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ORIGINAL ARTICLE
Year : 2014  |  Volume : 12  |  Issue : 4  |  Page : 323-329

Impact of mothers' oral hygiene knowledge and practice on oral hygiene status of their 12-year-old children: A cross-sectional study


1 Department of Public Health Dentistry, Faculty of Dental Sciences, SGT University, Gurgaon, Haryana, India
2 Department of Conservative and Endodontics, Faculty of Dental Sciences, SGT University, Gurgaon, Haryana, India
3 Department of Public Health Dentistry, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India

Date of Web Publication24-Dec-2014

Correspondence Address:
Sachin Chand
Department of Public Health Dentistry, Faculty of Dental Sciences, SGT University, Near Sultanpur Lake, Village Budhera, Gurgaon, Haryana 123 505
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-5932.147681

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  Abstract 

Introduction: Ignorance regarding oral diseases and oral health can be a major cause for a high prevalence of oral diseases. Parents' attitudes have a significant positive influence on the children's oral hygiene and oral health. Objectives: To assess the mothers' oral hygiene knowledge and practice and its impact on oral hygiene status of their 12-year-old children. Materials and Methods: A total of 900 children, 12 years old and their mothers were selected by random sampling from 10 administrative wards of Mathura city. The general information and data regarding mothers' oral hygiene knowledge and practice were obtained by personal interview using a pretested questionnaire. Clinical examination of the subjects was done using oral hygiene index-simplified (OHI-S) for both children and mothers. The data obtained were analyzed using SPSS (Statistical Package for the Social Sciences), version 11.5 for windows. One-way ANOVA and independent t-test were used to find out the impact of mothers' oral hygiene knowledge and practice on oral hygiene status of their 12-year-old children. Results: Mothers' oral hygiene knowledge was found to have a significant impact on oral hygiene status of their 12-year-old children. There was a significant difference in mean OHI-S score of children with mothers who had poor oral hygiene knowledge (1.1650), fair oral hygiene knowledge (0.8947) and good oral hygiene knowledge (0.6431). Mothers' oral hygiene practices also had a significant impact on the oral hygiene status of their 12-year-old children. Conclusion: Mothers' oral hygiene knowledge and practice had an impact on oral hygiene status of their 12-year-old children in Mathura city.

Keywords: Children, knowledge, mother, oral hygiene, practice


How to cite this article:
Chand S, Chand S, Dhanker K, Chaudhary A. Impact of mothers' oral hygiene knowledge and practice on oral hygiene status of their 12-year-old children: A cross-sectional study. J Indian Assoc Public Health Dent 2014;12:323-9

How to cite this URL:
Chand S, Chand S, Dhanker K, Chaudhary A. Impact of mothers' oral hygiene knowledge and practice on oral hygiene status of their 12-year-old children: A cross-sectional study. J Indian Assoc Public Health Dent [serial online] 2014 [cited 2019 Jun 25];12:323-9. Available from: http://www.jiaphd.org/text.asp?2014/12/4/323/147681


  Introduction Top


Ignorance regarding oral diseases and oral health can be a major cause for a high prevalence of oral diseases. It is well-documented that the right information, knowledge and practice regarding oral health and disease may serve as an instrument to lead the population with appropriate technology making them to adopt healthy practices protecting their own oral health. [1] Good oral hygiene has been advocated for promoting oral health and preventing oral diseases like periodontal disorders and dental caries justifying the slogan that "A clean tooth never decays."

Poor oral hygiene practices are an important factor among the causes of periodontal disorders. Moreover the failure of removing plaque and debris that is, not maintaining good oral hygiene has been one of the major etiological factors for the initiation of dental caries. Hence, the importance of oral hygiene against diseases like periodontal disorders and dental caries is quite evident.

