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      The Role of Mother’s Knowledge, Attitudes, Practices in Dental Caries on Vulnerably Preschool Children

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          Abstract

          Abstract Objective: To analyze the association between Early Childhood Caries (ECC) and mother´s knowledge, attitudes, and practices (KAP). Material and Methods: This cross-sectional study included a random sample of 163 preschool children aged 3-4 old in southern Brazil. The severity of dental caries and ECC was assessed by ICDAS criteria, while mothers completed the semi-structured questionnaire (KAP-ECC). Maternal behavior characteristics and answered questions about socioeconomic and demographic variables. Logistic regression was performed to evaluate the association of exploratory variables with ECC. For this approach, we calculated the odds ratio (OR) and 95% confidence intervals (95% IC). Results: Dental examinations revealed that 91.4% of children presented ECC (ICDAS = 3, 4, 5 or 6). Among those children, 31.9% presented cavities (ICDAS ≥ 3). Family income was significantly associated with the presence of ECC (OR 2.17; 95% CI: 1.41-3.36). Regarding KAP-ECC, mothers have knowledge related to ECC etiology, reported dental hygiene attitudes and practices that can prevent ECC but reported less healthy attitudes and practices regarding child’s diet, specifically with respect to bottle and breastfeeding habits (OR 0.52; 95% CI: 0.33-0.81). Conclusion: ECC was more frequent in children from low-income families and whose mothers reported the belief that milk with chocolate does not contribute to caries and that disagreed that it is normal that a 2-year-old baby wakes up during the night to suckle. That is, good knowledge toward health habits may impact on lower occurrence of ECC; however, this condition also depends on the socioeconomic level.

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          Most cited references32

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          The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries.

          This paper describes early findings of evaluations of the International Caries Detection and Assessment System (ICDAS) conducted by the Detroit Center for Research on Oral Health Disparities (DCR-OHD). The lack of consistency among the contemporary criteria systems limits the comparability of outcomes measured in epidemiological and clinical studies. The ICDAS criteria were developed by an international team of caries researchers to integrate several new criteria systems into one standard system for caries detection and assessment. Using ICDAS in the DCR-OHD cohort study, dental examiners first determined whether a clean and dry tooth surface is sound, sealed, restored, crowned, or missing. Afterwards, the examiners classified the carious status of each tooth surface using a seven-point ordinal scale ranging from sound to extensive cavitation. Histological examination of extracted teeth found increased likelihood of carious demineralization in dentin as the ICDAS codes increased in severity. The criteria were also found to have discriminatory validity in analyses of social, behavioral and dietary factors associated with dental caries. The reliability of six examiners to classify tooth surfaces by their ICDAS carious status ranged between good to excellent (kappa coefficients ranged between 0.59 and 0.82). While further work is still needed to define caries activity, validate the criteria and their reliability in assessing dental caries on smooth surfaces, and develop a classification system for assessing preventive and restorative treatment needs, this early evaluation of the ICDAS platform has found that the system is practical; has content validity, correlational validity with histological examination of pits and fissures in extracted teeth; and discriminatory validity.
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            Oral health-related quality-of-life scores differ by socioeconomic status and caries experience.

            (i) Quantify the relative association between child dental caries experience and maternal-reported child oral health-related quality of life (OHRQoL); (ii) examine whether that association differed according to family socioeconomic status (SES); and (iii) explore whether absolute OHRQoL varied by family SES at similar levels of child caries experience.
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              Oral health literacy among female caregivers: impact on oral health outcomes in early childhood.

              The aim of this study was to investigate the association of female caregivers' oral health literacy with their knowledge, behaviors, and the reported oral health status of their young children. Data on caregivers' literacy, knowledge, behaviors, and children's oral health status were used from structured interviews with 1158 caregiver/child dyads from a low-income population. Literacy was measured with REALD-30. Caregivers' and children's median ages were 25 yrs (range = 17-65) and 15 mos (range = 1-59), respectively. The mean literacy score was 15.8 (SD = 5.3; range = 1-30). Adjusted for age, education, and number of children, low literacy scores (< 13 REALD-30) were associated with decreased knowledge (OR = 1.86; 95% CI = 1.41, 2.45) and poorer reported oral health status (OR = 1.44; 95% CI = 1.02, 2.05). Lower caregiver literacy was associated with deleterious oral health behaviors, including nighttime bottle use and no daily brushing/cleaning. Caregiver oral health literacy has a multidimensional impact on reported oral health outcomes in infants and young children.

                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                pboci
                Pesquisa Brasileira em Odontopediatria e Clínica Integrada
                Pesqui. Bras. Odontopediatria Clín. Integr.
                Associação de Apoio à Pesquisa em Saúde Bucal (João Pessoa, PB, Brazil )
                1519-0501
                1983-4632
                2020
                : 20
                : e4687
                Affiliations
                [2] Santa Maria Rio Grande do Sul orgnameUniversidade Federal de Santa Maria orgdiv1School of Dentistry orgdiv2Department of Stomatology Brazil
                [4] Porto Alegre RS orgnameFederal University of Rio Grande do Sul orgdiv1Institute of Psychology Brazil
                [3] Canoas RS orgnameLutheran University of Brazil orgdiv1School of Dentistry Brazil
                [1] Porto Alegre RS orgnameFederal University of Rio Grande do Sul orgdiv1Faculty of Dentistry orgdiv2Department of Pediatric Dentistry Brazil
                Article
                S1983-46322020000100304 S1983-4632(20)02000000304
                10.1590/pboci.2020.007
                8e8971db-39f0-4d1d-b476-410361e8fc9f

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 17 October 2019
                : 15 March 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 40, Pages: 0
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                SciELO Brazil

                Self URI: Full text available only in PDF format (EN)
                Categories
                Original Article

                Cross-Sectional Studies,Dental Caries,Maternal Behavior,Socioeconomic Factors

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