Oral health behaviours and oral health-related dietary behaviours: The interrelationship and determinants by latent class analysis.

OBJECTIVE: This study aimed to investigate the level of oral health behaviours (OHB) and oral health-related dietary behaviours (OHD-B) and to find out their relationship and their determinants among a relatively large sample of university students. Research design and participants: In a cross-sectional study, 535 Iranian university students were selected in order to investigate their OHB and OHD-B through a self-administrated questionnaire. MAIN OUTCOME MEASURES: Tooth brushing, flossing, use of fluoride toothpaste, and sugary snacking collected data on OHB. Consumption frequency of 16 common cariogenic and non-cariogenic foodstuffs was used for evaluation of OHD-B. Latent class analysis (LCA) and latent class regression (LCR) were applied to identify classes of OHB and OHD-B and their potential determinants, respectively. ANOVA, Chi-square and Spearman's correlation were used. RESULTS: In total, 49.7% and 53.2% of participants had good OHB and OHD-B, respectively. The results of LCR indicated that female gender (OR: 8.22, 95% CI: 3.42-19.72), higher age (OR: 1.39, 95% CI: 1.04-1.85), doctorate level (OR: 6.99, 95% CI: 2.22-21.98), and being single (OR: 3.54, 95% CI: 1.36-9.19) were related to good OHB. Furthermore, LCR analysis showed that students who lived with their families had greater chance for having good OHD-B (OR: 3.01, 95% CI: 2.00-4.53). Students with good OHD-B reported brushing and flossing their teeth more frequently than those with poor OHD-B (P⟨0.05). CONCLUSIONS: The shortage of favourable oral health behaviours among university students highlights the importance of planning oral health programs to improve their oral health, especially their dietary behaviours.

School-based intervention to promote preadolescents' gingival health: a community trial.

OBJECTIVES: Evaluation of the effectiveness of a school-based oral health promotion intervention on preadolescents' gingival health. METHODS: A community trial designed for a 3-month intervention study in a representative sample of 9-year-olds (n = 457) in 16 schools in Tehran, Iran. The schools were randomly assigned to three intervention groups and one control group, each group comprising two boys' and two girls' schools. The first group of children (n = 115) received intervention via class work, solving a set of puzzles containing oral health messages, under supervision of their health counsellor. The second group (n = 114), intervention via parents, included an oral health education leaflet and a brushing diary for supervising the child's tooth-brushing; the third group (n = 111) received a combination of both these interventions. The control group (n = 117) had no intervention. Effects of the intervention were assessed as changes in dental plaque and gingival bleeding. Improvements in gingival health were recorded when half of the index teeth with plaque at baseline became clean (acceptable oral hygiene) or when all index teeth with bleeding at baseline became healthy (healthy gingiva). Statistical analysis included chi square, anova, t-test, Number Needed to Treat (NNT) and generalized estimating equations (GEE). RESULTS: At baseline, none of the children were free of plaque and all except for three boys had bleeding. After the trial, acceptable oral hygiene was more frequent in the parental-aid (P < 0.001) and the combined groups (P < 0.05), and healthy gingiva in both groups (P < 0.001) in comparison with the control group. Outcomes in the class-work group did not differ from those in the control group. The GEE models confirmed a strong intervention effect on healthy gingiva in both groups where parents were involved: parental-aid group (OR = 7.7, 95% CI: 2.2-27.7) and combined group (OR = 6.6, 95% CI: 2.0-22.1). In all intervention groups more girls than boys achieved healthy gingiva (OR = 2.5-2.6). Parents' education showed no impact on the outcome. CONCLUSIONS: When a school-based oral health intervention involves parents it may result in a significant improvement in the gingival health of preadolescents with poor gingival health at baseline.

Influence of mothers' oral health knowledge and attitudes on their children's dental health.