Practice leads to habits, the habits lead to change in behavior. Young children learn fast by observing the adults, listening to people they love and admire, and follow the action of loved ones such as parents, teachers, and their peer groups. It is said learning begins at home and mothers as the first and best teacher. [2] The children imitate the happening in the surrounding and adapt to the situation more quickly. They learn by observing the facts. Adult's attitude and their action are keenly observed by children, which holds true for oral health attitude and practices as well. The parents are instrumental in shaping children's character and oral health behavioral practices. [2]

Parents play a central role in giving children the information and encouragement needed for healthy lifestyles. Parents' attitudes have a significant positive influence on the children's oral hygiene and oral health. Within the family, the role of mother has been emphasized in relation to a child's oral health habits and status Despite changing roles and areas of responsibility within the family in the child's oral health-related lifestyle, the mother still seems to play the key role. [3]

More than any other social factors and contexts, mothers are considered to be very important mediators in their children's health behavior. [2] It is important that the knowledge, attitude and behavior of parents especially mothers regarding oral health practices including oral hygiene practices should be adequate so that they can disseminate such information and practices to their children. As health professionals, we should know the amount of correct information and the attitude and practices of parents and children so that we can modify their knowledge, attitude, and practices. Since such knowledge, attitude and practice differ from place to place depending upon socioeconomic and education conditions. For that reason, such type of studies is influenced by above mention facts. [2]

All the studies, which have been conducted so far are trying to correlate knowledge, attitude and practice with oral health in general including the oral hygiene status. Although they had taken a broader outlook on oral health-related behavior and practice, the importance of oral hygiene is embedded within it. Since the knowledge and practice of oral hygiene in particular is a paramount requirement for any oral health related behavior and practice, the importance of oral hygiene singularly should have been taken to throw more light as a first step relating the oral health knowledge, attitude and practice with oral hygiene status. Very few studies have been conducted correlating parents' especially mothers' oral hygiene knowledge and practice and its influence on oral hygiene status of their children especially in India.

Hence, keeping all these points in view a study was undertaken to assess the mothers' oral hygiene knowledge and practice and its impact on oral hygiene status of their 12-year-old children in Mathura city.

Aim of the study

To assess the mothers' oral hygiene knowledge and practice and its impact on the oral hygiene status of their 12-year-old children.

Objectives of the study

· To assess the oral hygiene knowledge and practice of mothers

· To assess the oral hygiene status of mothers and their 12-year-old children

· To correlate the oral hygiene knowledge of mothers with oral hygiene status of their 12-year-old children

· To correlate the oral hygiene practice of mothers with oral hygiene status of their 12-year-old children.


  Materials and methods Top


Mathura city is administratively divided into 5 zones with a total of 45 wards, each with a ward Councilor and an estimated population of 5000 inhabitants.

Sampling procedure

Prior to the present study, a pilot study was conducted in one of the randomly selected wards of Mathura with following objectives:

  • Estimation of prevalence of oral hygiene in 12-year-old children in Mathura based on which the sample size was determined for the present study
  • To standardize the examination procedures
  • To test and finalize the Proforma for data collection (validation of the questionnaire).
A sample size of 900 was calculated for the main study on the basis of the prevalence estimated by pilot study. The data of the pilot study were included in the main study. The 900 subjects, aged 12 years were selected from 10 administrative wards of Mathura city (2 wards were randomly selected from each zone, each ward had app. 100-150 inhabitants) by house to house study on the basis of following inclusion and exclusion criterion.

Inclusion criteria

  • Subjects who were willing to participate in the study
  • Subjects who completed 12 years of age
  • Subjects who were continuously residing in Mathura city right from birth.


Exclusion criteria

  • Subjects who were suffering from any acute or chronic diseases and were under medication
  • Subjects without parental consent
  • Children without mothers.


Ethical clearance

  • Before scheduling the present survey, the required ethical clearance was obtained from Institution Ethical Committee.
Informed consent

  • Before the data collection and clinical examination, the purpose and the methodology of the survey was explained to each of the subject, and informed consent was obtained.


