The in-home management of childhood fever associated with dental issues: a cross-sectional study of parental knowledge in Saudi Arabia

Background: Childhood fever originating from dental issues is a potentially serious health concern affecting numerous children. This study aims to investigate its prevalence in Saudi Arabia and parental knowledge regarding its management. Methods: Using a self-administered questionnaire, 951 parents attending various centers in Saudi Arabia were recruited in this cross-sectional study between 01 September and 31 December 2023. Results: The questionnaire includes parents’ demographic characteristics and fever management practices. Nearly 65% of parents expressed concern about fever’s harmful effects, including potential loss of consciousness, dehydration and brain damage. Moreover, 64.2% of parents report consistently using antibiotics without a prescription. Conclusions: Our findings demonstrated a lack of knowledge among parents when it comes to managing their children’s dental-related fever. A proactive educational approach to addressing this concern is required by healthcare professionals, as well as the community at large.

Fever; Dental problems; Consciousness; Brain damage; Antibiotics; Parental practice

[1] Carr EA, Wilmoth ML, Eliades AB, Baker PJ, Shelestak D, Heisroth KL, et al. Comparison of temporal artery to rectal temperature measurements in children up to 24 months. Journal of Pediatric Nursing. 2011; 26: 179–185.

[2] Al-Mukhaizeem F, Allen U, Komar L, Naser B, Roy L, Stephens D, et al. Comparison of temporal artery, rectal and esophageal core temperatures in children: results of a pilot study. Paediatrics & Child Health. 2004; 9: 461–465.

[3] El-Radhi AS. Determining fever in children: the search for an ideal thermometer. British Journal of Nursing. 2014; 23: 91–94.

[4] Shelburne SA, Keith D, Horstmann N, Sumby P, Davenport MT, Graviss EA, et al. A direct link between carbohydrate utilization and virulence in the major human pathogen group A Streptococcus. Proceedings of the National Academy of Sciences of the United States of America. 2008; 105: 1698–1703.

[5] Ministry of Health. Our oral health: key findings of the 2009 New Zealand oral health survey. Ministry of Health: Wellington. 2010.

[6] Baykan Z, Sahin F, Beyazova U, Ozçakar B, Baykan A. Experience of Turkish parents about their infants’ teething. Child: Care, Health and Development. 2004; 30: 331–336.

[7] Lloyd S. Teething in babies: separating fact from fiction. Professional Care of Mother and Child. 1996; 6: 155–156.

[8] Macknin ML, Piedmonte M, Jacobs J, Skibinski C. Symptoms associated with infant teething: a prospective study. Pediatrics. 2000; 105: 747–752.

[9] Peretz B, Ram D, Hermida L, Otero MM. Systemic manifestations during eruption of primary teeth in infants. Journal of Dentistry for Children. 2003; 70: 170–173.

[10] Cunha RF, Pugliesi DMC, Garcia LD, Murata SS. Systemic and local teething disturbances: prevalence in a clinic for infants. Journal of Dentistry for Children. 2004; 71: 24–26.

[11] Ramos-Jorge J, Pordeus IA, Ramos-Jorge ML, Paiva SM. Prospective longitudinal study of signs and symptoms associated with primary tooth eruption. Pediatrics. 2011; 128: 471–476.

[12] Wake M, Hesketh K, Lucas J. Teething and tooth eruption in infants: a cohort study. Pediatrics. 2000; 106: 1374–1379.

[13] Ige OO, Olubukola PB. Teething myths among nursing mothers in a Nigerian community. Journal of the Nigeria Medical Association. 2013; 54: 107–110.

[14] Ispas RS, Mahoney EK, Whyman RA. Teething signs and symptoms: persisting misconceptions among health professionals in New Zealand. NZ Dental Journal. 2013; 109: 2–5.

[15] Yuan J, Liu C, Li Z, Chen Q. Diagnostic strategies for diseases with fever in dental clinics. Journal of Zhejiang University Science B. 2023; 24: 352–358.

[16] Zheng J, Fang B, Zhang S, Yang C, Shen G, Qiu W, et al. Oral and maxillofacial surgery in China: past, present and future. Open Journal of Stomatology. 2013; 3: 354–358.

[17] Crocetti M, Moghbeli N, Serwint J. Fever phobia revisited: have parental misconceptions about fever changed in 20 years? Pediatrics. 2001; 107: 1241–1246.

[18] Taveras EM, Durousseau S, Flores G. Parents’ beliefs and practices regarding childhood fever: a study of a multiethnic and socioeconomically diverse sample of parents. Pediatric Emergency Care. 2004; 20: 579–587.

[19] Krantz C. Childhood fevers: developing an evidence-based anticipatory guidance tool for parents. Pediatric Nursing. 2001; 27: 567–571.

[20] Walsh A, Edwards H. Management of childhood fever by parents: literature review. Journal of Advanced Nursing. 2006; 54: 217–227.

[21] Hussain SM, Al-Wutayd O, Aldosary AH, Al-Nafeesah A, AlE’ed A, Alyahya MS, et al. Knowledge, attitude, and practice in management of childhood fever among Saudi parents. Global Pediatric Health. 2020; 7: 2333794X2093161.

[22] Al-Eissa YA, Al-Sanie AM, Al-Alola SA, Al-Shaalan MA, Ghazal SS, Al-Harbi AH, et al. Parental perceptions of fever in children. Annals of Saudi Medicine. 2000; 20: 202–205.

[23] Jaber L, Cohen IJ, Mor A. Fever associated with teething. Archives of Disease in Childhood. 1992; 67: 233–234.

[24] Galili G, Rosenzweig KA, Klein H. Eruption of primary teeth and general pathologic conditions. ASDC Journal of Dentistry for Children. 1969; 36: 51–54.

[25] AlAteeq MM, AlBader BO, Al-Howti SY, Alsharyoufi M, Abdullah JB. Parent’s knowledge and practice in home management of fever in their children in Riyadh, Saudi Arabia. Journal of Family Medicine and Primary Care. 2018; 7: 1012–1018.

[26] Sağer SG, Batu U, Ergüven M. Mothers’ knowledge levels about fever, antipyretics, febrile illnesses, antibiotic use, and febrile convulsions. 2021. Available at: https://hnhtipdergisi.com/jvi.aspx?un=HNHJ-65487&volume= (Accessed: 31 March 2024).

[27] Chang LC, Liu CC, Huang MC. Parental knowledge, concerns, and management of childhood fever in Taiwan. Journal of Nursing Research. 2013; 21: 252–260.

[28] Zyoud SH, Al-Jabi SW, Sweileh WM, Nabulsi MM, Tubaila MF, Awang R, et al. Beliefs and practices regarding childhood fever among parents: a cross-sectional study from Palestine. BMC Pediatrics. 2013; 13: 66.

[29] Penna A, Buchanan N. Paracetamol poisoning in children and hepatotoxicity. British Journal of Clinical Pharmacology. 1991; 32: 143–149.

[30] Kramer MS, Naimark LE, Roberts-Bräuer R, McDougall A, Leduc DG. Risks and benefits of paracetamol antipyresis in young children with fever of presumed viral origin. The Lancet. 1991; 337: 591–594.

[31] Kai J. What worries parents when their preschool children are acutely ill, and why: a qualitative study. The BMJ. 1996; 313: 983–986.