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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 1  |  Page : 1-5

Knowledge, attitude, and practices of parents on the importance of their Children's oral health in Greater Noida, India


Departments of Pedodontics Preventive Dentistry, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India

Date of Submission04-May-2020
Date of Decision20-Jul-2020
Date of Acceptance01-Oct-2020
Date of Web Publication31-Dec-2020

Correspondence Address:
Deepak Khandelwal
Department of Pedodontics and Preventive Dentistry, School of Dental Sciences, Sharda University, Greater Noida - 201 310, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJDS.IJDS_65_20

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  Abstract 


Background: Parents and family members are considered the primary source for knowledge about child rearing and health habits for children. Young children's oral health maintenance and outcomes are influenced by their parent's knowledge and beliefs, which affect oral hygiene and healthy eating habits. Parental perception has a long-term influence in determining a child's oral health status. Aim: The aim of this study is to assess the oral health-related knowledge, attitude, and practices (KAP) of parents with children aged 3–5 years. Materials and Methods: A total of 500 parents of children aged 3 to 5 years were included in the study. A self-administered questionnaire, written both in English and local language (Hindi), validated through pre-tested survey, was given to the parents to assess the oral health related KAP. The results were calculated on the basis of frequency and percentages using the SPSS software. Results: Males comprised 49.8% and females comprised 50.2% of the respondents of questionnaire. Majority of fathers and mothers of the study population agreed for the importance of primary teeth. Almost all the participants in this study agreed that a child's teeth should be brushed/cleaned. A little less than half of study population considered 1 year as the suitable age for the child's first dental visit. A higher proportion of females as compared to males felt that night time bottle/breastfeeding leads to caries. Conclusion: Parental attitude, knowledge, and practices are responsible for their child's oral health. No statistical significance was seen between mothers and fathers on perception of their child's oral health care.

Keywords: Attitude, knowledge, oral health


How to cite this article:
Singh S, Awasthi N, Goel D, Khandelwal D, Sachdeva P, Bakhtawar R. Knowledge, attitude, and practices of parents on the importance of their Children's oral health in Greater Noida, India. Indian J Dent Sci 2021;13:1-5

How to cite this URL:
Singh S, Awasthi N, Goel D, Khandelwal D, Sachdeva P, Bakhtawar R. Knowledge, attitude, and practices of parents on the importance of their Children's oral health in Greater Noida, India. Indian J Dent Sci [serial online] 2021 [cited 2021 Jan 24];13:1-5. Available from: http://www.ijds.in/text.asp?2021/13/1/1/305976




  Introduction Top


Parental perceptions about early childhood oral health are important to develop effective preventive measures since parent's health beliefs, behaviors, and practices usually have a direct influence on their children's dental health.[1] Parents who are concerned about their own oral health are more likely to be concerned about their child oral health.[2] Understanding parent's perceptions of their children's oral health and factors that motivate these perceptions can help dentistry overcome barriers that parents encounter in accessing dental care for their children.[3]

A better understanding of how well caregivers perceive their children's oral health status may improve utilization of dental care services.[4] Parental perceptions are particularly important due to the inability of preschool children to verbalize their emotions. Oral health care and visits to the dentist are associated with parental perceptions regarding children's oral health. Parents/guardians play the central role in ensuring their child's well-being and are the main decision makers with regard to the child's health care. A number of factors have been described as the predictors of parental perceptions regarding children's oral health, such as the child's age, household income, ethnicity, and oral health problems.[5]

Preschool children form an innocent and compassionate segment of the society and their oral health care is given due priority as it determines the oral health status of the future generations.[6] Children under the age of 5 years generally spend most of their time with parents and guardians, especially mothers, even when they attend preschools or nurseries. These early years involve “primary socialization” during which the earliest childhood routines and habits are acquired. Studies eliciting parental knowledge, attitudes, and preventive behaviors on oral health of children are scanty.[7] Young children's oral health maintenance and outcomes are influenced by their parent's knowledge and beliefs, which affect oral hygiene and healthy eating habits.[8] Considering, parent's important role in the well-being of young children, it is essential to explore their knowledge, attitude, and practices (KAP) as it affects the dental care that children receive at home and their access to professional dental services.[7] Parent's knowledge and positive attitude toward good dental care are very important in the prevention of oral-related diseases.[9]

There is a lack of data regarding attitude of parents in the population of Greater Noida. The present study was planned to assess the oral health-related KAP of parents with children aged 3–5 years.


