• Non ci sono risultati.

PARENTS KNOWLEDGE AND ATTITUDE ABOUT CHILDREN’S ORAL HEALTH

N/A
N/A
Protected

Academic year: 2021

Condividi "PARENTS KNOWLEDGE AND ATTITUDE ABOUT CHILDREN’S ORAL HEALTH"

Copied!
30
0
0

Testo completo

(1)

Reem Najem

Fifth year, group 16

PARENTS KNOWLEDGE AND ATTITUDE ABOUT

CHILDREN’S ORAL HEALTH

Master’s thesis

Supervisor Dr, Sandra Žemgulytė

(2)

LITHUANIAN UNIVERSITY OF HEALTH SCIENCES MEDICAL ACADEMY

FACULTY OF ODONTOLOGY

CLINIC FOR PREVENTIVE AND PEDIATRIC DENTISTRY

PARENTS’ KNOWLEDGE AND ATTITUDE ABOUT CHILDREN’S ORAL HEALTH

Master’s Thesis

The thesis was done

by student ... Supervisor... (signature) (signature)

... …... (name surname, year, group) (degree, name surname)

... 20…. ... 20…. (day/month) (day/month)

(3)

EVALUATION TABLE OF CLINICAL–EXPERIMENTAL MASTER’S THESIS

Evaluation: ... ...

Reviewer: ... ...

(scientific degree, name and surname)

Reviewing date: ...

Compliance with MT

No. MT parts MT evaluation aspects requirements and

evaluation Yes Partially No

1 Summary

(0.5 point)

Is summary informative and in compliance with the

thesis content and requirements? 0.3 0.1 0 2 Are keywords in compliance with the thesis essence? 0.2 0.1 0 3

Introduction , aim and tasks

(1 point)

Are the novelty, relevance and significance of the

work justified in the introduction of the thesis? 0.4 0.2 0 4 Are the problem, hypothesis, aim and tasks formed clearly and properly? 0.4 0.2 0 5 Are the aim and tasks interrelated? 0.2 0.1 0 6

Review of literature (1.5 points)

Is the author’s familiarization with the works of other

authors sufficient? 0.4 0.2 0 7 Have the most relevant researches of the scientists discussed properly and are the most important

results and conclusions presented? 0.6 0.3 0 8 Is the reviewed scientific literature related enough to the topic analysed in the thesis? 0.2 0.1 0 9 Is the author’s ability to analyse and systemize the scientific literature sufficient? 0.3 0.1 0

10

Material and methods

IS the research methodology explained comprehensively? Is it suitable to achieve

the set aim? 0.6 0.3 0 11 Are the samples and groups of respondents formed and described properly? Were the selection criteria

(4)

12

and methods

(2 points) A r e o t h e r r e s e a r c h m a t e r i a l s a n d t o o l s (questionnaires, drugs, reagents, equipment, etc.)

described properly? 0.4 0.2 0 13 Are the statistical programmes used to analyse data, the formulas and criteria used to assess the level of

statistical reliability described properly? 0.4 0.2 0 14 Results (2 points) Do the research results answer to the set aim and tasks comprehensively? 0.4 0.2 0 15 Does presentation of tables and pictures satisfy the requirements? 0.4 0.2 0 16 Does information repeat in the tables, picture and text? 0 0.2 0.4

17 Is the statistical significance of data indicated? 0.4 0.2 0

18 Has the statistical analysis of data been carried

out properly? 0.4 0.2 0

19

Discussion (1.5 points)

Were the received results (their importance, drawbacks) and reliability of received results assessed properly?

0.4 0.2 0

20

Was the relation of the received results with the latest data of other researchers assessed properly?

0.4 0.2 0

21 Does author present the interpretation of

results?

0.4 0.2 0

22

Do the data presented in other sections (introduction, review of literature, results) repeat?

0 0.2 0.3

23

Conclusions (0.5 points)

Do the conclusions reflect the topic, aim and

tasks of the Master’s thesis? 0.2 0.1 0

24

Are the conclusions based on the analysed material? Do they correspond to the research results?

0.2 0.1 0

25 Are the conclusions clear and laconic? 0.1 0.1 0

26 Is the references list formed according to the

(5)

27

References (1 point)

Are the links of the references to the text correct? Are the literature sources cited correctly and precisely?

0.2 0.1 0

28 Is the scientific level of references suitable for

Master’s thesis? 0.2 0.1 0

29

Do the cited sources not older than 10 years old form at least 70% of sources, and the not older than 5 years – at least 40%?

