Authors: Albino J1, Tiwari T, Henderson WG, Thomas J, Bryant LL, Batliner TS, Braun PA, Wilson A, Quissell DO.
We aimed to identify salutogenic patterns of parental knowledge, behaviors, attitudes, and beliefs that may support resistance to early childhood caries (ECC) among a high caries population of preschool American Indian (AI) children.
Participants were 981 child-parent dyads living on a Southwestern reservation who completed baseline assessments for an ongoing randomized clinical trial. T-tests were used to assess differences between reported knowledge, behaviors, and beliefs of parents whose children were caries-free (10.7 percent) and those whose children had caries (89.3 percent). Chi-square analyses were used for categorical variables.
Although there were no socio-demographic differences, parents of caries-free children viewed oral health as more important and reported more oral health knowledge and adherence to caries-preventing behaviors for their children. Parents of caries-free children were more likely to have higher internal locus of control, to perceive their children as less susceptible to caries, and to perceive fewer barriers to prevention. These parents also had higher sense of coherence scores and reported lower levels of personal distress and community-related stress.
Effective interventions for ECC prevention in high-caries AI populations may benefit from approaches that support and model naturally salutogenic behaviors.
© 2014 American Association of Public Health Dentistry.
Caries-free children; early childhood caries; parental behavior; salutogenic behaviors
- [PubMed - in process]
- [Available on 2015/9/1]
Authors: Batliner T1, Wilson AR, Tiwari T, Glueck D, Henderson W, Thomas J, Braun P, Cudeii D, Quissell D, Albino J.
This study assessed oral health status for preschool-aged children in the Navajo Nation to obtain data on baseline decayed, missing, and filled tooth surfaces (dmfs) and dental caries patterns, describe sociodemographic correlates of children’s baseline dmfs measures, and compare the children’s dmfs measures with previous dental survey data for the Navajo Nation from the Indian Health Service and the National Health and Nutrition Examination Survey (NHANES).
The analyzed study sample included 981 child/caregiver dyads residing in the Navajo Nation who completed baseline dmfs assessments for an ongoing randomized clinical trial involving Navajo Nation Head Start Centers. Calibrated dental hygienists collected baseline dmfs data from child participants ages 3-5 years (488 males and 493 females), and caregivers completed a basic research factors questionnaire.
Mean dmfs for the study population was 21.33 (SD = 19.99) and not appreciably different from the 1999 Indian Health Service survey of Navajo Nation preschool-aged children (mean = 19.02, SD = 16.59, P = 0.08). However, only 69.5 percent of children in the current study had untreated decay compared with 82.9 percent in the 1999 Indian Health Service survey (P < 0.0001). Study results were considerably higher than the 16.0 percent reported for 2-4-year-old children in the whites-only group from the 1999-2004 NHANES data. Age had the strongest association with dmfs, followed by child gender, then caregiver income and education.
Dental caries in preschool-aged Navajo children is extremely high compared with other US population segments, and dmfs has not appreciably changed for more than a decade.
© 2014 American Association of Public Health Dentistry.
American Indian; early childhood caries; oral health disparities; oral health status; untreated decay
- [PubMed - in process]
- [Available on 2015/9/1]
Author(s) : Cidro J, Zahayko L, Lawrence H, McGregor M, McKay K.
Introduction: Infant health and development is linked to a wide range of interventions including maternal nutrition and infant feeding. Early childhood caries (ECC) is a chronic condition that affects large proportions of Aboriginal children worldwide. The health of a child’s mouth is linked to their overall health and wellbeing and can have a significant impact in their day-to-day experiences of eating, playing, and sleeping. The rates of ECC have increased dramatically and communities, parents, and governments are increasingly burdened with the social, economic, and personal costs associated with treatment. There is a close association between ECC and unhealthy infant feeding practices and poor oral health care for infants. This research looked at traditional and culturally based approaches to healthy infant feeding and oral health care for infants in one remote First Nations community in northern Manitoba, Canada. Methods: Research was already under way in the community in a longer term intervention-based project called the Baby Teeth Talk Study (BTT). In discussions on the interim findings of the study, participants discussed traditional cultural approaches practised in the community for healthy infant feeding and oral health. Using a participatory research approach, the authors engaged in a partnership with the community partner who assisted with the development of research questions as well as identifying research participants. Grandmothers in the community were recruited to participate in a total of 20 interviews and four focus groups. Results: This article explores three key findings pertaining specifically to culturally based childrearing practices and infant oral health. Respondents discussed the importance of feeding infants country food (such as fish, moose and rabbit) at a young age for the overall health of the infant. Related to this was the use of traditional medicine to address oral health issues such as teething and thrush with salves made from tree bark rubbed on the gums of the infant. The role of swaddling and other thermal regulation techniques was identified as directly linked to oral health, particularly the development of healthy deciduous teeth. Conclusions: Local health knowledge keepers should be a part of the discussion around health programs and public health promotion. Opportunities to share the traditions of infant feeding is an essential component in restoring skills and pride and is a mechanism for building family and community relationships as well as intergenerational support.
Key words: Aboriginal, alternative medicine, complementary medicine, early childhood caries, indigenous, infant feeding, infant health, maternal health, oral health, teething.
Joseph Klejka, MD, Yukon-Kuskokwim Health Corp; Meghan Swanzy, DDS, Southcentral Foundation; Bradley Whistler, DMD, Alaska Dept of Health and Social Svcs. Caroline Jones, MD, Emory Univ School of Medicine, Atlanta, Georgia.Michael G. Bruce, MD, Thomas W. Hennessy, MD, Dana Bruden, MS, Stephanie Rolin, MPH, Arctic Investigations Program, National Center for Emerging and Zoonotic Infectious Diseases; Eugenio Beltrán-Aguilar, DMD, DrPH, Div of Oral Health, National Center for Chronic Disease Prevention and Health Promotion; Kathy K. Byrd, MD, Farah Husain, DMD, EIS officers, CDC. Corresponding contributor: Kathy K. Byrd, firstname.lastname@example.org, 404-718-8541.
Author(s) : Naidu A, Macdonald M, Carnevale FA, Nottaway W, Thivierge C, Vignola S.
Introduction: Early childhood caries (ECC), a disease characterized by tooth decay in the primary teeth of children, has become particularly burdensome in Aboriginal communities in Canada. Prevalence estimates of ECC range between 50% and 100%. Most concerning are the severe cases of ECC that require treatment with restorative surgery under general anesthesia. These surgeries often displace children and families from their local communities to specialty hospitals for treatment; further, they are very costly to dental insurance payers such as the government. This study used community-based participatory research (CBPR) to explore oral health and hygiene practices in the Algonquin community of Rapid Lake, Quebec. A key goal of the study was to create a culturally adapted activity to promote children’s oral health and hygiene practices. Methods: Focused ethnography was used to explore oral health beliefs and practices, and factors related to child oral health promotion with community members. Participants included children, parents, educators, healthcare workers, youth workers and elders. Semi-structured interviews were conducted with key informants. Following, two focus group interviews were conducted: one with parents and one with school children. All data were audio-recorded, transcribed and analyzed iteratively using thematic analysis. Preliminary findings were then used to develop oral health promoting activities for children in the community. These activities were designed in collaboration with community workers. Results: Three main themes emerged from the analysis: (1) a gap existed between oral health knowledge and oral health behaviors; (2) challenges for oral health promotion included attitudes and beliefs, access, and priorities; and (3) parents needed to be further integrated into health promotion strategies. Key outcomes included: (1) the development of Eagles & Otters, a game designed to increase children’s oral health knowledge; (2) an activity sheet to promote child oral health behaviors in the home; and (3) increased capacity in oral health promotion in local youth, community research partners and the student researcher. Conclusions: The findings of this study highlight the importance of both local and broader systemic interventions to promote children’s oral health. At the local level, child oral health and hygiene was promoted through the development of activities designed to increase children’s oral health knowledge and behaviors both at school and in the home where parents were directly implicated. Systemic level interventions are needed to address factors related to the social determinants of health, including cultural traditions, economic security, food security, and housing status. These factors contribute to overall health and enable the necessary conditions to promote and sustain oral health.
Key words: aboriginal health, community, early childhood caries, oral health, oral hygiene, participatory research.
Risk factors for dental caries in small rural and regional Australian communities
Author(s) : Zander A, Sivaneswaran S, Skinner J, Byun R, Jalaludin B
ABSTRACTIntroduction: Dental decay (caries) can cause pain, infection and tooth loss, negatively affecting eating, speaking and general health. People living in rural and regional Australian communities have more caries, more severe caries and more untreated caries than those in the city. The unique environmental conditions and population groups in these communities may contribute to the higher caries burden. In particular, some towns lack community water fluoridation, and some have a high proportion of Aboriginal people, who have significantly worse oral health than their non-Aboriginal counterparts. Because of these and other unique circumstances, mainstream research on caries risk factors may not apply in these settings. This study aimed to gather contemporary oral health data from small rural or regional Australian communities, and investigate caries risk factors in these communities. Methods: A cross-sectional survey consisting of a standardized dental examination and questionnaire was used to measure the oral health of 434 children (32% Aboriginal) aged 3-12 years in three small rural or regional areas. Oral health was determined as the deciduous and permanent decayed, missing and filled teeth (dmft/DMFT), and the proportion of children without caries. Risk factors were investigated by logistic regression. Results: The dmft/DMFT for children in this study was 1.5 for 5-6 year olds and 1.0 for 11-12 year olds (index groups reported). Independent predictors of having caries (Yes/No) were age group, holding a concession card (OR=2.45, 95%CI=1.58-3.80) and tooth-brushing less than twice per day (OR=2.11, 95% CI=1.34-3.34). Aboriginal status also became a significant variable under sensitivity analyses (OR 1.9, CI 1.12-3.24) when the tooth-brushing variable was removed. Gender, water fluoridation and parental education were not significant predictors of caries in these communities. Conclusions: The rural/remote children in this study had worse oral health than either state or national average in both the 5-6 year old and 11-12 year age group. Socioeconomic status, tooth-brushing and Aboriginal status were significantly associated with caries in these communities. To close the substantial gap in oral health outcomes between rural and metropolitan residents, approaches that target rural areas, Aboriginal people and those from low socioeconomic backgrounds are needed.
Key words: Aboriginal, Australia, dental caries, fluoridation, oral health.
Preventing caries in preschoolers Successful initiation of an innovative community based clinical trial in Navajo Nation Head Start
Authors: David O. Quissell, Lucinda L. Bryant, Patricia A. Braun, Diana Cudeii, Nikolas Johs, Vongphone L. Smith, Carmen George, William G. Henderson, Judith Albino