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 Table of Contents 
ORIGINAL ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 4  |  Page : 829-833  

Oral health of preschool children in Dhanbad District, Jharkhand: A gander into the maternal behavior and practices


1 Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
2 Department of Public Health Dentistry, Rajasthan Dental College & Hospital, Jaipur, Rajasthan, India
3 Department of Pedodontics, Daswani Dental College & Research Centre, Kota, Rajasthan, India

Date of Web Publication28-Feb-2017

Correspondence Address:
Gunjan Kumar
Department of Public Health Dentistry, Kalinga Institute of Dental Sciences, KIIT University, Campus-5, Patia, Bhubaneswar - 751 024, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4863.201151

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  Abstract 

Introduction: Mothers have an important role in taking decisions about their children's oral health. The study assessed the echelon of oral health behavior and practices of the mothers in relation to their preschool-aged children, which could possibly influence their oral health. Methods: A cross-sectional study was carried out among 312 mothers, selected randomly from eight blocks of Dhanbad District, Jharkhand State, by administering a structured questionnaire on oral health behavior and practices regarding oral health. Results: The overall data indicated that the practices of mothers about oral health of their preschool children increased as their age increased, which was however, not statistically significant (P > 0.47). The mothers who had less than higher secondary school education and belonging to lower socioeconomic groups had poorer oral health practices and was found to be statistically significant (P < 0.002 ). Conclusion: The mothers ought to inculcate positive practices and perceptions about preventive oral health for themselves first, to be good role models for their children.

Keywords: Maternal behavior, oral health practice, preschool children


How to cite this article:
Kumar G, Dileep C L, Ahuja R. Oral health of preschool children in Dhanbad District, Jharkhand: A gander into the maternal behavior and practices. J Family Med Prim Care 2016;5:829-33

How to cite this URL:
Kumar G, Dileep C L, Ahuja R. Oral health of preschool children in Dhanbad District, Jharkhand: A gander into the maternal behavior and practices. J Family Med Prim Care [serial online] 2016 [cited 2017 Mar 27];5:829-33. Available from: http://www.jfmpc.com/text.asp?2016/5/4/829/201151


  Introduction Top


Oral health is a major public health issue affecting all groups of the population. Poor oral health during the early years is directly associated with poor oral health outcomes in childhood and throughout adulthood as they remain susceptible to developing dental diseases throughout their life.[1] Children under the age of 5 years generally spend most of their time with their parents and guardians. During the first 3 years and preschool period, the role of parents is very vital in maintaining good oral health of the child, since they are the main caregivers of oral health. This includes eating and drinking habits of the child and healthy behaviors established as norms in the home and it relies on the knowledge and behavior of parents and the elder siblings.[2],[3] Opinions and beliefs of mothers are valuable considerations in forays into children's oral health initiatives.[2],[4] In Jharkhand, studies on oral health perception are scarce, especially for those under 6 years.


  Materials and Methods Top


The present cross-sectional study was conducted using a structured questionnaire which was administered to the mothers of the preschool children, who were under 6 years of age. The ethical clearance was obtained from the Institutional Review Board, and informed consent was obtained from the wards of the study participants. The study was conducted on a randomly selected sample of mothers in the rural areas of Dhanbad District.

The sample size was calculated using the formula: n = z2pq/d2, where n = sample size, P = prevalence of disease, q = free from disease, d = allowable error and z = point on the normal deviation. Accordingly, 312 mothers were selected with an age range of 18–35 years. The education of the mothers was classified as belonging to illiterate, primary school, intermediate, and above. The income of the families was classified as below Rs. 5000, Rs. 5000–10,000, Rs. 10,000–15,000, and above Rs. 15,000 per month. The samples were taken from the eight blocks of Dhanbad District and from each Block, 39 mothers were selected.

Statistical analysis

The data were tabulated and statistically analyzed using the Statistical Package for Social Sciences, Version 12. The Chi-square test was used for comparing the oral health practices of the mothers in relation to their oral health.


  Results Top


The study was conducted in Dhanbad, a major District of Jharkhand State. A total of 312 mothers of preschool children participated in the study. The age of the mothers ranged between 18 and 25 years (34.6%), 26 and 35 years (59.3%), and 35 years and above (6.1%). Almost half of the mothers (44.9%) were illiterate and those who had up to primary, intermediate, and above intermediate education were, 43.6%, 8.6%, and 2.9%, of the study group, respectively. A whopping 79.2% of the mothers had a meager monthly income below Rs. 5000, and those who had the monthly family income in the next higher brackets were 18.6%, 0.9%, and 1.3% of the study group, respectively [Table 1].
Table 1: Distribution of the mothers by age group, education level, and family income

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A majority of the children belonged to the 3-year (33.6%) and 4- year (35.2%) age groups, followed by 5-year (27.4%) and 6-year (3.8%) age groups. The data on feeding practices revealed that the children were breastfed during the initial period and weaned off later to bottle feeding.

