Oral Health Knowledge, Attitude, Practice, Perceptions and Barriers to Dental Care among Libyan Parents

Hala Fathalla BenGhasheer; Roslan Saub

doi:10.17126/joralres.2022.009

Hala Fathalla BenGhasheer Dept. Community Oral Health and Clinical Prevention, Faculty of Dentistry, University of Benghazi, Benghazi, Libya.
Roslan Saub Dept. Community Oral Health and Clinical Prevention, Faculty of Dentistry, University Malaya, Kuala Lumpur, Malaysia.

DOI: https://doi.org/10.17126/joralres.2022.009

Abstract

Aim: To assess parental oral health knowledge, attitude, practice (KAP), perceptions of their children's oral health status, and explore the barriers to dental care utilization among Libyan parents living in Malaysia.
Material and Methods: A cross-sectional study was conducted among Libyan parents of children aged 1- 7 years old who lived in Malaysia. A 63-items questionnaire was constructed, validated, and pretested. Six hundred self-administered questionnaires were distributed Data were analyzed using IBM SPSS version 22.0. A generalized Linear Model was used to test the possible relationships between KAP scores and different sociodemographic factors. A significant level for all the statistical tests was predetermined at p?0.05.
Results: A total of 381 questionnaires were included, of which fathers' responses constituted 189 (49.6%), and mothers' responses constituted 192 (50.4%). Most of the parents exhibited good oral health knowledge (77.2%), positive attitudes (86.4%), and were adherent to good oral health practice (78.7%) with mean values of 10.6 (SD=1.8), 9.5 (SD=1.5), and 7.9 (SD=1.4) respectively. Gender, age, and income had statistically significant relationships (p<0.05) with KAP scores. The majority (81.1%) of parents rated their child's oral health as good. More than one-third of parents (35.7%) perceived no need for dental care, and 18.6% perceived no need to treat the primary teeth as they will be replaced.
Conclusion: Good Knowledge and positive attitudes towards oral health are not necessarily translated into favorable practices. The lack of perceived need and low value attributed to primary teeth created barriers to seek dental care services among the majority of surveyed parents. Attention must be directed to behavior change strategies rather than providing oral health education alone to improve the children's oral health outcomes.

References

[1]. Bhaskar V, McGraw KA, Divaris K. The importance of preventive dental visits from a young age: systematic review and current perspectives. Clin Cosmet Investig Dent. 2014;6:21-7. doi: 10.2147/CCIDE.S41499. PMID: 24672258; PMCID: PMC3964025.

[2]. Bennadi D, Reddy CV, Sunitha S, Kshetrimayum N. Oral Health status of 3-6 year old children and their mother’s oral health related knowledge, attitude and practices in Mysore City, India. Asian J Med Sci. 2014;6(2):66-71. doi.org/10.3126/ajms.v6i2.11097

[3]. Nepaul P, Mahomed O. Influence of Parents' Oral Health Knowledge and Attitudes on Oral Health Practices of Children (5-12 Years) in a Rural School in KwaZulu-Natal, South Africa. J Int Soc Prev Community Dent. 2020;10(5):605-612. doi: 10.4103/jispcd.JISPCD_273_20. PMID: 33282770; PMCID: PMC7685284.

[4]. Morales-Chávez M & Mendoza -Hernández Y. Caries and premature loss of the first permanent molar in grade school children, and parents' knowledge level, in Vargas state, Venezuela. J Oral Res. 2019; 8(2):166-72. doi: 10.17126/joralres.2019.026.

[5]. Skeie MS, Riordan PJ, Klock KS, Espelid I. Parental risk attitudes and caries-related behaviours among immigrant and western native children in Oslo. Community Dent Oral Epidemiol. 2006;34(2):103-13. doi: 10.1111/j.1600-0528.2006.00256.x. PMID: 16515674.

[6]. Okada M, Kawamura M, Miura K. Influence of oral health attitude of mothers on the gingival health of their school age children. ASDC J Dent Child. 2001;68(5-6):379-83, 303. PMID: 11985205.

[7]. Okada M, Kawamura M, Kaihara Y, Matsuzaki Y, Kuwahara S, Ishidori H, Miura K. Influence of parents' oral health behaviour on oral health status of their school children: an exploratory study employing a causal modelling technique. Int J Paediatr Dent. 2002 Mar;12(2):101-8. doi: 10.1046/j.1365-263x.2002.00338.x. PMID: 11966888.