0.2 0.1 0

Additional sections, which may increase the collected number of points 30 Annexes Do the presented annexes help to understand

the analysed topic? +0.2 +0.1 0

31

Practical recommendatio

ns

Are the practical recommendations suggested

and are they related to the received results? +0.4 +0.2 0 General requirements, non-compliance with which reduce the number of points 32

General requirements

Is the thesis volume sufficient (excluding annexes)? 15-20 pages (-2 points) <15 pages (-5 points)

33 Is the thesis volume increased

artificially?

-2 points

-1 point

34 Does the thesis structure satisfy the

requirements of Master’s thesis? -1 point -2 points

35

Is the thesis written in correct

language, scientifically, logically and laconically?

-0.5 point -1 points

36 Are there any grammatical, style or

computer literacy-related mistakes?

-2

points -1 points

37

Is text consistent, integral, and are the volumes of its structural parts

balanced?

-0.2 point -0.5 points

38 Amount of plagiarism in the thesis. >20%

(not evaluated)

39

Is the content (names of sections and subsections and enumeration of

pages) in -0.2 point

(6)

*Remark: the amount of collected points may exceed 10 points. Reviewer’s comments: ___________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _________________________________________ ___________________________ Reviewer’s name and surname Reviewer’s signature

compliance with the thesis structure and aims?

40

Are the names of the thesis parts in compliance with the text? Are the titles of sections and sub-sections distinguished logically and correctly?

-0.2 point -0.5 points

41 Was the permit of the Bioethical

Committee received (if necessary)? -1 point

42 Are there explanations of the key

terms and abbreviations (if needed)? -0.2 point

-0.5 points

43

Is the quality of the thesis typography (quality of printing, visual aids, binding) good?

-0.2 point -0.5 points

(7)

TABLE OF CONTENTS SUMMARY ... 8 INTRODUCTION... 9 REVIEW OF LITERATURE………... 11 Tooth brushing………. 11 Primary dentition ……… 12

Early childhood caries ………. 13

Transmission of bacteria from mother to child………... 14

Fluoride ……….. 14

METHODS AND MATERIALS………... 15

(8)

SUMMARY

Aim: To assess the parent’s knowledge about duration frequency and manner of child’s tooth brushing, importance of primary dentition to the permanent one , bacterial transmission, dental caries

development, time of first dental visit of parents.

Material and methods: Questionnaire was designed for parents to assess their knowledge and attitude about children’s oral health. 16 items were included to the questionnaire (5 about demographic data and 11 were related to oral health). Survey was carried out in in Lebanon Tripoli private dental clinic “Rym Naji”. SPSS 19 program was used for statistical analysis.

Results: Most of the parents had good knowledge about recommended frequency of tooth brushing (90%), parental role in children tooth brushing (82.5%). 71.7% of participants knew that mothers can transmit bacteria to them by sharing spoons or licking pacifiers However, only a half of parents knew when to start brushing baby’s teeth. Surprisingly, only 36.7% of parents knew about using fluoride in the toothpaste. In addition, a half of parents did not know about primary dentition influence on space maintaining for permanent teeth. Only a half of parents knew that caries in primary teeth can be that predictor of permanent teeth lesions. Most of parents (75%) never checked or knew that water at home should contain fluoride.

Conclusion: knowledge of parents regarding their children oral health vary. Education level is the most important factor to maintain good oral health as shown in this study. Yet health programs and

practitioners should always interfere in the society by spreading all important information about oral health.

(9)

INTRODUCTION

It is known that parent’s behavior and knowledge affect their children oral health because they are the caregivers until a child can depend on himself. Parents are affected by many factors such as age, education, experience, and stress that will have a great influence on their children oral health. [1] In addition, to mentioned above, WHO recently published a global review of oral health which emphasize that despite the great improvement in oral health of population in different countries, worldwide problems still persist particularly among underprivileged groups in both developing and developed countries.[2] 60 to 90 % of school aged children are affected by dental caries, which is probably the most prevalent disease of all child disease, and if left untreated it may lead to many problems such as pain, suffering, productivity loss(ex: at school) and development of severe functional and social limitations in the individuals afflicted by it.[3] It has been proved that the main etiological factors of dental caries are cariogenic bacteria, frequent intake of fermentable carbohydrates, disorder of salivary production and composition, and poor mineralization of hard dental tissue. Moreover, indirect factors like socioeconomic, psychological, and behavioral habits help to explain the distribution of dental caries within population. When parents tend to start taking care of their children’s teeth as soon as they erupt, a healthier life can always be obtained. Care can be attained by visiting a dental practitioner not later than the age of one year, in this case, any anomalies such as teeth decay, not mineralized teeth or any habits like thumb sucking and mouth breathing can be solved in early stage.[4] A dentist will also advise parents on how to brush their child teeth, how much frequent it should be, and when to start using tooth paste with fluoride.

