Knowledge and Attitude about Early Childhood Caries among Pregnant Mothers from Low Socioeconomic Status: A Questionnaire Study.

BACKGROUND: For health and well-being, oral health is an integral component. Unfortunately, many children are afflicted with dental caries at an early age, even those as young as 12 months. By imparting knowledge, awareness among parents about this disease can bring about reduction of early childhood caries (ECC) at an early stage. AIM: The aim of this study was to evaluate knowledge and attitude of expectant mothers about ECC and to reassess the level of knowledge after giving anticipatory guidance.
MATERIALS AND METHODS: The questionnaire consisted of 10 questions which were distributed to 100 participants after which anticipatory guidance was given to them. After 15 days, the same questionnaire was distributed among the participants with order of the questions interchanged. Chi-square test was used for statistical analysis.
RESULTS: There was a significant improvement in the knowledge and attitude about the disease after giving the anticipatory guidance among the participants. P < 0.01 and the result were statistically significant.
CONCLUSION: Knowledge and attitude of mothers were found to increase on provision of anticipatory guidance, which was retained even after 15 days.

INTRODUCTION

Early childhood caries (ECC) is a virulent form of dental decay which is characterized by improper feeding habits and unusual dietary practices. ECC is a serious health problem that continues to affect infants, toddlers, and preschool children worldwide. The prevalence of this disease varies from population to population, disadvantaged children, regardless of race, ethnicity, or culture.[1] Children from low socioeconomic status are most vulnerable to the disease maybe because their mothers lack knowledge about it.[2] As the preventive strategies are integral to improve the oral health of young children, it is important to understand the social value that mothers ascribe to the knowledge and attitude about the disease.[3] The purpose of this study was to evaluate the knowledge and attitude of pregnant mothers about ECC and to reassess their level of knowledge after giving anticipatory guidance. Hence, this study was aimed to evaluate the knowledge and attitude about ECC among expectant mothers from low socioeconomic status and to reassess their knowledge after providing anticipatory guidance.

MATERIALS AND METHODS

It was a quasi-experimental study. Institutional Ethical Committee clearance and written as well as verbal consent were obtained from the participants before the start of the study. A total of 100 expectant mothers were randomly selected from government hospitals, Salem, who belonged to low socioeconomic status, had a basic education only up to 10th class, and were pregnant for the first time, and the exclusion criteria were women who refused to take part in the study and those who could not read and write.

A printed questionnaire consisting of 10 questions relating to ECC in the local language (Tamil) was used for this study. The questionnaire was prepared to assess their knowledge on facts about ECC and its prevention and the attitude of expectant mothers about oral hygiene and dental visits. The questionnaire was prechecked for construct and content validity and was rated in a 3-point Likert scale as (a) agree, (b) don’t know, and (c) disagree.

Dental health education was given to these mothers after obtaining their basic knowledge and attitude from the questionnaire. One-to-one education was provided using 10 commandments about ECC. The session lasted for 15 min. After 15 days, the same questionnaire with the order of questions rearranged was given to these mothers for reassessing their improvement in knowledge and attitude about ECC.

Statistical analysis

After collecting the pre- and post-assessment questionnaires, by adding the scores allocated to the each option, the scores of knowledge and attitude were calculated. Analysis of the data was carried out using SPSS statistical software (v. 19, SPSS Inc., Chicago, IL, USA). Chi-square test was used for statistical analysis.

RESULTS

Knowledge and attitude among the expectant mothers about ECC during the prequestionnaire assessment were found to be very low as shown in [Table 1 and Graph 1]. There was a significant improvement in the knowledge and attitude after giving anticipatory guidance as shown in [Table 2 and Graph 2] and the result was statistically significant (P < 0.01).

Table 1

Result of the preassessment questionnaire

Graph 1

Result of the pre-assessment questionnaire

Table 2

Result of the postassessment questionnaire

Graph 2

Result of the post-assessment questionnaire

DISCUSSION

Imparting knowledge to expectant mothers is one of the effective approaches to promote oral health. Not only does it improve the mother's oral condition, but it also improves the infant and toddler's future oral health.

It is crucial to discover expectant mother's knowledge and attitudes toward infant and preschool dental health and oral health quality of life if advancements are ever to be made. As per the study conducted by Saied-Moallemi et al. in 2008, mothers play an important role in establishing their child's oral health behaviors from an early age. Hence, in this study, we have targeted only expectant mothers.[45]

The significant influence of mothers’ attitudes on children's oral health found here may be attributed to the impact of their attitudes on their parental caring behaviors for their children.[678]

In this study, we have used a one-to-one anticipatory guidance technique to provide information about ECC to expectant mothers since anticipatory guidance provides a framework for prevention that goes beyond caries to address all aspects of children's oral health.[910] A 3-point Likert scale was chosen since it does not require the participants to provide concrete yes or no answer and allows them to respond in a degree of agreement.[11]

In a study conducted in Salem, Tamil Nadu, the prevalence of ECC was found to be 16%. ECC was seen more in children among working mothers, low parental education, and low socioeconomic groups. Hence, we have conducted this study among the subjects of low socioeconomic status in Salem area and to provide them anticipatory guidance to prevent the disease.[12]

Many studies in the literature have only assessed knowledge of oral diseases, oral health behaviors, need for treatment, and dental visits of pregnant women; however, this study has evaluated the effect of training interventions during pregnancy and their sustainability effect on ECC. To determine the impact of intervention, the scores of variables at baseline were recorded.[13141516] There was a significant improvement in the knowledge among the subjects after giving anticipatory guidance. The limitations of this study include small sample size and short follow-up periods.

CONCLUSION

Presentation of the anticipatory guidance through the direct one-to-one counseling showed a significant improvement in the knowledge among expectant mothers about prevention strategies for ECC. Therefore, we should provide health education programs on anticipatory guidance and infant oral health care at an early stage possibly before the prenatal period for maximum benefits.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.