Exploring child and family-level influences on oral hygiene practices (OHP)—a qualitative study from South India

Background: Early Childhood Caries (ECC) is a global oral health issue that can be effectively prevented through improved oral health literacy and practices. Parental beliefs, attitudes, and cultural factors significantly influence children’s adoption of oral hygiene practices (OHP). Recent literature indicates a knowledge gap among parents and caregivers regarding these practices. Methods: This qualitative study explored traditional oral health beliefs, perspectives, and practices among parents and caregivers of children aged 0-3 years, both with and without ECC. Data was collected through 24 semi-structured interviews and 2 focus group discussions. Additionally, information on oral health practices and health-seeking behaviors was gathered to gain in-depth insights. The research was guided by the Fisher-Owen’s model, focusing on child and family-level influences. Results: Audio recordings were analyzed using thematic analysis with NVivo software. The analysis revealed two main themes related to child-level influences and three under family-level influences. Findings indicated that child-and family-level determinants contribute to inadequate OHP. These include the child’s tender age and poor cooperation with OHP, coupled with parents’ limited awareness of oral hygiene’s importance, specifically regarding tooth brushing methods, toothpaste use, and fluoride’s role in ECC prevention, nighttime brushing, and poor self-efficacy. Conclusions: Preventing ECC necessitates attitudinal and behavioral changes among parents and caregivers. These observations highlight a lack of knowledge about oral health and OHP among parents, underscoring the need for enhanced parental awareness and understanding through educational programs and the development of effective oral health policies to improve oral health outcomes in young children.