Top

BMC Oral Health

Published in:

Open Access 01-12-2023 | Research

Early childhood caries: parents’ knowledge, attitude and practice towards its prevention in refugee camps in Erbil, Iraq

Authors: Hamsa Mohammed Al-Dahan, Sherzad Ali Ismael

Published in: BMC Oral Health | Issue 1/2023

Abstract

Background

Early childhood caries is a significant oral health issue in socially deprived communities, including refugees, where prevention plays a crucial role in minimizing the challenges and costs associated with treating early childhood caries. To improve oral health outcomes, it is important to understand parents’ knowledge, attitudes, and practices. This study aims to assess the oral health knowledge, practices, and attitudes of refugee parents.

Methods

This cross-sectional study included 503 parents/caregivers residing in Erbil’s refugee camps in Iraq, with healthy preschool children aged one to six years. Structured questionnaire was utilized in conducting individual interviews with parents to evaluate their knowledge, attitudes, and practices. The questionnaire collected demographic information and data on access to oral health services.

Results

A total of 503 out of 505 households actively participated in the study, resulting in a high response rate of 99.6%. Demographic analysis revealed that the majority of respondents were female parents, constituting 92.05% of the sample. Within the participant pool, the primary age groups were 26–35 years (55.3%) and 18–25 years (26.2%). Educational background analysis revealed that a significant proportion of parents had attained a secondary school education (29.6%) or primary school education (27.4%). Statistical analysis further established a noteworthy association between educational background and knowledge level. The investigation of participants’ knowledge uncovered notable gaps and misconceptions pertaining to early childhood caries, with an overall mean score of 5.1. Assessing the overall attitude of parents, a mean score of 3.87 (SD = 1.29) suggested a generally unfavorable attitude towards oral hygiene practices and prevention of early childhood caries. In terms of actual practices, parents demonstrated a mean practice score of 5.7.

Conclusions

This study emphasizes knowledge gaps and misconceptions among parents in refugee camps regarding early childhood caries in preschool children. Findings revealed low knowledge scores, limited understanding of hidden sugars, delayed oral hygiene practices, and limited knowledge about fluoride.

American Academy of Pediatrics, Section on Pediatric Dentistry and Oral Health. Policy statement–oral health risk assessment timing and establishment of the dental home. Pediatrics. 2014;133(6):1113–8.

American Dental Association. (2018). Baby bottle tooth decay. Retrieved from https://www.mouthhealthy.org/en/az-topics/b/baby-bottle-tooth-decay.

Edelstein BL. Early childhood caries: a public health perspective. Pediatr Dent. 2002;24(5):410–8.

National Institute of Dental and Craniofacial Research. (2018). Tooth decay in children (age 2 to 11). Retrieved from https://www.nidcr.nih.gov/research/data-statistics/tooth-decay/children.

Tiberia MJ, Milgrom PM, Northridge ME, Gould EM. Prevalence of early childhood caries among very young urban Boston children compared with US children. J Public Health Dent. 2016;76(1):59–66.

Anil S, Anand PS. Early Childhood caries: prevalence, risk factors, and Prevention. Front Pediatr. 2017;5:157. https://doi.org/10.3389/fped.2017.00157. PMID: 28770188; PMCID: PMC5514393.CrossRefPubMedPubMedCentral

UNHCR. (2021). Syria emergency. Retrieved from https://www.unhcr.org/syria-emergency.html.

UNICEF. (2021). Syrian crisis. Retrieved from https://www.unicef.org/emergencies/syrian-crisis.

Hallett KB, O’Rourke PK. (2003). Social and Behavioural Determinants of Early Childhood Caries. Aust Dent J, Vol.48, No.1, (Mar 2003), pp. 27–33, ISSN 0045–0421.

10.

Berg JH. In: Slayton RL, editor. Early childhood oral health. Singapore: Wiley-Blackwell; 2009. ISBN 978-0-8138-2416-1.

11.

Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the Dmft: the human and Economic Cost of Early Childhood Caries. J Am Dent Assoc. 2009;140(6):650–7. (Jun 2009.CrossRefPubMed

12.

Vargas CM, Ronzio CR. (2006). Disparities in Early Childhood Caries. BMC Oral Health, Vol.6 No.Suppl 1, (August 2006), pp. S3, ISSN 1472–6831.

13.

