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Association between parental guilt and oral health problems in preschool children: a hierarchical approach.

Gomes MC, Clementino MA, Pinto-Sarmento TC, Martins CC, Granville-Garcia AF, Paiva SM - BMC Public Health (2014)

Bottom Line: The multivariate model was carried out on three levels using a hierarchical approach from distal to proximal determinants: 1) socio-demographic aspects; 2) health perceptions; and 3) oral health problems.The frequency of parental guilt was 22.8%.The following variables were significantly associated with parental guilt: parental perception of child's oral health as poor (PR = 2.010; 95% CI: 1.502-2.688), history of toothache (PR = 2.344; 95% CI: 1.755-3.130), cavitated lesions (PR = 2.002; 95% CI: 1.388-2.887), avulsion/luxation (PR = 2.029; 95% CI: 1.141-3.610) and tooth discoloration (PR = 1.540; 95% CI: 1.169-2.028).

View Article: PubMed Central - PubMed

Affiliation: Postgraduate Program in Dentistry, State University of Paraiba (UEPB), 1325/410 Capitão João Alves de Lira, 58428-800 Campina Grande, PB, Brazil. anaflaviagg@hotmail.com.

ABSTRACT

Background: Dental caries and traumatic dental injury (TDI) can play an important role in the emergence of parental guilt, since parents feel responsible for their child's health. The aim of the present study was to evaluate the influence of oral health problems among preschool children on parental guilt.

Methods: A preschool-based, cross-sectional study was carried out with 832 preschool children between three and five years of age in the city of Campina Grande, Brazil. Parents/caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The item "parental guilt" was the dependent variable. Questionnaires addressing socio-demographic variables (child's sex, child's age, parent's/caregiver's age, mother's schooling, type of preschool and household income), history of toothache and health perceptions (general and oral) were also administered. Clinical exams for dental caries and TDI were performed by three dentists who had undergone a training and calibration exercise (Kappa: 0.85-0.90). Poisson hierarchical regression was used to determine the significance of associations between parental guilt and oral health problems (α = 5%). The multivariate model was carried out on three levels using a hierarchical approach from distal to proximal determinants: 1) socio-demographic aspects; 2) health perceptions; and 3) oral health problems.

Results: The frequency of parental guilt was 22.8%. The following variables were significantly associated with parental guilt: parental perception of child's oral health as poor (PR = 2.010; 95% CI: 1.502-2.688), history of toothache (PR = 2.344; 95% CI: 1.755-3.130), cavitated lesions (PR = 2.002; 95% CI: 1.388-2.887), avulsion/luxation (PR = 2.029; 95% CI: 1.141-3.610) and tooth discoloration (PR = 1.540; 95% CI: 1.169-2.028).

Conclusion: Based on the present findings, parental guilt increases with the occurrence of oral health problems that require treatment, such as dental caries and TDI of greater severity. Parental perceptions of poor oral health in their children and history of toothache were predictors of greater feelings of parental guilt.

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Analysis model used in the study.
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Fig1: Analysis model used in the study.

Mentions: Descriptive analysis was performed to characterize the sample. Bivariate Poisson regression analysis with robust variance was used to determine the significance of associations between the independent variables and parental guilt (p < 0.05). The multivariate model followed a hierarchical approach from distal to proximal determinants on three levels:[1] socio-demographic data;[2] health perceptions; and[3] oral health problems (Figure 1)[30]. On each level, the backward stepwise method was used for the selection of variables having with a p-value < 0.20 in the bivariate analysis as well as variables considered epidemiological determinants. Variables with a p-value < 0.05 in the adjusted analysis were maintained in the final regression model. Interactions among dental caries and TDI were tested using Wald’s test. Variance inflation factors were calculated to test collinearity among the predictors in the adjusted model. The Statistical Package for Social Sciences (SPSS for Windows, version 20.0, SPSS Inc, Chicago, IL, USA) was used for the statistical analyses.Figure 1


Association between parental guilt and oral health problems in preschool children: a hierarchical approach.

