The impact of parental oral health behaviors on the oral health of children

INTRODUCTION

Influence of parental oral health habits and knowledge on their children's oral health is well-documented.^1-3 Poor oral habits in children increase risk of dental caries.^4-6 Low socioeconomic status and inadequate parental oral health behaviors also contribute to dental caries.^7-10 Other factors, such as gender and various dimensions, including developmental aspects, play role.^11,12 Recognizing critical role of oral hygiene in overall health, it is crucial to provide comprehensive guidelines on children's oral health behavior and its correlation with dental caries. Addressing these multifaceted factors is essential for designing public health initiatives targeting both children and parental behaviors to enhance oral health and overall quality of life.

Oral health is intertwined with overall health and quality of life.¹³ Globally, oral diseases pose significant public health challenges.¹⁴ In developing countries, dental caries prevalence has surged, affecting many adults and approximately 60% of schoolchildren.^14,15 Studies in Iran report elevated mean dmft values, surpassing global and regional averages.^16,17 School-age period, spanning childhood to adolescence, is pivotal for developing oral health-related behaviors, beliefs, and habits.^13-17 Poor oral health in schoolchildren leads to limitations in daily activities and absenteeism.¹⁴ To address this, WHO advocates integrating oral health promotion into school activities and curricula.¹⁸ Effective programs often require reinforcement at home, primarily by mothers.¹⁸ Recent Iranian research underscores the impact of targeting oral health promotion in both school and home settings, resulting in improved children's oral health.¹ Parental and teacher involvement, particularly that of mothers, significantly reinforces these programs.^1,19

LITERATURE SEARCH

This study is based on a comprehensive literature search conducted on September 19, 2023, in the Medline and Cochrane databases, utilizing the medical topic headings (MeSH) and a combination of all available related terms, according to the database. To prevent missing any possible research, a manual search for publications was conducted through Google Scholar, using the reference lists of the previously listed papers as a starting point. We looked for valuable information in papers that discussed the impact of parental oral health behaviors on the oral health of children. There were no restrictions on date, language, participant age, or type of publication.

DISCUSSION

Oral health is integral component of overall well-being, and it is vital to instill and maintain excellent oral hygiene practices, particularly during childhood. Children, with their developing dentition and limited ability to independently care for their teeth, are particularly susceptible to oral health issues. Consequently, extensive attention has been directed towards examining impact of parental oral health behaviors on their children's oral health. This aspect is not only a subject of research but also a focal point in public health policy.

Numerous behavioral theories (Table 1), such as health belief model (Figure 1) and the Theory of Reasoned Action, emphasize the role of knowledge and attitudes in behavioral change.^20,21 This becomes particularly relevant when assessing parents' knowledge and attitudes toward their children's health behavior and status. Parents are central in providing children with information and encouragement for healthy living.²² Parents' knowledge, beliefs, and the attitudes regarding oral health significantly influence their children's tooth-brushing behaviour.^2,23,24 Additionally, parents' attitudes positively impact their children's dental caries as well as the gingival health.^25,26

In the family context, mothers play a pivotal role in shaping their children's oral health habits and status.^10,27,28 Despite changing family roles, mothers continue to influence their children's oral health-related lifestyles.²⁹ Further research is recommended to identify factors promoting children's oral health behavior, focusing on family characteristics and parent-child relationships.^2,22,24 While extensive research has examined parents' oral health-related knowledge and attitudes concerning preschoolers' oral health, limited studies have investigated school-aged children.^23,26 Understanding this relationship is crucial, particularly in societies where mothers play a significant role in raising their children.