Fluoride has a huge importance in fighting cavity. Fluoride is usually present in water, but in different cities water tab does not contain enough amount needed. In that case, dentist should be asked to prescribe systemic supplement either by drops, pills or flavored jelly candies, and apply topical fluoride by varnish, gel, or specific percentage in tooth paste.[5]

(10)

2004 the WHO indicated that dental caries level (Decayed, Missing, and Filled teeth) DMFT index among 12 years old was high >4.4 in Lebanon.[7]

Hypothesis:

Aim: The aim is to examine the knowledge and attitude between parents from different communities and to highlight the most important factor that should be improved and implanted to enhance the oral health in the society.

Objective:

1) To design the questionnaire 2) To collect and analyze the data

3) To analyze the literature sources related to the study and compare the results of accomplished survey with other one.

(11)

Literature review

The oral health knowledge of the parents reflects the oral health and related habits of the children during infancy and throughout the preschool years. Parents play an important role on establishment of skills for their children. There are limited data for the oral health of children during the early childhood period in developing countries. A good understanding of parental knowledge, attitudes, beliefs and awareness regarding oral health, habits and hygiene is essential for the effective implementation of oral health promotion efforts aimed at improving the dental health of preschool children.[8]

Tooth Brushing

Tooth brushing habits that parents teach to their children in early years of life has a significant influence on maintaining good level of oral hygiene later in life. Thereby, tooth brushing is a simple and effective way to decrease plaque formation and prevent caries as well as periodontal diseases.[9] Most of parents, especially first time to be, always wonder when to start the oral health care for their baby. Oral health care can began from the first days in child’s life. The baby’s gum can be cleaned twice daily especially after feeding and before bedtime by a wet piece of cloths or a gauze and wiped gently, but a toothbrush and a toothpaste are forbidden in this stage of life. When first tooth erupt a tipped small smooth toothbrush can be introduced to their life, and brushing should be done very gently to not build a bad memory of tooth brushing for all life. Tooth paste containing fluoride is essential to use when the child is two to three years old. The amount of tooth paste should be as a rise or pea size, spitting the paste is hard at the beginning, but with assistance of parent and instructions day by day will teach them how to spit and make the process easier. Supervisor and assistance of parents during

brushing is one of the things parents fail to do. This can be due to many reasons such as busy parents, very hard attitude of child, lake of knowledge, and sometimes carelessness. Parents should assist

(12)

removes plaque, bio film, and clean directly beneath the gingival margins which leads to prevention of periodontal diseases. In Bass technique the bristles of toothbrush should be projected 45 degrees to the tooth surface starting from the gingival sulcus, vibration motion should be done from 15 to 20 times on each tooth surface. The Bass method is indicated to patients with exposed roots, cleaning cervical areas, and open proximal spaces. In addition to techniques mentioned above, Fone’s method is also used and recommended for children since it is a simple method to do. Shortly, toothbrush bristles are placed on teeth surface and rotational movement should be done 4 to 5 rotations per set of teeth. A study was done in India about effectiveness of different tooth brushing techniques which are mentioned above on the removal of dental plaque in 6-8 years old children, this study compared three methods of brushing among children at school, and it proved that the most effective method was Bass followed by horizontal scrub and least efficacy was seen in Fone’s technique. [11]

Primary Dentition

Infant in normal situation have 20 crowns of primary teeth which will erupt in arranged sequence gradually until age three.. First tooth eruption is considered to be a very interesting event for parents who wait for it to celebrate and ensure their baby’s development. The average age of first primary tooth eruption is about six to ten months were lower central incisor starts to show. By then, the four central incisors two upper and two lower will be presented. Jaws complete development to make space for permanent teeth to grow and start erupting by the age of six.[12,13,14] Each tooth eruption period is usually combined with symptoms as irritability, decreased appetite, gum rubbing, mood disturbance, sleeping problems, fever, diarrhea, rush, and vomiting. Symptoms associated with primary tooth eruption decrease with age. These signs usually were observed during the eruption of primary incisor. [15]

(13)

that case.[16] The sequence of eruption and exfoliation of primary teeth is a predictor for straight, organized, and well-arranged permanent teeth eruption. The most important teeth to retain, preserve are the canine and 2nd primary molar, these teeth have the longest roots and serve for stable location for

other teeth and prevent their migration. Mesial drift as a result of space is believed to be a phenomenon of permanent molars only. The major reason these teeth move misally when a space opens up is their mesial inclination, so that they erupt misally, except when primary canine is lost and laterals tend to migrate distally. The premature loss of primary molars and canine by either extraction or normal exfoliation will have a direct effect on permanent teeth eruption and occlusion relationship between jaws. The early loss of molars especially second primary molar before the eruption of the permanent first molar will have a great influence on losing the space for the second premolar to erupt thus leading to impaction of second premolar, spacing in lower jaw, and angle class 2 or 3 may occur. [17]

Early Childhood Caries

Early Childhood Caries is defined as the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries) or filled tooth surfaces in any primary tooth in a preschool-age child between birth and 71 months of age [18].Dental caries is one of the most common chronic infectious disease caused by the collaboration between Streptococcus mutans bacteria, and biofilm on enamel surface. These bacteria break down sugars for energy, causing an acidic environment in the mouth and result in demineralization of the enamel of the teeth and dental caries. Its consequences can affect the quality of life of the child and family, and can have significant social and economic concerns beyond the immediate family as well. Untreated carious teeth can impair general diseases and untreated lesions can cause dental complications. Newly erupting teeth should be protected from contact with carious primary ones [19,20].

