The relationship between parenting, family interaction and childhood dental caries: A case-control study

a b s t r a c t The aim of this case-control study was to explore the relationship between parenting practices, parent echild interaction and childhood dental caries, using a sample of 5e8-year old children from the Netherlands. Cases were defined as children with four or more decayed, missing or filled teeth and controls were caries free. Cases (n ¼ 28) and controls (n ¼ 26) were recruited from a referral centre for paediatric dental care and a general dental practice, respectively. Parenting practices and parentechild interactions of the child's primary caregiver were observed using Structured Interaction Tasks and subsequently rated on seven dimensions: positive involvement, encouragement, problem-solving, discipline, monitoring, coercion and interpersonal atmosphere. All Structured Interaction Tasks were videotaped, and coded by trained and calibrated observers blind to the dental condition. Differences in parenting dimensions between cases and controls were analysed using multivariate analysis of variance, independent samples T-tests, c 2 -tests and multiple logistic regression analyses. Controls had significantly higher scores on the dimensions positive involvement, encouragement, problem-solving and interpersonal atmosphere, compared to cases. Parents of controls were also less likely to show coercive behaviours. These associations remained statistically significant after adjustment for the mother's education level, tooth brushing frequency and the frequency of consuming sugary foods and drinks, except for coercion. There was no significant difference in discipline between cases and controls. In conclusion, this case-control study found a significant relationship between parenting practices, parent echild interaction quality and childhood dental caries. Our findings suggest that parenting practices may be an important factor to consider in caries preventive programs

Simulation Workshop to Test STAR: a Home-based Toothbrushing Intervention within Childsmile

In Scotland, where socio-economic inequalities in child tooth decay persist, Childsmile’s community-based Dental Health Support Workers (DHSWs) deliver tailored interventions to families in need of additional support in the home setting, including the promotion of supervised toothbrushing in the early years. Aims: The aim of this study was to test the feasibility and acceptability of the STAR toothbrushing tool with DHSWs and families in a simulated setting to support implementation of supervised toothbrushing in the home. Methods: In August 2022, the STAR tool was developed/co-designed with DHSWs. It aims to help families to identify barriers to toothbrushing and provide strategies to overcome these barriers. A two day simulation workshop, was held in Glasgow Dental School, with four DHSWs, two parents and two simulated parents, who tested the acceptability and feasibility of the tool. The simulated interactions between DHSWs and parents were video recorded and analysed using the Function Resonance Analysis Method (FRAM) - a novel approach in this area. Exit interviews with participants were audio recorded and analysed using Framework analysis and the modified Consolidated Framework for Implementation Research (CFIR). Full NHS ethical approval and participant consent were obtained. Results: DHSWs and parents responded positively to the use of the STAR tool and reported it was easy to use and adaptable to families with different barriers to toothbrushing. Six weeks follow-up found that parents had been able to use the strategies given to them to make beneficial changes to their toothbrushing routines. FRAM analysis showed that the STAR tool can be used flexibly by DHSWs to provide tailored toothbrushing advice to families. Conclusions: In this simulation study, use of the STAR tool was feasible and acceptable to DHSWs and parents and allowed families to make improvements to their toothbrushing routines. The STAR tool is currently being rolled out and evaluated across the 14 NHS Scotland Health Boards

Multi-source data approach for personalized outcome prediction in lung cancer screening: update from the NELSON trial

Trials show that low-dose computed tomography (CT) lung cancer screening in long-term (ex-)smokers reduces lung cancer mortality. However, many individuals were exposed to unnecessary diagnostic procedures. This project aims to improve the efficiency of lung cancer screening by identifying high-risk participants, and improving risk discrimination for nodules. This study is an extension of the Dutch-Belgian Randomized Lung Cancer Screening Trial, with a focus on personalized outcome prediction (NELSON-POP). New data will be added on genetics, air pollution, malignancy risk for lung nodules, and CT biomarkers beyond lung nodules (emphysema, coronary calcification, bone density, vertebral height and body composition). The roles of polygenic risk scores and air pollution in screen-detected lung cancer diagnosis and survival will be established. The association between the AI-based nodule malignancy score and lung cancer will be evaluated at baseline and incident screening rounds. The association of chest CT imaging biomarkers with outcomes will be established. Based on these results, multisource prediction models for pre-screening and post-baseline-screening participant selection and nodule management will be developed. The new models will be externally validated. We hypothesize that we can identify 15-20% participants with low-risk of lung cancer or short life expectancy and thus prevent ~140,000 Dutch individuals from being screened unnecessarily. We hypothesize that our models will improve the specificity of nodule management by 10% without loss of sensitivity as compared to assessment of nodule size/growth alone, and reduce unnecessary work-up by 40-50%

Obesity and caries in four-to-six year old English children: a cross-sectional study.

