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ORIGINAL ARTICLE
Year : 2019  |  Volume : 37  |  Issue : 1  |  Page : 3-7
 

Knowledge, attitude, and practical behavior of parents regarding their child's oral health in New Delhi


Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India

Date of Web Publication25-Feb-2019

Correspondence Address:
Dr. Gyanendra Kumar
Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JISPPD.JISPPD_257_18

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   Abstract 


Objective: The objective of this study was to determine the knowledge, attitude, and practical behavior of parents regarding their children's oral health in New Delhi. Methodology: A cross-sectional study was conducted among 500 parents who reported in outpatient department in the Department of General Medicine at Maulana Azad Medical College and in the Department of Pedodontics and Preventive Dentistry at Maulana Azad Institute of Dental Sciences, New Delhi. Data were collected through a self-administered questionnaire. The statistical analysis was performed using the Statistical Package for Social Sciences software (21.0 version; Inc., Chicago IL, USA) for descriptive and multivariate analysis, and the level of statistical significance used in this study was chosen at P < 0.005. Results: The results of this explorative research showed that the sample selected had a relatively good knowledge regarding the importance of the primary teeth, the fact that problems in primary teeth can affect the permanent teeth, brushing frequency on daily basis, and brushing aids. Participants were aware about the effect of prolonged bottle feeding and sticky foods on the dentition. On the other hand, the majority of participants failed to recognize the ideal time of first dental visit. Parents showed positive attitudes regarding the importance of regular dental visit and their role in their children's daily oral hygiene habits. Conclusion: In New Delhi, parental awareness and attitudes regarding their children's oral health are relatively good. However, the high dental caries prevalence in children in Central New Delhi contradict the study findings, which prove the fact that changing parental behavior and attitudes toward their children's oral health is far more important than increasing their knowledge only.


Keywords: Child oral health, oral hygiene practice, parental attitude


How to cite this article:
Kumar G, Dhillon JK, Vignesh R, Garg A. Knowledge, attitude, and practical behavior of parents regarding their child's oral health in New Delhi. J Indian Soc Pedod Prev Dent 2019;37:3-7

How to cite this URL:
Kumar G, Dhillon JK, Vignesh R, Garg A. Knowledge, attitude, and practical behavior of parents regarding their child's oral health in New Delhi. J Indian Soc Pedod Prev Dent [serial online] 2019 [cited 2019 May 26];37:3-7. Available from: http://www.jisppd.com/text.asp?2019/37/1/3/252857





   Introduction Top


Good oral health is an integral component of good general health. Although enjoying good oral health includes more than just having healthy teeth, many children have inadequate oral and general health because of active and uncontrolled caries. A new dental caries pattern is seen in 6-year-old and younger children. The American Academy of Pediatric Dentistry (AAPD) defines this early childhood caries (ECC) as “the presence of one or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child under the age of six.” However, in children younger than 3 years of age, this pattern is called severe ECC which is defined as the presence of one or more cavitated, missing (due to caries), or filled smooth surfaces in primary maxillary anterior teeth or a decayed, missing, or filled score of ≥ 4 (age 3), ≥5 (age 4), or ≥ 6 (age 5) surfaces.[1]

Oral health is the mirror of general health and cannot be isolated. Although there have been improvements in the oral health of children over the last 50 years due to widespread exposure to fluoride, dental caries remains a serious public health problem disproportionately affecting individuals from low-income and minority status. Chronic pain from decayed teeth can have a significant impacts on a child's well-being and that of their family. It affects their ability to learn, thrive, and develop, as a result of interrupted sleep and difficulty in eating due to pain.

Dental caries may also be an initial sign of wider health and social care issues such as poor nutrition and obesity and, in some instances, may indicate safeguarding and neglect of the child.[2] This has an effect on the whole family, for example, parents or caregivers may have to take time off work to take their children to the dentist and children may miss school days due to toothache and dental treatment needs.[3] Dental caries is the most frequently treated oral disease in dental practice. Since preventing dental caries is a huge challenge for the public, increasing parental knowledge and utilizing preventive methods, as practiced in developed countries, may lead to decreased dental caries and improved health of children. Family imposes the most important effects on the psychological, physical, and social aspects of health from the moment a child is born. After birth and especially during early childhood, parents have the responsibility to maintain and to improve the child's oral and dental health.

