Skip to main content
Top
Published in: BMC Oral Health 1/2015

Open Access 01-12-2015 | Research article

A qualitative study of the views of adolescents on their caries risk and prevention behaviours

Authors: Emma Hall-Scullin, Joanna Goldthorpe, Keith Milsom, Martin Tickle

Published in: BMC Oral Health | Issue 1/2015

Login to get access

Abstract

Background

The purpose of this study was to explore the attitudes and beliefs of adolescents towards dental caries and their use or non-use of caries prevention regimens.

Methods

Adolescents aged 16 years from four state-funded secondary schools in North West of England (n = 19). Purposive sampling strategically selected participants with characteristics to inform the study aims (gender, ethnicity, and caries status). Semi-structured interviews were transcribed verbatim and analysed using a framework approach.

Results

14 codes within five overarching themes were identified: “Personal definition and understanding of oral health”; “Knowledge of oral health determinants”; “Influences on oral health care”; Reason for oral health behaviours”; and “Oral health in the future”. Adolescents conceptualise oral health as the absence of oral pathology and the ability to function, which included an aesthetic component. Appearing to have healthy teeth was socially desirable and equated with positive self-image. The dominant influence over oral health behaviours was habitual practice encouraged by parents from a young age, with limited reinforcement at school or by dental practices. At this transitional age, participants recognised the increasing influence of peers over health behaviours. Self-efficacy pertained to diet modification (reduction in sugar-ingestion) and oral hygiene behaviour (tooth-brushing). A lack of understanding of caries aetiology was evident. Behaviours were mitigated by a lack of environmental support; and a desire for immediate gratification often overcame attempts at risk-reducing behaviour.