Early Childhood Caries is demarcated as the presence of one or more decayed, missing due to caries, or filled tooth surfaces in any primary tooth in a child under the age of six, furthermore, caries usually start to attack labial surfaces of anterior incisors of the upper jaw. . Mandibular incisors are affected only in severe cases.[21]

(14)

usually do. Neglecting oral hygiene has a great impact on caries development, it gives the best medium with all mentioned factors to establish Baby Bottle caries.[22]

Transmission of bacteria from mother to child

Many studies have found that cavity-causing bacteria can be transmitted from caregivers or parents especially mothers to infants and toddlers during the period when the children's immune systems are not fully developed.[23] This type of transmission is called "vertical transmission," and it is most likely from caregivers with severe untreated tooth decay. Recently, various studies have shown that the bacteria can also be transmitted among classmates and siblings, and it is known as "horizontal transmission."[24]

But to what degree these vertical or horizontal transmissions are responsible for cavities in young children has been "hard, if not impossible, to quantify," says Dr. Paul Reggiardo, a pediatric dentist in Huntington Beach, Calif., and public policy advocate for the California Society of Pediatric Dentistry. Young children who have high levels of Streptococcus mutans, cavity-causing bacteria are five times more likely to have tooth decay compared to those with a lower levels it. Children under the age of two appear to be more susceptible to infection with S. mutans. "The child initially has the mother's

immunity, and then as that wears off, there's this window of infectivity where the child does not have that resistance until they start building their own, and they're particularly susceptible then," says Reggiardo.[25]

Normal micro flora such as streptococci , lactobacilli, staphylococci ,and corynibacteria of the oral cavity includes this bacteria but with a certain acceptable level, nevertheless when young children get an over exposure and transmission of the bacteria before their immune systems are able to defend them off, the bacteria can colonize more effectively, driving the infant to a higher risk of cavities. The key of transmission of the bacteria is the timing in accordance with immune system.[26,27]

Fluoride

Systemic fluorides are those ingested into the body. During tooth formation, ingested fluorides become incorporated into tooth structures. Fluorides ingested regularly during the time when teeth are

(15)

fluoride is present in saliva, which continually bathes the teeth providing a reservoir of fluoride that can be incorporated into the tooth surface to prevent decay. Fluoride also becomes incorporated into dental plaque and facilitates further remineralization. Sources of systemic fluoride include water, dietary fluoride supplements in the forms of tablets, drops or lozenges and fluoride present in food and beverages. Topically applied fluoride provides local protection on the tooth surface. Topical fluorides include toothpastes, mouth rinses and professionally applied fluoride foams, gels and varnishes. As mentioned previously, systemic fluorides also provide topical protection. Low levels of fluoride in saliva and plaque from sources such as optimally fluoridated water can prevent and reverse the process of dental decay. Levels of fluoride in toothpaste vary according to age of the patient. Toothpastes containing 1350-1500ppm fluoride are the most effective. Dentist may advise you to use higher concentration toothpaste if you or your child is at a risk of tooth decay [28].

Children under three years old should brush twice daily, with a smear of toothpaste containing no less than 1000ppm fluoride. Children between three and six years old should brush at least twice daily with a pea-sized amount of toothpaste containing more than 1000ppm fluoride [29, 30].

(16)

METHODS AND MATERIAL

A self-administered structured questionnaire written in English took place in the summer of 2016 from June to august in Lebanon, Tripoli 2nd capital located in the north were population is around 550,000

people. The questionnaire was distributed to 120 parents who had children aged between 1 to 4 years, it was distributed to them in a private clinic called Rym Naji dental clinic located in city center.

Those questionnaires were designed to examine the knowledge of parents about their children’s oral health. Five questions asking the parents about the age of their children and number of the children in the family. In addition to which parent is answering the questionnaire, mother or father, and their age as well as their level of education. The other eleven questions were about the oral health of the children including the subjects of teeth brushing, dental caries, bacterial transmission, fluoride, and parents have the option to answer by either I know, sort of know, and finally didn’t know.

The 120 parents were divided into 65 mothers and 55 fathers aged between 22 to 63 years old.

