Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers
Tóm tắt
Little is known about oral health in early childhood in the West Indies or the views and experiences of caregivers about preventive oral care and dental attendance The aims of this study were to explore and understand parents and caregivers’ experience of oral healthcare for their preschool aged children and how, within their own social context, this may have shaped their oral health attitudes and behaviours. These data can be used to inform oral health promotion strategies for this age group. After ethical approval, a qualitative study was undertaken using a focus group approach with a purposive sample of parents and caregivers of preschool children in central Trinidad. Group discussions were initiated by use of a topic guide. Audio recording and field notes from the three focus groups, with a total of 18 participants, were transcribed and analysed using a thematic approach. Despite some ambivalence toward the importance of the primary teeth, the role of fluoride and confusion about when to take a child for their first dental visit, most participants understood the need to ensure good oral hygiene and dietary habits for their child. Problems expressed included, overcoming their own negative experiences of dentistry, which along with finding affordable and suitable dental clinics, affected their attitude to taking their child for a dental visit. There was difficulty in establishing good brushing routines and controlling sweet snacking in the face of many other responsibilities at home. Lack of availability of paediatric dental services locally and information on oral health care were also highlighted. Many expressed a need for more contact with dental professionals in non-clinic settings, for oral health care advice and guidance. Parents and caregivers in this qualitative study showed generally positive attitudes towards oral health but appear to have encountered several barriers and challenges to achieving ideal preventive care for their child, with respect to healthy diet, good oral hygiene and dental attendance. Oral health promotion should include effective dissemination of oral health information, more practical health advice and greater access to dental care for families with preschool children.
Tài liệu tham khảo
Tinanoff N, Resine S: Update on early childhood caries since the surgeon General's report. Acad Pediatr. 2009, 9: 396-403. 10.1016/j.acap.2009.08.006.
O' Mullane D, Parnell C: Early childhood caries: a complex problem requiring a complex solution. Comm Dent Health. 2011, 28: 254-
Filstrup SL, Briske D, da Fonesca M, Lawrence L, Wandera A, Inglehart MR: Early childhood caries and quality of life: child and parent perspectives. Padiar Dent. 2003, 25: 431-440.
Klassen MA, Veerkamp JS, Hoogstraten J: Young children’s oral health related quality of life and dental fear under general anaesthesia: a randomized controlled trial. Eur J Oral Sci. 2009, 117: 273-278. 10.1111/j.1600-0722.2009.00627.x.
Sheiham A: Dental caries affects body weight, growth and quality of life in preschool children. Brit Dent J. 2006, 201: 625-626. 10.1038/sj.bdj.4814259.
Cunnion DT, Spiro A, Jone JA, Rich SE, Papageorgio CP, Cassamassio P, Hayes C, Carcia RI: Paediatric oral health-related quality of life improvement after treatment of early childhood caries: a prospective multisite study. J Dent Child (Chic). 2010, 77: 4-11.
Telakar-Pahel B, Rozier RG, Slade GD: Parental perceptions of children's oral health: The Early Childhood Oral Health Impact Scale. Health Qual Life Outcomes. 2007, 5: 6-10.1186/1477-7525-5-6. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1802739/pdf/1477-7525-5-6.pdf]
Adewakun AA, Beltran-Aguilar E: Early childhood caries in Anguilla, British West Indies. Am J Gen Dent. 2003, 16: 42-47.
Vignarajah S, Williams G: Prevalence of dental caries and enamel defects in the primary dentition of Antiguan preschool children aged 3–4 years including an assessment of their habits. Comm Dent Health. 1992, 9: 349-360.
Naidu RS, Prevatt I, Simeon D: The oral health and treament needs of schoolchildren in Trinidad and Tobago: findings of a national survey. Int J Paed Dent. 2006, 16: 412-418. 10.1111/j.1365-263X.2006.00755.x.
Naidu RS, Boodoo D, Percival T, Newton JT: Dental emergencies presenting to a university-based paediatric clinic in the West Indies. Int J Paed Dent. 2005, 15: 177-184. 10.1111/j.1365-263X.2005.00625.x.
Holbrook WP, de Soet JJ, De Graff J: Prediction of dental caries in preschool children. Caries Res. 1993, 27: 424-430. 10.1159/000261574.
Fisher-Owens S, Gansky S, Platt LJ, Weintraub JA, Soobader MJ, Bramlett MD, Newacheck PW: Influences on children's oral health: A conceptual model. Paediatrics. 2007, 120: 510-520. 10.1542/peds.2006-3084.
Blinkhorn AS: Promoting dietary changes in order to control dental caries. Dent Health. 1991, 29: 3-6.