Parental oral health behaviors encompass a broad spectrum of practices that exert both direct and indirect influences on their children's oral health.¹¹ As mentioned earlier, these encompass regular dental check-ups, adherence to recommended oral hygiene routines, maintaining a balanced diet, and the avoidance of detrimental oral habits such as smoking and excessive sugar consumption. Furthermore, the role of parental supervision and active involvement in a child's oral care routine is pivotal in establishing robust oral hygiene practices during their early years.³¹

Parents serve as primary role models for their children in various aspects of life, including oral health.³² Children tend to emulate their parents' behaviors and attitudes towards oral hygiene. When parents prioritize their oral health by consistently attending dental appointments, adhering to regular brushing and flossing routines, and making wise dietary choices, their children are more inclined to adopt these practices. Parental participation in a child's daily oral hygiene regimen is instrumental during their formative years.³¹ As we delve into the intricate web of parental influences on children's oral health, it becomes evident that parents are not just passive observers but active facilitators. They guide their children through the crucial stages of toothbrushing habits.³³ These habits, introduced and practiced daily by children under parental guidance, serve as the first line of defense against oral pathologies like periodontal diseases and dental caries.³⁴ Parents wield considerable influence in shaping their children's dietary habits, which directly impact oral health.³⁵ A diet abundant in sugary snacks and beverages heightens the risk of tooth decay. Conversely, parents who advocate for a balanced diet with restricted sugar intake contribute to improved oral health outcomes for their children. Further, parental awareness regarding preventive measures, such as fluoride treatments and dental sealants, plays a pivotal role in reducing the likelihood of dental issues in children.³⁶ Identifying dental problems early and promptly intervening is facilitated when parents prioritize regular dental check-ups for their children. Parents who abstain from detrimental oral habits, such as smoking or excessive alcohol consumption, safeguard not only their own oral health but also set a positive example for their children.³⁷ These behaviors can result in adverse oral health outcomes and increase the likelihood of children adopting similar habits in the future.

The influence of parental oral health behaviors on their children's oral health is profound and multi-dimensional. Parents serve as role models, educators, and facilitators of healthy oral habits during a child's developmental years.^22,29,31 Encouraging parental engagement in oral health promotion and prevention programs is imperative for enhancing the oral health outcomes of subsequent generations. Public health initiatives should underscore the significance of parental involvement and offer resources and education to assist parents in cultivating sound oral health practices in their children. Ultimately, the proactive efforts of parents can make a substantial contribution to reducing the prevalence of oral diseases among children and promoting enduring oral health.^10,26,27

Furthermore, it is essential to acknowledge the interconnectedness of oral health with overall health and well-being. Establishing and maintaining good oral hygiene practices from an early age is not only conducive to a healthy mouth but also contributes to an individual's overall health.³⁸ Given the vulnerability of children to oral health issues, parental involvement in oral health promotion becomes even more critical. Parents play a pivotal role as nurturers and educators, shaping their children's oral health habits and attitudes. In this holistic approach to oral health, family environments that encourage and support healthy choices are key influencers.²⁹ Parents with effective coping skills and self-efficacy in leading healthy lives set positive examples.^39-41 Moreover, satisfaction with healthcare and trust in the dental system reinforce the value of oral health.⁴²

Furthermore, research reveals that parental behaviors hold more sway over children's oral health behavior than knowledge and attitudes alone.²³ Mothers' oral health-related knowledge, for instance, has been correlated with dental caries in 3-year-old children.²⁵ However, it is essential to recognize that differences exist between boys and girls regarding the factors influencing their dental health. Boys are more influenced by their father's occupational level, while girls are more affected by their father's knowledge and behavior.⁴³ This underscores the need for comprehensive school health educational interventions involving the entire family, providing children with well-rounded preventive guidelines.

In this holistic perspective, we must acknowledge the profound impact of social, cultural, environmental, and economic conditions on family life.⁴⁴ These contextual factors play a pivotal role in shaping oral health attitudes and behaviors, either positively or negatively. Therefore, any approach to oral health promotion must consider these broader influences to create a more effective and sustainable impact on children's oral health and, by extension, their overall well-being.

CONCLUSION

In summary, parental oral health habits significantly impact children's oral well-being, underscoring the importance of comprehensive public health initiatives. This influence extends to various facets of children's lives, from daily oral routines to dietary choices and overall quality of life. Recognizing parents as active facilitators in shaping children's oral health behaviors is essential, emphasizing the need for holistic family-centered interventions that consider broader contextual factors.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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