Questions were transferred to excel and coded by letters from A to P, while answers were numbered by 1, 2 or, 3. The 120 questionnaires were numbered from 1 to 120 and all results had been transferred to Excel program. After that, all information on excel were transferred to SPSS 19 program, which gave the demographic results and the P values of the topics that were chosen to compare. P values were used to assess if statistically significant differences are noticed between certain groups. The level of

significance was set at P<0.05.

(17)

RESULTS

Demographic data are presented in Table1. Overall 120 participants filled the questionnaires. A higher number of mothers answered the questionnaires than fathers (54.20% vs. 45.80%), however there was no significant difference between the results. The most prevalent age group of parents was 36-45 years with a percentage of 44.90%, and more than a half of the participants (59.2%) were graduated

university. A number of children distributed almost similarly, in addition, the most prevail age groups was 3 years (29.20%), and the average number of children in one family was 3 to 4 which occupied (58.30%).

Variables Percentage(%) Frequency(N)

Child's age(year) 1 20% 24 2 25% 30 3 29.20% 35 4 25.80% 31 Number of children (1-2) 21.70% 26 (3-4) 58.30% 70 ( 5> ) 20% 24

Person who answered

(18)

Table 1 . Demographic data are described by frequency and percentage

Most of the parents had good knowledge about recommended frequency of tooth brushing (90%) , moreover, that they need to brush teeth for children (82.5%), that broken teeth can caused by caries (60%). 71.7% of participants answered that they "mothers can transmit bacteria to them by sharing spoons or licking pacifiers”.

However, they had poor knowledge of when to start brushing baby’s teeth, 53.3% of parents did not know about recommended beginning of child’s tooth brushing. Surprisingly, only 36.7% of parents knew about using fluoride in the toothpaste. Furthermore, almost a half of parents (47.5%) did not know that primary teeth erupt until 3 year old. In addition, a half of parents (49.2%) did not know about primary dentition influence on space maintaining for permanent teeth. Only a half of parents (48.3%) knew that caries in primary teeth can be that predictor of permanent teeth lesions.

Consequently, more than a half of parents (68.3%) did not know about time of the first checkup. Most of parents (75%) never checked or knew that water at home should contain fluoride in it, and if not they should contact the doctor or dentist to give them extra supply.

45> 11.50% 14

Education

Did not graduate from secondary school 16.70% 20

Graduated from secondary school 24.20% 29

(19)

Table 2. Answers of questions related to parents knowledge expressed by frequency and percentage.

Table 3 relates the knowledge of parent with the level of education they reached. It clearly shows that parents who graduated from university has the highest percentage in “I know” compared to those who did not graduate from secondary school. Regarding the usage of a tooth paste with fluoride at age 2 (47.5% p=0.001) who graduated parents from university knew that information, (40% p=0.02) believed that mother can transmit bacteria to her baby by sharing spoon or licking pacifiers, (39.16% p=0.02)

Questions Did of know % (N) Sort of know % (N) Know % (N) Tooth brushing starts as soon as baby has his first tooth 53.3(64) 2.5(3) 44.2(53) Brushing 2 times each day. With a small, soft brush for 2

minutes

1.7(2) 8.3(10) 90(108)

When your child is about 2 years old, you need to start to use toothpaste with fluoride

36.7(44) 25.8(31) 36.7(44)

There are 20 baby primary teeth in total and they erupt until age 3

47.5(57) 20.8(25) 31.7(38)

While your child is young, you need to brush their teeth 6.7(8) 10.8(13) 82.5(99)

Broken baby teeth can be caused by cavities 21.7(26) 18.3(22) 60(72)

Primary teeth hold space for the permanent teeth to come straight

49.2(59) 17.5(21) 33.3(40)

Mother can transmit bacteria to their babies by sharing spoons or licking pacifiers

16.7(20) 11.7(14) 71.7(86)

The significant predictor of caries lesion in permanent teeth is caries in primary teeth

36.7(44) 15(18) 48.3(58)

Doctors and dentists say take your baby to a dentist for checkup around age 1

68.3(82) 10(12) 21.7(26)

Learn if your home water has fluoride in it. If not , talk to your doctor or dentist about how to get enough to protect your baby's teeth

(20)

knew that broken milky teeth can be caused by cavities, while (34.167% p=0.009) did not know that they should visit the dentist for the first time around age 1.

