Investigating parents' and prospective parents' knowledge of oral hygiene for infants and children

Background: The aim of this study was to investigate the knowledge of parents and future parents regarding the oral hygiene of newborns and children. Understanding parental awareness is crucial to identifying gaps in knowledge and improving early oral health practices. Methods: An anonymous questionnaire was constructed and disseminated to patients of dental practices and parents of children attending nursery and primary schools in municipalities between Vicenza and Padua. Data collection took place from January 2022 to June 2023, yielding 600 completed questionnaires, of which 532 were completed by women and 68 by men. Statistical analysis was performed to evaluate the influence of educational levels on oral hygiene knowledge and practices. Results: Significant differences (p < 0.05) were observed based on participants’ educational levels. Parents with higher educational attainment demonstrated better knowledge regarding the appropriate age to start oral hygiene, the impact of sugary drinks on tooth decay, and the transmissibility of carious disease. Among university-educated parents, 83.8% reported frequent brushing, compared to 76.4% of parents with only elementary or middle school education. Additionally, over 25% of respondents expressed concerns about toothpaste safety, and there was limited understanding of the importance of early oral hygiene practices and fluoride use. Conclusions: The findings highlight the need for targeted educational interventions to improve parents’ understanding of oral hygiene, with a particular focus on nutrition, bacterial transmissibility, and the importance of early oral care. Educators, healthcare professionals, and community programs should prioritize addressing the gaps identified, especially among parents with lower educational backgrounds, to foster better oral health practices from an early age.

Oral hygiene knowledge; Parental awareness; Preventive dentistry; Community dentistry

[1] Acs G, Shulman R, Ng MW, Chussid S. The effect of dental rehabilitation on the body weight of children with early childhood caries. Pediatric Dentistry. 1999; 21: 109–113.

[2] Alkarimi HA, Watt RG, Pikhart H, Sheiham A, Tsakos G. Dental caries and growth in school-age children. Pediatrics. 2014; 133: e616–e623.

[3] Mishu MP, Tsakos G, Heilmann A, Watt RG. Dental caries and anthropometric measures in a sample of 5- to 9-year-old children in Dhaka, Bangladesh. Community Dentistry and Oral Epidemiology. 2018; 46: 449–456.

[4] Abanto J, Carvalho TS, Mendes FM, Wanderley MT, Bönecker M, Raggio DP. Impact of oral diseases and disorders on oral health-related quality of life of preschool children. Community Dentistry and Oral Epidemiology. 2011; 39: 105–114.

[5] Gomes MC, Pinto-Sarmento TC, Costa EM, Martins CC, Granville-Garcia AF, Paiva SM. Impact of oral health conditions on the quality of life of preschool children and their families: a cross-sectional study. Health and Quality of Life Outcomes. 2014; 12: 55.

[6] Faisal MR, Mishu MP, Jahangir F, Younes S, Dogar O, Siddiqi K, et al. The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children’s oral health: a systematic review and meta-analysis. PLOS ONE. 2022; 17: e0262118.

[7] Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, et al; GBD 2015 Oral Health Collaborators. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990–2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. Journal of Dental Research. 2017; 96: 380–387.

[8] Akera P, Kennedy SE, Lingam R, Obwolo MJ, Schutte AE, Richmond R. Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income countries: a systematic review and meta-analysis. BMC Oral Health. 2022; 22: 264.

[9] Bagramian RA, Garcia-Godoy F, Volpe AR. The global increase in dental caries. A pending public health crisis. American Journal of Dentistry. 2009; 22: 3–8.

[10] Large J, Marshman Z. Does dental caries lead to stunting and wasting in children? Evidence-Based Dentistry. 2022; 23: 144–145.

[11] Marinho VC, Higgins JP, Sheiham A, Logan S. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews. 2003; 2003: CD002278.

[12] Adair PM, Burnside G, Pine CM. Analysis of health behaviour change interventions for preventing dental caries delivered in primary schools. Caries Research. 2013; 47: 2–12.

[13] Strohmenger L, Cagetti MG, Campus G, Rosmarini M, De Carli A, Gatti M, et al. National guidelines for the promotion of oral health and the prevention of oral diseases in developmental age. 2013. Available at: https://www.salute.gov.it/imgs/C_17_pubblicazioni_867_allegato.pdf (Accessed: 04 June 2023).

[14] Castilho AR, Mialhe FL, Barbosa Tde S, Puppin-Rontani RM. Influence of family environment on children’s oral health: a systematic review. The Journal of Pediatrics. 2013; 89: 116–123.

[15] Jahanshahi R, Amanzadeh S, Mirzaei F, Baghery Moghadam S. Does motivational interviewing prevent early childhood caries? A systematic review and meta-analysis. Journal of Dentistry. 2022; 23: 161–168.

[16] Petersen PE, Peng B, Tai B, Bian Z, Fan M. Effect of a school-based oral health education programme in Wuhan City, Peoples Republic of China. International Dental Journal. 2004; 54: 33–41.

[17] Peng B, Petersen PE, Bian Z, Tai B, Jiang H. Can school-based oral health education and a sugar-free chewing gum program improve oral health? Results from a two-year study in PR China. Acta Odontologica Scandinavica. 2004; 62: 328–332.