Conclusions

Parents primarily influence the habitual behaviours of adolescents. With age, the external environment (availability of sugar and peers) has an increasing influence on behaviour. This suggests that to improve adolescent health, oral health promoters should engage with parents from early childhood and create supportive environments including public policy on sugar availability to encourage uptake of risk-minimising behaviours.
Literature
1.
go back to reference Pitts N, Chadwick B, Anderson T. Report 2: Dental Disease and Damage in Children England, Wales and Northern Ireland. Children’s Dental Health Survey 2013. Online: National Statistics Office; 2015. Pitts N, Chadwick B, Anderson T. Report 2: Dental Disease and Damage in Children England, Wales and Northern Ireland. Children’s Dental Health Survey 2013. Online: National Statistics Office; 2015.
4.
go back to reference Fisher-Owens SA, Gansky SA, Platt LJ, Weintraub JA, Soobader M-J, Bramlett MD, et al. Influences on Children’s Oral Health: A Conceptual Model. Pediatrics. 2007;120(3):e510–20. doi:10.1542/peds.2006-3084.PubMed Fisher-Owens SA, Gansky SA, Platt LJ, Weintraub JA, Soobader M-J, Bramlett MD, et al. Influences on Children’s Oral Health: A Conceptual Model. Pediatrics. 2007;120(3):e510–20. doi:10.​1542/​peds.​2006-3084.PubMed
6.
7.
go back to reference Larson N, Neumark-Sztainer D, Hannan P, Story M. Family meals during adolescence are associated with higher diet quality and healthful meal patterns during young adulthood. J Am Diet Assoc. 2007;107:1502–10. doi:10.1016/j.jada.2007.06.012.PubMed Larson N, Neumark-Sztainer D, Hannan P, Story M. Family meals during adolescence are associated with higher diet quality and healthful meal patterns during young adulthood. J Am Diet Assoc. 2007;107:1502–10. doi:10.​1016/​j.​jada.​2007.​06.​012.PubMed
8.
go back to reference Stokes E, Ashcroft A, Platt M. Determining Liverpool adolescents’ beliefs and attitudes in relation to oral health. Health Educ Res. 2006;21(2):192–205. doi:10.1093/her/cyh055.PubMed Stokes E, Ashcroft A, Platt M. Determining Liverpool adolescents’ beliefs and attitudes in relation to oral health. Health Educ Res. 2006;21(2):192–205. doi:10.​1093/​her/​cyh055.PubMed
10.
go back to reference Petersen P, Kwan S. Evaluation of community-based oral health promotion and oral disease prevention – WHO recommendations for improved evidence in public health practice. Community Dent Health. 2004;21:319–29.PubMed Petersen P, Kwan S. Evaluation of community-based oral health promotion and oral disease prevention – WHO recommendations for improved evidence in public health practice. Community Dent Health. 2004;21:319–29.PubMed
12.
go back to reference Ostberg A. Adolescents’ views of oral health education. A qualitative study. Acta Odontol Scand. 2005;63(5):300–7.PubMed Ostberg A. Adolescents’ views of oral health education. A qualitative study. Acta Odontol Scand. 2005;63(5):300–7.PubMed
14.
go back to reference Trulsson U, Strandmark M, Mohlin B, Berggren U. A qualitative study of teenagers’ decisions to undergo orthodontic treatment with fixed appliance. J Orthod. 2002;29(3):197–204. doi:10.1093/ortho/29.3.197.PubMed Trulsson U, Strandmark M, Mohlin B, Berggren U. A qualitative study of teenagers’ decisions to undergo orthodontic treatment with fixed appliance. J Orthod. 2002;29(3):197–204. doi:10.​1093/​ortho/​29.​3.​197.PubMed
15.
16.
go back to reference Communities and Local Government. The English Indices of Deprivation 2010. Online: Department for Communities and Local Government; 2011. Communities and Local Government. The English Indices of Deprivation 2010. Online: Department for Communities and Local Government; 2011.
18.
go back to reference BASCD. Oral Health Survey of 12 year old children in England 2008/2009. National protocol. NHS Dental Epidemiology Programme 2009. BASCD. Oral Health Survey of 12 year old children in England 2008/2009. National protocol. NHS Dental Epidemiology Programme 2009.
22.
go back to reference Fitzgerald R, Thomson W, Schafer C, Loose M. An exploratory qualitative study of Otago adolescents’ views of oral health and oral health care. N Z Dent J. 2004;100(3):62–71.PubMed Fitzgerald R, Thomson W, Schafer C, Loose M. An exploratory qualitative study of Otago adolescents’ views of oral health and oral health care. N Z Dent J. 2004;100(3):62–71.PubMed
23.
go back to reference Bergstrom E, Skold U, Birkhed D, Lepp M. Adolescents’ experiences of participating in a school-based fluoride varnish programme in Sweden. Swed Dent J. 2012;36(3):133–41.PubMed Bergstrom E, Skold U, Birkhed D, Lepp M. Adolescents’ experiences of participating in a school-based fluoride varnish programme in Sweden. Swed Dent J. 2012;36(3):133–41.PubMed
24.
go back to reference Mays N, Pope C. Rigour and qualitative research. Br Med J. 1995;311(46):109–12. Mays N, Pope C. Rigour and qualitative research. Br Med J. 1995;311(46):109–12.
25.
go back to reference Ostberg A, Jarkman K, Lindblad U, et al. Adolescents’ views of oral health education. A qualitative study. Acta Odontol Scand. 2005;63(5):300–7.PubMed Ostberg A, Jarkman K, Lindblad U, et al. Adolescents’ views of oral health education. A qualitative study. Acta Odontol Scand. 2005;63(5):300–7.PubMed
26.
go back to reference Adair PM, Petersen PE, Douglass C, Burnside G, Nicoll AD, Gillett A, et al. Developing explanatory models of health inequalities in childhood dental caries. Community Dent Health. 2004;21(Supple 1):86–95.PubMed Adair PM, Petersen PE, Douglass C, Burnside G, Nicoll AD, Gillett A, et al. Developing explanatory models of health inequalities in childhood dental caries. Community Dent Health. 2004;21(Supple 1):86–95.PubMed
27.
go back to reference Harker R, Morris J. Children’s Dental Health in the United Kingdom, 2003. Summary Report. London: Office for National Statistics; 2005. Harker R, Morris J. Children’s Dental Health in the United Kingdom, 2003. Summary Report. London: Office for National Statistics; 2005.
28.
