Reversing the decay of preschool oral health: a mixed methods approach to examining the influences on preschool oral health.
The prevalence of early childhood caries is high in certain populations. Early childhood caries has a significant effect on an individual’s immediate oral health status as well as their oral health status later in life. It is important that good oral health behaviours are performed from an early age in order to protect both primary and secondary teeth. Preschoolers do not have the capacity to properly care for their oral health, and therefore are reliant on their caregivers to perform good oral health behaviours. Local and international health agencies have had an increasing focus on preschool oral health care. Despite its growing importance there is little research on what factors influence how a parent cares for their preschooler’s oral health. This thesis aims to fill part of this gap, especially within the New Zealand context. This research takes a closer look at the knowledge factors that parents have, and examines whether these factors have a direct impact on the preschool oral healthcare provided. This thesis uses a mixed methods approach. The research involved two phases, a quantitative phase (n=1056), where a secondary analysis of an existing dataset was carried out, and a qualitative phase (n=6), which consisted of individual interviews with parents from low income communities. The interview questions were developed after analysing the quantitative data, and were in line with the theoretical framework, the Fisher-Owens Model (Fisher-Owens et al., 2007). Overall the results showed a plethora of factors influence how a parent cares for their preschooler’s oral health. Impacting factors were found to exist on multiple levels. A significant relationship was seen between a parent having oral health knowledge and being more likely to perform recommended oral health behaviours on their preschooler. Differences in parents’ knowledge by population characteristics were also seen. Examples of this include parents who had older preschoolers and parents who brushed their own teeth at least twice a day, were both more likely to have the appropriate knowledge. Parents felt they had insufficient information on the recommended preschool oral health behaviours. Parents based a lot of their current knowledge on their own oral health behaviours, as well as information they received from Plunket Services. Parents often noted time pressures and the consumption of sugar as factors that hindered their ability to care for their preschooler’s teeth. Currently there is limited preschool oral health research in New Zealand. Overall, this research expands on the knowledge base for preschool oral health in New Zealand. Establishing factors that influence how a parent cares for their preschooler's oral health in New Zealand provides a good starting point to base future oral health promotion. In particular, identifying that knowledge has a positive effect on the oral health behaviours parents perform on their child provides a mandate to focus on increasing parents’ oral health knowledge. Confirming that factors other than knowledge impact how a parent cares for their preschooler’s oral health means that a broader approach to improving preschool oral health should be considered. This thesis will be beneficial for any individual who is involved in paediatric health care, as well as policy makers in this area. An increased focus on preventative action can have a beneficial effect by reducing the health care requirements an individual may have throughout their lifetime. Due to the significant cost (both financial and social) of poor oral health, any reduction in dental caries would result in cost benefits to the individual and the state.
Advisor: Smith, Moira; Waa, Anaru
Degree Name: Master of Public Health
Degree Discipline: Department of Public Health
Publisher: University of Otago
Keywords: health; preschool; newzealand; oralhealth; dental; mixed methods
Research Type: Thesis