Mexican-origin children have higher rates of decay and lower dental utilization rates than children from all other racial/ethnic groups. Different cultural groups' interpretations of dental symptoms illuminate their different decision-making process about seeking care. Through ethnography in a small rural U.S. city, we examined low-income Mexican immigrant caregivers' interpretations of their children's dental symptoms and evaluations of the need for treatment.
We conducted 49 in-depth interviews with 26 Mexican immigrant caregivers about their perceptions of their children's dental symptoms, and observations of five such caregivers' help-seeking episodes and 30 other caregivers' presentation of their children's symptoms at dental clinics. All interviews and fieldnotes were analyzed qualitatively through a series of readings and codings.
A conceptual model of caregivers' decision-making processes was developed. Most caregivers deduced the health of teeth from visible appearance, and thus children's complaints of pain alone were often ineffective in triggering a dental visit. Caregivers often delayed treatment because they viewed their children's oral disease as mere "stains" requiring cleaning rather than as bacterial infections requiring restorative treatment. Parents appeared to confuse carious "stains" with fluorosis stains common in rural Mexico.
Even when Mexican immigrant caregivers recognize a dental problem, they often misinterpret it as a "stain." Caregivers' interpretations of decay were shaped by their lack of experience with children's decay in rural Mexico. Oral health education programs should help rural immigrant caregivers distinguish between "stains" and "cavities," and understand the heightened oral hygiene requirements of the cariogenic diet in industrialized countries.
"However, even for those who had dental coverage through a governmental health benefit program, the underutilization of dental services for younger children has been very common especially the preventive services . Low dental attendance may stem from the trending belief of immigrant families that professional care is needed only when a dental problem arises, rather than seeking out preventive measures    . "
[Show abstract][Hide abstract] ABSTRACT: Purpose
. To evaluate the impact of an educational workshop on parental knowledge, attitude, and perceived behavioral control regarding their child’s oral health.
Materials and Methods
. A one-time oral health education workshop including audio/visual and hands-on components was conducted by a trained dentist and bilingual community workers in community locations. Participants were African parents of children who had lived in Canada for less than ten years. The impact of the workshop was evaluated by a questionnaire developed based on the theory of planned behavior.
. A total of 105 parents participated in this study. Participants were mainly mothers (mean age
years) who came to Canada as refugee (77.1%) and had below high school education (70%). Paired
-test showed a significant difference in participants’ knowledge of caries, preventive measures, and benefits of regular dental visits after the workshop (
). A significant improvement was also found in parental attitudes toward preventive measures and their perceived behavioral control (
). Parents’ intention to take their child to a dentist within six months significantly altered after the workshop (
. A one-time hands-on training was effective in improving parental knowledge, attitude, perceived behavioral control, and intention with respect to their child’s oral health and preventive dental visits in African immigrants.
"This reflects a level of poverty that makes paying out-of-pocket for dental services extremely difficult if not prohibitive. As a group, caregivers had had significant experience with children's oral disease: for example, of the 38 immigrant Mexican or Salvadoran caregivers, 23 (60%) reported that their focal child under age six had had cavities; eight reported their child had no dental visit yet and seven reported their child had had a visit but no cavities yet [47,48]. "
[Show abstract][Hide abstract] ABSTRACT: Latino children experience a higher prevalence of caries than do children in any other racial/ethnic group in the US. This paper examines the intersections among four societal sectors or contexts of care which contribute to oral health disparities for low-income, preschool Latino1 children in rural California.
Findings are reported from an ethnographic investigation, conducted in 2005-2006, of family, community, professional/dental and policy/regulatory sectors or contexts of care that play central roles in creating or sustaining low income, rural children's poor oral health status. The study community of around 9,000 people, predominantly of Mexican-American origin, was located in California's agricultural Central Valley. Observations in homes, community facilities, and dental offices within the region were supplemented by in-depth interviews with 30 key informants (such as dental professionals, health educators, child welfare agents, clinic administrators and regulatory agents) and 47 primary caregivers (mothers) of children at least one of whom was under 6 years of age.
Caregivers did not always recognize visible signs of caries among their children, nor respond quickly unless children also complained of pain. Fluctuating seasonal eligibility for public health insurance intersected with limited community infrastructure and civic amenities, including lack of public transportation, to create difficulties in access to care. The non-fluoridated municipal water supply is not widely consumed because of fears about pesticide pollution. If the dentist brought children into the clinic for multiple visits, this caused the accompanying parent hardship and occasionally resulted in the loss of his or her job. Few general dentists had received specific training in how to handle young patients. Children's dental fear and poor provider-parent communication were exacerbated by a scarcity of dentists willing to serve rural low-income populations. Stringent state fiscal reimbursement policies further complicated the situation.
Several societal sectors or contexts of care significantly intersected to produce or sustain poor oral health care for children. Parental beliefs and practices, leading for example to delay in seeking care, were compounded by lack of key community or economic resources, and the organization and delivery of professional dental services. In the context of state-mandated policies and procedures, these all worked to militate against children receiving timely care that would considerably reduce oral health disparities among this highly disadvantaged population.
BMC Oral Health 02/2008; 8(1):8. DOI:10.1186/1472-6831-8-8 · 1.13 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To investigate caregiver beliefs and behaviors as key issues in the initiation of home oral hygiene routines. Oral hygiene helps reduce the prevalence of early childhood caries, which is disproportionately high among Mexican-American children.
Interviews were conducted with a convenience sample of 48 Mexican-American mothers of young children in a low income, urban neighborhood. Interviews were digitally recorded, translated, transcribed, coded and analyzed using standard qualitative procedures.
The average age of tooth brushing initiation was 1.8 +/- 0.8 years; only a small proportion of parents (13%) initiated oral hygiene in accord with American Dental Association (ADA) recommendations. Mothers initiated 2 forms of oral hygiene: infant oral hygiene and regular tooth brushing. For the 48% of children who participated in infant oral hygiene, mothers were prompted by pediatrician and social service (WIC) professionals. For regular tooth brushing initiation, a set of maternal beliefs exist about when this oral hygiene practice becomes necessary for children. Beliefs are mainly based on a child's dental maturity, interest, capacity and age/size.
Most (87%) of the urban Mexican-American mothers in the study do not initiate oral hygiene practices in compliance with ADA recommendations. These findings have implications for educational messages.
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