Table 3. Comparison between levels of parent’s education with their knowledge. Education of parents Didn't graduate from secondary school Graduated from secondary school Graduated from university Total P value

When your child is about 2 years old, you need to start to use toothpaste with fluoride 0.001 Didn't know 5(4.16%) 1(0.83%) 2(1.6%) 8(6.5%) Sort of know 0 1(0.83%) 12(10%) 13(10.83%) Know 15(12.5%) 27(22.5%) 57(47.5%) 99(82%) Total 20(16.67%) 29(24.167%) 71(59.167%) 120(100%)

Mother can transmit bacteria to their babies by sharing spoons or licking pacifiers 0.02 Didn't know 7(5.83%) 2(1.67%) 11(9.167%) 20(16.67%) Sort of know 1(0.83%) 1(0.83%) 12(10%) 14(11.67%) Know 12(10%) 26(21.67%) 48(40%) 86(71.67%) Total 20(16.67%) 29(24.167%) 71(59.1%) 120(100%)

Broken baby teeth can be caused by cavities 0.002

Didn't know 9(7.5%) 9(7.5%) 8(6.67%) 26(21.67%) Sort of know 1(0.83%) 5(4.167%) 16(13.3%) 22(18.3%) Know 10(8.3%) 15(12.5%) 47(39.16%) 72(60%) Total 20(16.6%) 29(24.1%) 71(59.16%) 120(100%)

Doctors and dentists say take your baby to a dentist for checkup around age 1 0.009

(21)

DISSCUSSION

Various studies and articles were done regarding the knowledge and attitude of parents regarding their children’s oral health. First of all, many studies considered that mother has a greater role than father in affecting the oral health of her children. They emphasized that mothers can transmit many of her habits such as frequency sugar intake, and oral hygiene care to her child. Moreover, mothers usually spend more time with their children than fathers do, as a result mothers will have more knowledge and educating her is a priority[32,33]. In contrary to studies done, this study showed that there is no significant difference in knowledge between gender (mother and father). When answers of both

genders were compared no difference was recorded. To give a slight explanation of the result obtained, families in Lebanon and especially in Tripoli are strongly interconnected, mother and father share the same work and care in raising their children.[34]

This study is based mainly on the comparison of level of education parents have reached to with the level of knowledge about their children’s oral health. Each information will be compared to other similar new studies done with our results in respect to level of education.

The most common concept known by most of parents, is brushing the teeth of their children. A study done in Mangalore India sated that 84% of children were brushing their teeth with a tooth paste and assisted by their parents. The result confirms the percentage obtained by this study were 90% of parents knew that brushing teeth is essential for their children. Meanwhile parents with high level of education rather the parents who graduated from university confirmed a better knowledge compared to other groups of parents with lower level education [35].

Transmission of bacteria from mother to child by sharing spoon or licking pacifier is a challenging subject. In 2015, explorative study done in Finland to assess mothers on health knowledge and behaviors such as sharing a spoon with child, kissing on the lips, and the mothers’ tooth brushing,

Sort of know

0 0 12(10%) 12(10%)

Know 2(1.67%) 6(5%) 18(15%) 26(21.67%)

(22)

smoking, age, and level of education. Results Of the mothers indicated that 38 % kissed their child on the lips and 14 % shared a spoon with their child, and 11 % believed that oral bacteria cannot be transmitted from mother to child. The study revealed two diverging dimensions of the mothers’ health behaviors. More emphasis in health education ought to be put to how to avoid bacterial transmission from caregiver to child during feeding. This study that was done in Finland ensures that level of education is an important factor in knowledge and here a confirmation is done by a study to certify our study were 59.1% of university educated parents totally knew that bacteria can be transmit through mothers saliva, and P=0.002 which is highly significant.[36]

Furthermore, one of the questions that was asked to parents from different levels of education was about cavities and its influence. Precisely, one of the cavity effect is tooth breakage. Many effects can be mentioned and confirmed by systematic reviews such as, bad taste, halitosis, canal infection, abscess, etc. these influences will lead to complications and complains from the patient. Patient will face pain, weight loss, tooth loss, and others. To summarize, a small cavity has a big outcome on patients life that will stop him/her from performing normal activities during the day (ex: school).[37] Results of this study presented that 60% of total parents knew that broken baby tooth can be caused by cavities, however parents who graduated from university occupied 39.16% of parents who know were P=0.002 which is highly significant.

(23)

factor that plays a role in higher knowledge. Nevertheless, overall 68.3% didn’t even have a clue on when to take their children to the doctor [38].

Conclusion

Knowledge of parents regarding their children’s oral health vary significantly. Education level is proved to be the most effective factor that influence on oral health knowledge as shown in this study. Parents who graduated from university fortuned the highest percentage of knowledge compared to other lower education levels. Yet health programs and practitioners should always interfere in the society by spreading all important information about oral health.

ACKNOWLEDGEMENT

I would like to thank Doctor Sandra Žemgulytė for her expert advice and engorgement throughout my difficulties that faced me in achieving my thesis, As well as Doctor Rym Naji who provided her clinic as a place to perform the assessment of parents, I respectfully appreciate her support.

