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Summary. Objectives. The aim of this study was to examine the simultaneous interrelationships between parents oral health behaviour and the oral health status of their
school children.
Sample and methods. Subjects comprized 296 pairs of parents (mother or father) and
their children at an elementary school in Hiroshima. The childs dental examination
was performed using the World Health Organization (WHO) caries diagnostic criteria
for decayed teeth (DT) and filled teeth (FT). The Oral Rating Index for Children (ORIC) was used for the childs gingival health examination. Hiroshima University Dental
Behavioural Inventory (HU-DBI) was used for the assessment of the parents oral health
behaviour. A parent child behavioural model was tested by the linear structural relations
(LISREL) programme.
Results. There was a significant correlation between DT and ORI-C (r = 0168; P < 001).
Correlation was found between ORI-C and oral health behaviour in children (OHB-C)
(r = 0182; P < 001). OHB-C was significantly associated with the HU-DBI (r = 0251;
P < 0001). The hypothesized model after some revisions was found to be consistent
with the data (2 = 13, d.f. = 6, P = 097; Goodness of Fit Index = 0999). Parents
oral health behaviour affected their childrens oral health behaviour (P < 0001). Childrens oral health behaviour affected their DT through its effect on gingival health level.
Parents oral health behaviour also had a significant direct effect on their childrens
DT (P < 005). Childrens grade affected both DT and their oral health behaviour.
Conclusions. Parents oral health behaviour could influence their childrens gingival
health and dental caries directly and/or indirectly through its effect on childrens oral
health behaviour.
Introduction
Adoption of consistent behavioural habits in childhood
takes place at home, with the parents, especially the
Correspondence: Dr Mitsugi Okada, Department of Paediatric
Dentistry, Hiroshima University Faculty of Dentistry, 12-3
Kasumi, Minami-ku, Hiroshima 7348553, Japan. E-mail:
mitsugi@hiroshima-u.ac.jp
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M. Okada et al.
2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 101108
103
Table 1. Percentage distribution of the parents with agree responses for each item on childrens oral health behaviour (OHB-C).
No.
1.
2.
3.
4.
5.
Item descriptions
My
My
My
My
My
child
child
child
child
child
Boys
(n = 148)
Girls
(n = 148)
Chi-square
test
Total
(n = 296)
81
71
84
26
49
88
83
84
32
43
NS
*
NS
NS
NS
84
77
84
29
46
In the calculation of the OFIB-C: (A)One point is given for each of these agree responses. (D)One point is given for each of these
disagree responses. Cronbachs alpha = 051. Significant differences between boys and girls; *P < 005, NS = not significant.
2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 101108
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M. Okada et al.
n
Mean
SD
Grade
DT
FT
ORI-C
OHB-C
HU-DBI
Grade
DT
FT
ORI-C
OHB-C
HU-DBI
296
351
172
1
0139*
0466***
0052
0158**
0011
296
037
102
296
193
192
296
008
092
296
250
125
296
500
216
1
0119*
0168**
0073
0153**
1
0005
0103
0002
1
0182**
0079
1
0251***
Grade = childs school grade; DT = the number of decayed teeth; FT = the number of filled teeth; ORI-C = oral rating index for children;
OHB-C = childs oral health behaviour; HU-DBI = parents oral health behaviour. Pearsons correlation coefficient (*P < 005, **P < 001,
***P < 0001).
Discussion
The results of this study showed that parents oral
health behaviour had a direct influence on their
childrens number of decayed teeth. Furthermore,
parents oral health behaviour had an indirect effect
on gingival health level of their children through
childrens own oral health behaviour. The finding is
in agreement with those of Sasahara et al. [2], Sarnat
et al. [3] and strom & Jakobsen [9], who reported
a significant correlation between parental oral health
behaviour and their childs oral health behaviour.
The findings of this study support the importance
of the continued emphasis on parents self-care
strategies for not only their oral health but also their
childrens oral health. Sallis & Nader [8] presented
a conceptual model of family influences on health
behaviour. The model comprizes four major components: (i) the family environment and interrelationships
2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 101108
105
between health behaviours of the family members; (ii) the antecedents and consequences of
health behaviours; (iii) the influential mechanisms,
namely response facilitation, observational learning
and observation of consequences; and (iv) external
influences.
strom & Jakobsen [9] also reported that there
were statistically significant associations of use of
dental floss, tooth brushing and drinking of nonsugared mineral water among parents and their
adolescent offspring. Stewart et al. [10] showed that
there was a statistically significant increase in selfefficacy for brushing and flossing following psychological interventions to improve oral hygiene
behaviour. In Japan, most people do not know how
to use dental floss [19,20]. Although the role of
social cognitive variables on oral hygiene behaviour
(the daily removal of dental plaque by brushing and
flossing) has received little research attention in Japan,
children who have been encouraged in their preventive health behaviour may have self-efficacy during
growth and development. In this study, parents oral
health behaviour had a direct effect on DT for boys,
whereas for girls it had an indirect effect on DT
through their oral health behaviour and gingival
2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 101108
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M. Okada et al.
school children and their parents oral health behaviour have significant direct relationships with the
childrens dental caries. Parents oral health behaviour could influence their childrens gingival health
and dental caries directly, or indirectly through its
effect on childrens oral health behaviour, although
differences in cultural background and education
between countries may have contributed to the trend
seen in the results of this study.
Rsum. Objectifs. Cette tude a eu pour objectif
dexaminer les interrelations simultans entre
lhygine buccale des parents et ltat de sant
buccale de leur enfant scolaris.