AIM: This was to evaluate the influence of mothers' oral health-related knowledge and attitudes on the tooth-brushing behaviour and dental health of their children and to compare the effect of these maternal aspects on child's oral health. STUDY DESIGN AND METHODS: In 2005, an oral health study conducted among a random sample of 457 mother and child pairs in Tehran, Iran, used self-administered questionnaires to provide data on mothers' oral health-related knowledge and attitudes and children's tooth-brushing behaviour. Clinical data allowed assessment of dental status of the primary and permanent dentition. STATISTICS: Chi-square test and binary logistic regression models were employed. RESULTS: Generally, mothers had extensive knowledge of and positive attitudes towards oral health. Mothers' higher level of oral health knowledge and better attitude scores were associated with children's sound dentition (p<0.05), while only mothers' better attitude was associated with children's twice-daily tooth brushing (p=0.001). The multivariate analyses showed that children of mothers with higher attitude scores were more likely to brush their teeth twice daily (OR = 2.1; 95% CI 1.2 - 3.7) and have sound dentition (OR = 12.4; 95% CI 1.8 - 85.9). The models revealed that mother's knowledge per se had no effect on children's sound dental health, but showed an additive effect with mother's attitudes. CONCLUSIONS: Because twice-daily tooth-brushing behaviour and sound dentition in 9-year-olds were associated with their mothers' positive oral health-related attitudes, in developing oral health promotion programs for children and adolescents, the considerable potential of mothers should be a major focus of oral health professionals.

Oral health behaviour of Iranian mothers and their 9-year-old children.

PURPOSE: The present study examined associations between the oral health behaviour (OHB) of Iranian mothers and the OHB and oral health status of their children. MATERIALS AND METHODS: In 2005, two self-administered questionnaires provided data on the OHB of a random sample of 9-year-old children (n = 459) and their mothers in Tehran, Iran. Brushing frequency, use of fluoridated toothpaste and number of sugary snacks between meals served as oral self-care (OSC) assessment criteria for both. A clinical examination was performed for children at school. DMFT/dmft values, the restoration index (RI) and the unmet treatment needs index (UTN) facilitated an assessment of children's dental status and treatment. Chi-square test, bivariate correlation, and binary logistic regression model were employed in these analyses. RESULTS: Mother's OSC correlated with child's OSC (r = 0.18; p < 0.01). The reported children's brushing frequency correlated with mothers' brushing frequency (r = 0.2; p < 0.01). High maternal OSC levels were associated with lower dental treatment (DT) values in children (p < 0.01). Children's RI was positively and UTN negatively associated with mothers' OSC (p < 0.01). In the model, mothers' OSC (OR = 2.1) and female gender (OR = 2.1) were associated with children's OSC, while mothers' OSC was strongly associated with DT (OR = 11.0) and RI (OR = 34.0) in children. CONCLUSIONS: Higher OSC levels of the surveyed mothers were reflected positively in the oral health status and behaviour of their offspring. The potential of mothers to play a significant role in the oral health of their children should be kept in mind when developing oral health promotion programmes.

Disparities in oral health of children in Tehran, Iran.

AIM: This was to investigate the association between parents' educational level and oral health of Iranian primary school children. METHODS: Data came from the voluntary clinical examination in 2005 of a random sample of 459 third-year primary school children in the 16 schools in Tehran, together with a self-administered questionnaire regarding information on the educational level of the parents. The study used the dmft/DMFT values for dental status, and the CPI, and PI to assess periodontal condition. STATISTICS: One-way ANOVA, Kruskal-Wallis and Mann-Whitney U tests were used. RESULTS: The mean dmft value was 4.2 (SD+2.9) in boys and 3.4 (SD+2.6) in girls for the whole study group. The children of the low education parents had more dental caries than those of high education parents in both primary (p<0.01) and in permanent teeth (p<0.05). A strong association was found between high parental education and restorations in primary teeth (p<0.001), but only a trend for restorations in permanent teeth. Mean number of sextants with a CPI score 0 was significantly associated with parents' educational level (p<0.01). CONCLUSION: The disparities in the oral health of children need to be considered when developing oral health promotion programmes.