Children's oral health-related behaviors: individual stability and stage transitions.

UNLABELLED: In 2001-2005 in Pori, Finland, a program of oral health promotion (OHP) was targeted to schoolchildren and people involved in their life to provide social support for participants of the experimental group of a randomized clinical trial (RCT) on controlling caries. OBJECTIVES: Our aim was to describe the individual stability and stage transitions for behaviors among children exposed to OHP in Pori and to ascertain whether these phenomena differed in the group that was also exposed to the experimental regimen of the RCT. METHODS: The study population consisted of all 5th and 6th graders who started the 2001-2002 school year in Pori (n = 1691); 1362 of them were monitored throughout the 3.4-year study. Of these children, 1138 were exposed to OHP and 224 to OHP and the experimental regimen of the RCT. Data on toothbrushing and use of xylitol products, candies, and soft- and sports drinks were gathered with questionnaires. Behavior variables were dichotomized into good and poor. The stability of behaviors and stage transitions was evaluated. RESULTS: Over half of the children had stable behaviors throughout the study. For those children whose behaviors changed, the behavior was more likely to improve than to worsen. For most behaviors, good behavior at baseline was associated with the ability to maintain the achieved good behavior and to recover from lapses to poor behaviors. CONCLUSION: In childhood, behaviors, especially good ones, are rather stable. If healthy behaviors are learned young, lapses into poor behaviors, for instance during the teens, are likely be temporary rather than permanent.

Changes in children's oral health-related behavior, knowledge and attitudes during a 3.4-yr randomized clinical trial and oral health-promotion program.

The aim of our study was to compare the changes in children's oral health-related behavior, knowledge, and attitudes obtained using an oral health-promotion approach, a risk-strategy and promotion approach, and reference area, and to report changes in the behavior of children between the experimental and the control groups of a randomized clinical trial (RCT). The study population consisted of all fifth and sixth graders who started the 2001-2002 school year in Pori, Finland (n = 1,691), where the RCT and program of oral health promotion were implemented for 3.4 yr. Children with at least one active caries lesion were randomly assigned to experimental (n = 250) and control (n = 247) groups. Children in Rauma (n = 807) acted as the reference. Changes in children's self-reported behavior, knowledge, and attitudes were compared between groups. The subjects in the oral health-promotion group and in the risk-strategy and promotion group in Pori tended to show greater improvement in most of their oral health-related behaviors than those in the reference group, and children in the RCT experimental group showed greater improvement in most of their oral health-related behaviors than those in the RCT control group. Children can be helped to improve their oral health-related behavior by intervention, including oral hygiene and dietary counseling, or by implementing a multilevel-approach oral health-promotion program.

Oral health-related behaviors predictive of failures in caries control among 11-12-yr-old Finnish schoolchildren.

The aim of this study was to determine whether the baseline oral health-related behaviors of the participants of the intervention group of a randomized clinical trial conducted in Pori, Finland, were predictive of failures in controlling caries. Three definitions of failure were considered, namely if the children developed one or more, three or more, or five or more new caries lesions, as evidenced by the change in number of decayed, missing or filled surfaces (Delta DMFS) during the follow-up period of 3.4 yr. Children (n = 497) aged 11-12 yr, with at least one active initial caries lesion at baseline, were studied. The data were based on clinical examinations in 2001 and 2005 and on a questionnaire on oral health-related behaviors that was administered in 2001. Associations between baseline behaviors and the measures of failure in caries control were evaluated using logistic regression analyses. Self-reported tooth brushing with fluoride toothpaste at least twice a day reduced the risk of failure. Children who, at baseline, reported eating candy at least once a day were more likely to experience failure at the levels of three or more and five or more new lesions.

Gender differences in child-related and parent-related determinants of oral health-related lifestyle among 11- to 12-year-old Finnish schoolchildren.

OBJECTIVE: The aim of this study was to ascertain whether child-related and parent-related characteristics were associated differently with oral health-related lifestyle among boys and girls. MATERIAL AND METHODS: The study population consisted of 5th and 6th graders and their parents in Pori, Finland. There were 1691 children ranging in age between 11 and 12 years. The data were gathered by questionnaires. For the analyses, we grouped children and parents within three lifestyle groups: favorable, moderate and poor. Differences in child-related and/or parent-related characteristics between boys and girls were analyzed with logistic regression analyses; those with a favorable lifestyle comprised the healthy lifestyle group, and those with a moderate or poor lifestyle the unhealthy lifestyle group. RESULTS: Oral health-related lifestyle was healthy more often among girls than among boys. In both genders, those who considered toothbrushing important for pleasing authorities more often had a healthy lifestyle. Girls who considered toothbrushing important for health and appearance were more likely to have a healthy lifestyle than those who did not. The effect of parents' oral health-related lifestyle was slightly stronger among boys than among girls. Among girls, however, high occupational level of father was indicative of healthy lifestyle. CONCLUSIONS: Among girls and boys, there are similarities and differences in factors related to oral health-related lifestyle. The parents' model is important for both, but the effect is stronger among boys than among girls. Among girls, attitudes on health and appearance are positively associated with a health-related lifestyle.