Gomes MC, Clementino MA, Pinto-Sarmento TC, Martins CC, Granville-Garcia AF, Paiva SM - BMC Public Health (2014)

Analysis model used in the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4150983&req=5

Fig1: Analysis model used in the study.
Mentions: Descriptive analysis was performed to characterize the sample. Bivariate Poisson regression analysis with robust variance was used to determine the significance of associations between the independent variables and parental guilt (p < 0.05). The multivariate model followed a hierarchical approach from distal to proximal determinants on three levels:[1] socio-demographic data;[2] health perceptions; and[3] oral health problems (Figure 1)[30]. On each level, the backward stepwise method was used for the selection of variables having with a p-value < 0.20 in the bivariate analysis as well as variables considered epidemiological determinants. Variables with a p-value < 0.05 in the adjusted analysis were maintained in the final regression model. Interactions among dental caries and TDI were tested using Wald’s test. Variance inflation factors were calculated to test collinearity among the predictors in the adjusted model. The Statistical Package for Social Sciences (SPSS for Windows, version 20.0, SPSS Inc, Chicago, IL, USA) was used for the statistical analyses.Figure 1

Bottom Line: The multivariate model was carried out on three levels using a hierarchical approach from distal to proximal determinants: 1) socio-demographic aspects; 2) health perceptions; and 3) oral health problems.The frequency of parental guilt was 22.8%.The following variables were significantly associated with parental guilt: parental perception of child's oral health as poor (PR = 2.010; 95% CI: 1.502-2.688), history of toothache (PR = 2.344; 95% CI: 1.755-3.130), cavitated lesions (PR = 2.002; 95% CI: 1.388-2.887), avulsion/luxation (PR = 2.029; 95% CI: 1.141-3.610) and tooth discoloration (PR = 1.540; 95% CI: 1.169-2.028).

View Article: PubMed Central - PubMed

Affiliation: Postgraduate Program in Dentistry, State University of Paraiba (UEPB), 1325/410 Capitão João Alves de Lira, 58428-800 Campina Grande, PB, Brazil. anaflaviagg@hotmail.com.

ABSTRACT

Background: Dental caries and traumatic dental injury (TDI) can play an important role in the emergence of parental guilt, since parents feel responsible for their child's health. The aim of the present study was to evaluate the influence of oral health problems among preschool children on parental guilt.

Methods: A preschool-based, cross-sectional study was carried out with 832 preschool children between three and five years of age in the city of Campina Grande, Brazil. Parents/caregivers answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The item "parental guilt" was the dependent variable. Questionnaires addressing socio-demographic variables (child's sex, child's age, parent's/caregiver's age, mother's schooling, type of preschool and household income), history of toothache and health perceptions (general and oral) were also administered. Clinical exams for dental caries and TDI were performed by three dentists who had undergone a training and calibration exercise (Kappa: 0.85-0.90). Poisson hierarchical regression was used to determine the significance of associations between parental guilt and oral health problems (α = 5%). The multivariate model was carried out on three levels using a hierarchical approach from distal to proximal determinants: 1) socio-demographic aspects; 2) health perceptions; and 3) oral health problems.

Results: The frequency of parental guilt was 22.8%. The following variables were significantly associated with parental guilt: parental perception of child's oral health as poor (PR = 2.010; 95% CI: 1.502-2.688), history of toothache (PR = 2.344; 95% CI: 1.755-3.130), cavitated lesions (PR = 2.002; 95% CI: 1.388-2.887), avulsion/luxation (PR = 2.029; 95% CI: 1.141-3.610) and tooth discoloration (PR = 1.540; 95% CI: 1.169-2.028).

Conclusion: Based on the present findings, parental guilt increases with the occurrence of oral health problems that require treatment, such as dental caries and TDI of greater severity. Parental perceptions of poor oral health in their children and history of toothache were predictors of greater feelings of parental guilt.

Show MeSH
Related in: MedlinePlus