[18] Naidu J, Nandlal B. Evaluation of the effectiveness of a primary preventive dental health education programme implemented through school teachers for primary school children in Mysore city. Journal of International Society of Preventive & Community Dentistry. 2017; 7: 82–89.

[19] Pakhomov GN, Moller IJ, Atanassov NP, Kabackchieva RI, Sharkov NI. Effect of an amine fluoride dentifrice on dental caries used in a community-based oral health education program. Journal of Public Health Dentistry. 1997; 57: 181–183.

[20] Hartono SW, Lambri SE, van Palenstein Helderman WH. Effectiveness of primary school-based oral health education in West Java, Indonesia. International Dental Journal. 2002; 52: 137–143.

[21] Haleem A, Siddiqui MI, Khan AA. School-based strategies for oral health education of adolescents—a cluster randomized controlled trial. BMC Oral Health. 2012; 12: 54.

[22] Jaime RA, Carvalho TS, Bonini GC, Imparato J, Mendes FM. Oral health education program on dental caries incidence for school children. Journal of Clinical Pediatric Dentistry. 2015; 39: 277–283.

[23] Yusof ZY, Jaafar N. Health promoting schools and children’s oral health related quality of life. Health and Quality of Life Outcomes. 2013; 11: 205.

[24] Nyandindi U, Milén A, Palin-Palokas T, Robison V. Impact of oral health education on primary school children before and after teachers’ training in Tanzania. Health Promotion International. 1996; 11: 193–201.

[25] Section On Oral Health. Maintaining and improving the oral health of young children. Pediatrics. 2014; 134: 1224–1229.

[26] Abou El Fadl R, Blair M, Hassounah S. Integrating maternal and children’s oral health promotion into nursing and midwifery practice—a systematic review. PLOS ONE. 2016; 11: e0166760.

[27] George A, Sousa MS, Kong AC, Blinkhorn A, Patterson Norrie T, Foster J, et al. Effectiveness of preventive dental programs offered to mothers by non-dental professionals to control early childhood dental caries: a review. BMC Oral Health. 2019; 19: 172.

[28] Tsai C, Raphael S, Agnew C, McDonald G, Irving M. Health promotion interventions to improve oral health of adolescents: a systematic review and meta-analysis. Community Dentistry and Oral Epidemiology. 2020; 48: 549–560.

[29] Hoeft KS, Barker JC, Masterson EE. Urban Mexican-American mothers’ beliefs about caries etiology in children. Community Dentistry and Oral Epidemiology. 2010; 38: 244–255.

[30] Azevedo MS, Romano AR, Dos Santos I da S, Cenci MS. Knowledge and beliefs concerning early childhood caries from mothers of children ages zero to 12 months. Pediatric Dentistry. 2014; 36: 95–99.

[31] Ludovichetti FS, Zuccon A, Lucchi P, Cattaruzza G, Zerman N, Stellini E, et al. Mothers’ awareness of the correlation between their own and their children’s oral health. International Journal of Environmental Research and Public Health. 2022; 19: 14967.

[32] Roberts K, Condon L. How do parents look after children’s teeth? A qualitative study of attitudes to oral health in the early years. Community Practitioner. 2014; 87: 32–35.

[33] Naidu RS, Nunn JH. Oral health knowledge, attitudes and behaviour of parents and caregivers of preschool children: implications for oral health promotion. Oral Health and Preventive Dentistry. 2020; 18: 245–252.

[34] Berzinski M, Morawska A, Mitchell AE, Baker S. Parenting and child behaviour as predictors of toothbrushing difficulties in young children. International Journal of Paediatric Dentistry. 2020; 30: 75–84.

[35] Mustafa M, Nasir EF, Åstrøm AN. Attitudes toward brushing children’s teeth—a study among parents with immigrant status in Norway. International Journal of Paediatric Dentistry. 2021; 31: 80–88.

[36] Firmino RT, Martins CC, Faria LDS, Martins Paiva S, Granville-Garcia AF, Fraiz FC, et al. Association of oral health literacy with oral health behaviors, perception, knowledge, and dental treatment related outcomes: a systematic review and meta-analysis. Journal of Public Health Dentistry. 2018; 78: 231–245.

[37] Ludovichetti FS, Signoriello AG, Colussi N, Zuccon A, Stellini E, Mazzoleni S. Soft drinks and dental erosion during pediatric age: a clinical investigation. Minerva Dental and Oral Science. 2022; 71: 262–269.

[38] Sbricoli L, Bernardi L, Ezeddine F, Bacci C, Di Fiore A. Oral hygiene in adolescence: a questionnaire-based study. International Journal of Environmental Research and Public Health. 2022; 19: 7381.

[39] Marashi SZ, Hidarnia A, Kazemi SS, Zarei F. Factors predicting oral health behaviors among students age 13–15 years in Shushtar city, Iran. BMC Oral Health. 2023; 23: 691.

[40] Ludovichetti FS, Zambon G, Cimolai M, Gallo M, Signoriello AG, Pezzato L, et al. Efficacy of two toothpaste in preventing tooth erosive lesions associated with gastroesophageal reflux disease. Applied Sciences. 2022; 12: 1023.

[41] Chan AKY, Tsang YC, Jiang CM, Leung KCM, Lo ECM, Chu CH. Diet, nutrition, and oral health in older adults: a review of the literature. Dentistry Journal. 2023; 11: 222.