Pediatric Dental Care

Tooth decay is one of the most pressing and prevalent pediatric health issues in the US. Dental caries causes various problems, including oral pain, difficulty concentrating, unnecessary school absenteeism, poor oral health (OH) during adulthood, and poor appearance. The possession of knowledge about pediatric oral health among parents and other caregivers can help prevent dental caries and its associated consequences. A literature review was conducted to understand whether parents or caregivers have sufficient pediatric OH knowledge and the influence of such knowledge on their children/grandchildren's dental health. Reviewed literature shows that caregivers are knowledgeable in some areas of children’s OH and not knowledgeable in others. Also, higher education institutions are paying less attention to pediatric dental/oral health. Relevant stakeholders should work towards filling the knowledge gap of pediatric OH among parents.

Tooth decay has become one of the most significant and prevalent pediatric health issues in the United States. Over 25% of children aged 2-5 years suffer from early childhood dental caries before joining kindergarten (Mahat & Bowen, 2017). By age nineteen, 68 percent of children and adolescents have experienced dental cavities in their permanent teeth (Mahat & Bowen, 2017). Tooth decay leads to various problems, including oral pain, difficulty concentrating, excessive school absenteeism, poor oral health (OH)during adulthood, and poor appearance. A goal of Healthy People 2020 is to bring down the percentage of children with untreated decay and dental caries. Such a goal can only be achieved if dental hygienists have the competencies to promote children’s oral health through preventive services and education. Again, the American Academy of Pediatric Dentists (AAPD) recommends parents receive adequate education on children’s oral and primary teeth hygiene. As such, there is an urgent need to improve caregivers’ knowledge about pediatric oral health, which could help prevent dental caries in children.

Literature Review

The importance of educating youth and parents about children’s oral health, as a strategy of preventing periodontal diseases in the pediatric population, has been widely examined. Kuba (2022) explored the barriers to children’s dental and oral health. In this article, the author explored the major hindrances to tackling tooth decay, which she described as “the most common chronic disease among children in the United States” (Kuba, 2022, p.10). Notably, Kuba acknowledges the existence of a knowledge gap among parents, caregivers, and youth regarding oral/dental health behaviors and practices. She noted that her job transcended helping patients, including educating her staff, parents, and caretakers on the most recent procedures and technology. Kuba (2022) recognizes that parents and dental professionals must educate children about the best approaches to ensuring oral health to make them the drivers of their dental health in the future. Kuba believes it is her responsibility to transfer the relevant information to these stakeholders. She states, "I wholeheartedly believe it is my role to give them this information” (Kuba, 2020, p.11).

Moreover, scholars have paid considerable attention to the family dynamic concerning oral health. Williams et al. (2020) investigated how grandparent caregivers' dental health knowledge shapes their behaviors and perceptions regarding their grandchildren’s dental health. Study participants included seventy-five grandparents who were the primary caregivers to at least one grandchild. Grandparents reported that most of the grandparents (75%) correctly identified “two times a year” as the number of times a child should visit the dentist for a checkup and cleaning (Williams et al., 2020, p.764). However, 26 percent of the participants failed in establishing early indicators of tooth decay on an image of a child’s tooth. Additionally, findings showed that greater OH knowledge was associated with good dental health behaviors, positive attitude towards oral hygiene, and a tendency to inspect their grandchildren’s teeth for cavities and encourage them to brush the recommended number of times daily.

Mahat and Bowen (2017) conducted a study to explore caregivers' knowledge of dental/oral health risk factors. The study sample comprised eighty-seven parents whose children attended preschools and daycare centers. Total caregiver knowledge scores spanned from 7 to 17, representing a moderate understanding of children’s OH risks. Participants were knowledgeable about several aspects of children's OH, but were uninformed about others. Although many parents understood that baby teeth are vital and that permanent teeth and baby teeth should be brushed daily, few of them considered baby tooth cavities as factors underlying long-lasting dental problems. Results from this study mirror those Williams et al. (2020) reported in significant ways. Of the 75 grandparents in the research conducted by Williams et al. (2020), 41 missed questions about when a child brushing children's teeth with toothpaste should begin, 31 at what age dental checkups should begin, and 35 at the age at which children can have dental cavities. Also, 54% could not identify white spots in a child’s teeth as a symptom of tooth decay.

