visits | 0.1 | 0.105 |
*significant.
Oral health has an important role in the general well-being of individuals. Since oral health behaviors can affect the oral health, attempting to construct good oral health behaviors can affect the general health of individuals. Indeed, the adoption of good oral health habits in childhood often takes place with parents, especially with mothers [
Since parents are the primary social force influencing child development in the early childhood years, it seems that interventions targeting parental oral health beliefs and practices may be beneficial in the prevention of oral health problems such as dental caries [
This study assessed some characteristics and behaviors of parents that may affect oral health behaviors and oral health statuses of their children. There was a significant relationship between the history of having dental problems in parents and dmft index in their children. Several factors, such as neglecting oral health by parents and their inability to pay for health services and genetic factors, might interpret this relationship. Parental history of dental problems may show their consideration to oral health behaviors. A lot of factors may cause poor oral health status of parents and these factors may cause poor dental health (high dmft) in children. Some previous studies have also addressed this issue [
The relationship between plaque index of children with mother’s education and history of dental problems in parents was significant. This means that the presence of dental problems in parents may follow by some problems such as poor hygiene (high-plaque index) in their children. It can also show that high dental problems in parents may affect their consideration to hygienic behaviors of their children; so, healthy parents are more likely to have children with lower plaque index than unhealthy parents. This finding confirms the previous study findings [
A significant relationship was found between education of mothers and plaque index of children. It can interpreted that education of mothers can increase their knowledge about health behavior followed by increasing their ability to supervise hygienic practices of their children.
This confirms the previous studies results which have reported that parents with higher education have more positive attitudes and stronger intentions to control children’s health behavior than low-educated parents [
The study showed that frequency of tooth brushing in parents is significantly in relationship with frequency of tooth brushing in their children. Tooth brushing skills and appropriateness of oral hygiene in parents can affect the frequency and quality of tooth brushing in children, because children learn many of behaviors from their parents; so, it is predictable that they follow their parents’ behavior for tooth brushing.
A study by Vanagas et al. has reported that oral hygiene skills and attitudes of parents toward children oral health are significantly associated with the development of oral hygiene skills including tooth brushing in their children [
Parental frequency consumption of sweet foods between meals had a significant relationship with this behavior in their children. Some studies revealed a parental and child’s eating behavioral relationship [
There was not a significant relationship between parental frequency of dental visits and child’s dental visits (
However, results of the study can provide an overview of the relationship between some parental factors and health and the status of their children, but generalization of them is limited because the study is cross-sectional, and the sample size is not very large.
There are also some problems in studies by questionnaires, for example, despite the emphasis on confidentiality of the project data, parental bias in responding to questions might occur. Forgetting some information by respondents is another problem of these types of studies.
It can be concluded from the study results that some important health behaviors in parents, such as tooth brushing habits and frequency of consumption of sweet foods, are important determinants of these behaviors in their young children. Children with high-educated mothers had lower plaque index than the others. So, promoting parents’ knowledge and attitude could affect their children oral health behavior and status.
This study was supported financially by Vice Chancellor for Research, Kerman University of Medical Sciences. Author thanks all parents and children who participated in the study. They also wish to sincerely thank Professor Bahrampor and Dr. Shahravan for their statistical advice.