BACKGROUND: Obesity and caries are common conditions in childhood and can have significant implications on children's wellbeing. Evidence into their association remains conflicting. Furthermore, studies examining the ssociation between obesity and caries commonly focus on individual-level determinants. The present study aimed to examine the association between obesity and caries in young English children and to determine the impact of deprivation and area-level characteristics on the distribution of the two conditions. METHODS: This was a cross-sectional study among children in Plymouth city aged four-to-six years. Anthropometric measurements included weight and height (converted to Body Mass Index centiles and z-scores), and waist circumference. Caries was assessed by using the sum of the number of teeth that were decayed, missing or filled. A questionnaire was used to obtain information on children's demographic characteristics, oral hygiene, and dietary habits. The impact of deprivation on anthropometric variables and caries was determined using Linear and Poisson regression models, respectively. Multiple logistic regression was used to assess the association between different anthropometric measures and caries. Logistic regression models were also used to examine the impact of several demographic characteristics and health behaviours on the presence of obesity and caries. RESULTS: The total sample included 347 children aged 5.10 ± 0.31 (mean ± SD). Deprivation had a significant impact on caries and BMI z-scores (p < 0.05). Neither BMI- nor waist circumference z-scores were shown to be significantly associated with dental caries. Among the neighbourhood characteristics examined, the percentage of people dependent on benefits was found to have a significant impact on caries rates (p < 0.05). Household's total annual income was inversely related to caries risk and parental educational level affected children's tooth brushing frequency. CONCLUSIONS: No associations between any measure of obesity and caries were found. However, deprivation affected both obesity and caries, thus highlighting the need to prioritise disadvantaged children in future prevention programmes

Just add positivity? Dental caries, obesity and problem behaviour in children: the role of parents and family relations

Dit proefschrift laat verbanden zien tussen opvoeding en gezinsfunctioneren enerzijds en mondgezondheid van kinderen anderzijds. Daarnaast werden associaties tussen overgewicht, gedragsproblemen en cariës bij kinderen in kaart gebracht. In het onderzoek werden drie onderzoeksmethoden gebruikt: groepsinterviews met ouders, vragenlijsten en video-observaties. De kern van het onderzoek bestond uit de observatie van ouder-kind interacties die werden opgenomen op video en daarna beoordeeld ten aanzien van opvoedvaardigheden van de ouder. Er kwam een uitgesproken en significant verschil naar voren tussen kinderen met en kinderen zonder cariës betreffende de gemeten gezinsfactoren. Positieve opvoedvaardigheden zoals positieve betrokkenheid, positieve bekrachtiging en probleemoplossend vermogen werden minder vaak gezien bij kinderen met cariës. Het onderzoek liet ook een andere belangrijke uitkomst zien: kinderen van ouders die als opvoedstijl een dwingende en strenge manier van disciplineren hadden, gecombineerd met het uiten van weinig warmte, hadden grotere kans op het ontwikkelen van cariës. Er bestond geen relatie tussen een ongezond hoog lichaamsgewicht en de aanwezigheid van cariës. Er werd een significante relatie tussen gedragsproblemen en de aanwezigheid van cariës bij kinderen gevonden, die wellicht kan worden verklaard door een onderliggende invloed van opvoeding en gezinsfunctioneren. Alle gebruikte methoden maken een verband duidelijk tussen ouder-kind interactie en de aanwezigheid van cariës bij kinderen. Toekomstig onderzoek zou zich kunnen richten op het ontwerpen en testen van oudergerichte interventies, ingezet op het verwerven van positieve opvoedvaardigheden. Dit zou ouders kunnen brengen tot minder streng en minder dwingend opvoedgedrag en tot het uiten van meer betrokkenheid en warmte. Mogelijk zal dit leiden tot positieve uitkomsten zoals een afname van de aanwezigheid van cariës, een afname van overgewicht en zelfs misschien reductie van gedragsproblemen bij kinderen

Uitblinkers: De uitdaging van tandenpoetsen bij een kind

Gedragsverandering in de tandheelkundige praktijk lijkt redelijk eenvoudig. Met voorlichting en instructie verwachten we ouders te kunnen motiveren tot betere zelfzorg. Toch blijkt de praktijk weerbarstig. Onderzoek laat zien dat veel ouders wel over voldoende kennis en motivatie beschikken, maar dat zij barrières ervaren om de mondhygiëne-adviezen in praktijk te brengen. Hoe kunt u hierbij helpen? In dit artikel maakt u kennis met een nieuw ontwikkelde interventie, genaamd ‘Uitblinkers’. ‘Uitblinkers’ is een laagdrempelige gespreksmethodiek voor de dagelijkse praktijk, gericht op de uitdagingen die ouders in de opvoeding kunnen ervaren in relatie tot het tandenpoetsen bij hun kind