Practical recommendation:

Knowledge of parents in many fields regarding their children’s oral health should be improved, those fields include fluoride usage and dosage, time of first visit to the dentist and transmission of bacteria from caregiver to the child. Improvement can be done by advertisements on TV and social media, as well as lectures organized by social guiders and dental practitioners.

CONFLICT OF INTERESTS

(24)

References

1. Castilho AR, Mialhe FL, Barbosa Tde S, Puppin-Rontani RM. Influence of family environment on children’s oral health: a systematic review. J Pediatr (Rio J). 2013;89(2):116−123

2. Marcenes W, Muirhead VE, Murray S, Redshaw P, Bennett U, Wright D. Ethnic disparities in the oral health of three- to four-year-old children in East London. 2013;215(2):E4.

3. Kasmaei P, Amin Shokravi F, Hidarnia A, Hajizadeh E, Atrkar-Roushan Z, Karimzadeh Shirazi K. Brushing behavior among young adolescents: does perceived severity matter. 01414:8 DOI: 10.1186/1471-2458-14-8.

4. Doumit M, Doughan B.La santé bucco-dentaire des écoliers au Liban. Sante. 2002;12(2). 5. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral

diseases and risks to oral health. 2005 Sep; 83(9): 661–669.

6. Bozorgmehr. E, Hajizamani. A, Oral Health Behavior of Parents as a Predictor of Oral Health Status of Their Children. 2013: 741783.

7. Theodore P, Joel H. Use of Fluoride Products for Young Patients at High Risk of Dental Caries. 2014; 35(8).

8. Raghavendra M Shetty, Deoghare A, Rath S, Sarda R, Tamrakar A. Influence of mother's oral health care knowledge on oral health status of their preschool child.2016:

10.4103/1658-6816.174291

9. Pullishery F, Panchmal G, Shenoy R. Parental Attitudes and Tooth Brushing Habits in Preschool Children in Mangalore, Karnataka: A Cross-sectional Study. 2013; 6(3): 156–160.

10. Lyttle C, Stoops F, Welbury R, Wilson N. Tooth eruption and teething in children. The pharmaceutical Journal. 2015 (17).

11. Enaam A, Amal H. Time and sequence of eruption of primary teeth in relation to breastfeeding in sudanese children. doi: 10.14295/bds.2014.v17i3.1025.

(25)

13. Kobayashi TY, Gomide MR, Carrara CF. Timing and sequence of primary tooth eruption in children with cleft lip and palate. J. Appl. Oral Sci. 2010;18(3)

14. Smita P. Patil, Prashant B. Patil, Meena V. Kashetty. Effectiveness of different tooth brushing techniques on the removal of dental plaque in 6–8 year old children of Gulbarga. 2014; 4(2): 113–116.

15. Massignan C, Cardoso M, Porporatti AL, Aydinoz S, Canto Gde L, Mezzomo LA, Bolan M.Signs and Symptoms of Primary Tooth Eruption: A Meta-analysis.Pediatrics. 2016;137(3) 16. Peedikayil FC. Delayed tooth eruption. e-Journal of Dentistry. 2011;1(4).

17. Nunn R ,Murray A, Sandler J. Loss of deciduous teeth – Is timing important to the GDP? 2011; 38: 55–64

18. www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/statement-on-early-childhood-caries.

19. Krzyściak W, Pluskwa KK, Jurczak A, Kościelniak D. The pathogenicity of the Streptococcus genus 2013; 32(11): 1361–1376.

20. Scottish Dental Clinical Effectiveness Programme. JAM:Sdcep 2010 ; 9781905829080.

21. Fung MHT, Wong MCM, CM Lo ECM, Chu CH. Early Childhood Caries: A Literature Review. Oral Hyg Health. doi:10.4172/2332-0702.1000107.

22. Çolak H, Dülgergil T, Dalli M, Early childhood caries update: A review of causes, diagnoses, and treatments. 2013; 4(1): 29–38.

23. Azarpazhooh A, Main PA. Main pit and fissure sealants in the prevention of dental caries in children and adolescents: A Systematic Review. 2008;74(2):171-7.

24. Majumdar S et al. Normal Microbial Flora of Oral Cavity. 2014;2(4):62-66. 25. Amanda Mascarelli. Tooth decay is contagious from parents to children.2011 26. Gomez J. Detection and diagnosis of the early caries lesion. 2015; 15(1): S3.