Oral health-related knowledge, attitudes, behavior, and family characteristics among Finnish schoolchildren with and without active initial caries lesions.

OBJECTIVE: The aim of this study was to determine whether the presence of active initial caries lesions among 11 to 12-year-old schoolchildren is associated with parental and child-related factors and whether there are gender differences in these associations. MATERIAL AND METHODS: The data were gathered by questionnaires from children and their parents, who replied without knowing the other's answers. All the children were invited to participate in a screening for the presence or absence of active initial caries lesions. Factors associated with children's initial caries were studied with logistic regression analyses. RESULTS: The parents' self-assessed poor dental health, the parents' and the child's poor oral health-related behavior, and the child's response "I don't know" to the question concerning his/her parents' possible dental caries were associated with the presence of active initial caries lesions. The results of logistic regression analyses were different between girls and boys. Among the girls, many parent-related factors were associated with the presence of initial caries. Among the boys, most factors were related to the child; and of the parent-related factors, only parents' poor self-assessed dental health was associated with initial caries; the effect was modified by the father's occupational level. CONCLUSIONS: Parental factors affect boys' and girls' dental health differently. Among boys, the effect of the fathers was seen as the father's occupational level; among girls, parental knowledge and behavior were important. When school interventions to promote health are planned, the important role of the parents should be emphasized.

Parental influence on children's oral health-related behavior.

OBJECTIVE: The aim of this study was to determine whether there are differences between oral health-related knowledge, attitudes, beliefs and behaviors of children and their parents, and to identify the family-related factors associated with children's poor or good oral health-related behavior. MATERIAL AND METHODS: The data were gathered by means of questionnaires from 11-12-year-old schoolchildren and their parents who replied without having knowledge of the answers of the others. Differences between subgroups of children were analyzed by cross-tabulation, and the factors related to children's good or poor oral health-related behavior by logistic regression analyses. RESULTS: Parents of children who reported good oral health-related behavior had better knowledge and more favorable behaviors than those of other parents. Predictors for a child's poor oral health-related behavior were the child's poor knowledge, male gender, the parent's frequent consumption of sweets, and the parent's infrequent use of xylitol gum. When a less strict threshold for the child's poor oral health-related behavior was used, more predictors entered the model: the parent's unfavorable use of fluoride toothpaste; among girls, the parent's lack of knowledge; and among children whose mother's occupation level was high, the parent's infrequent use of xylitol gum. The parents of children whose oral health behavior was favorable were more likely to have a high level occupation and favorable oral health-related behaviors. CONCLUSIONS: Oral health-related knowledge of children and their parents seems to be associated with children's oral health-related behavior. Parents' behaviors, but not attitudes, were associated with children's oral health behavior.

Oral health-related knowledge, attitudes, and beliefs among 11 to 12-year-old Finnish schoolchildren with different oral health behaviors.

The aim of this study was to explore oral health-related knowledge, attitudes, and beliefs among 11 to 12-year-old schoolchildren with favorable, moderate, or poor behavior related to oral health. The data were gathered by questionnaire. Recommendations commonly used in Finland in oral health education were chosen as the criteria for selection of groups of children with favorable, moderate, and poor oral health behavior. Differences between groups were analyzed using crosstabulations and factors related to unfavorable behavior using logistic regression analysis. The percentage of children with appropriate knowledge was higher in the good behavior group (GB) than in the other groups. The groups differed most in the children's knowledge of the recommendation to use fluoride toothpaste at least twice a day. Most children in the GB group considered it important to brush their teeth for the fresh feeling this gave. The majority of children in all groups considered it important to brush their teeth when going to the dentist. The majority also considered brushing important for avoiding tooth decay and tooth discoloration as well as for having fresh breath. Unfavorable knowledge, attitudes, beliefs, and behavior tended to accumulate in the same children. Factors associated with unfavorable behavior were male sex, mother's low skill occupation level, and child's poor knowledge of oral health-related facts.