Parental attitudes to the care of the carious primary dentition

Abstract

Objectives: To examine parents' attitudes to the dental care of their children, taking into account the family's socio-economic background, dentally-related behaviour including the child's level of dental anxiety and dental treatment history.

Methods: A cross sectional study of all 5-year-old children living in Ellesmere Port and Chester. All children were clinically examined; dmft and its components were recorded. A postal questionnaire was sent to the children's parents to measure their preferences for dental care with reference to two scenarios, (1) if their child had a carious but asymptomatic primary tooth, or (2) if their child had a carious primary tooth which was causing toothache. Parents were also asked to provide information on the dental attendance pattern of their child and an assessment of their child's dental anxiety. Family socio-economic status was recorded using the Townsend material deprivation index of the electoral ward in which they resided.

Results: Questionnaires were distributed to the home addresses of the 1,745 children who were clinically examined, and 1,437 were returned, giving a response rate of 82%. In both scenarios the majority of parents were happy to leave the decision on treatment to the dentist. In the asymptomatic tooth scenario, approximately one third of parents wanted the tooth to remain untreated but periodically monitored, only 6% expressed a desire to have their child's tooth restored. Multivariate analysis showed that parents of children who had a filling (OR 4.32 95%CI 2.21-8.43) or extraction (OR 2.24 95%CI 1.11-4.53) in the past were significantly more likely to want restorative care for their children. In the scenario where the child had toothache, multivariate analysis confirmed that parents had a preference for an intervention (extraction or filling) if they lived in a deprived area (Townsend score OR 1.10, 95% CI 1.04, 1.16) or if their child had had an extraction (OR 4.35, 95% CI 1.59, 11.88) or filling (OR 2.39, 95% CI 1.05, 5.45) in the past, after controlling for gender, attendance and parentally reported anxiety. When preference for an extraction was considered as the dependent variable, there was no significant relationship with past restorative treatment. In both scenarios there was no association between parentally reported anxiety of the child and parental preferences for treatment.

Conclusions: In this part of the UK, there was little explicit support amongst parents for the restoration of asymptomatic carious primary teeth. Parental expectations for the dental care of young children with caries in their primary teeth, were closely related to the treatment experiences of the child. Families living in deprived areas expressed a preference for more interventionist care than their more affluent counterparts. Parentally judged anxiety of the child or their past dental attendance behaviour had no association with parents' preferences for the care of their children.