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Published in: BMC Oral Health 1/2012

Open Access 01-12-2012 | Research article

Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers

Authors: Rahul Naidu, June Nunn, Maarit Forde

Published in: BMC Oral Health | Issue 1/2012

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Abstract

Background

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.

Method

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.

Results

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.

Conclusion

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.
Literature
1.
2.
go back to reference O' Mullane D, Parnell C: Early childhood caries: a complex problem requiring a complex solution. Comm Dent Health. 2011, 28: 254- O' Mullane D, Parnell C: Early childhood caries: a complex problem requiring a complex solution. Comm Dent Health. 2011, 28: 254-
3.
go back to reference 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. 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.
4.
go back to reference 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.CrossRef 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.CrossRef
5.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
6.
go back to reference 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. 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.
7.
go back to reference 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]CrossRef 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]CrossRef
8.
go back to reference Adewakun AA, Beltran-Aguilar E: Early childhood caries in Anguilla, British West Indies. Am J Gen Dent. 2003, 16: 42-47. Adewakun AA, Beltran-Aguilar E: Early childhood caries in Anguilla, British West Indies. Am J Gen Dent. 2003, 16: 42-47.
9.
go back to reference 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. 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.
10.
go back to reference 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.CrossRef 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.CrossRef
11.
go back to reference 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.CrossRef 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.CrossRef
12.
go back to reference Holbrook WP, de Soet JJ, De Graff J: Prediction of dental caries in preschool children. Caries Res. 1993, 27: 424-430. 10.1159/000261574.CrossRefPubMed Holbrook WP, de Soet JJ, De Graff J: Prediction of dental caries in preschool children. Caries Res. 1993, 27: 424-430. 10.1159/000261574.CrossRefPubMed
13.
go back to reference 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.CrossRef 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.CrossRef
14.
go back to reference Blinkhorn AS: Promoting dietary changes in order to control dental caries. Dent Health. 1991, 29: 3-6. Blinkhorn AS: Promoting dietary changes in order to control dental caries. Dent Health. 1991, 29: 3-6.
15.
go back to reference 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. 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.
16.
go back to reference 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.CrossRef 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.CrossRef
17.
go back to reference Naidu R, Davis L: Parent's views on factors influencing the dental health of Trinidadian preschool children. Comm Dent Health. 2008, 25: 44-49. Naidu R, Davis L: Parent's views on factors influencing the dental health of Trinidadian preschool children. Comm Dent Health. 2008, 25: 44-49.
19.
go back to reference Green J, Thorogood N: (Eds): Qualitative methods for health research. 2009, London: Sage Publications Ltd Green J, Thorogood N: (Eds): Qualitative methods for health research. 2009, London: Sage Publications Ltd
20.
go back to reference Masood M, Masood Y, Newton JT: Methods of qualitative research in dentistry. Dent Update. 2010, 37: 326-336.PubMed Masood M, Masood Y, Newton JT: Methods of qualitative research in dentistry. Dent Update. 2010, 37: 326-336.PubMed
21.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
22.
go back to reference 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.CrossRef 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.CrossRef
23.
go back to reference 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.CrossRef 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.CrossRef
24.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
25.
go back to reference 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. 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.
26.
go back to reference 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.CrossRef 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.CrossRef
27.
go back to reference Bowling A: Research methods in health. 1999, Buckingham: Open University Press Bowling A: Research methods in health. 1999, Buckingham: Open University Press
28.
go back to reference Kitzinger J: Introducing focus groups. Brit Med J. 1995, 311: 299-302.PubMed Kitzinger J: Introducing focus groups. Brit Med J. 1995, 311: 299-302.PubMed
31.
go back to reference 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.CrossRef 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.CrossRef
32.
go back to reference 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. 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.
33.
go back to reference Kent G, Croucher R: Achieving oral health: The social context of dental care. 1998, Oxford: Wright Kent G, Croucher R: Achieving oral health: The social context of dental care. 1998, Oxford: Wright
34.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
35.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
36.
go back to reference Nettleton S: Understanding dental health beliefs: an introduction to enthography. Brit Dent J. 1986, 161: 45-147.CrossRef Nettleton S: Understanding dental health beliefs: an introduction to enthography. Brit Dent J. 1986, 161: 45-147.CrossRef
37.
go back to reference Naidu R, Lalwah S: Dental anxiety in sample of West Indian adults. West Indian Med J. 2010, 59: 567-572.PubMed Naidu R, Lalwah S: Dental anxiety in sample of West Indian adults. West Indian Med J. 2010, 59: 567-572.PubMed
38.
go back to reference Locker D, Lidell A: Clinical correlates of dental anxiety. Comm Dent Oral Epidemiol. 1992, 36: 347-356. Locker D, Lidell A: Clinical correlates of dental anxiety. Comm Dent Oral Epidemiol. 1992, 36: 347-356.
39.
go back to reference Newton J, Edwards JC: Psychometric properties of the Modified Dental Anxiety Scale. Comm Dent Health. 2005, 22: 40-42. Newton J, Edwards JC: Psychometric properties of the Modified Dental Anxiety Scale. Comm Dent Health. 2005, 22: 40-42.
40.
go back to reference 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. 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.
41.
go back to reference Finch H, Keegan J, Ward K: Barriers to the receipt of dental care. A qualitative study. 1988, London: Social and Community and Planning Research Finch H, Keegan J, Ward K: Barriers to the receipt of dental care. A qualitative study. 1988, London: Social and Community and Planning Research
43.
go back to reference 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. 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.
44.
go back to reference British Society of Paediatric Dentistry: A policy document on oral health in preschool children. Int J Paed Dent. 2003, 13: 279-285.CrossRef British Society of Paediatric Dentistry: A policy document on oral health in preschool children. Int J Paed Dent. 2003, 13: 279-285.CrossRef
45.
go back to reference 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. 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.
46.
go back to reference 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.CrossRef 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.CrossRef
47.
go back to reference 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.CrossRef 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.CrossRef
48.
49.
go back to reference Miller W, Rollnick S: Motivational Interviewing: Preparing people for change. 2002, New York: The Guilford Press Miller W, Rollnick S: Motivational Interviewing: Preparing people for change. 2002, New York: The Guilford Press
50.
go back to reference Levine RS, Stillman-Lowe CR: The Scientific Basis of Oral Health Education. 2009, London: BDJ Books Levine RS, Stillman-Lowe CR: The Scientific Basis of Oral Health Education. 2009, London: BDJ Books
51.
go back to reference Department of Health: Delivering better oral health: an evidence-based toolkit for prevention. 2007, London: Department of Health Department of Health: Delivering better oral health: an evidence-based toolkit for prevention. 2007, London: Department of Health
52.
go back to reference WHO: Health Promotion Glossary. 1998, Geneva: WHO WHO: Health Promotion Glossary. 1998, Geneva: WHO
53.
go back to reference 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.CrossRef 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.CrossRef
55.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
56.
go back to reference 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.PubMed 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.PubMed
57.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
58.
go back to reference 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.CrossRef 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.CrossRef
59.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
62.
go back to reference 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.CrossRef 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.CrossRef
Metadata
Title
Oral healthcare of preschool children in Trinidad: a qualitative study of parents and caregivers
Authors
Rahul Naidu
June Nunn
Maarit Forde
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2012
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/1472-6831-12-27

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