Adair PM, Pine C, Burnside G, Nicoll AD, Gillet A, Anwar S: Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and soci0-economically diverse groups. Comm Dent Health. 2004, 21 (Suppl): 102-111.
Finlayson TL, Siefert K, Ismail AI, Sohn W: Maternal self-efficacy and 1–5 year-old children's brushing habits. Comm Dent Oral Epidmiol. 2007, 35: 272-281. 10.1111/j.1600-0528.2007.00313.x.
Naidu R, Davis L: Parent's views on factors influencing the dental health of Trinidadian preschool children. Comm Dent Health. 2008, 25: 44-49.
Savage J: Ethnography and health care. Brit Med J. 2000, 321: 1400-1402. 10.1136/bmj.321.7273.1400.
Green J, Thorogood N: (Eds): Qualitative methods for health research. 2009, London: Sage Publications Ltd
Masood M, Masood Y, Newton JT: Methods of qualitative research in dentistry. Dent Update. 2010, 37: 326-336.
Lahti S, Hausen HW, Vaskilimpi T: The perceptions of users about barriers to the use of free systematic oral care among Finnish preschool children: a qualitative study. Acta Odontol Scand. 1999, 57: 139-143. 10.1080/000163599428869.
Gussey M, Waters E, Kilpatrick NM: A qualitative study exploring barriers to a model of shared care for preschool children's oral health. Brit Dent J. 2006, 201: 165-170. 10.1038/sj.bdj.4813877.
Hilton I, Stephen S, Barker JC, Weintraub JA: Cultural factors and children's oral health care: a qualitative study of young children. Comm Dent Oral Epidemiol. 2007, 35: 429-438. 10.1111/j.1600-0528.2006.00356.x.
Mofidi M, Zeldin LP, Rozier RG: Oral health of early head start children: a qualitative study of staff, parents and pregnant women. Am J Public Health. 2009, 99: 245-251. 10.2105/AJPH.2008.133827.
Daly B, Clarke W, McEvoy W, Periam K, Zoitopoulos L: Child oral health concerns amongst parents and primary care givers in a Sure Start Local Programme. Comm Dental Health. 2010, 27: 167-171.
Buerlein J, Horowitz AM, Child WL: Perspectives of Maryland women regarding oral health during pregnancy and early childhood. J Pub Health Dent. 2011, 71: 131-135. 10.1111/j.1752-7325.2010.00211.x.
Bowling A: Research methods in health. 1999, Buckingham: Open University Press
Kitzinger J: Introducing focus groups. Brit Med J. 1995, 311: 299-302.
Obeng CS: Dental care issues for African immigrant families of preschoolers. Early Childhood Care and Practice. 2008, 10: 2-http://ecrp.uiuc.edu/v10n2/obeng.html,
Scambler S, Klass C, Wright D, Gallagher J: Insights into the oral health beliefs and practices of mothers from a north London Orthdox Jewish community. BMC Oral Health. 2010, 10: 14-10.1186/1472-6831-10-14.http://www.biomedcentral.com/1472-6831/10/14,
McGrath C, Bedi R: Measuring the impact of oral health related quality of life in Britain using OHQoL-UK(W). J Pub Health Dent. 2003, 63: 73-77.
Nuttall N, Steele JG, Pine CM, White D, Pitts NB: The impact of oral health on people in the UK. In A Guide to the UK Adult Dental Health Survey 1998. Edited by: Nutall S, Steele JG, Nunn J, Pine C, Treasure E, Bradnock G, Morris J, Kelly M, Pitts NB, White D. 2001, London: BDJ Books, 29-40.
Kent G, Croucher R: Achieving oral health: The social context of dental care. 1998, Oxford: Wright
Naidu R, Gobin I, Newton JT: Perceptions and use of dental quacks (unqualified dental practitioners) and self-rated oral health in Trinidad. Int Dent J. 2003, 53: 447-454. 10.1002/j.1875-595X.2003.tb00886.x.
Milgrom P, Mancil L, King B, Weinstein P, Wells N, Jeffcott E: An explanatory model of the dental care utilization of low-income children. Med Care. 1998, 36: 554-566. 10.1097/00005650-199804000-00011.
Nettleton S: Understanding dental health beliefs: an introduction to enthography. Brit Dent J. 1986, 161: 45-147.
Naidu R, Lalwah S: Dental anxiety in sample of West Indian adults. West Indian Med J. 2010, 59: 567-572.
Locker D, Lidell A: Clinical correlates of dental anxiety. Comm Dent Oral Epidemiol. 1992, 36: 347-356.
Newton J, Edwards JC: Psychometric properties of the Modified Dental Anxiety Scale. Comm Dent Health. 2005, 22: 40-42.
