Oral Health Knowledge, Attitudes and Behaviour of Parents and Caregivers of Preschool Children: Implications for Oral Health Promotion.

PURPOSE: The aim of this study was to describe oral health knowledge, attitudes and behaviours of parents and caregivers of preschool children in order to inform an oral health promotion strategy. MATERIALS AND METHODS: A sample of parents and caregivers of children attending nine randomly selected preschools in central Trinidad were invited to complete a self-administered questionnaire on early childhood oral health. RESULTS: A total of 309 parents and caregivers participated: 88% were female, 74.4% were of Indian ethnicity, with 50.4% in manual employment, and 50.2% educated to secondary level. 59.1% felt a child's first dental visit should be when all primary teeth are present. 64% had not taken their child for a dental visit. 81.6% rated their child's oral health as good or better and 28% would want an asymptomatic, decayed primary tooth extracted rather than filled. Over 80% used fluoride toothpaste. 52.8% always supervised their child's toothbrushing, and 44% claimed to be using the recommended pea-size amount. 26.2% reported having used a sweetened feeding bottle or infant feeder at night. CONCLUSION: Parents and caregivers of preschool children in this sample had reasonable oral health knowledge. However, despite generally positive attitudes towards preventive oral healthcare, confusion regarding dental attendance, supervised toothbrushing, fluoride use and sugar intake suggests that these items require particular emphasis in oral health promotion programmes aimed at improving early childhood oral health.

Prevalence of Enamel Developmental Defects and Relationship with Early Childhood Caries in Trinidad.

PURPOSE: The purpose of this study was to describe the prevalence of developmental defects of enamel (DDE) and their relationship with early childhood caries (ECC) among preschool children in Trinidad. METHODS: A cross-sectional oral health survey of 251 three- to five-year-old preschool children was undertaken in central Trinidad. The decayed, missing, and filled primary teeth (dmft) index and the DDE index were used to measure visible caries experience and enamel developmental defects, respectively. RESULTS: Sixty-three children (25.1 percent) had some type of DDE. The most common defects were diffuse opacities and demarcated opacities. A greater severity of visible caries experience was associated with enamel opacities and hypoplasia (P<0.05). CONCLUSIONS: DDEs are prevalent among this group of preschool children in Trinidad and are risk factors for ECC, which emphasizes the importance of preventive oral health care in early childhood for these high-risk children.

Perceived competency at graduation among dental alumni of the University of the West Indies.

The aims of this study were to describe levels of self-rated competency of dental graduates from the University of the West Indies (UWI) and to investigate relationships with gender and the effect of curriculum change. A thirty-two item self-reported postal questionnaire was sent to UWI dental alumni (1994-2002). The questionnaire included twenty-eight competencies that could be rated on a 5-point scale: 1 (not at all competent) to 5 (very competent). Overall preparedness for practice could also be rated from 1 (not at all prepared) to 5 (very prepared). The response rate was 77.4 percent, with a mean age of 29.3 years. Items with the highest mean scores were taking an adequate medical history (4.49), recognizing and treating dental caries (4.46), oral examination (4.36), and giving dental health education (4.35). Those with the lowest rating were designing and undertaking clinical research (2.29), dealing with practice management issues (2.52), designing and delivering crown and bridge work (3.33), and recognizing pathologic occlusions (3.33). Overall preparedness for practice was rated as 3.27. Female graduates rated four competencies significantly higher than males. Graduates exposed to the new curriculum perceived greater overall preparedness for general dental practice, suggesting the change to a competency-based curriculum was effective.

Sources of stress and psychological disturbance among dental students in the West Indies.

The aim of this study was to investigate sources of stress and psychological disturbance in dental students across the five years of undergraduate study at a dental school in Trinidad. Eighty-three percent of students completed a modified version of the Dental Environment Stress questionnaire (DES) and the Brief Symptom Inventory (BSI). On a scale ranging from 0 (not stressful) to 5 (highly stressful), overall mean DES scores for each of the five years of study were 1.58, 1.83, 2.65, 2.39, and 2.61 respectively, suggesting that levels of stress increase over the five years with a noticeable spike at the transition between the preclinical and clinical phases. Significant differences were found between specific stressors across the five years of study. Seven specific stressors and the stressor domains of Academic work and Clinical factors were more stressful for female students (t-test p < 0.05). The Global Severity Index of the BSI indicated that 54.8 percent of males and 44.2 percent of females were in the clinical range indicating significant psychological disturbance. Psychological disturbance was significantly associated with stress levels for male students (Spearmans rank correlation r = 0.56; p < 0.001), but not generally for female students. Further development is needed of dental educational programs that enhance students' psychosocial well-being.