[8]. Kay E, Locker D. A systematic review of the effectiveness of health promotion aimed at improving oral health. Community Dent Health. 1998;15(3):132-44. PMID: 10645682.

[9]. Petersen PE, Kwan S. Equity, social determinants and public health programmes--the case of oral health. Community Dent Oral Epidemiol. 2011;39(6):481-7. doi: 10.1111/j.1600-0528.2011.00623.x. PMID: 21623864.

[10]. Sehrawat P, Shivlingesh KK, Gupta B, Anand R, Sharma A, Chaudhry M. Oral health knowledge, awareness and associated practices of pre-school children's mothers in Greater Noida, India. Niger Postgrad Med J. 2016 Jul-Sep;23(3):152-7. doi: 10.4103/1117-1936.190344. PMID: 27623728.

[11]. Ru-Shing Tang, Shun-Te Huang, Hong-Sen Chen, Szu-Yu Hsiao, Hsin-Yu Hu, Fu-Hsiung Chuang.The association between oral hygiene behavior and knowledge of caregivers of children with severe early childhood caries. J Dent Sci. 2014;9(3): 277–82. doi:10.1016/j.jds.2013.02.025.

[12]. Thomas A, Jacob A, Kunhambu D, Shetty P, Shetty S. Evaluation of the knowledge and attitude of expectant mothers about infant oral health and their oral hygiene practices. J Int Soc Prev Community Dent. 2015 Sep-Oct;5(5):400-5. doi: 10.4103/2231-0762.163405. PMID: 26539393; PMCID: PMC4606605.

[13]. Thyath MN, Nishad SG, Sharma M, Zaidi I. Impact of socioeconomic status and parental factors on child oral health- a review of literature. J Adv Med Dent Sci Res 2015;3(2):153–7.

[14]. Reza M, Amin MS, Sgro A, Abdelaziz A, Ito D, Main P, Azarpazhooh A. ORAL HEALTH STATUS OF IMMIGRANT AND REFUGEE CHILDREN IN NORTH AMERICA: A SCOPING REVIEW. J Can Dent Assoc. 2016;82:g3. PMID: 27548669.

[15]. Gao X, Ding M, Xu M, Wu H, Zhang C, Wang X, Feng X, Tai B, Hu D, Lin H, Wang B, Zheng S, Liu X, Rong W, Wang W, Wang C, Si Y. Utilization of dental services and associated factors among preschool children in China. BMC Oral Health. 2020;20(1):9. doi: 10.1186/s12903-019-0996-x. PMID: 31914978; PMCID: PMC6950915.

[16]. Amin MS, Harrison RL. Understanding parents' oral health behaviors for their young children. Qual Health Res. 2009;19(1):116-27. doi: 10.1177/1049732308327243. PMID: 18997150.

[17]. Castilho AR, Mialhe FL, Barbosa Tde S, Puppin-Rontani RM. Influence of family environment on children's oral health: a systematic review. J Pediatr (Rio J). 2013;89(2):116-23. doi: 10.1016/j.jped.2013.03.014. PMID: 23642420.

[18]. Abuaisha AA, Huda BZ, Suriani I. Oral hygiene habits and its association with dental caries among children aged 8-12 year in Libyan schools, Klang Valley, Malaysia. Int J Public Heal Clin Sci. 2016; 3(1):44–58.

[19]. Wong FMF. Factors Associated with Knowledge, Attitudes, and Practices Related to Oral Care Among the Elderly in Hong Kong Community. Int J Environ Res Public Health. 2020;17(21):8088. doi: 10.3390/ijerph17218088. PMID: 33147890; PMCID: PMC7672548.

[20]. Bond TG, Fox CM. Applying the Rasch model: fundamental measurement in the human sciences. New York: Routledge. 2015.

[21]. Suprabha BS, Rao A, Shenoy R, Khanal S. Utility of knowledge, attitude, and practice survey, and prevalence of dental caries among 11- to 13-year-old children in an urban community in India. Glob Health Action. 2013;6:20750. doi: 10.3402/gha.v6i0. 20750. PMID: 23639177; PMCID: PMC3643074.

