Knowledge, attitudes and behaviour towards preventive oral care in early childhood among paediatricians in Trinidad and Tobago: findings of a national survey.

OBJECTIVE: To determine paediatrician's knowledge and attitudes about oral health in Trinidad and Tobago. DESIGN AND METHOD: A pre-tested questionnaire was sent out via survey monkey to 70 out of 75 paediatricians registered with the Medical Board of Trinidad and for whom email addresses were available. Hard copies of the questionnaires were delivered to the paediatric departments of the Eric Williams Medical Sciences complex. Paediatricians that were unable to complete the questionnaire online were asked to complete hard copies. RESULTS: Forty-nine paediatricians responded, yielding a response rate of 70%. Most (95.9%) of the participants had positive views about routine dental visits, but yet only 28.6% advised a first dental visit between the ages 6 months and 1 year. Although the majority (91.8%) had positive views on fluoride supplementation, knowledge of appropriate fluoride dosages was not in keeping with current guidelines. Mixed views on the role of breastfeeding as a risk factor for developing decay were seen among respondents; 63.3% of the paediatricians indicated that they did not receive any education on the oral health of young children during their specialty training, and most felt they required additional training in this area. CONCLUSIONS: Paediatricians in Trinidad and Tobago demonstrated positive attitudes toward oral health. However, their knowledge with respect to oral disease prevention including the use of fluoride, and timing of the first dental visit appear to be lacking. Paediatricians may benefit from continuing education with regards to the oral health of children.

Oral health among children attending an oncology clinic in Trinidad.

Objectives: Little is known about the oral health of paediatric oncology patients in the Caribbean. Poor oral health can complicate oncology treatment, negatively affecting a child's health. In children undergoing chemotherapy or bone marrow transplant, odontogenic infections can progress to life-threatening sepsis. The aim of this study is to investigate the oral health among children attending an oncology clinic in Trinidad. Material and Methods: Sample population included paediatric oncology patients attending a children's hospital in Trinidad. Subsequent to obtaining informed consent, a 14-item questionnaire was administered to parents/caregivers. An intra-oral examination was undertaken by two dentists to assess soft tissues, gingival health, and dentition status, using visual examination only. Results: Seventy-one children and their caregivers participated in the study. The children consisted of both patients warded or attending as outpatients; 53.5% of patients were male and the mean age 6.64 (SD 3.33) years with a range of 1 to 15 years. Gingivitis and mucositis were present among 41.3% and 3% of patients, respectively. The prevalence of visible dental caries was 54.3%. Caries experience (dmft) was 2.28 (SD 3.63), and for those children with some caries experience (dmft > 0), this was 5.59 (SD 3.72). The majority (62.5%) had never visited a dentist. The most common dental treatment needs were dental prophylaxis (98.4%) and restorative treatment (50.8%). Acute lymphocytic leukaemia (39.1%) was the most common malignancy among this sample, and patients were at varying stages of cancer treatment. Conclusions: Oral health among this sample of paediatric oncology patients was generally poor, with untreated caries being common, and the majority of children not having had any previous dental care. Preventive dental care for these patients should include oral hygiene instruction, dietary advice, topical fluoride application along with management of carious lesions, and odontogenic infections. This preliminary study highlights the need for closer collaboration between general dental practitioners, paediatric dentists, and paediatric oncology physicians, in caring for these patients.