  Materials and Methods Top


The sample size consisted of 500 parents of school-going children of both genders aged 3–5 years studying in Greater Noida city, India. The schools included were both private and government. An official permission was obtained from the administrative authority of each school for carrying out the study. A self-administered questionnaire, written both in English and local language (Hindi), validated through pre-tested survey, was given to the class teachers which was sent to the parents along with school diary. They were asked to return back the questionnaire along with the answers to the school on next day which were then collected from teachers.[7] The questionnaire was divided into four sections:

Section I: Questions to gather information related to parents, demographic characteristics including gender, age, employment, educational level, etc.

Section II: Questions to assess the children's oral health-care knowledge among parents.

Section III: Questions aimed to assess the attitude the parents toward their children oral health care.

Section IV: Questions aimed to assess the practices of parents regarding their children's oral health care.

Informed consent was obtained from all parents enrolled in the study. Approval for the survey was duly obtained from the Institutional Ethics Committee (ref no. IEC/2016/76-A/47).


  Results Top


Statistical analysis was carried out using the Statistical Package for the Social Sciences software (SPSS) Version 21.0. Armonk, NY: IBM Corp. Continuous variable such as age was summarized as mean and standard deviation. Categorical variables were summarized as frequencies. Inferential statistics were performed using the Chi-square test and Independent t-test.

Demographic profile of study population: Males comprised 49.8% and females comprised 50.2% of the respondents of questionnaire. Parents of 15.6% children were professionals, whereas 31.2% were unemployed. Majority of them (75.2%) were graduates and 0.2% were illiterates [Table 1].
Table 1: Demographic profile of study population

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[Table 2] illustrates the responses of parents to each question. Majority of fathers and mothers of study population agreed for the importance of primary teeth. The differences in their responses were not found to be statistically significant. 94.4% parents agreed from importance of primary teeth. 11.8% parents did not know how cavities can be prevented. Most of the study population reported that they knew about the cause of caries and how to prevent it. Restoration was considered as the best treatment option for a primary tooth with caries (45.6%). A little less than half of study population considered 1 year as the suitable age for the child's first dental visit and felt that the first dental visit should be before child's first birthday (46%). Majority of fathers and mothers (75%) of study population agreed that the child should return to dentist for follow-up visits.
Table 2: Children's oral health care knowledge among parents

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[Table 3] illustrates approximately 75% of parents believed balanced diet is essential for healthy growth of the baby's diet while 14% did not know about balanced diet. A higher proportion of females as compared to males felt that night time bottle/breast feeding leads to caries, but this difference was failed to reach the level of statistical significance. Most of the participants (60%) agreed with the fact that caries is caused by bacteria that are transmitted by sharing feeding utensils while 8% parents had no idea about this. Almost all the participants in this study agreed that a child's teeth should be brushed/cleaned (95%).
Table 3: attitude the parents towards their children oral health care

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Reponses of fathers and mothers toward the question “Do you cut the food into small pieces before giving to the child?” were found to be significantly different. Significantly higher number of fathers reported it as frequently while more number of mothers reported it as sometimes. Only 8.8% of the study population reported that they never give sweet food to the child (liquid/solid). Majority of fathers and mother (73.6%) always supervise their child's tooth brushing. 56.4% of parents have never used pacifier dipped in to sweet liquid for their child [Table 4].
Table 4: Practices of parents regarding their children's oral health care

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  Discussion Top


The present study assessed the oral health-related KAP of parents with children aged 3–5 years of Gautam Budh Nagar district, Greater Noida, India using questionnaire based on the review done on parental perception on the importance of their children's first dental visit by Hussein et al.[1] Parental perceptions about their childhood oral health are important to develop preventive measures since parent's health beliefs, behavior, and practices usually have a direct influence on their children's dental health.[1] Parent's positive dental attitudes result in children with better oral hygiene. Parent's oral health knowledge and good dental health care practices prevent premature loss of primary teeth, and it can reduce the risk of future decay in permanent teeth.