Foster T, Perinpanayagam H, Pfaffenbach A, et al. Recurrence of early childhood caries after comprehensive treatment with general anesthesia and follow-up. J Dent Child (Chic). 2006;73:25–30.PubMed

14.

Lin YT, Kalhan AC, Lin YJ, Kalhan TA, Chou CC, Gao XL, Hsu CS. Risk assessment models to predict caries recurrence after oral rehabilitation under general anaesthesia: a pilot study. Int Dent J. 2018;68(6):378–85. https://doi.org/10.1111/idj.12396. Epub 2018 May 8. PMID: 29740814; PMCID: PMC9379028.CrossRefPubMed

15.

Lee GH, McGrath C, Yiu CK. Evaluating the impact of caries prevention and management by caries risk assessment guidelines on clinical practice in a dental teaching hospital. BMC Oral Health. 2016;16(1):58. https://doi.org/10.1186/s12903-016-0217-9.CrossRefPubMedPubMedCentral

16.

Ismail AI. (2003). Determinants of Health in Children and the Problem of Early Childhood Caries. Pediatr Dent, Vol.25, No.4, (Jul-Aug 2003), pp. 328 – 33, ISSN 0164–1263.

17.

Savage MF, Lee JY, Kotch JB, Vann WF Jr. (2004). Early Preventive Dental Visits: Effects on Subsequent Utilization and Costs. Pediatrics, Vol.114, No.4, (Oct 2004), pp. e418-23, ISSN 1098–4275.

18.

American Academy of Pediatrics. Brush, book, bed: implementation guide. Available at: https://downloads.aap.org/AAP/PDF/BBBGuide.pdf Accessed December 21, 2021.

19.

Vos MB, Kaar JL, Welsh JA, American Heart Association Nutrition Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention, et al. Council on Functional Genomics and Translational Biology; and Council on Hypertension. Added sugars and Cardiovascular Disease risk in children: a scientific statement from the American Heart Association. Circulation. 2017;135(19):e1017–34.CrossRefPubMed

20.

Heyman MB, Abrams SA. Section on Gastroenterology, Hepatology, and Nutrition; Committee on Nutrition. Fruit juice in infants, children, and adolescents: current recommendations. Pediatrics. 2017;139(6):e20170967.CrossRefPubMed

21.

Finlayson TL, Siefert K, Ismail AI, Delva J, Sohn W. (2005). Reliability and Validity of Brief Measures of Oral Health-Related Knowledge, Fatalism, and Self-Efficacy in Mothers of African American Children. Pediatr Dent, Vol.27, No.5, (Sep-Oct 2005), pp. 422-8, ISSN 0164–1263.

22.

Elamin A, Garemo M, Mulder A. Determinants of dental caries in children in the Middle East and North Africa region: a systematic review based on literature published from 2000 to 2019. BMC Oral Health. 2021;21(1):237. https://doi.org/10.1186/s12903-021-01482-7.CrossRefPubMedPubMedCentral

23.

Al-Hosani E, Rugg-Gunn A. Combination of low parental educational attainment and high parental income related to high caries experience in pre-school children in Abu Dhabi. Community Dent Oral Epidemiol. 1998;26(1):31–6. https://doi.org/10.1111/j.1600-0528.1998.tb01921.x.CrossRefPubMed

24.

Figueiredo MJ, de Amorim RG, Leal SC, Mulder J, Frencken JE. Prevalence and severity of clinical consequences of untreated dentine carious lesions in children from a deprived area of Brazil. Caries Res. 2011;45(5):435–42. https://doi.org/10.1159/000330531.CrossRefPubMed

25.

Da Silva K. A role for the family in children’s oral health. N Y State Dent J. 2007;73(5):55–7.PubMed

26.

Mani S, John J, Ping W, Ismail N. (2012). Early Childhood caries: parents knowledge, attitude and practice towards its Prevention in Malaysia. https://doi.org/10.5772/33898.

27.

Sabbagh H, Alghamdi D, Almutairi W, Alshahrani S, Alghamdi A. Knowledge and Practices for Early Childhood Caries Prevention among parents of the Children Visiting King Abdulaziz University Pediatric Dental Clinics, Kingdom of Saudi Arabia. J Contemp Dentistry. 2019;9:53–8. https://doi.org/10.5005/jp-journals-10031-1253.CrossRef

28.

Ganji RK, Ganji K, Patil S, Alhadi A, Alhadi M. (2018). Parent’s knowledge, attitude and Practice on Prevention of Early Childhood Caries in Al Jouf Province, Saudi Arabia. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. 18. 1–9. https://doi.org/10.4034/PBOCI.2018.181.03.