The entire survey period spanned over the period of 3 months. The single trained examiner carried out all the examinations in the survey. The diagnostic variability in two assessments was found to be small, and agreement was found to be in the range of kappa coefficient of 85-90%. Type III examination was done.

Oral hygiene assessment

Recording of data

A pretested Proforma was used to assess mother's oral hygiene knowledge and practice and its impact on oral hygiene status of their 12-year-old children in Mathura city. The following data were recorded:

  • General information
  • Clinical examination
  • Questionnaire.


General information

name, age, sex, mother's name, occupation, education and income if employed, father's name, occupation, education, income, no. of children and address with telephone number.

Clinical examination

clinical examinations were carried out to record the oral hygiene status (which included debris and calculus) of children and their mothers. The index used to find the oral hygiene status of children and mothers was oral hygiene index-simplified (OHI-S). [4]

Questionnaire

A questionnaire was prepared to assess the oral hygiene knowledge and practice of mothers. Questionnaire consisted of 18 closed-ended questions. First 6 questions were related to oral hygiene knowledge and remaining 12 questions (Q7-Q18) were used to assess the oral hygiene practices of mothers. Knowledge was measured by giving scores to their answers. Scoring was done on the basis of Good, Fair and Poor scores.

  • Poor knowledge - score between 0 and 5
  • Fair knowledge - score between 6 and 10
  • Good knowledge - score > 10.


Statistical analysis

The data obtained were analyzed using SPSS (Statistical Package for the Social Sciences SPSS Inc., Chicago, IL) version 11.5 for windows. Mean and standard deviation (SD) was calculated for each clinical parameter. One-way ANOVA test was used for evaluation of the association between mothers' oral hygiene knowledge, practices and oral hygiene status of their children. Independent t-test was used to find the impact of mothers' oral hygiene practices on oral hygiene status of their children. Significance for all statistical tests was predetermined at a P ≤ 0.05.


  Results Top


An epidemiological study was conducted to assess the mothers' oral hygiene knowledge and practice and its impact on oral hygiene status of their 12-year-old children in Mathura city. There was a total of 900 study subjects aged 12 years out of which 519 (57.7%) were the males and 381 (42.3%) were the females.

Mothers with good oral hygiene status were around 325, and 657 children were found to have good oral hygiene [Table 1]. Out of 900 subjects, 85% mothers were found to have a fair knowledge about oral hygiene [Table 2].
Table 1: Oral hygiene status of mothers and children


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Table 2: Distribution of mothers according to their oral hygiene knowledge score


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[Table 3] depicts the distribution of mothers according to their oral hygiene practices. Mothers in the habit of eating pan and betel nut were found to be 29%, and 83% of the mothers have never got their teeth cleaned from a dentist.
Table 3: Distribution of mothers according to their oral hygiene practices


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[Table 4] Out of 900, only 28% mothers supervise their children's oral hygiene practices.

[Table 5] shows the correlation between mother's oral hygiene knowledge and oral hygiene status of their children. One-way ANOVA was applied to determine the correlation between mothers' oral hygiene knowledge and oral hygiene status of their 12-year-old children. It was found that mothers' oral hygiene knowledge had a significant correlation with oral hygiene status of their children (P = 0.00). On further analysis by post-hoc Tukey test, it was found that there was a statistically significant difference in mean OHI-S score (1.1650) of children whose mothers had poor oral hygiene knowledge when compared with mean OHI-S score (0.8947) of children whose mothers had fair oral hygiene knowledge and mean OHI-S score (0.6431) of children whose mothers had good oral hygiene knowledge (P = 0.00,). Similarly, a statistically significant difference was found in mean OHI-S score of children whose mothers had fair oral hygiene knowledge and mean OHI-S score of children whose mothers had good oral hygiene knowledge.
Table 4: Distribution of mother's according to the oral hygiene practices they teach to their children


