$1.6 million dental study aims to correct parent/caregiver misperceptions to improve dental attention to children’s teeth

Dental researchers hope to vastly improve oral health in children by countering a common misperception that dental care for baby teeth isn’t important because they just fall out anyway.

Researchers at Case Western Reserve University School of Dental Medicine and the University of Washington Northwest Center to Reduce Oral Health Disparities in Seattle plan to launch and test this fall a behavioral intervention to change what parents and caregivers believe about the importance of keeping baby teeth cavity-free. They hope the effort encourages parents and caregivers to seek dental care for their children.

headshot of Suchitra Nelson

Suchitra Nelson

Suchitra Nelson, professor of community dentistry at Case Western Reserve, will lead a $1.6 million, 2.5-year study, “Family Intervention with Caregivers of Children with Dental Needs,” funded by National Institute of Dental and Craniofacial Research (Grant number: U01DE024167).

The researchers will design a new referral letter and educational materials and review whether those resources inspire 660 parents and caregivers recruited for the study to keep their children’s teeth healthy.

The goal: to find a new way to overcome misperceptions caregivers of children from kindergarten to fourth grade have about baby teeth and the need for general dental care. The researchers ultimately hope to improve the oral health of children nationally.

“We have an opportunity to change the public health standard of practice with this new referral letter and educational materials,” Nelson said.

The study is a response to the federal Healthy People 2020, an initiative to close the gap in access to health care for minorities and the poor. Nelson said tooth decay is increasing for impoverished children between ages 2 and 11.

Researchers will recruit caregivers of children with tooth decay that need professional dental care. With consent from caregivers, the children will be rescreened seven months into the study to track whether dental care was sought to fix the tooth decay.

Many parents mistakenly believe that, because baby teeth simply fall out, there’s no need for children to visit the dentist until they have permanent teeth, Nelson said. But baby teeth with decay can infect emerging permanent teeth, resulting in the need for a filling or extraction.

The need for a new kind of intervention emerged from a four-year study of 562 children from elementary schools in East Cleveland, a Cleveland suburb.

In that study, funded by the Health Resources and Services Administration, the children received initial dental exams—the results of which were given to their parents. Parents of children who needed dental care were referred to local dentists.

But only one in five parents notified that their child needed dental care responded, said Nelson. She concluded that caregiver-level interventions were needed to address misperceptions and to give adequate information about resources to help them seek dental care for their child.

Nelson and her team hope to change that.

She is working on the new approach with Gerald Ferretti, chair of the department of pediatric dentistry; Jeffrey Albert, professor in department of epidemiology and biostatistics at the School of Medicine; Wonik Lee, assistant professor in community dentistry; Peter Milgrom, professor of dental public health sciences and pediatric dentistry at the University of Washington’s School of Dentistry; and Christine Riedy, lecturer at the Harvard School of Dental Medicine.

They will develop and test a new letter and a dental guide for parents and caregivers that focus on dispelling childhood dental myths. The materials will be sent to the study’s participants, who have children in elementary schools in East Cleveland and in the state of Washington.

The researchers will draw from emerging illness perception research, using theoretical framework of the “Common Sense Model of Self-Regulation.” That approach investigates concepts, such as identity, consequences, controllability, cause, timeline and emotional representation, of tooth decay.

Caregivers will answer questionnaires three times during the first year of the study to see if the letter and guide had positively changed misperceptions about oral health.

“We hope to develop a model that others can use to change caregivers’ perceptions and improve the oral health of children,” Nelson said.