Pathways between parental and individual determinants of dental caries and dental visit behaviours among children: Validation of a new conceptual model

Abstract

Objectives: To delineate the pathways between the parental and individual determinants of dental caries and dental visit behaviours among children, using path analysis.

Methods: The study employed an observational design; the study sample consisted of 583 parent-child dyads. Data were collected using a sociodemographic and oral health behaviour form, the Parenting Styles and Dimensions Questionnaire, the Corah Dental Anxiety Scale and the Children's Fear Survey Schedule-Dental Subscale. A conceptual model was developed, and it consisted of four endogenous variables (dental caries, children's oral health, dental visit behaviours and children's dental anxiety) and four exogenous ones (parental socioeconomic status, parental dental anxiety, parental oral health behaviours and parenting style). Path analysis was used to test the compatibility of the conceptual model, with a statistical significance at P < .001.

Results: 49.1% of participants (n = 286) were male. The mean age of participants was 8.3 (SD = 2.1). The mean DMFT score was 6.0 (SD = 3.0) and the mean Frankl behaviour score 3.0 (SD = 1.0). Parental socioeconomic status showed the strongest association with dental caries (β = .276; P < .001), and children's dental anxiety had the strongest association with dental visit behaviours (β = -.414; P < .001). Parental socioeconomic status and oral health behaviours were directly associated with dental caries (P < .001), and parental socioeconomic status had the most association. Parenting style and parental and children's dental anxiety were associated with dental visit behaviours (P < .001). Further, while all parental variables except prior exposure to training about oral and dental health were significantly correlated with dental caries, only educational level and coverage by health insurance were significantly associated with Frankl behaviour scale score.

Conclusions: This study developed and validated a conceptual model that delineates the pathways between the parental and individual determinants of children's oral health and dental visit behaviours. The model should help us to understand these pathways to lower the incidence of dental caries and improve dental visit behaviours among children.

Keywords: caries; children; dental health; dental visit behaviour.