Education level, dental habits of low-income parents linked to their children’s oral health

Researchers hope to improve dental health by changing caregiver behavior

Studies have long associated low-income areas with poor oral health. But dental researchers at Case Western Reserve University and University of Washington sensed that other factors related to income may be at work—in particular, education level.

So they recently investigated how a parent or other caregiver’s education level and dental habits affect children’s dental health.

With data from 423 low-income African-American kindergarteners and their caregivers from a CWRU dental school study in 2007, researchers tested the hypothesis that a caregiver’s education level influences how often they and their children brush their teeth and visit the dentist for routine checkups, and how those habits result in decayed or filled teeth.

The results supported the hypothesis:

  • Caregivers who completed high school were 1.76 times more likely to visit the dentist, compared with those who did not graduate high school.
  • The children of caregivers with high school diplomas were nearly six times more likely to visit the dentist routinely.
  • Children who visited the dentist regularly had about one-fourth as many untreated cavities as those who didn’t.
  • The education level of caregivers was directly associated with about a third fewer untreated decayed teeth, and 28 percent fewer decayed or filled teeth among the children they cared for.

The findings, reported in the Caries Research article “Caregiver’s Education Level and Children Dental Caries in African Americans: A Path Analytic Study,” confirm the role of caregiver education in child dental decay and indicate that the caregiver’s behavior influences a child’s oral health habits.

As a result, researchers hope to encourage parents to become better role models for their children, who pick up on both the positive and negative habits of their caregivers.

In the past, improving oral health has focused on educating children about good dental habits. The research team has provided children in the study with dental examinations, tooth sealants, toothbrushes and toothpaste. Children also received lessons on proper care of their teeth.

When dental problems where found during annual exams, letters were sent to parents to tell them their children needed follow-up dental care. But not all caregivers sought help for their children, Masahiro Heima, a pediatric dentist and faculty member at Case Western Reserve School of Dental Medicine, said.

And nearly 100 of the study’s participants—with or without a high school education—did not seek routine dental care at least once a year.

So it was the clear the message wasn’t getting through.

“Changing their ways with literature and instructions, didn’t always work,” said Heima. “So we need to focus on behavioral changes.”

Lee Wonik and Suchitra Nelson, from Case Western Reserve School of Dental Medicine, and Peter Milgrom, from University of Washington School of Dentistry, contributed to the study.

Health Resources and Service Administration’s Maternal and Child Health Bureau (R40-MC07838) and the National Center for Research Resources’ Clinical Translational Study (UL1 RR024989) funded the study.