There is a need to know the dental awareness about parent's knowledge about their children's oral health. Hence, the present study was conducted in the Department of General Medicine at Maulana Azad Medical College and in the Department of Pedodontics and Preventive Dentistry at Maulana Azad Institute of Dental Sciences, Delhi.


   Methodology Top


This survey was conducted on patients who reported in the outpatient department in the Department of General Medicine at Maulana Azad Medical College and in the Department of Pedodontics and Preventive Dentistry at Maulana Azad Institute of Dental Sciences. Five hundred patients were included in this study, and the sample selection was done using random sampling technique.

The questionnaire of 20 questions was developed using existing questions from validated survey tools (Oge and Douglas,[4] 2018; Gold and Tomar,[5] 2016; and Kowash and Pinfield 2000).[6]

Parent's participation in this study was voluntary, free of constraint, and in fully informed manner. The questionnaire was delivered on a face-to-face interview basis. Data were analyzed using the Statistical Package for Social Sciences 21.0 version (IBM corporation, Java, Chicago, USA) for descriptive and multivariate analysis, and the level of statistical significance used in this study was chosen at P < 0.005.


   Results Top


In this study, 35.6% were male and 64.4% were female as shown in [Figure 1]. Regarding the importance of primary teeth [Figure 2], 89% of participants believed that primary teeth are important, while 3.4% did not. About 7.6% of the participants did not know about the importance of primary teeth. About 65% of the participants thought that problems in primary dentition could affect the permanent dentition, whereas 14.8% did not. Nearly 20% did not know whether such effect exists.
Figure 1: Distribution of participants according to gender

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Figure 2: Perception of the importance of primary teeth

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With regard to the first dental visit [Figure 3], only 5.8% answered that the first dental visit should be at 6 months of age. However, 84.6% believed that the first dental visit is when the child has dental problem. Out of 322 female participants, only 15.5% knew the ideal time of the first dental visit. However, 21.2% of male participants knew the ideal time of the first dental appointment.
Figure 3: First dental visit

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Then, [Figure 4] shows that 10.4% of participants thought that toothbrushing should be once daily, while 88.8% answered twice daily. Few participants (0.8%) reported occasionally brushing, and no participant thought that the child should not brush his/her teeth.
Figure 4: Frequency of brushing

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[Figure 5] shows that 94.8% of participants use a toothbrush with fluoridated toothpaste to clean their children's teeth. However, 4.0% use a toothbrush with nonfluoridated toothpaste. Few parents (1.2%) are not using any type of toothpaste. All participants [Figure 6] were aware that improper tooth brushing, sweet and sticky foods are the main components that can cause dental caries. Moreover, the effect of prolonged and frequent bottle-feeding impacts the child's dental health (15.1%). 3.8% of the population believed that only imbalanced diet could cause dental caries but rest stated other reasons also that could cause dental caries.
Figure 5: Type of toothpaste used

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Figure 6: Reasons for the dental caries

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Then, 97.8% [Figure 7] said that supervision of toothbrushing below 5 years is needed and the rest did not know whether it is required or not. [Figure 8] shows that 93.8% agreed that oral health will impact the general health and only 6.2% did not know.
Figure 7: Supervision of toothbrushing below 5 years

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Figure 8: Awareness about the impact of oral health on general health

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Most of the parents did not know that the continuous oral habits such as mouth breathing, tongue thrusting, thumb sucking, lip biting, and nail biting could cause malocclusion. [Figure 9] shows that 92% agreed that oral habits causes irregular teeth and jaws, 4% disagree and 4% are not aware of the fact, and [Figure 10] shows that 88.8% agreed that intervention should be needed for continuous oral habits.
Figure 9: Oral habits causes irregular teeth and jaws

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Figure 10: Need for the correction of oral habits as perceived by parents

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   Discussion Top


The present study was aimed at evaluating the current oral health knowledge and attitudes of parents of children in the outpatient department reporting in the Department of General Medicine at Maulana Azad Medical College and in the Department of Pedodontics and Preventive Dentistry at Maulana Azad Institute of Dental Sciences. Overreporting is to be assumed in all the points because respondents often give socially desirable answers.