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Table 5: Children's oral hygiene status in relation to mother's oral hygiene knowledge


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[Table 6] shows the correlation between mothers' oral hygiene practices and oral hygiene status of their children. Significant difference was found between mothers supervising their child oral hygiene to mothers not supervising, mothers having adverse oral habits

[Table 7] Out of 900 subjects, 708 mothers were using brush and toothpaste and only 10 mothers were using indigenous aids.
Table 6: Children's oral hygiene status in relation to
mother's oral hygiene practice of their children


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Table 7: Children's oral hygiene status in relation to mother's oral hygiene practice


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[Table 8] Significant difference was found between mean OHI-S score of children whose mothers are rinsing after every meal to those who are not rinsing.
Table 8: Children's oral hygiene status in relation to mother's oral hygiene practice of rinsing after every meal and oral hygiene status of their children


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  Discussion Top


Childhood, particularly the preschool years, is a critical time to learn oral hygiene skills. If oral hygiene skills are acquired and maintained in early childhood, these skills can become established oral habits and are less liable to change. [2] Mothers play a key role in the development of the oral hygiene habits of their children, and it is essential that parents have knowledge on oral hygiene practice. [2]

Results of the present study showed that 80 (8.9%) mothers had poor oral hygiene knowledge whereas 768 (85.3%) had fair oral hygiene knowledge and remaining 52 (5.8%) had good knowledge regarding oral hygiene. This variation might be due to the level of education and socioeconomic status of the mothers.

Among 900 mothers, 109 (12.1%) mothers assisted or supervise in cleaning their children' teeth whereas 791 (87.9%) mothers neither assisted nor supervise in cleaning of their children' teeth. When the oral hygiene maintenance practice among the mothers were assessed, it was found that 708 (78.7%) mothers used toothbrush and toothpaste for cleaning their teeth, 99 (11%) mothers used toothbrush and powder, 83 (9.2%) mothers used finger and powder for cleaning of their teeth whereas 10 (1.1%) mothers' used indigenous aids for cleaning of their teeth. In the present study, 739 (82.1%) mothers used to clean their teeth once a day, 158 (17.6%) mothers twice a day whereas 3 (0.3%) mothers used to clean their teeth more than twice a day. The study conducted by Elena and Petr [5] showed that 57% of the mothers brushed their teeth at least twice a day whereas our study shows only 17.6% of mothers clean their teeth twice a day.

Most of the mothers were having fair to good level oral hygiene knowledge as found in the study whereas mothers, and their children were found to have fair oral hygiene and good oral hygiene respectively. Children, whose mothers had poor oral hygiene knowledge, had mean OHI-S score of 1.16 whereas children whose mothers had fair and good oral hygiene knowledge had mean OHI-S score of 0.89 and 0.64, respectively, and this difference was found to be statistically significant. Children, whose mothers had fair to good oral hygiene knowledge, had good oral hygiene in comparison to those children whose mothers had poor oral hygiene knowledge.

More than any other social factor, mothers influence the health behaviors of their children. It is important that the knowledge of parents especially mothers regarding oral health practices including oral hygiene practices should be adequate so that they can disseminate such information and practices to their children. In the present study, 79.1% of mothers were found to have education level of higher and so might have a higher level of oral hygiene knowledge. Also, most of the mothers were unemployed and so, they could spend more time on inculcating good oral hygiene maintenance practices in their children leading to better oral hygiene of their children.

Similar findings were reported by Smyth et al. [6] and Saied-Moallemi et al. [7] who found that subjects with strong knowledge, 77.0% (95% confidence interval [CI]: 70.0-84.1%) showed a positive attitude to oral healthcare, versus 68.2% (95% CI: 63.2-73.2%) of the subjects with weak healthcare knowledge. Greater knowledge was associated with better oral hygiene.