Mthodes. Sujets comprenant 296 paires parents
(pre ou mre) et leurs enfants dans une cole
lmentaire de Hiroshima. Lexamen dentaire de
lenfant a t ralis laide des critres diagnostiques de carie de lOrganisation Mondiale de la
Sant (OMS) pour les dents caries (DT) et obtures
(FT). Lindice dvaluation buccal pour les enfants
(ORI-C) a t utilis pour lexamen de la sant
gingivale des enfants. Le HU-DBI (Evaluation de
comportement dentaire de lUniversit de Hiroshima)
a t utilis pour valuer les habitudes dhygine
buccale des parents. Un modle comportemental
parent-enfant a t test par le programme LISREL
(relations structurelles linaires).
Rsultats. Il y avait une corrlation significative
entre DT et ORI-C (r = 0,168; p < 0,01). Une corrlation a t retrouve entre ORI-C et les habitudes
de sant buccale des enfants (OHB-C) (OHB-C)
(r = 0,182; p < 0,01). OHB-C tait significativement
associ HU-DBI (r = 0,251; p < 0,001). Le modle
suppos aprs quelques rvisions tait reliable aux
donnes data (2 = 1,3, df = 6, p = 0,97; Indice
dadquation = 0,999). Les habitudes de sant
buccale des parents avaient galement un effet direct
sur les habitudes de sant buccale des enfants
( p < 0,001). Les habitudes de sant buccale des
enfants affectaient leurs DT par leur effet sur ltat
de sant gingivale. Les habitudes de sant buccale
des parents avaient aussi un effet significatif direct
sur les DT de leurs enfants ( p < 0,05). Les habitudes
de sant buccale des parents affectaient les habitudes de sant buccale de leurs enfants ( p < 0,001).
Le grade des enfants affectait la fois le DT et leurs
habitudes de sant buccale.
Conclusions. Les habitudes de sant buccale des
parents pourraient avoir une influence directe sur la
sant gingivale et les caries de leurs enfants et/ou
2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 101108
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References
1 Blinkhorn AS. Dental preventive advice for pregnant and
nursing mothers sociological implications. International
Dental Journal 1981; 31: 14 22.
2 Sasahara H, Kawamura M, Kawabata K, Iwamoto Y. Relationship between mothers gingival condition and caries
experience of their 3-year-old children. International Journal
of Paediatric Dentistry 1998; 8: 261267.
3 Sarnat H, Kagan A, Raviv A. The relation between mothers
attitude toward dentistry and the oral status of their children.
Pediatric Dentistry 1984; 6: 128 131.
4 Chang C, Chen LH, Chen PY. Developmental stages of Chinese childrens concepts of health and illness in Taiwan.
Chung Hua Min Kuo Hsiao Erh Ko I Hsueh Hui Tsa Chih
1994; 35: 2735.
5 Bandura A. Social Foundations of Thought and Action: a
Social Cognitive Theory. Englewood Cliffs, New Jersey:
Prentice Hall, 1986.
6 Blinkhorn AS. Influence of social norms on toothbrushing
behavior of preschool children. Community Dentistry and
Oral Epidemiology 1978; 6: 222 226.
7 Jreskog KG. Structural analysis of covariance and correlation matrices. Psychometrika 1978; 43: 443477.
8 Sallis JF, Nader PH. Family determinants of health behaviors.
2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 101108
108
10
11
12
13
14
15
16
17
M. Okada et al.
18 World Health Organization. Individual tooth status and treatment need. In: Oral Health Surveys: Basic Methods, 3rd edn.
Geneva: World Health Organization, 1987: 3439.
19 Fukai K, Maki Y, Takaesu Y. Oral health behavior of adults
in relation to age groups [in Japanese, English abstract]. Journal of Dental Health 1996; 46: 676682.
20 Kawamura M, Iwamoto Y. Present state of dental health
knowledge, attitudes/ behaviour and perceived oral health of
Japanese employees. International Dental Journal 1999; 49:
173 181.
21 Arbuckle JL, Wothke W. Amos 40 Users Guide. Chicago:
SmallWaters, 1999.
22 Taura K. Relationship between dental caries in deciduous
teeth and tooth brushing in nursery school children [in
Japanese, English abstract]. Journal of Dental Health 1981;
31: 2 16.
23 Kawamura M, Sasaki T, Imai-Tanaka T, Yamasaki Y,
Iwamoto Y. Service-mix in general dental practice in Japan:
a survey in a suburban area. Australian Dental Journal 1998;
43: 410 416.
24 Eccleston B. Social equality: the distribution of income and
wealth. In: State and Society in Post-War Japan. Oxford:
Blackwell Publishing, 1993: 164167.
25 Kobayashi S, Kawasaki K, Takagi O et al. Caries experience
in subjects 18 22 years of age after 13 years discontinued
water fluoridation in Okinawa. Community Dentistry and Oral
Epidemiology 1992; 20: 81 83.
26 Tsurumoto A, Wright FAC, Kitamura T, Fukushima M,
Campain AC, Morgan MV. Cross-cultural comparison of
attitudes and opinions on fluorides and fluoridation between
Australia and Japan. Community Dentistry and Oral Epidemiology 1998; 26: 182 193.
27 Ozawa I. Increasing choices for women. In: Blueprint for a
New Japan. Tokyo: Kodansha International, 1994: 192
194.
2002 BSPD and IAPD, International Journal of Paediatric Dentistry 12: 101108