Caregiver’s oral health literacy is associated with prevalence of untreated dental caries in preschool children

Montes, Gisele Ristow; Bonotto, Danielle Veiga; Ferreira, Fernanda Morais; Menezes, José Vitor Nogara Borges; Fraiz, Fabian Calixto

doi:10.1590/1413-81232018247.18752017

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FREE THEMES • Ciênc. saúde colet. 24 (7) • July 2019 • https://doi.org/10.1590/1413-81232018247.18752017 copy

Caregiver’s oral health literacy is associated with prevalence of untreated dental caries in preschool children

Alfabetismo em saúde bucal dos cuidadores é associado com a prevalência de cárie não tratada em pré-escolares

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aim of this study was to evaluate the relationship between oral health literacy (OHL) among caregivers and untreated dental caries among preschoolers. A cross-sectional study was conducted involving 415 preschool children and their caregivers from Curitiba, Brazil. The children were examined for dental caries and dental plaque. The caregivers’ OHL was evaluated using an instrument translated and validated for Brazilian Portuguese: the Brazilian Rapid Estimate of Adult Literacy in Dentistry-30. The prevalence of children with untreated caries was 42.9% (95%CI: 38.1-47.7%). A low degree of OHL was found among 15.7% (95%CI: 12.2-19.2) of caregivers. The multivariable Poisson regression analysis indicated a higher prevalence of untreated caries among children whose caregivers had a low OHL (PR = 1.35; 95% CI: 1.01-1.79), those with visible plaque (PR = 1.28; 95% CI: 1.01-1.62) and those who never or only occasionally had their teeth brushed by their caregivers (PR = 1.48; 95% CI: 1.16-1.91) in comparison to those without these conditions. In conclusion, a higher prevalence of untreated dental caries was found among preschool children whose caregivers had a low degree of OHL.

Dental caries; Health literacy; Oral health; Caregivers; Child

Variable		Untreated caries			Univariate analysis*

		Present n(%)	Absent n(%)	Total n(100%)	p-value	Crude PR	95% CI
Child’s sex	Male	82(41.8)	114(58.2)	196	0.681	1
	Female	96(43.8)	123(56.2)	219	0.681	1.05	0.84-1.31
Caregiver’s schooling (years of study)	Up to 8	45(50.6)	44(49.4)	89	0.056	1
	More than 8	124(39.7)	188(60.3)	312		1.27	0.99-1.63
Caregiver’s marital status	Married/in stable union	118(38.8)	186(61.2)	304	0.011	1
	Single/widowed/separated	56(52.3)	51(47.7)	107		1.34	1.07-1.69
BREALD-30	Low	41(63.1)	24(36.9)	65	<0.001	1
	High	137(39.1)	213(60.9)	350	<0.001	1.61	1.28-2.02
Visible plaque	Absent	94(39.0)	147(61.0)	241	0.058	1
Visible plaque	Present	84(48.3)	90(51.7)	174	0.058	1.23	0.99-1.54
Use of toothpaste	Never/rarely	11(55.0)	9(45.0)	20	0.213	1
Use of toothpaste	Always	165(42.3)	225(57.7)	390	0.213	1.30	0.86-1.97
Tooth brushing	Always	141(39.9)	212(60.1)	353	<0.001	1
Tooth brushing	Never/rarely	37(60.7)	24(39.3)	61	<0.001	1.52	1.20-1.93
Child needed to visit dentist and could not afford it	Did not occur	81(40.5)	119(59.5)	200	0.335	1
Child needed to visit dentist and could not afford it	Occurred	91(45.3)	110(54.7)	201	0.335	1.12	0.89-1.40

Variable		BREALD-30				Univariate analysis *

		Low n (%)	High n (%)	Total n (100%)	p-value	Crude PR	95% CI
Untreated caries	Absent	24 (10.1)	213 (89.9)	237	<0.001	1
Untreated caries	Present	41 (23)	137 (77)	178	<0.001	2.27	1.43-3.62
PUFA**	Negative	56 (14.5)	329 (85.5)	385	0.018	1
PUFA**	Positive	9 (30)	21(70)	30	0.018	2.06	1.13-3.75
Visible plaque	Absent	35 (14.5)	206 (85.5)	241	0.452	1
Visible plaque	Present	30 (17.2)	144 (82.8)	174	0.452	1.19	0.76-1.86

Variables		p-value	Adjusted PR	95% CI
BREALD-30	High	0.043	1
BREALD-30	Low	0.043	1.35	1.01-1.79
Visible plaque	Absent	0.043	1
Visible plaque	Present	0.043	1.28	1.01-1.62
Tooth brushing	Always	0.002	1
Tooth brushing	Never/rarely	0.002	1.49	1.16-1.91
Household income (based on BMW*)		0.089	0.92	0.85-1.01
Marital status (stable union)	Yes	0.630	1
Marital status (stable union)	No	0.630	1.07	0.82-1.38
Caregiver’s schooling	> 8 years	0.900	1
Caregiver’s schooling	≤ 8 years	0.900	1.02	0.76-1.36

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[1] Collaborations

All authors have made substantive contribution to this study and/or manuscript. GR Montes, FM Ferreira and FC Fraiz were responsible for conception and design of the study. Gisele Ristow Montes and DV Bonotto participated in the data collection. The data analysis and interpretation was performed by GR Montes, DV Bonotto, JVNB Menezes, FM Ferreira and FC Fraiz. All authors contributed to the conceptual framework of article writing and interpretation of the material, as well as the final version. It has been reviewed and approved by all authors.