Andrew Lesley, Wenden Elizabeth, Estai Mohamed, Wallace Ruth
School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia.
School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.
Child Care Health Dev. 2025 Jul;51(4):e70095. doi: 10.1111/cch.70095.
Early childhood caries (ECC) is the most common chronic health condition among Australian preschool-aged children. Untreated, ECC can affect children's physical and emotional health and future social opportunities. ECC is largely preventable through primary caregivers' correct understanding of oral health promoting diets, oral hygiene practices and dental service engagement. The study aim is to explore Western Australian (WA) primary caregivers' child oral health knowledge, experience and practices. The Fisher-Owens socioecological model of child oral health was applied across the study to structure and interpret the findings across the complex, interactive sociocultural influences on child oral health.
The mixed-methods convergent research design included a questionnaire and focus group sessions with a purposive sample of primary caregivers of children aged under 5 years across two geographical WA locations (metropolitan and regional areas). Questions sought to understand participant knowledge, practices and experiences across categories of tooth safe diet and feeding practices, oral hygiene and oral health services. Questionnaire data underwent simple descriptive statistical analysis. Focus group data were organised using Nvivo v12 software and analysed using the codebook approach to thematic analysis, in which the coding process is guided by Braun and Clarke's predetermined coding frame. The study explored the social determinants of participants' geographical location, English language status and educational attainment.
Participants (n = 42) completed the questionnaires and attended one of 10 focus groups. Findings reveal that despite the availability of evidence-based oral health guidelines for health professionals, participants reported they received inconsistent messages on the topic. Widespread confusion is evident from all social backgrounds about child oral health and hygiene, in particular, fluoride use, brushing regimes and dietary sugars. Dental service engagement is suboptimal, influenced by lack of availability, cost and perception of a lack of child-friendly dental services. Cost is a particular factor influencing lower dental service engagement among English as an additional language primary caregivers, whereas lack of availability affects those in regional areas.
Individual, community and wider structural recommendations are offered to promote equitable, accessible and consistent child oral health promotion and dental services.
幼儿龋齿（ECC）是澳大利亚学龄前儿童中最常见的慢性健康问题。若不加以治疗，ECC会影响儿童的身心健康以及未来的社交机会。通过主要照料者对促进口腔健康的饮食、口腔卫生习惯以及牙科服务的正确理解，ECC在很大程度上是可以预防的。本研究的目的是探索西澳大利亚州（WA）主要照料者的儿童口腔健康知识、经验和做法。本研究采用了儿童口腔健康的费舍尔-欧文斯社会生态模型，以构建和解释在复杂的、相互作用的社会文化因素对儿童口腔健康的影响下所获得的研究结果。
混合方法收敛性研究设计包括一份问卷以及焦点小组会议，研究对象为西澳大利亚州两个地区（大都市地区和偏远地区）5岁以下儿童的主要照料者的目的性样本。问题旨在了解参与者在牙齿安全饮食和喂养习惯、口腔卫生以及口腔健康服务等方面的知识、做法和经验。问卷数据进行了简单的描述性统计分析。焦点小组数据使用Nvivo v12软件进行整理，并采用主题分析的编码手册方法进行分析，其中编码过程以布劳恩和克拉克预先确定的编码框架为指导。本研究探讨了参与者地理位置、英语语言状况和教育程度的社会决定因素。
参与者（n = 42）完成了问卷调查，并参加了10个焦点小组中的一个。研究结果显示，尽管有针对卫生专业人员的循证口腔健康指南，但参与者表示他们在这个主题上收到的信息并不一致。所有社会背景的人对儿童口腔健康和卫生，特别是氟化物的使用、刷牙方式和膳食糖，都存在普遍的困惑。牙科服务的参与度不理想，这受到服务可及性、成本以及对缺乏儿童友好型牙科服务的认知的影响。成本是影响以英语为第二语言的主要照料者较低的牙科服务参与度的一个特别因素，而服务可及性不足则影响偏远地区的人。
提出了个人、社区和更广泛的结构性建议，以促进公平、可及和一致的儿童口腔健康促进和牙科服务。
