Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economically diverse groups

Pauline M. Adair, Cynthia M. Pine*, Girvan Burnside, Alison D. Nicoll, Angela Gillett, Shahid Anwar, Zdenek Broukal, Ivor G. Chestnutt, Dominique Declerck, Xi Ping Feng, Roberto Ferro, Ruth Freeman, Donna Grant-Mills, Tshepo Gugushe, Jaranya Hunsrisakhun, Maria Irigoyen-Camacho, Edward C.M. Lo, Mohamed Hanif Moola, Sudeshni Naidoo, Ursuline NyandindiVibeke Juul Poulsen, Francisco Ramos-Gomez, Noëline Razanamihaja, Swarngit Shahid, Marit Slåttelid Skeie, O. Patricia Skur, Christian Splieth, Choo Soo Teo, Helen Whelton, David W. Young

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

169 Citations (Scopus)


Objective: The aim of this international study was to develop a valid and reliable psychometric measure to examine the extent to which parents' attitudes about engaging in twice-daily tooth brushing and controlling sugar snacking predict these respective behaviours in their children. A supplementary objective was to assess whether ethnic group, culture, level of deprivation or children's caries experience impact upon the relationships between oral health related behaviours, attitudes to these respective behaviours and to dental caries. Clinical setting: nurseries, health centres and dental clinics in 17 countries. Participants: 2822 children aged 3 to 4 years and their parents. Main outcome measures: Dental examination of children and questionnaire to parents. Results: factor analysis identified 8 coherent attitudes towards toothbrushing, sugar snacking and childhood caries. Attitudes were significantly different in families from deprived and non-deprived backgrounds and in families of children with and without caries. Parents' perception of their ability to control their children's toothbrushing and sugar snacking habits were the most significant predictors of whether or not favourable habits were reported. Some differences were found by site and ethnic group. Conclusions: this study supports the hypothesis that parental attitudes significantly impact on the establishment of habits favourable to oral health. An appreciation of the impact of cultural and ethnic diversity is important in understanding how parental attitudes to oral health vary. Further research should examine in a prospective intervention whether enhancing parenting skills is an effective route to preventing childhood caries.

Original languageEnglish
Pages (from-to)102-111
Number of pages10
JournalCommunity Dental Health
Issue number1 SUPPL.
Publication statusPublished - Mar 2004


  • Attitudes
  • Behaviour
  • Child
  • Dental health
  • Efficacy
  • Parent


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