29.

Jain R, Oswal KC, Chitguppi R. Knowledge, attitude and practices of mothers toward their children’s oral health: a questionnaire survey among subpopulation in Mumbai (India). J Dent Res Sci Dev. 2014;1(2):40–5. https://doi.org/10.4103/2348-3407.135073.CrossRef

30.

Salama AA, Konsowa EM, Alkalash S. Mothers’ knowledge, attitude, and practice regarding their primary school children’s oral hygiene. Menoufia Med J. 2020;33:11. https://doi.org/10.4103/mmj.mmj_300_19.CrossRef

31.

Al-Jaber AS, Al-Qatami HM, Abed Al Jawad FH. Knowledge, attitudes, and practices of parents on early childhood caries in Qatar-A Questionnaire Study. Eur J Dent. 2022;16(3):669–79. https://doi.org/10.1055/s-0041-1739446. Epub 2021 Dec 22. PMID: 34937104; PMCID: PMC9507593.CrossRefPubMed

32.

Suma Sogi HP, Hugar SM, Nalawade TM, Sinha A, Hugar S, Mallikarjuna RM. Knowledge, attitude, and practices of oral health care in prevention of early childhood caries among parents of children in Belagavi city: a questionnaire study. J Family Med Prim Care 2016 Apr-Jun;5(2):286–90. https://doi.org/10.4103/2249-4863.192332. PMID: 27843829; PMCID: PMC5084549.

33.

Dikshit P, Limbu S, Gupta S, Pradhan R. Evaluation of knowledge, attitude and practices of parents toward their children oral Health compared with their Dental Caries status. Birat J Health Sci. 2018;3:447. https://doi.org/10.3126/bjhs.v3i2.20943.CrossRef

34.

Nowak AJ, Casamassimo PS, Scott J, Moulton R. Do infant feeding practices influence early childhood caries? A systematic review. Pediatr Dent. 2019;41(2):101–6.

35.

American Academy of Pediatric Dentistry. Guidelines for monitoring and management of pediatric patients before, during, and after sedation for diagnostic and therapeutic procedures. Pediatr Dent. 2019;41(4):E26–E52.

36.

Chan SC, Tsai JS, King NM. (2002). Feeding and Oral Hygiene Habits of Preschool Children in Hong Kong and Their Caregivers’ Dental Knowledge and Attitudes. Int J Paediatr Dent, Vol.12, No.5, (Sep 2002), pp. 322 – 31, ISSN 0960–7439.

37.

Stanford Medicine Children’s Health. (n.d.). A child’s first dental visit fact sheet. Retrieved May 31., 2023, from https://www.stanfordchildrens.org/en/topic/default?id=a-childs-first-dental-visit-fact-sheet-1-150939.

38.

Abaklı İnci M, Özer H, Açar Tuzluca S. Evaluation of parents’ knowledge and attitudes about early childhood caries. Int Dent Res. 2022;12(Suppl1):50–8. https://doi.org/10.5577/intdentres.446.CrossRef

39.

Hawley G, Holloway P. Measuring health behaviours–which tools should we use? Community Dent Health. 1994;11(3):129–30. PMID: 7953929.PubMed

Title: Early childhood caries: parents’ knowledge, attitude and practice towards its prevention in refugee camps in Erbil, Iraq
Authors: Hamsa Mohammed Al-Dahan
Sherzad Ali Ismael
Publication date: 01-12-2023
Publisher: BioMed Central
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-03516-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Early childhood caries: parents’ knowledge, attitude and practice towards its prevention in refugee camps in Erbil, Iraq

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2023

The reliability of using light therapy compared with LASER in pain reduction of temporomandibular disorders: a randomized controlled trial

Prevalence of dental caries and relation with nutritional status among school-age children in resource limited setting of southern Ethiopia

Coexpression network analysis identified MT3 as a hub gene that promotes the chemoresistance of oral cancer by regulating the expression of YAP1

Patterns and predictors of public dental service utilisation among refugees in Victoria, Australia: a latent profile and multilevel analysis

Mesenchymal stem cell-derived extracellular vesicles for treatment of bone loss within periodontitis in pre-clinical animal models: a meta-analysis

Parameters associated with radiographic distal surface caries in the mandibular second molar adjacent to an impacted third molar