Document Type : Original Article
Authors
1 Department of Pedodontics, Faculty of Dentistry, Ege University
2 Department of Midwifery, Faculty of Health Sciences, Ege University, Izmir, Turkey
Abstract
INTRODUCTION: An oral health program for mothers starting from pregnancy in a disadvantaged
district of İzmir was performed in 2013–2016. Dental behaviors and their determinants among
intervention and control groups were compared in the third phase of the program.
METHODS: This nonrandomized‑controlled study was conducted in Phase 3. The intervention group
began with 248 pregnant women; 69.4% (n = 172) of mothers with 6–9‑month‑old babies participated
in Phase 2, 2014. At Phase 3 (18–24 months), 68.6% (n = 118) of mothers in the intervention group
and 113 mothers living in another district as controls were included. Sociodemographic characteristics,
determinants of behaviors, and outcomes defined as dental behaviors in the last week were assessed
using a questionnaire.
RESULTS: Regarding knowledge, perceived severity, and fatalistic beliefs, the intervention group
had higher correct answer percentages. The percentage of mothers who could clean their children’s
teeth before sleep was higher in the intervention group (76.3%; P < 0.05), but the difference was
lost by a child’s resistance. The significant difference on avoiding bedtime nursing (65.3%) and
sugary snacks (74.4%) in the intervention group disappeared with the obstacle of a child’s protests
or interference from relatives. In the intervention group, 32.2% of the mothers reported that they
did not give any sugary snacks, 43.2% had never fed during sleep, and 26.3% cleaned their
children’s teeth during the last week. The results in the control group were 24.8%, 18.6%, and 8.8%,
respectively (P < 0.05).
CONCLUSIONS: The program improved the mothers’ views regarding the determinants of dental
behaviors, but greater support against obstacles was needed. Social environmental support is planned
for the following stages of the program.
Keywords
Childhood Caries (ECC): Classifications, Consequences and
Preventve Strategies. American Academy of Pediatric Dentistry;
2014. Available from: http://www.aapd.org. (Accessed June 1,
2017)
2. Peltzer K, Mongkolchati A. Severe early childhood caries and
social determinants in three‑year‑old children from Northern
Thailand: A birth cohort study. BMC Oral Health 2015;15:108.
3. Finlayson TL, Siefert K, Ismail AI, Sohn W. Psychosocial factors
and early childhood caries among low‑income African‑American
children in Detroit. Community Dent Oral Epidemiol
2007;35:439‑48.
4. Hoeft KS, Barker JC, Shiboski S, Pantoja‑Guzman E, Hiatt RA.
Effectiveness evaluation of contra caries oral health education
program for improving Spanish‑speaking parents’ preventive
oral health knowledge and behaviors for their young children.
Community Dent Oral Epidemiol 2016;44:564‑76.
5. NaiduR, Nunn J, Irwin JD. The effect of motivational interviewing
on oral healthcare knowledge, attitudes and behaviour of parents
and caregivers of preschool children: An exploratory cluster
randomised controlled study. BMC Oral Health 2015;15:101.
6. Weinstein P, HarrisonR, Benton T. Motivating mothers to prevent
caries: Confirming the beneficial effect of counseling. J Am Dent
Assoc 2006;137:789‑93.
7. Singhal A, Chattopadhyay A, Garcia AI, Adams AB, Cheng D.
Disparities in unmet dental need and dental care received
by pregnant women in Maryland. Matern Child Health J
2014;18:1658‑66.
8. Vamos CA, Thompson EL, Avendano M, Daley EM, QuinonezRB,
Boggess K. Oral health promotion interventions during
pregnancy: A systematic review. Community Dent Oral
Epidemiol 2015;43:385‑96.
9. Ozen B, Ozer L, Başak F, Altun C, Açıkel C. Turkish women’s
self‑reported knowledge and behavior towards oral health during
pregnancy. Med Princ Pract 2012;21:318‑22.