Oral hygiene of children whose mothers help them while cleaning their teeth was good and of children whose mothers don't help them was also found to be good. The mean OHI-S score of children whose mothers help them while cleaning their teeth was 0.8595 (SD = 0.40006) in comparison to those whose mothers don't help them was 0.9171 (SD = 0.45445) but this difference was not statistically significant as found in the present study. Mean OHI-S score of children whose mothers still supervising their child's teeth was 0.7992 (SD = 0.42728) whereas mean OHI-S score was 0.9455 (SD = 0.44313) for children whose mothers were not supervising their child's teeth and the difference between both groups was found to be statistically significant. It was found that children, whose mothers were using toothbrush and toothpaste for cleaning of their teeth had good oral hygiene in comparison to those children whose mothers were using powder with finger and indigenous aids for cleaning of their teeth, and it was found to be statistically significant. It can be attributed to the fact whatever mothers use for cleaning of their teeth their children also follow them. Toothpaste with toothbrush was found to more effective in the removal of debris and plaque in comparison to other aids. Similar results were found in the study conducted by De la Rosa et al. [8] However, the results of the study conducted by Parizotto et al. in 2003 [9] did not support this.

Oral hygiene status of all children was found to be good whether their mothers used to clean their teeth once a day, twice a day or more than twice a day. Mean OHI-S score of children whose mothers cleaned their teeth once in a day was 0.9178 (SD = 0.45216) whereas it was 0.8361 (SD = 0.39410) and 1.0667 (SD = 0.45092) for those children whose mothers cleaned their teeth twice a day and more than twice a day respectively but this difference was found to be not statistically significant. Elena and Petr [5] found that 57% of mothers answered that they brushed their teeth at least twice a day.

Mean OHI-S scores of children whose mothers help their child cleaning his teeth from 1 to 6 years, 2-6 years, 1-5 years and 1-8 years were 0.8861 (SD = 0.43352), 0.8996 (SD = 0.44321), 1.0229 (SD = 0.50938) and 0.8579 (SD = 0.24566), respectively. When one-way ANOVA was applied, no statistically significant difference was found. In the present study, the mothers had started supervising their children's teeth cleaning at an early age within the range of 1-2 years till the time when the children were self-sufficient in cleaning their teeth on their own which led to good oral hygiene of their children. Gussy et al. [10] reported that most parents (95%) believed that they should begin cleaning their child's teeth when or soon after the teeth first appeared as instead of waiting until all the primary teeth were present.

One of the important oral hygiene practices is rinsing the oral cavity after every meal and majority of the mothers (75.1%) used to rinse their oral cavity after every meal as found in the study. Mean OHI-S scores of children whose mothers rinse their oral cavity after every meal, don't rinse and rinse occasionally were 0.8738 (SD = 0.41581), 0.9831 (SD = 0.48323) and 1.0172 (SD = 0.54186), respectively and when statistically analysis was employed this difference was found to be statistically significant. Children whose mothers rinse their oral cavity after every meal had low mean OHI-S score in comparison to other groups.

It was found that most of the mothers were having fair oral hygiene, and their children had good oral hygiene. This can be due to the fact that young children learn fast by observing the adults, listening to people they love and admire, and follow the action of loved ones such as parents, teachers and their peer groups. It is said learning begins at home and mothers as the first and best teacher. So children will have better oral hygiene if their mothers practice oral hygiene maintenance regularly. Almost similar results are seen in the study conducted by ur Rehman et al. [11] who found that 36.3% children in their study had good oral hygiene, 60.3%, and 3.3% were having fair and bad oral hygiene respectively. Mahesh Kumar et al. [12] in their study found that above 80% children were having good oral hygiene and 20% were with poor oral hygiene. More than any other social factors and contexts, mothers are considered to be very important mediators in their children's health behavior. It is important that the knowledge, attitude and behavior of parents especially mothers regarding oral health practices including oral hygiene practices should be adequate so that they can disseminate such information and practices to their children. As health professionals, we should know the amount of correct information and the attitude and practices of parents and children so that we can modify their knowledge, attitude, and practices.

