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Parents' perceived barriers and enablers to providing optimal infant oral care
Olivia Walsh1, Amrit Chauhan2, My-Van Trinh1,3
1Inflammatory Origins, Murdoch Children's Research Institute, Royal Children's Hospital, 70 Flemington Rd, Parkville, VIC, 3052, Australia.
Insights
Parents face challenges in providing optimal infant oral care, with social influences and knowledge being key factors. Support is needed for managing child behavior and consistent health messaging to improve early childhood dental health.
Area of Science:
- Pediatric Dentistry
- Public Health
- Behavioral Science
Background:
- Early childhood caries (ECC) significantly impacts child well-being and is a leading cause of preventable hospitalizations.
- Preventive measures like twice-daily toothbrushing and early dental visits are crucial for infant oral health.
- Understanding parental barriers and enablers is essential for developing effective ECC prevention strategies.
Purpose of the Study:
- To explore the barriers and enablers parents encounter in delivering optimal oral care for children aged 0-36 months.
- To investigate parental perspectives on the timing of the first dental visit and twice-daily toothbrushing.
Main Methods:
- Qualitative study involving online semi-structured interviews with Australian parents of young children (0-36 months).
- Interviews guided by the Theoretical Domains Framework (TDF) to explore oral care behaviors.
- Data analysis using framework analysis to identify themes, barriers, and enablers.
Main Results:
- Fifteen interviews revealed that social influences, environmental context/resources, and knowledge were dominant TDF domains.
- Key themes identified include conflict, family/social norms, desire for positive experiences, and uncertainty.
- Parents experience complex decision-making, influenced by perceived conflicts with their child and social/family norms.
Conclusions:
- Interventions should address parental challenges in managing child behavior and competing priorities for twice-daily toothbrushing.
- Consistent messaging from health professionals is vital to encourage timely first dental visits.
- Findings provide a foundation for targeted interventions to improve infant oral care practices.
Background:
Early childhood caries (tooth decay) can adversely affect child growth, development and well-being and is a leading cause of preventable hospitalisation for pre-school aged children. This necessitates the introduction of preventive measures in infancy, including twice daily toothbrushing and timely dental visits. This study explored the barriers and enablers parents face in providing optimal oral care for their young children.
Methods:
We interviewed Australian parents with 0-36-month-old children about two key behaviours related to their child's oral health: (1) the timing of first dental visit and (2) twice daily toothbrushing. Parents were recruited via social media advertising and all interviews were conducted online via Zoom. Interviews were based on a semi-structured interview guide mapped to the Theoretical Domains Framework (TDF). All interviews were audio recorded and transcribed. Data was coded to the TDF, summarised, and categorised as a barrier or enabler before being grouped into themes and sub-themes using framework analysis.
Results:
Fifteen interviews were completed between May 2022- May 2023. Thirteen of the 14 TDF domains were represented in the data. The three most dominant TDF domains across the dataset were social influences, environmental context and resources, and knowledge. Four themes were developed from the data: (1) Conflict, (2) Family and social norms, (3) Wanting a positive oral health experience, and (4) Uncertainty. These themes represent both barriers and enablers to optimal infant and young children's oral care. Parents face complex decision-making challenges regarding their young children's oral health care, particularly managing actual and perceived conflicts with their child. Knowledge and social and family norms influence their approach to managing these barriers.
Conclusions:
The key influences enabling or preventing optimal infant oral care identified in this study lay the foundation for interventions to target these behaviours. To encourage a timely first dental visit, parents need consistent messaging from dental and other health professionals. To encourage twice daily toothbrushing, parents need more support in managing their child's behaviour and competing priorities.
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