10. Kısa S, Zeyneloğlu S. Inpatient postpartum women’s status of oral
hygiene habits and visit to the dentist during their most recent
pregnancy. TAF Prev Med Bull 2013;12:65‑74.
11. Ismail AI, Sohn W, Lim S, Willem JM. Predictors of dental caries
progression in primary teeth. J Dent Res 2009;88:270‑5.
12. Merrick J, Chong A, Parker E, Roberts‑Thomson K, Misan G,
Spencer J, et al. Reducing disease burden and health inequalities
arising from chronic disease among indigenous children: An early
childhood caries intervention. BMC Public Health 2012;12:323.
13. Raingruber B. Contemporary health promotion in nursing
practice. In: Health Promotion Theories. 2nd ed. California: Jones
and Barlett Learning; 2017.
14. Finlayson TL, Siefert K, Ismail AI, Sohn W. Maternal self‑efficacy
and 1‑5‑year‑old children’s brushing habits. Community Dent
Oral Epidemiol 2007;35:272‑81.
15. Kay E, Locker D. A systematic review of the effectiveness of
health promotion aimed at improving oral health. Community
Dent Health 1998;15:132‑44.
16. Ismail AI, Ondersma S, Jedele JM, Little RJ, Lepkowski JM.
Evaluation of a brief tailored motivational intervention to
prevent early childhood caries. Community Dent Oral Epidemiol
2011;39:433‑48.
17. Watt RG. Strategies and approaches in oral disease prevention
and health promotion. Bull World Health Organ 2005;83:711‑8.
18. FreudenthalJJ, Bowen DM. Motivational interviewing to decrease
parental risk‑related behaviors for early childhood caries. J Dent
Hyg 2010;84:29‑34.
19. Hart JT. The inverse care law. Lancet 1971;1:405‑12.
20. Macintyre S. Inequalities in Health in Scotland: What Are They
and What Can We Do About Them? Medical Research Council;
2007. Avaılable from: http://www.sphsu.mrc.ac.uk/reports/
OP017.pdf. (Accessed November 10, 2018),
21. BoggessKA, UrlaubDM, MoosMK, PolinkovskyM, El‑KhorazatyJ,
Lorenz C. Knowledge and beliefs regarding oral health among
pregnant women. J Am Dent Assoc 2011;142:1275‑82.
22. Medeiros PB, Otero SA, Frencken JE, Bronkhorst EM, Leal SC.
Effectiveness of an oral health program for mothers and their
infants. Int J Paediatr Dent 2015;25:29‑34.
23. Schroth RJ, Edwards JM, Brothwell DJ, Yakiwchuk CA,
Bertone MF, Mellon B, et al. Evaluating the impact of a community
developed collaborative project for the prevention of early
childhood caries: The healthy smile happy child project. Rural
Remote Health 2015;15:3566.
24. Clifford H, Johnson NW, Brown C, Battistutta D. When can
oral health education begin? Relative effectiveness of three oral
health education strategies starting pre‑partum. Community Dent
Health 2012;29:162‑7.
25. Plutzer K, Spencer AJ. Efficacy of an oral health promotion
intervention in the prevention of early childhood caries.
Community Dent Oral Epidemiol 2008;36:335‑46.
26. Hamilton FA, Davis KE, Blinkhorn AS. An oral health promotion
programme for nursing caries. Int J Paediatr Dent 1999;9:195‑200.
27. Chung LH, Gregorich SE, Armitage GC, Gonzalez‑Vargas J,
Adams SH. Sociodemographic disparities and behavioral factors
in clinical oral health status during pregnancy. Community Dent
Oral Epidemiol 2014;42:151‑9.
28. Usturalı Mut AN, Öcek ZA, Yücel U, Çiçeklioğlu M, Eden E. The
Dental Service Needs of Pregnant Women Living in Izmir‑Bornova
and Socioeconomic Variables Related to The Utilization of These
Services (Dokuz Eylül Tıp Fak Derg 2014;23:93‑103.
)