Titel: Parental influence and the development of dental caries in children aged 0–6 years: A systematic review of the literature.
Auteurs: M.M. Al Hothali, K.A van Nes
AIM: Early childhood caries (ECC) is one of the most chronic diseases in children. Several studies have considered biological and dietary habits as main risk factors, while less attention was giving to the parental influence on children dental health. Since parents have a significant impact on their children, the positive intervention towards parental behavior and beliefs may play a major role in ECC prevention. Due to lack of systematic reviews on the subject (parents’ influences on dental caries development in children aged 0-6 years) the current review explains the role of parents and their effect on their children’s oral health.
METHODS: All published studies between 2006- 2011, which examined the parental influences on caries risk of children aged 0-6 years were considered for the review. Fifty five studies were included based on the selection criteria: 47 studies were cross-sectional in design, seven were longitudinal and one was case control. The outcome variable for each study was to measure caries prevalence or severity.
RESULTS: The review discussed many parental factors that might influence the dental caries development in their children. The most commonly tested factor was sociodemographic factors such as parents income, high birth order, low educated parents, families belong to minor ethnicity group or having an immigrant status and children who live in less urbanization areas (n= 45 studies). These were all associated with high caries development (84%). Secondly, parental feeding practice was discussed in the review (n=39) with 85% significant association with caries progression; it was clear that ECC in children is related to parents who spend more money on discretionary sugar. Thirdly, children oral hygiene behavior was one of the factors associated with caries risk in 36 studies with 72% significant association; children who start tooth brushing after 12 months of age or those who have difficulties in brushing developed more caries. Nine studies about parents oral health found that the status of parents oral health, transmission of S.mutans between parents and children, knowledge and attitude of parents to oral health, diet of parents, missing dental appointments and parental dental fear were significantly associated with high caries development (89%). Fourthly, parents attributes was described in 21 studies with 62% significant association between caries development and parents age, psychological conditions and grandparents as daytime care giver. Lastly, parental attitudes, knowledge, and beliefs were described in 10 studies, and 100% found that idea inherited, attitude to diet, brushing and oral health are copied between parents and children, which are relatively related to high caries risk.
CONCLUSIONS: The review points out the importance of understanding the multifactorial parental effects on the development of ECC and highly encourages further investigations and classifications regarding parental influence and dental caries development.