Association between the caregivers' oral health literacy and the oral health of children and youth with special health care needs

• Published in: PloS one 2022-01, Vol.17 (1), p.e0263153
• Main Authors: Baskaradoss, Jagan Kumar, AlSumait, Aishah, Behbehani, Eman, Qudeimat, Muawia A
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Adult; Beliefs, opinions and attitudes; Caregivers; Caregivers - psychology; Child; Children; Children & youth; Cognitive ability; Confidence intervals; Congenital anomalies; Congenital defects; Consent; Cross-Sectional Studies; Demographic aspects; Dental caries; Dental Caries - epidemiology; Dentistry; Disabled Children; Female; Gingival index; Graph theory; Health Behavior; Health care; Health education; Health Literacy; Humans; Knowledge; Kuwait - epidemiology; Literacy; Male; Medicine and Health Sciences; Middle Aged; Oral diseases; Oral Health; Oral hygiene; People and Places; Persons With Hearing Impairments; Plaque index; Questionnaires; Reading comprehension; Regression analysis; Sample size; Schools; Social factors; Social Sciences; Socioeconomic Factors; Socioeconomics; Statistical analysis; Students; Surveys and Questionnaires; Teeth; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0263153

Previous studies have shown that children of caregivers with low oral health literacy (OHL) had more untreated caries than children of caregivers with adequate OHL. However, there is a paucity of information on this relationship among children and youth with special health care needs (CYSHCN). Accordingly, this study aims to assess the association between the caregivers' OHL and the oral health status of CYSHCN. This cross-sectional study was conducted in four schools dedicated for CYSHCN. A 48-item questionnaire gathered information about the demographic and socioeconomic factors, the child/adolescent's medical condition, dental characteristics, caregiver self-efficacy and the child's dental attitude. The Comprehensive Measure of Oral Health Knowledge (CMOHK) questionnaire was used to assess the caregivers' OHL. The Löe & Silness gingival index (GI) and the Silness & Löe plaque index (PI) were used to assess gingival health and plaque levels, respectively. Directed acyclic graphs (DAGs) were utilized for the selection of the appropriate set of confounding variables for regression analysis. The mean score differences and 95% confidence intervals (CI) were estimated to quantify the associations of the various covariates with oral health outcome variables. This study included 214 child/caregiver dyads. Most participants were physically disabled (56.1%) followed by children with hearing difficulty (9.8%) and congenital anomalies/syndromes (7.9%). The mean PI and GI of the children was 1.26±0.52 and 1.30±0.47, respectively. The median CMOHK score was 12 and the respondents were dichotomized based on the median value. Low caregiver oral health conceptual knowledge was significantly associated with higher PI scores (β [95% CI] = -0.26 [-0.41, -0.13]; p