go back to reference NHS. NHS Dental Epidemiology Programme Survey of 12-year-old children, 2008/09. Supplementary Report. Reporting measures of plaque, self-perception of enamel opacities, self-reporting of symptoms and impact on quality of life.2011. NHS. NHS Dental Epidemiology Programme Survey of 12-year-old children, 2008/09. Supplementary Report. Reporting measures of plaque, self-perception of enamel opacities, self-reporting of symptoms and impact on quality of life.2011.
29.
go back to reference Levine R, Nugent Z, Rudolf M, Sahota P. Dietary patterns, tooth-brushing habits and caries experience of schoolchildren in West Yorkshire, England. Community Dent Health. 2007;24(2):82–7.PubMed Levine R, Nugent Z, Rudolf M, Sahota P. Dietary patterns, tooth-brushing habits and caries experience of schoolchildren in West Yorkshire, England. Community Dent Health. 2007;24(2):82–7.PubMed
31.
go back to reference Ritchie J, Spencer L. Analyzing qualitative data. In: Bryman A, Burgess R, editors. Qualitative data analysis for applied policy research. London: Routledge; 1994. p. 173–94. Ritchie J, Spencer L. Analyzing qualitative data. In: Bryman A, Burgess R, editors. Qualitative data analysis for applied policy research. London: Routledge; 1994. p. 173–94.
34.
go back to reference Bower E, Scrambler S. The contributions of qualitative research towards dental public health practice. Community Dent Oral Epidemiol. 2007;35(3):161–9.PubMed Bower E, Scrambler S. The contributions of qualitative research towards dental public health practice. Community Dent Oral Epidemiol. 2007;35(3):161–9.PubMed
35.
go back to reference PHE. Child Health Profile: Blackburn with Darwen. PHE, 2014. PHE. Child Health Profile: Blackburn with Darwen. PHE, 2014.
36.
go back to reference Lader D, Chadwick B, Chestnutt I, et al. Children’s Dental Health in the United Kingdom, 2003. Summary Report. London: Office for National Statistics; 2005. Lader D, Chadwick B, Chestnutt I, et al. Children’s Dental Health in the United Kingdom, 2003. Summary Report. London: Office for National Statistics; 2005.
37.
go back to reference Rooney E, Davies G, Neville J, Robinson M, Perkins C, Bellis M. NHS Dental Epidemiology Programme for England. Oral health Survey of 12 year old Children 2008/2009. Summary of caries prevalence and severity results. 2010. Rooney E, Davies G, Neville J, Robinson M, Perkins C, Bellis M. NHS Dental Epidemiology Programme for England. Oral health Survey of 12 year old Children 2008/2009. Summary of caries prevalence and severity results. 2010.
38.
go back to reference Ostberg A, Jarkman K, Lindblad U, et al. On self-perceived oral health in Swedish adolescents. Swed Dent J. 2002;155:1–87. Ostberg A, Jarkman K, Lindblad U, et al. On self-perceived oral health in Swedish adolescents. Swed Dent J. 2002;155:1–87.
39.
go back to reference PHE. Tackling poor oral health in children Local government’s public health role. Local Government Association; 2014. PHE. Tackling poor oral health in children Local government’s public health role. Local Government Association; 2014.
40.
go back to reference PHE. Local authorities improving oral health: commissioning better oral health for children and young people. An evidence-informed toolkit for local authorities. London: Public Health England; 2013. PHE. Local authorities improving oral health: commissioning better oral health for children and young people. An evidence-informed toolkit for local authorities. London: Public Health England; 2013.
41.
go back to reference NICE. Oral health: approaches for local authorities and their partners to improve the oral health of their communities2014 October NICE. Oral health: approaches for local authorities and their partners to improve the oral health of their communities2014 October
42.
go back to reference Hedman E, Gabre P, Birkhed D, Lepp M. Adolescents’ experiences of a two-year oral health intervention programme in two Swedish secondary schools. Int J Dent Hyg. 2013;11(4):244–52. doi:10.1111/idh.12035.PubMed Hedman E, Gabre P, Birkhed D, Lepp M. Adolescents’ experiences of a two-year oral health intervention programme in two Swedish secondary schools. Int J Dent Hyg. 2013;11(4):244–52. doi:10.​1111/​idh.​12035.PubMed
43.
go back to reference Bergstrom E, Skold U, Birkhed D, et al. Adolescents’ experiences of participating in a school-based fluoride varnish programme in Sweden. Swed Dent J. 2012;36(3):133–41.PubMed Bergstrom E, Skold U, Birkhed D, et al. Adolescents’ experiences of participating in a school-based fluoride varnish programme in Sweden. Swed Dent J. 2012;36(3):133–41.PubMed
46.
go back to reference 46. Arthur S, Barnard M, Day N, Ferguson C, Gilby N, Hussey D et al. Evaluation of the National Healthy Schools Programme: Final Report: Department of Health 2011. 46. Arthur S, Barnard M, Day N, Ferguson C, Gilby N, Hussey D et al. Evaluation of the National Healthy Schools Programme: Final Report: Department of Health 2011.
47.
go back to reference Ostberg A, Jarkman K, Lindblad U, Halling A. Adolescents’ perceptions of oral health and influencing factors: a qualitative study. Acta Odontol Scand. 2002;60(3):167–73.PubMed Ostberg A, Jarkman K, Lindblad U, Halling A. Adolescents’ perceptions of oral health and influencing factors: a qualitative study. Acta Odontol Scand. 2002;60(3):167–73.PubMed
50.
51.
52.
go back to reference Cooper A, O’Malley L, Elison S, Armstrong R, Burnside G, Adair PM et al. Primary school-based behavioural interventions for preventing caries. Cochrane Database of Systematic Reviews 2013 doi:10.1002/14651858.CD009378.pub2. Cooper A, O’Malley L, Elison S, Armstrong R, Burnside G, Adair PM et al. Primary school-based behavioural interventions for preventing caries. Cochrane Database of Systematic Reviews 2013 doi:10.​1002/​14651858.​CD009378.​pub2.
Metadata
Title
A qualitative study of the views of adolescents on their caries risk and prevention behaviours
Authors
Emma Hall-Scullin
Joanna Goldthorpe
Keith Milsom
Martin Tickle
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2015
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-015-0128-1

Other articles of this Issue 1/2015

BMC Oral Health 1/2015 Go to the issue