Pine C, Adair PM, Peterson PE, Douglass C, Burnside G, Nicoll AD: Developing explanatory models of health inequalities in childhood dental caries. Comm Dental Health. 2004, 21 (Supplement): 86-95.
Finch H, Keegan J, Ward K: Barriers to the receipt of dental care. A qualitative study. 1988, London: Social and Community and Planning Research
Barker J, Horton SB: An ethnographic study of latino preschool children's oral health in rural California: Intersections among family, community, provider and regulatory sectors. BMC Oral Health. 2008, 8: 8-10.1186/1472-6831-8-8.http://www.biomedcentral.com/1472-6831/8/8,
American Academy of Paediatric Dentistry: Policy on early childhood caries (ECC): classifications, consequences and preventive strategies. Reference manual - Oral Health Policies. 2011, 33: 47-49.
British Society of Paediatric Dentistry: A policy document on oral health in preschool children. Int J Paed Dent. 2003, 13: 279-285.
Nowak A, Casamssimo PS: The dental home. In Early Childhood Oral Health. Edited by: Berg JH, Slayton RL. 2009, Iowa City: Wiley-Blackwell, 154-169.
Al-Ghanim NA, Adenubi JO, Wyne AA, Khan NB: Caries prediction model in preschool children in Riyadh, Saudi Arabia. Int J Paed Dent. 1998, 8: 115-122. 10.1046/j.1365-263X.1998.00073.x.
Hunter ML, Hood HC, Hunter B, Kingdon A: Reported infant feeding, oral hygiene and dental attendance patterns in children aged 5 years and under referred for extraction of teeth under general anesthetic. Int J Paed Dent. 1997, 7: 243-248.
Bandura A: Toward a unifying theory of behavioural change. Psychol Rev. 1977, 84: 191-215.
Miller W, Rollnick S: Motivational Interviewing: Preparing people for change. 2002, New York: The Guilford Press
Levine RS, Stillman-Lowe CR: The Scientific Basis of Oral Health Education. 2009, London: BDJ Books
Department of Health: Delivering better oral health: an evidence-based toolkit for prevention. 2007, London: Department of Health
WHO: Health Promotion Glossary. 1998, Geneva: WHO
Horowitz A, Kleinman DV: Oral health literacy: The new imperative to better oral health. Dent Clinics North Am. 2008, 52: 333-344. 10.1016/j.cden.2007.12.001.
Morris N, Maclean CD, Chew LD, Littenberg B: The single item literacy screener: Evaluation of a brief instrument to indentify limited reading ability. BMC Fam Pract. 2006, 7: 7-10.1186/1471-2296-7-7.http://biomedcentral.com/1471-2296/7/21,
Vann W, Lee JY, Baker D, Divaris K: Oral health literacy among female caregivers: Impact on oral health outcomes in early childhood. J Dent Res. 2010, 89: 1395-1400. 10.1177/0022034510379601.
Ramroop V, Wright D, Naidu R: Dental health knowledge and attitudes of primary school teachers toward developing dental health education. West Indian Med J. 2011, 60: 576-580.
Weinstein P, Harrison R, Benton T: Motivating mothers to prevent caries. Confirming the beneficial effect of counselling. J Am Dent Assoc. 2006, 137: 789-793.
Plutzer K, Spencer AJ: Efficacy of an oral health intervention in the prevention of early childhood caries. Com Dent Oral Epidemiol. 2008, 36: 335-346. 10.1111/j.1600-0528.2007.00414.x.
Naidu RS, Gobin I, Newton JT, Ashraph A, Gibbons D: The working practices and job satisfaction of dental nurses in Trinidad and Tobago; findings of a National Survey. Int Dent J. 2002, 52: 321-324. 10.1002/j.1875-595X.2002.tb00878.x.
Nash DA, Friedman JW, Mathu-Muju RK, Robionson PG, Satur J, Moffat S, Kardos R, Lo ECM, Wong AHH, Jaafar N, Van Den Heuval J, Phantumvanit P, Chu EO, Naidu R, Naidoo L, McKenzie I, Fernando E: A Review of the Global Literature on Dental Therapists. 2012, Michigan: WK Kellog Foundation,http://www.wkkf.org/knowledge-center/resources/2012/04/nash-executive-summary.aspx,
Mason M: Sample size and saturation in PhD studies using qualitative interviews. Forum: Qualitative Social Res. 2010, 11: 3-http://www.qualitative-research.net/index.php/fqs/article/view/1428/3027,
Guest G, Bunce A, Johnson L: How many interviews are enough? An experiment in data saturation and variability. Field Methods. 2006, 18: 59-82. 10.1177/1525822X05279903.
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