When the mothers were asked about the pattern of sweet consumption by their children, a majority of them reported the consumption to be once a day, i.e., among 34.3%, 41.4%, and 72.5% children, across the age groups, respectively [Table 2]. However, there was no statistically significant difference observed among the mothers according to age (χ2 = 7.55, P > 0.47), education (χ2 = 15.76, P > 0.20), and family income (χ2 = 10.57, P > 0.56).
Table 2: Pattern of sweet consumption by the children in the study group

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Apropos the frequency of cleaning the child's teeth by their mothers, it was found that most of the mothers brushed their child's teeth once a day, i.e., among 89.5%, 74.4%, and 92.7% children, across the age groups, respectively [Table 3]. Statistically significant differences were observed among the mothers according to age (χ2 = 16.94, P < 0.002), educational status (χ2 = 14.76, P < 0.002), and family income (χ2 = 19.38, P < 0.004).
Table 3: Pattern of cleaning of teeth by the children in the study group

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A majority of the mothers used a toothbrush to clean their child's teeth, i.e., among 63.9%, 74.3%, and 65.4% children, across the age groups, respectively [Table 4]. However, there was no statistically significant differences observed among the mothers according to age (χ2 = 4.35, P > 0.63), educational status (χ2 = 9.95, P > 0.35) and family income (χ2 = 11.53, P > 0.24).
Table 4: Manner of cleaning of teeth by the children in the study group

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A greater number of mothers used a tooth paste to clean their child's teeth, i.e. among 63.2%, 72.1%, and 52.3% children, across the age groups, respectively [Table 5]. However, there was no statistically significant difference observed among the mothers according to age (χ2 = 14.40, P > 0.72), educational status (χ2 = 18.8, P > 0.11) and family income (χ2 = 6.02, P > 0.91).
Table 5: Material used for cleaning the teeth by the children

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  Discussion Top


Oral health has a pivotal role in the general well-being of individuals and the adoption of good oral health habits in childhood often takes place with active guidance from caregivers, teachers, dentist, physician, and parents, especially the mothers.[5],[6],[7],[8],[9],[10] It appears that interventions targeting parental oral health beliefs and practices might be beneficial in the prevention of oral health problems.[11]

In the present study, parents with poor education and economic background probably had poorer perception regarding dental health. The knowledge and practices of the mothers about their wards' oral health varied with increasing age. These findings were similar to the outcome of the study undertaken by Talekar et al.[12]

It has been established that higher the mother's education level, the lower their child's caries experience and this finding is similar to the results published by Pacharuniti et al.[13]

It was found that the most deprived families, in terms of the education level of the parents showed the least positive attitude and had the weakest motivation for controlling their child's sugar snacking habits. A majority of the mothers were aware that sugary items could lead to dental caries. It has been suggested that the parents with a general, improved level of education might be better able to assess an appropriate source of information and understand the contents more clearly. These findings were similar to the findings of the study conducted by Moulana et al.[14] and Kamolmatyakul and Saiong.[15]

It was observed that parents living in deprivation and those who had no further education, all had less chances of having high levels of dental knowledge and positive dental attitudes. These observations were similar to the findings put forth by Williams et al.[16]

It was seen that children from disadvantaged groups had the lowest level of dental health. The parents' age and education levels were the key factors in the preschool children's dental health which were in accordance with the findings of the study conducted by Mattila et al.[17]

Although not statistically significant, good oral health behaviors were observed more among the older mothers than the younger ones. This could perhaps be explained on the premise that the former were more likely to have had various oral health experiences compared to the latter. These results were similar to the findings of the study conducted by Pacharuniti et al.[13] A majority of the parents (67.9%) selected a toothbrush as the most appropriate cleaning aid for their children's teeth and similar findings were reported by Naidu and Davis.[18]

In the present study, around two-third of the study subjects used a toothbrush and toothpaste for brushing their ward's teeth which was higher than in the study carried out by Pullishery et al.[19]


  Conclusion Top


Notable health behaviors in parents, such as tooth brushing habits and frequency of consumption of sweet foods, are important determinants of these behaviors in their children. A majority of the mothers had a poor perception of their child's oral health and thus steps ought to be taken to educate and motivate the mothers about the importance of regular dental visits. Since primary care physicians and dentists could influence the oral health behavior of the mothers, they have to focus more on oral/dental prevention than just depend on clinical therapy.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Kawashita Y, Kitamura M, Saito T. Early childhood caries. Int J Dent 2011;2011:725320.  Back to cited text no. 1
    