Parents and family members are considered the primary source for knowledge about child rearing and health habits for children, which undoubtedly has a long-term influence in determining a child's oral health status. They are considered as the keys in achieving the best oral health outcomes and assuring well-being for children. A similar study was conducted by Mahmoud et al. in Dubai in which adequate knowledge was found among 58.2% of the mothers, 99% exhibited the excellent attitude; however, only 20% followed good practice toward their children's oral health. Poor knowledge and practice of mothers were significantly associated with mothers occupation and education. Employed mothers had a significantly higher score of knowledge.[9]

Forty-six percent of the study population considered 1 year as suitable age for the child for his first dental visit and felt that that the 1st dental visit should be before child first birthday. The differences in the responses of fathers and mothers were not found to be statistically significant. According to a study conducted in Riyadh, 38% of the parents reported that six months or at least 12 months are the first dental visit of their children.[10] In a study carried out by Reddy et al., 74.7% participants did not know that a child should be consulted/taken to a dentist before 1 year of age.[11] Winnier et al. showed 39% of the parents believe that first dental visit should be 1 year of age while 21% reported to be 6 months.[12]

More than half of the fathers and mothers of the study population were found to agree with the fact that tooth decay is caused by bacteria that are transmitted by sharing feeding utensils. Nagarajappa et al. reported 41% of the parents agreed that tooth decay is caused by bacteria transmitted by sharing feeding utensils.[7] The role of bacteria in the causation of dental caries was not acknowledged by most of the parents which was reflected by the prevalent practice of sharing utensils and biting food into small pieces before feeding in this study which was in accordance with the studies by Mani et al.[13]

Majority of parents agreed to the fact that “A balanced diet is essential for the healthy growth of the baby's diet.” The differences in the responses of fathers and mothers were not found to be statistically significant. A higher proportion of females as compared to males was found to agree with the fact that “Night time bottle/breastfeeding can cause tooth decay,” but this difference failed to reach the level of statistical significance. The role of night time bottle/breastfeeding as a cause of tooth decay was not acknowledged by majority of parents. This is in accordance to the results of a study conducted by Rwakatema et al.[14]

Ninety-four percent of the study population were found to agree with the fact that “A child's teeth should be brushed/cleaned.” Another study which was conducted by Dikshit et al. showed that parents used toothbrush (56.5%) and toothpaste (88.7%) to clean the teeth their child's teeth which was done twice a day or after meals by 38.7% participants.[15] Majority of fathers and mothers in this study reported that they always supervise their childs tooth brushing.

Reponses of fathers and mothers toward the question “Do you bite the food into small pieces before giving to the child?” were found to be significantly different. Significantly higher number of fathers reported it as frequently while more number of mothers reported it as sometimes. Majority of fathers and mothers of the study population reported that they give sweet food to the child (liquid/solid) sometimes. The differences in the responses of fathers and mothers were not found to be statistically significant. Majority of fathers and mothers of the study population reported that they never use pacifier dipped into sweet liquid for the child. The differences in the responses of fathers and mothers were not found to be statistically significant. Dental caries is the most common oral disease that affects a significant number of the Indian population. National Health Survey conducted in 2004 throughout India has revealed 51.9% of 5-year-old children to be affected by dental caries.[16] Caregiver's perception of their children's oral health is significantly associated with their children's caries experience. Parent's positive dental attitude is important as they are the primary caregivers for children.


