Oral hygiene and dental caries among children with heart defects and caregivers' oral healthcare knowledge, attitudes and practices

Abstract

Background: Children with a medical disability are those whose medical condition puts their general health further at risk if they suffer dental disease. Because of this risk to health, or even to life, their dental care is of vital importance. The dental caries experience and the oral hygiene status among these children in Kenya and other developing countries has not been extensively investigated. In addition, the caregivers' knowledge, attitudes and practices of oral healthcare for these children remains unknown. Objective: The present study was to determine dental caries experience and oral health hygiene status among children with heart disease and their caregiver's knowledge, attitude and practices in Nairobi Materials and methods Setting: Three paediatric cardiology clinics in Nairobi, Kenya: the KNH, GGCH and Mater Hospital. Study design: This was a descriptive cross-sectional study Data analysis: The data was coded and analyzed using SPSS version 12.0 and the results presented in the form of frequency diagrams, tables and pie charts. Xlll RESULTS: A total of 81 children were examined and the parents/guardians who accompanied them were interviewed. The mean age of the children was 8.16±2.81 years; males were 44(54.3%) while females were 37(45.7%). The prevalence of dental caries in the deciduous teeth was 65.57%, and in permanent teeth it was 40%. The mean dmft was 2.85±3.45 (n=61) and the mean DMFT was 0.95±1.55 (n=64). The mean decayed untreated carious teeth was d=2.65±3.37 (n=61) in deciduous teeth and D=0.81±1.39 (n=64) in permanent teeth. The oral hygiene status was poor with mean plaque score of 1.72±0.59 (n=81). Except for one child with excellent OH; 7 had good OH; 37(45.7%) had fair oral hygiene; and 36(44.4%) had poor oral hygiene. The knowledge on the causes and prevention of dental diseases was generally good. However, the knowledge on oral healthcare fora child with heart disease was poor with only a third of the caregivers knowing the importance of maintaining good oral health as a preventive measure for complications arising from dental diseases. In addition, 57(70%) caregivers had never received any professional advice on the dental care of a child with heart disease Majority of the caregivers 80% (n=65) generally had positive attitudes while only 20% (n=16) caregivers had negative attitudes. There was no statistically significant relationship between the caregivers attitudes and the dental caries experience and XIV the oral hygiene status among the children with respective p values of p=0.697 and p=0.234(p:50.05) With regard to oral healthcare practices, 68 (84%) of the caregivers displayed unfavourable practices compared to 13(16%) who categorized as displaying favourable oral healthcare practices for their children. Only 22(27.2%) of the children had seen a dentist, with hardly any preventive dental treatment done. Despite 75(93%) of the children claiming that they clean teeth, only 33(44%) cleaned at least twice a day; and 62(83%) cleaned their teeth without the caregivers' supervision. There was significant relationship between the caregivers' oral health care knowledge and the oral hygiene status among the children with mann witney u test Z= -2.090 p=0.039(p:50.05). However, there was no significant relationship between the caregivers oral healthcare practices and the dental caries experience and the oral hygiene status among the children with respective p=0.197and p=0.160(p:50.05) Conclusion: The prevalence of dental caries was high. Most of the children cleaned their teeth though inappropriately and majority of them had never been to a dentist for any preventive oral health measure. The oral hygiene of the children and the caregivers' oral healthcare knowledge for children with heart disease was poor.