2.
Bozorgmehr E, Hajizamani A, Malek Mohammadi T. Oral health behavior of parents as a predictor of oral health status of their children. ISRN Dent 2013;2013:741783.  Back to cited text no. 2
    
3.
Oredugba F, Agbaje M, Ayedun O, Onajole A. Assessment of mothers' oral health knowledge: Towards oral health promotion for infants and children. Health 2014;6:908-15.  Back to cited text no. 3
    
4.
Al-Shalan TA. Factors affecting Saudi parents' perception of their children's first dental visit. J Contemp Dent Pract 2003;4:54-66.  Back to cited text no. 4
    
5.
Mitchell-Royston L, Nowak A, Silverman J. Interprofessional Study of Oral Health in Primary Care, Final Report May, 2014. Chicago: Pediatric Oral Health Research and Policy Center, American Academy of Pediatric Dentistry; 2014. p. 19.  Back to cited text no. 5
    
6.
Mota A, Oswal KC, Sajnani DA, Sajnani AK. Oral health knowledge, attitude, and approaches of pre-primary and primary school teachers in Mumbai, India. Scientifica (Cairo) 2016;2016:5967427.  Back to cited text no. 6
    
7.
Kaur S, Kaur B, Ahluwalia SS. Oral health knowledge, attitude and practices amongst health professionals in Ludhiana, India. Dentistry 2015;5:315.  Back to cited text no. 7
    
8.
Nagaraj A, Biswas G, Shravani G, Sontakke P, Kumawat H, Jain P. Knowledge, attitude and practice of dental treatment among medical officers at PHCs of Amer and Jamwaramgarh Tehsil, Jaipur, Rajasthan – A pilot study. IOSR J Dent Med Sci 2014;13:115-20.  Back to cited text no. 8
    
9.
Naidu R, Nunn J, Irwin JD. The effect of motivational interviewing on oral healthcare knowledge, attitudes and behaviour of parents and caregivers of preschool children: An exploratory cluster randomised controlled study. BMC Oral Health 2015;15:101.  Back to cited text no. 9
    
10.
Suwansingha O, Rirattanapong P. Preschool children's caregivers' attitudes and behavior regarding bottle feeding in Bangpakong, Chachoengsao. J Int Soc Prev Community Dent 2014;4 Suppl 2:S93-8.  Back to cited text no. 10
    
11.
Hooley M, Skouteris H, Boganin C, Satur J, Kilpatrick N. Parental influence and the development of dental caries in children aged 0-6 years: A systematic review of the literature. J Dent 2012;40:873-85.  Back to cited text no. 11
    
12.
Talekar BS, Rozier RG, Slade GD, Ennett ST. Parental perceptions of their preschool-aged children's oral health. J Am Dent Assoc 2005;136:364-72.  Back to cited text no. 12
    
13.
Pacharuniti N, Sithan H, Lapying P, Kiewkarnka B. Oral health preventive behavior among mothers with preschool children in Nakhon Pathom Province, Thailand. J Public Health Dev 2004;2:23-35.  Back to cited text no. 13
    
14.
Moulana SA, Yashoda R, Puranik MP, Hiremath SS, Gaikwad R. Knowledge, attitude and practices towards primary dentition among the mothers of 3-5 year old pre-school children in Bangalore city. J Indian Assoc Public Health Dent 2012;19:83-92.  Back to cited text no. 14
    
15.
Kamolmatyakul S, Saiong S. Oral health knowledge, attitude and practices of parents attending Prince of Songkla University Dental Hospital. Int J Health Promot Educ 2007;45:111-3.  Back to cited text no. 15
    
16.
Williams NJ, Whittle JG, Gatrell AC. The relationship between socio-demographic characteristics and dental health knowledge and attitudes of parents with young children. Br Dent J 2002;193:651-4.  Back to cited text no. 16
    
17.
Mattila ML, Rautava P, Sillanpää M, Paunio P. Caries in five-year-old children and associations with family-related factors. J Dent Res 2000;79:875-81.  Back to cited text no. 17
    
18.
Naidu RS, Davis L. Parents' views on factors influencing the dental health of Trinidadian pre-school children. Community Dent Health 2008;25:44-9.  Back to cited text no. 18
    
19.
Pullishery F, Shenoy Panchmal G, Shenoy R. Parental attitudes and tooth brushing habits in preschool children in Mangalore, Karnataka: A cross-sectional study. Int J Clin Pediatr Dent 2013;6:156-60.  Back to cited text no. 19
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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