for the planning of public oral health policies12. Thus, understanding that dental ..... Feldens EG, Feldens CA, Raupp SMM, Wessler ALM, Graeff. SL, Kramer PF.
Braz J Oral Sci. July-September 2005 - Vol. 4 - Number 14
Oral hygiene practices, parents’ education level and dental caries pattern in 0 to 5 years-old children Suzely Adas Saliba Moimaz1 Ronald Jefferson Martins 2 Franklin Delano Soares Forte 3 Nemre Adas Saliba4 1
PhD Assistant Professor at the Department of Child and Social Dentistry of the Dental School of Araçatuba- Paulista State University 2 Master’s Degree Candidate in Preventive and Social Dentistry at the Dental School of Araçatuba- Paulista State University 3 Doctor’s Degree Candidate in Preventive and Social Dentistry at the Dental School of Araçatuba- Paulista State University 4 Full Professor at the Department of Child and Social Dentistry of the Dental School of Araçatuba- Paulista State University
Received for publication: January 27, 2005 Accepted: March 01, 2005
Abstract Understanding that dental caries has multifactorial aspects, we attempted to verify the influence of food habits, oral hygiene practices, and parents’ education level in the occurrence of this disease in children. One-hundred-thirty children, aged 0 to 60 months, both male and female, were examined in the municipality of Bilac- São Paulo- Brazil. The examination was carried out on the day of National Multivaccination Campaign, using the DMFT index, with the codes and criteria established by WHO. A questionnaire with open and closed questions about children’s food and hygiene habits and parents’/ tutors’ level of education was applied to parents/tutors. The data were processed using Epi-Info 6.04 software, having been considered significant at p 3 years old Total
04 14 07 05 01 31
3.0 10.7 5.3 3.8 0.7 23.8
14 57 22 05 01 99
10.7 43.8 16.9 3.8 0.7 76.1
18 71 29 10 02 130
13.8 54.6 22.3 7.6 1.5 100.0
Frequency of hygienization once twice 3 or more times does not remember /did not do it Total
05 13 09 04 31
3.8 10.0 6.9 3.0 23.8
14 47 25 13 99
10.7 36.1 19.2 10.0 76.1
19 60 34 17 130
14.6 46.1 26.1 13.0 100.0
Person responsible for hygienization Child Parent/Tutor Child and Parent/Tutor Does not know Total
05 12 14 0 31
3.8 9.2 10.7 0 23.8
15 53 22 09 99
11.5 40.7 16.9 6.9 76.1
20 65 36 09 130
15.3 50.0 27.6 6.9 100.0
Hygienization tools Toothbrush Toothbrush and dental floss Soft cotton cloth Does not know Total
29 02 0 0 31
22.3 1.5 0 0 23.8
76 10 03 10 99
58.4 7.6 2.3 7.6 76.1
105 12 03 10 130
80.7 9.2 2.3 7.6 100.0
Use of fluoride toothpaste Yes No Total
29 02 31
22.3 1.5 23.8
85 14 99
65.3 10.7 76.1
114 16 130
87.6 12.3 100.0
p=0.4NS
Table 2 – Pattern of night milk feeding and sugar addition to the contents of night bottles of children with and without dental caries, Bilac – São Paulo - Brazil, 2002 Form and time of feeding
Breast Bottle before bedtime Bottle when going to sleep Bottle during sleep Weaned Total Addition of sugar in the bottle Yes No Total p =0.01 OR= 1.2 CI=0.2 – 2.3
780
With caries
Caries-free
Total
n
%
n
%
01 09 14 03 04 31
0.7 6.9 10.7 2.3 3.0 23.8
04 32 40 10 13 99
3.0 24.6 30.7 53.8 10.0 76.1
n 05 41 54 13 17 130
% 3.8 31.5 41.5 10.0 13.0 100
20 06 26
18.5 5.6 24.1
66 16 82
61.1 14.8 75.9
86 22 108
79.6 20.4 100.0
Braz J Oral Sci. 4(14):778-782
Oral hygiene practices, parents’ education level and dental caries pattern in 0 to 5 years-old children
Table 3 - Education level of fathers and mothers of children with and without dental caries, Bilac – São Paulo - Brazil, 2002 Variable
Fathers Mothers Total
Education level
< > < >
8 8 8 8
years years years years
With caries
Caries-free
Total
Statistics
n
%
n
%
n
%
16 15 15 16 31
12.3 11.5 11.5 12.3 23.8
44 55 48 51 99
33.8 42.3 36.9 39.2
60 70 63 67 130
46.1 53.8 48.4 51.5 100.0
toothpaste, once the water supply of city in which the research was carried out is not fluoridated. Children’s teeth are brushed mostly twice a day (46.1%), which leads to a disorganization of the dental biofilm. Cow milk presents lower cariogenicity when compared to human milk14. The addition of sugar to the contents of bottles given to non-breast-fed babies was verified. Milk added with sugar has been evidenced to present a higher cariogenic potential and the prevalence of caries is higher in children fed at night, when going to sleep or already asleep10,15-17. In this study, most children were artificially fed at night. Similar reports were made by several authors18-20. Feldens et al.21 when studying the oral hygiene patterns and toothpaste use by the children population of Porto Alegre, observed that 100% of the children used the toothbrush before the first year of life, a result higher than the one found in this research (54.6%). Parents are responsible for the oral hygiene of their children and dental surgeons are responsible for the adequate orientation of parents, stimulating the practice as daily routine 22 . Newbrun 23 recommended active participation of parents in the daily toothbrushing, due to the children’s lack of motor skills to perform the adequate movements to brush their teeth appropriately. In this study, it was verified that in most cases the parents were responsible for toothbrushing (50%), followed by the parents in conjunction with the child (27.6%), in accordance with the findings of Feldens et al.21. There is currently a greater concern about fluoride sources and its exposition to young children, as it may be a factor causing dental fluorosis24. It was observed in this study that the great majority of children used fluoride toothpaste more than twice a day. Orientation is needed regarding the correct use of fluoride toothpaste, as for example, the technique of disposing the toothpaste transversely on the toothbrush23,25. There was no statistically significant correlation between the education level of parents and the presence of dental caries. In the study of Fraiz and Walter5 a correlation was verified regarding the fathers’ education level. However, that was not observed concerning the mothers. Maas et al. 11 emphasized that social class and parents’ level of education do not interfere with the children’s oral hygiene. Early attention is needed to provide parents with information about oral health, even during pregnancy, especially because
76.1
p = 0.4 NS p = 1.00 NS
the expectant mother is more susceptible to acquire healthy habits that will consequently be passed on to the child26. Studies verified a reduction in the dental caries index and risk reversion when attention to this is given early27-28. The results of this study are important for the Municipal Health Department to plan oral health policies and to carry out further assessments. Acknowledgements The authors thank the dental surgeons Claudia Letícia Vendrame dos Santos and Antônio Carlos Pacheco Filho (Nino), the employee of the Department of Child and Social Dentistry of FOA- UNESP Nilton César Sousa, Mrs Edivete Aparecida Silva Martins, the parents and children that took part in the survey and also Municipal Health Department. References 1.
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