General dental practitioners' approach to caries prevention in high-caries-risk children.

AIMS: To evaluate the advice and preventive care provided by General Dental Practitioners (GDPs) to high-caries-risk children in Jordan. METHODS: A cross-sectional study using an open-ended questionnaire. GDPs were presented with a high-caries-risk child scenario and asked regarding: (1) oral hygiene and dietary advice they would give; (2) preventive-care they would offer; (3) barriers they face in prevention delivery. Answers were compared to an evidence-based guideline. Data were input into SPSS-20 and analysed using descriptive statistics and frequencies. Chi-square test was used to compare results by age, gender, practice location and type. RESULTS: One-hundred and sixty GDPs were approached and 128 agreed to participate (80%), of whom 87 (69%) were female. The average age was 31 years [range 22-50]. Sixty-nine percent practiced in the capital, Amman. Sixty-five percent gave advice on tooth-brushing frequency, but only 23% suggested brushing at bed-time and 24% recommended parental supervision. None provided advice on toothpaste fluoride content. Seventy-one percent advised reducing sugary-food amounts, but only 21% focused on frequency and 2% suggested using diet diaries. Most knew about fissure-sealants (77%) and fluoride-varnish (80%). Forty-two percent reported barriers to delivering preventive-care, including parental attitudes (36%), child cooperation (30%), financial reward (19%), and training (6%). Participants practicing outside of the capital were less likely to use fluoride-varnish [P = 0.002] and more likely to report barriers [P = 0.001]. CONCLUSIONS: Advice delivered by GDPs to high-caries-risk children in Jordan does not meet the standards of an evidence-based guideline. Future initiatives for oral-health-promotion should aim to address the barriers reported, especially outside the capital.

Do expectant mothers know how early childhood caries can be prevented? A cross-sectional study.

AIM: To evaluate the awareness, knowledge, and beliefs about early childhood caries (ECC) among a sample of expectant mothers and to determine their preferences to help design appropriate interventions. METHODS: Expectant mothers attending for antenatal care at a large public hospital were interviewed and asked to complete a questionnaire about ECC. The questionnaire was pre-tested and validated and contained questions about risk factors, presentations, management, and complications of ECC. Participants were also asked about their preferred method for oral health education about ECC. Data were analysed using SPSS for Windows release and descriptive statistics were generated. RESULTS: Four-hundred expectant mothers were approached and 380 (95%) agreed to participate. 59% reported brushing twice or more daily, but only 10% attended the dentist regularly. Only 16% thought that tooth brushing should start as soon as primary teeth erupt. Most (68%) thought that bottle feeding does not need to stop before the age of two. The majority believed that sugar is better consumed between meals (81%) and in portions throughout the day (85%). Only 12% thought that a child should have their first dental visit by the age of one. Educational level influenced knowledge on several aspects of ECC prevention. The participants suggested leaflets (38%) and social media (24%) as methods for oral-health-education delivery. CONCLUSION: Expectant mothers lack adequate knowledge about ECC prevention. There is a need for interventions that deliver advice on child toothbrushing, dietary practices, and dental attendance as part of wider general-health promotion.

Knowledge and behaviour of parents in relation to the oral and dental health of children aged 4-6 years.

AIM: To evaluate baseline knowledge and behaviour of parents with regard to the oral and dental health of their young children. METHODS: Following ethical approval, six urban and rural schools were identified. Questionnaires were distributed to the parents of pupils (children aged 4-6 years). The questionnaire included several questions evaluating parental knowledge and behaviour of oral and dental health issues in their children. Each question was assigned a score of either 0 or 1 being inconsistent or consistent with current paediatric guidelines giving a maximum score of 6 for knowledge and 7 for behaviour. Chi-square analysis was used to analyse associations among variables. RESULTS: Parental knowledge varied widely among parents and across questions; however, 70.2 % of parents had scores greater than 3 (range 0-6). The majority of parents (65.8 %) also had scores greater than 3 (range 0-7) for behaviour. Deficiencies were noted in oral hygiene practices; very few parents brushed their child's teeth and were not aware of the recommended age of the first dental visit at 1 year (Age 1 visit). Parents without free medical care demonstrated high levels of knowledge (P < 0.05). Almost half of the parents thought that the information available to them on the oral health of their young children was insufficient. CONCLUSION: Parents appeared to have limited knowledge regarding the dental and oral health of their young children. This study indicates a need for improved education for parents, particularly in toothbrushing behaviour and use of toothpaste. Education strategies tailored to the Irish population should be explored.