Limitations

The present study did not take into account the oral hygiene knowledge and practice of fathers, other family members or guardians, which must have had an impact on oral hygiene status of children especially in case of mothers who were employed. Oral hygiene knowledge and practices are influenced by a number of factors like occupation, income, and dietary factors etc., which were not taken into consideration in the present study.


  Recommendations and suggestions Top


Further studies are recommended with a larger sample size on children of other age groups as well to get a better picture of the impact of mothers' oral hygiene knowledge and practice on the oral hygiene of their children and also taking into consideration the other member of the family or guardians of the children.


  Conclusion Top


The study concludes that mothers' oral hygiene knowledge and practice were found to have a significant impact on oral hygiene status of their 12-year-old children. Although oral hygiene of children was found to be of good status irrespective of their mothers' oral hygiene status which was fair.

 
  References Top

1.
Loan D, Evghenikos A, Petersen PE, Salavastru C, Stan A. Oral health-Teachers behavior change-A major factor of progress. J Prev Med 2005;13:108-15.  Back to cited text no. 1
    
2.
Saied-Moallemi Z, Vehkalahti MM, Virtanen JI, Tehranchi A, Murtomaa H. Mothers as facilitators of preadolescents' oral self-care and oral health. Oral Health Prev Dent 2008;6:271-7.  Back to cited text no. 2
    
3.
Saied-Moallemi Z, Murtomaa H, Tehranchi A, Virtanen JI. Oral health behaviour of Iranian mothers and their 9-year-old children. Oral Health Prev Dent 2007;5:263-9.  Back to cited text no. 3
    
4.
Greene JC, Vermillion JR. The simplified oral hygiene index. J Am Dent Assoc 1964;68:25-31.  Back to cited text no. 4
    
5.
Elena B, Petr L. Oral health and children attitudes among mothers and schoolteachers in Belarus. Stomatologija Balt Dent Maxillofac J 2004;6:40-3.  Back to cited text no. 5
    
6.
Smyth E, Caamano F, Fernández-Riveiro P. Oral health knowledge, attitudes and practice in 12-year-old schoolchildren. Med Oral Patol Oral Cir Bucal 2007;12:E614-20.  Back to cited text no. 6
    
7.
Saied-Moallemi Z, Virtanen JI, Ghofranipour F, Murtomaa H. Influence of mothers' oral health knowledge and attitudes on their children's dental health. Eur Arch Paediatr Dent 2008;9:79-83.  Back to cited text no. 7
    
8.
De la Rosa M, Zacarias Guerra J, Johnston DA, Radike AW. Plaque growth and removal with daily toothbrushing. J Periodontol 1979;50:661-4.  Back to cited text no. 8
[PUBMED]    
9.
Parizotto SP, Rodrigues CR, Singer Jda M, Sef HC. Effectiveness of low cost toothbrushes, with or without dentifrice, in the removal of bacterial plaque in deciduous teeth. Pesqui Odontol Bras 2003;17:17-23.  Back to cited text no. 9
    
10.
Gussy MG, Waters EB, Riggs EM, Lo SK, Kilpatrick NM. Parental knowledge, beliefs and behaviours for oral health of toddlers residing in rural Victoria. Aust Dent J 2008;53:52-60.  Back to cited text no. 10
    
11.
ur Rehman MM, Mahmood N, ur Rehman B. The relationship of caries with oral hygiene status and extra-oral risk factors. J Ayub Med Coll Abbottabad 2008;20:103-8.  Back to cited text no. 11
    
12.
Mahesh Kumar P, Joseph T, Varma RB, Jayanthi M. Oral health status of 5 years and 12 years school going children in Chennai city - An epidemiological study. J Indian Soc Pedod Prev Dent 2005;23:17-22.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]



 

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