  Conclusion Top


No statistical significance was seen between mothers and fathers on perception of their child's oral health care. This study showed that parental attitude, knowledge, and practices are responsible for their child's oral health. The clinical implication of this survey was to emphasize on the need for the oral health education of the parents of school children and planning needed to be done aiming at improving oral health knowledge of parents.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Hussein AS, Abu-Hassan MI, Schroth RJ, Ghanim AM. Parent's perception on the important of their children's first dental visit (A cross-sectional pilot study in Malaysia). J Oral Res 2013;1:17-25.  Back to cited text no. 1
    
2.
Law CH, Razak IA, Saub R. Parental perception of the importance of the primary dentition and children's caries experience. Annal Dent Univ Malaya 2000;7:11-5.  Back to cited text no. 2
    
3.
Talekar BS, Rozier RG, Slade GD, Ennett ST. Parental perceptions of their preschool-aged children's oral health. J Am Dent Assoc 2005;136:364-72.  Back to cited text no. 3
    
4.
Bodhale P, Karkare S, Khedkar S. Knowledge and attitude of parents toward oral health maintenance and treatment modalities for their children. J Dent Res Rev 2014;1:24-7.  Back to cited text no. 4
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5.
Gomes MC, Clementino MA, Pinto-Sarmento TC, Costa EM, Martins CC, Granville-Garcia AF, et al. Parental perceptions of oral health status in preschool children and associated factors. Braz Dent J 2015;26:428-34.  Back to cited text no. 5
    
6.
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 Develop 2014;1:40.  Back to cited text no. 6
    
7.
Nagarajappa R, Kakatkar G, Sharda AJ, Asawa K, Ramesh G, Sandesh N. Infant oral health: Knowledge, attitude and practices of parents in Udaipur, India. Dent Res J (Isfahan) 2013;10:659-65.  Back to cited text no. 7
    
8.
Suresh BS, Ravishankar TL, Chaitra TR, Mohapatra AK, Gupta V. Mother's knowledge about pre-school child's oral health. J Indian Soc Pedod Prev Dent 2010;28:282-7.  Back to cited text no. 8
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9.
Mahmoud N, Kowash M, Hussein I, Hassan A, Al Halabi M. Oral health knowledge, attitude, and practices of Sharjah mothers of preschool children, United Arab Emirates. J Int Soc Prev Community Dent 2017;7:308-14.  Back to cited text no. 9
    
10.
Almulhim B, Alammro B. Knowledge and attitude toward oral health practice among the parents in Riyadh city. J Indian acad Dent Spec Res 2016;3:14-6.  Back to cited text no. 10
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11.
Reddy P, Anjum MS, Monica M, Yadav K, Abbas I, Kanakamedala S. Evaluation of oral health knowledge among care takers working in baby day care centers of greater Hyderabad. Webmed Central Public Health 2014;5:WMC004733.  Back to cited text no. 11
    
12.
Winnier JJ, Parmar A, Mehta S, Bambal K, Bhatia R. Oral hygiene maintenance in children – A survey of parental awareness. Int J Oral Health Med Res 2015;2:1-5.  Back to cited text no. 12
    
13.
Mani SA, Aziz AA, John J, Ismail NM. Knowledge, attitude and practice of oral health promoting factors among caretakers of children attending day-care centers in Kubang Kerian, Malaysia: A preliminary study. J Indian Soc Pedod Prev Dent 2010;28:78-83.  Back to cited text no. 13
[PUBMED]  [Full text]  
14.
Rwakatema DS, Ng'ang'a PM. The oral health knowledge, attitudes and practices of the parents/guardians of pre school children in Moshi. East Afr Med J 2009;86:520-5.  Back to cited text no. 14
    
15.
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. BJHS 2018;3:447-52.  Back to cited text no. 15
    
16.
National Oral Health Survey and Fluoride Mapping. An Epidemiological Study of oral Health Problems and Estimation of Fluoride Levels in Drinking Water. Vol. 32. New Delhi: Dental Council of India; 2004. p. 67-78.  Back to cited text no. 16
    



 
 
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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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