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      Factors Affecting Oral Hygiene and Tooth Brushing in Preschool Children, Shiraz/Iran

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          Statement of Problem:

          Inadequate tooth brushing and inappropriate oral hygiene can lead to dental caries, the most common chronic diseases of childhood with several side effects.


          To evaluate factors affecting on preschool children’s oral hygiene and tooth brushing in Shiraz, Iran

          Materials and Methods:

          In this cross-sectional study, we selected 453 children registered in Shiraz kindergartens in 2013 by randomized cluster sampling. The children’s tooth brushing and oral hygiene were assessed using a reliable and valid questionnaire and Simplified Debris Index (DI-S), respectively. A dental student examined all the children in each kindergarten to determine their DI-S. The relationship between the children’s demographic variables and their oral hygiene and tooth brushing status were evaluated.


          Tooth brushing for 272 children (71.2%) had been started after the age of 2 years. The teeth in 96 children (24.2%) had been brushed lower than once daily. The mean of the children’s DI-S was 1.19 ± (0.77). The DI-S of only 126 children (31.8%) was found to be good and very good. After controlling the effect of confounding factors, we found that the children’s tooth brushing frequency was significantly associated with the number of children in the family and mothers’ employment status. The age at which tooth brushing had been started was significantly associated with the fathers’ education. Furthermore, the DI-S was associated with children’s age, number of the children in the family, and their mothers’ education.


          Oral hygiene and tooth brushing of the preschool children were not in a desirable status. Interventional procedures, especially educational programs, are recommended for children and their parents. These programs seem to be more necessary for older children, low socioeconomic families, and families with more than one child.

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          Most cited references 31

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            Systemic diseases caused by oral infection.

            Recently, it has been recognized that oral infection, especially periodontitis, may affect the course and pathogenesis of a number of systemic diseases, such as cardiovascular disease, bacterial pneumonia, diabetes mellitus, and low birth weight. The purpose of this review is to evaluate the current status of oral infections, especially periodontitis, as a causal factor for systemic diseases. Three mechanisms or pathways linking oral infections to secondary systemic effects have been proposed: (i) metastatic spread of infection from the oral cavity as a result of transient bacteremia, (ii) metastatic injury from the effects of circulating oral microbial toxins, and (iii) metastatic inflammation caused by immunological injury induced by oral microorganisms. Periodontitis as a major oral infection may affect the host's susceptibility to systemic disease in three ways: by shared risk factors; subgingival biofilms acting as reservoirs of gram-negative bacteria; and the periodontium acting as a reservoir of inflammatory mediators. Proposed evidence and mechanisms of the above odontogenic systemic diseases are given.
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              Parental perceptions of their preschool-aged children's oral health.

              Parents have an important role in making decisions about their children's oral health. The purpose of the authors' study was to determine parental perceptions of their children's oral health status and factors correlated with these perceptions of health. The authors analyzed data for 3,424 children (2-5 years of age) from the Third National Health and Nutrition Examination Survey. They based the dependent variable on a question asked of primary caregivers: "How would you describe the condition of [child's name]'s natural teeth?" Explanatory variables included demographic variables, dental visits, perception of child's general health, need for dental care and presence of tooth caries. Eighty-nine percent of parents rated their child's oral health as excellent, very good or good, and 11 percent rated it as fair or poor (mean = 2.7 on a five-point scale, with 1 being excellent and 5 being poor). Tooth caries, perceived need for dental cleaning and treatment, lower income and poorer general health perceptions were associated with poorer parental ratings. Actual disease and perceived need are associated significantly with parents' perceptions of their children's oral health. Understanding parents' perceptions of their children's oral health and factors that motivate these perceptions can help dentistry overcome barriers that parents encounter in accessing dental care for their children.

                Author and article information

                J Dent Biomater
                J Dent Biomater
                Journal of Dental Biomaterials
                Journal of Dental Biomaterials (Iran )
                June 2017
                : 4
                : 2
                : 394-402
                [a ]Department of Dental Public Heath, School of Dentistry, Non-communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
                [b ]Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
                Author notes
                *Corresponding Author: Maryam Zeraatkar, Department of Dental Public Health, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
                Copyright: © Journal of Dental Biomaterials

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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