The role of the mother in her child's oral health habits and status received a special emphasis. Despite changing roles and areas of responsibility within the family, the mother still seems to play the key role in the child's oral health-related lifestyle. In this study, there was no statistical significance between males and females in any point. However, females seem to have better knowledge and attitudes regarding their children's oral health. A vast majority of the respondents knew that primary teeth are important and most of them correctly identified that problems in primary teeth could affect the permanent ones.

However, more than one-third reported that they visit the dentist only when the child experienced pain. It has been proven that regular visits to the dentist are very/fairly important for preventing dental caries and periodontal disease. These results were in accordance with the study conducted in Kuwait.[7]

Many participants believed that the first dental visit is when the child experiences pain. This is, however, in contraindication to the current AAPD recommendation that every child should begin to receive oral health risk assessment by 6 months of age by a qualified pediatrician or a qualified pediatrics health-care professional.

Most of the participants reported brushing their children's teeth twice daily. Moreover, the majority reported using a fluoridated toothpaste for cleansing their children's teeth. These findings go along with the evidence in the literature that toothbrushing with a fluoridated toothpaste should be done twice daily.

A positive aspect of the respondents was that the majority of them knew that prolonged and frequent bottle-feeding, and sweets and sticky foods affect the child's dental health. To reduce caries in children, parents need to be taught about the importance of reducing high-frequency exposures to obvious and hidden sugars. Recommendations include avoiding frequent consumption of juices or other sugar-containing drinks in the bottle or sippy cup, discouraging the behavior of a child sleeping with a bottle, promoting noncariogenic foods for snacks and fostering eating patterns consistent with the food guide pyramid. In addition, other recommendations include limiting cariogenic foods to meal times and restricting sugar-containing snacks that are slowly eaten (e.g., candy, cough drops, lollipops, and suckers). Moreover, clearing cariogenic foods from the child's oral cavity rapidly by toothbrushing after sugar attack is necessary.


   Conclusion Top


We can conclude from the present study that the knowledge of parents regarding oral health of their children in Central New Delhi is relatively good. However, this knowledge is not reflected by the current figures of caries experience in children. Hence, the knowledge is not implemented, and the attitudes and/or behaviors toward oral health need to be changed and improved. A change can be achieved only by developing comprehensive oral healthcare programs aimed at changing attitudes as well as providing parents with necessary skills to take the appropriate action.

It is also recommended that camps be conducted across various playschools around the country so that the basic knowledge about oral health of preschool children is reinforced to the parents of these children.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
American Academy of Pediatrics: Policy on early childhood caries (ECC): Classifications, consequences, and preventive strategies. Peadiatrics 2011;35:50-3.  Back to cited text no. 1
    
2.
Chou R, Cantor A, Zakher B, Mitchell JP, Pappas M. Preventing dental caries in children <5 years: Systematic review updating USPSTF recommendation. Pediatrics 2013;132:332-50.  Back to cited text no. 2
    
3.
Burton JP, Drummond BK, Chilcott CN, Tagg JR, Thomson WM, Hale JD, et al. Influence of the probiotic streptococcus salivarius strain M18 on indices of dental health in children: A randomized double-blind, placebo-controlled trial. J Med Microbiol 2013;62:875-84.  Back to cited text no. 3
    
4.
Oge OA, Douglas GV, Seymour D, Adams C, Csikar J. Knowledge, attitude and practice among health visitors in the United Kingdom toward children's oral health. Public Health Nurs 2018;35:70-7.  Back to cited text no. 4
    
5.
Gold JT, Tomar S. Oral health knowledge and practices of WIC staff at Florida WIC program. J Community Health 2016;41:612-8.  Back to cited text no. 5
    
6.
Kowash MB, Pinfield A, Smith J, Curzon ME. Dental health education: Effectiveness on oral health of a long-term health education programme for mothers with young children. Br Dent J 2000;188:201-5.  Back to cited text no. 6
    
7.
Al-Ansari JM, Honkala S. Gender differences in oral health knowledge and behavior of the health science college students in Kuwait. J Allied Health 2007;36:41-6.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10]



 

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