186 - Understanding Parent Supervised Toothbrushing in Early Childhood

Abstract:

Purpose: To investigate factors associated with parent-supervised toothbrushing (PSB) in preschool-aged children, integrating quantitative analysis from a community-based study and thematic data from a qualitative study.

Methods: The quantitative component used parent-reported questionnaires and clinical data from a community-based oral-epidemiologic study among 3-5-year-old children in North Carolina to investigate associations of socio-demographic factors, oral hygiene habits, and ECC status with PSB. Bivariate analysis utilized chi-square and two-sample t-tests. Multivariable analysis used generalized estimating equations accounting for complex study design using log-binomial regression. The qualitative component used semi-structured interviews with parents/caregivers recruited from pediatrics offices, to explore experiences and identify PSB facilitators and barriers. Thematic analysis relied on the Theoretical Domains Framework.

Results: Among 6,222 participants in the quantitative study, 61% reported PSB. In multivariable analysis, older age was associated with lower PSB (P < 0.0001), while male gender (P=0.0004), higher parental education (P=0.026), and frequent brushing (P=0.021) were associated with higher PSB. Hispanics and Whites had greater PSB prevalence than African Americans (P < 0.0001). Thematic analysis revealed that most parents valued and felt confident in PSB. Challenges included time constraints, child resistance, and competing priorities. Facilitators included professional guidance, routines, positive reinforcement, and social norms. Barriers were linked to environmental context, behavioral regulation, and child factors, while motivators centered on preventing dental problems.

Conclusion: This mixed-methods study integrated quantitative and qualitative data to study the prevalence of PSB in a multi-ethnic community-based sample, identify relevant sociodemographic predictors, underlying values, contextual barriers and facilitators, informing targeted and theory-driven interventions for sustained PSB.

Identify Supporting Agency and Grant Number: Research supported by the Department of Pediatric Dentistry and Dental Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill.