Volschan, B. C. G. (2006). The Journal of Pediatric Dentistry, 31, 48-51.
Early childhood caries (ECC) is recognized globally as a major chronic condition with health and quality-of-life implications that extend beyond childhood and adolescence. Substantial research has focused on physiological factors and biobehavioral processes associated with ECC; however, minimal data exist on psychosocial and behavioral factors and ECC. Toward this goal, this cross-sectional study of 65 children (<5 years of age) and 46 of their mothers/primary caregivers included a semi-structured interview approach to examine behaviors, knowledge values, practices, and perceptions about dental health in mother-child dyads from a low-income, high-environmental-risk community in Brazil. Mother/caregiver interviews were conducted in participants' homes and recorded and transcribed by the investigator on the day of the interview. Dental examinations were conducted on child participants following standard procedures used in Brazil. Based on results of dental examinations, children were classified as caries active or caries free; thematic analysis of the interview data was conducted separately for each group. For the caries-active group, thematic analysis suggested that children from this low-income, high-environmental-risk community had less-than-optimal nutrition and oral hygiene and poorer overall health than their caries-free counterparts. Although mothers' knowledge of proper dental hygiene was adequate, motivation to implement changes in eating and oral hygienic behaviors was low. Mothers of children in the caries-free group reported good personal oral hygiene, attempts to model those behaviors in providing oral/dental care for their young children, and more concerted efforts in providing good nutrition in the home environment. Caries-free children also had better overall systemic health and sleeping patterns than their active-caries counterparts. Although this study had methodological limitations, the results, placed in context of related research on health disparities, point to the need for access to and availability of integrated systems of care for children and families from low-income, high-environmental-risk communities.
Laura L. Hayman