Dental health hygienists are the backbone of dental/oral health for any healthcare system. Such professionals treat and prevent periodontal diseases as well as correct dental irregularities. Claiborne and Naaval (2022) also sought to explore the clinical experiences and curriculum related to pediatric and prenatal OH in the community college and university dental hygienist programs. In their findings, the authors highlighted the inattention given to pediatric OH by institutions of higher learning. Specifically, dental health students lacked adequate hands-on experience with children and opportunities for interprofessional collaboration. Claiborne and Naaval (2022) noted that dental health courses allocated relatively lower time to pediatric oral health care than prenatal dental health.

The need for parents to be equipped with sufficient knowledge of pediatric dental care has been an area of interest for researchers. Claibone and Naaval (2022) examined this topic from the perspective of providing clinical guidance and health education to pregnant women. The authors highlighted that prenatal OH not only affects women but also their children's health status. Children born to women who had a tooth loss or untreated tooth decay had an increased likelihood of having dental caries in comparison with their counterparts. Mahat and Bowen (2017) agreed with Claiborne and Naaval (2022). Mahat and Bowen (2017) state, “studies have shown that parental knowledge of oral health has a significant influence on children’s dental caries, and there is an association between lack of parental knowledge and dental caries among children.” The authors cited Bandura’s social cognitive theory, arguing that the overt behavior of a significant other represents a crucial factor for social influence.

The study conducted by Claiborne and Naaval (2022) can be considered as an outlier as the implications of its findings are tough on strengthening dental/oral health programs in American community colleges and universities. In this regard, no other research in the reviewed literature relates to improving the education of dental health students. Instead, the central issues that Kuba (2022), Williams et al. (2020), and Mahat and Bowen (2022) examined revolve around enhancing children’s OH knowledge among caregivers. The three researchers agree that parents and other caregivers are important stakeholders whose understanding of good OH practices and behaviors is critical for the dental/OH of the patients.

Methods and Procedures

Topic Selection

The topic under investigation was chosen because the author had been exposed to trends on medical websites describing pediatric dental caries as a gradually developing pandemic.

Resource Search and Selection

A systematic search of articles was conducted in several databases, including PsycINFO, Web of Science, PubMed, the Cochrane Library, Google Scholar, and Wiley Open Access.

Search Terms

Several search terms were used to identify sources for this project. The keywords that guided the article search included "pediatric," dental care,” parent/caregiver,” “education,” “knowledge of pediatric oral health," "pediatric dental health," "dental caries/tooth decay," “periodontal diseases”, and “education.” This search resulted in 14 articles. Filters were used to narrow down the search. The filters included relevance, peer review, and research that had to be based on pediatric populations.

Boolean Strings

The Boolean search strings were “Parent pediatric oral health knowledge AND dental caries,” and “children’s oral health knowledge AND periodontal diseases.”

Age of Sources

The significant literature will be reviewed. Only sources from the last 10 years were considered for inclusion in the literature review.

Discussion

The examined literature agreed that there is a need to improve parents' and caregivers' knowledge about pediatric OH. Three of the reviewed articles reveal that this is an urgent concern, given the growing prevalence of tooth decay in children and the potential benefits children can reap from educating caregivers about children's dental/oral health. The reviewed articles show the need for dental health professionals to assess parents and grandparent caregivers on their pediatric OH knowledge and educate them to fill identified gaps. Also, there is a need for dental/OH programs in higher education institutions to increase credit hours for dental health students in pediatric OH. The Commission on Dental Accreditation for Allied Dental Education notes that graduates must be competent to deliver dental hygiene services for the entire population, including children (Claiborne & Naaval, 2022). Increasing credit hours would foster the acquisition of such competencies. Future research should be conducted to identify the most appropriate method of delivering OH education to caregivers of different ages and cultural backgrounds.

In conclusion, dental caries is a significant health issue affecting children in the US. As such, caregivers should know about pediatric OH, which could be an effective strategy to prevent tooth decay in children. The literature shows that parents and grandparent caregivers lack knowledge in critical areas of children’s OH. Relevant stakeholders should ensure this knowledge gap is filled.