[22]. Wahengbam PP, Kshetrimayum N, Wahengbam BS, Nandkeoliar T, Lyngdoh D. Assessment of Oral Health Knowledge, Attitude and Self-Care Practice Among Adolescents - A State Wide Cross- Sectional Study in Manipur, North Eastern India. J Clin Diagn Res. 2016;10(6):ZC65-70. doi: 10.7860/JCDR/2016/20693.8002. PMID: 27504414; PMCID: PMC4963774.

[23]. McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion programs. Health Educ Q. 1988;15(4):351-77. doi: 10.1177/109019818801500401. PMID: 3068205.

[24]. Williams NJ, Whittle JG, Gatrell AC. The relationship between socio-demographic characteristics and dental health knowledge and attitudes of parents with young children. Br Dent J. 2002 ;193(11):651-4; discussion 642. doi: 10.1038/sj.bdj.4801652. PMID: 12607623.

[25]. Nagarajappa R, Kakatkar G, Sharda AJ, Asawa K, Ramesh G, Sandesh N. Infant oral health: Knowledge, attitude and practices of parents in Udaipur, India. Dent Res J (Isfahan). 2013;10(5):659-65. PMID: 24348626; PMCID: PMC3858743.

[26]. Rwakatema DS. Oral health knowledge, attitudes and practices of parents/guardians of pre-school children in Moshi, Tanzania. East Afr Med J. 2009;86(11):520–25. doi: 10.4314/eamj.v86i11.55831.

[27]. Suvarna R, Rai K, Hegde AM. Knowledge and Oral Health Attitudes among Parents of Children with Congenital Heart Disease. Int J Clin Pediatr Dent. 2011;4(1):25-8. doi: 10.5005/jp-journals-10005-1076. PMID: 27616854; PMCID: PMC4999633.

[28]. Grahn K, Wikström S, Nyman L, Rydberg A, Stecksén-Blicks C. Attitudes about dental care among parents whose children suffer from severe congenital heart disease: a case-control study. Int J Paediatr Dent. 2006;16(4):231-8. doi: 10.1111/j.1365-263X.2006.00736.x. PMID: 16759319.

[29]. Wilson A, Brega AG, Batliner TS, Henderson W, Campagna EJ, Fehringer K, Gallegos J, Daniels D, Albino J. Assessment of parental oral health knowledge and behaviors among American Indians of a Northern Plains tribe. J Public Health Dent. 2014;74(2):159-67. doi: 10.1111/jphd.12040. PMID: 24117628; PMCID: PMC4065026.

[30]. Al-Zahrani AM, Al-Mushayt AS, Otaibi MF, Wyne AH. Knowledge and attitude of Saudi mothers towards their preschool children's oral health. Pak J Med Sci. 2014;30(4):720-4. doi: 10.12669/pjms.304.5069. PMID: 25097504; PMCID: PMC4121685.

[31]. Ashkanani F, Al-Sane M. Knowledge, attitudes and practices of caregivers in relation to oral health of preschool children. Med Princ Pract. 2013;22(2):167-72. doi: 10.1159/000341764. PMID: 22986905; PMCID: PMC5586720.

[32]. Wapniarska K, Bu?a K, Hilt A. Parent's pro-health awareness concerning oral health of their children in the light of survey research. Przegl Epidemiol. 2016;70(1):59-63, 137-40. PMID: 27344476.

[33]. Almoudia MM, Husseina AS, Dossb JG, Schrothcd RJ. Expectant mothers' readiness to initiate preventive oral health care for their children. Saudi J Dent Res. 2016;7(2):118–26.

[34]. Carletto-Körber F, Isla C, Abrahim L, Cornejo LS. Knowledge, attitudes, practices and oral health status in adolescents of the city of Córdoba, Argentina. J Oral Res. 2018;7(9):418-25. doi.org/10.17126/joralres.2018.085.

[35]. Razeghi S, Amiri P, Mohebbi SZ, Kharazifard MJ. Impact of Health Promotion Interventions on Early Childhood Caries Prevention in Children Aged 2-5 Years Receiving Dental Treatment Under General Anesthesia. Front Public Health. 2020;8:6. doi: 10.3389/fpubh.2020.00006. PMID: 32175299; PMCID: PMC7055204.