(26)

28. Wirralct. T. Protocol for Application of Topical Fluoride 2011.

29. Petersson L, The role of fluoride in the preventive management of dentin hypersensitivity and root caries. 2013; 17(1): 63–71

30. Taking care of your child’s smile. JADA 2014; 145(5). 31. ADA Center for evidence- based dentistry JADA:2013;1-118.

32. 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(4):282-7

33. Al-Zahrani AM, Al-Mushayt AS, Otaibi MF, Wyne AH. Knowledge and attitude of Saudi mothers towards their preschool children’s oral health. Pak J Med Sci. 2014; 30(4): 720–724. 34. Antonucci TC, Ajrouch KJ, Abdulrahim S. Social Relations in Lebanon: Convoys Across the

Life Course.Gerontologist. 2015; 55 (5): 825-835.

35. Pullishery F, Shenoy Panchmal G, Shenoy R. Parental Attitudes and Tooth Brushing Habits in Preschool Children in Mangalore, Karnataka: A Cross-sectional Study.Int J Clin Pediatr Dent. 2013; 6(3): 156–160.

36. Virtanen JI, Vehkalahti KI, Vehkalahti MM. Oral health behaviors and bacterial transmission from mother to child: an explorative study.BMC Oral Health. 2015;(3)15:75.

37. Nishi M, Harding M, Kelleher V, Whelton H, Allen F. Knowledge of caries risk factors/ indicators among Japanese and Irish adult patients with different socio-economic profiles: a cross-sectional study. BMC Oral Health. 2017;16;17(1):55.

(27)

EVALUATION FORM OF THE MASTER’S THESIS FOR THE MEMBER OF DEFENCE COMMITTEE

Graduate student ___________________________________________________________________, of the year ______, and the group _____ of the integrated study programme of Odontology

Master’s Thesis title: ………...……….………...………… ………...….………...……...

Remarks of the member of evaluation committee of Master’s Thesis

______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

No. MT evaluation aspects Evaluation

Yes Partially No

1 Has the student’s presentation lasted for more than 10 minutes?

2 Has the student presented the main problem of the Master’s thesis, its aim and tasks?

3 Has the student provided information on research methodology and main research instruments?

4 Has the student presented the received results comprehensively?

5 Have the visual aids been informative and easy to understand?

6 Has the logical sequence of report been observed?

7 Have the conclusions been presented? Are they resulting from the results?

8 Have the practical recommendations been presented?

9 Have the questions of the reviewer and commission’s members been answered correctly and thoroughly?

(28)

Evaluation of the Master’s Thesis

_____________________________________________________________________________

Member of the MT evaluation committee:

________________ ___________________________ _____________________

(scientific degree) (name and surname) (signa

Parent’s knowledge and attitude of children oral health. What is age of your child?

How many children are in your family?

Who is answering the questionnaire: Mother: ... Father ... What is your age?

What is your education’s level? Basic (didn’t graduate secondary school)... Graduated secondary school...

High (graduated college or university)... Didn’t Know Sort of Know Know for Sure Tooth brushing starts as soon as baby has

the first tooth.

Brushing 2 times each day. With a small, soft brush for 2 minutes.

When your child is about 2 years old, you need to start to use toothpaste with

fluoride.

There are 20 baby primary teeth total and they erupts until 3 years old. While your child is young, you need to brush the teeth for your child.

Broken baby teeth can be caused by cavities.

(29)

I am Reem Najem student of dentistry 5th year, this is my final research project, and the aim is to

analyse the parents’ knowledge about the oral status of their children.

FORM OF SUBJECT’S AGREEMENT

I agree to participate in survey performed by Reem Najem (student of Odontology faculty in LUHS MA)

Signature of subject_____________________

Nr._______________ Date____________ Mothers can transmit the bacteria to

their babies by sharing spoons or licking pacifiers.

The significant predictor of caries lesions in permanent teeth is caries in primary teeth.

(30)

Riferimenti

Documenti correlati

Altri dati difficili da reperire sono stati quelli relativi agli assegnisti di ricerca, complessi da disaggregare per genere perché non gestiti a livello centralizzato, ma dai

questionnaire consisted of 11 questions, which were related to the following items toothbrushing procedure and used measures for oral hygiene, frequency of toothbrushing, parent’s

To evaluate the overall perception, knowledge and attitude toward teeth bleaching and aesthetics among the international dental, medical and veterinarian students in

In order to make network configuration and management an automatic task, independent of the specific devices implementing the network, our architecture is composed of three

In this case, the intersection is either a degenerate or non–degenerate Hermitian curve, according as C is tangent or secant to all the other surfaces in the pencil... Thus,

We aimed to investigate whether the duration of prodromal period and initial laboratory values have effect on metabolic control in first two years following diagnosis in patients

The data set is structured in order to analyse the Environmental Impacts Assessment for three alternatives of the above mentioned high-speed railway track in

La maggior parte delle vedove si comporta come Limbania Doria che dopo la morte del marito Giannotto Embriaco ri- torna alla casa paterna, lasciando agli Embriaci il fi glio Oberto,