Socio-Behavioral Factors and Early Childhood Caries - Assignment Example

Socio-Behavioral Factors and Early Childhood Caries Glossary 1)Socio-behavioral factors involve aspects that relate with an individual’s behavior and social being. Behavior is a multifaceted aspect, which includes the psychological processes that make up an individual. It traverses from the individual’s cognitive skills, to temperament, the genetically acquired behavior, emotions, and motivations. These behavioral aspects relates with the ability of an individual to belong in a group, which forms the social component hence resulting to socio-behavioral factors (NIH n.d, pg. 1). In this research, aspects relating to the interactions with others as well as the inherent personal qualities in children are being examined for the causation of dental carriers. 2)Preschool children refer to children that are on their early childhood education. It usually occurs to children before they are at a position of joining primary school. Though the ages may slightly vary, most of the preschool children are usually between the age of three and six years. This research examines pupils in this level of education for the prevalence of dental carries. 3)Early childhood carries refers to a kind of tooth decay that occurs to children that are in their first five years of growth after birth. Children can develop this condition in their infancy, either as toddlers or as preschoolers (Kail 2011, p.2). 4)Primary maxillary anterior teeth refer to the deciduous teeth that develop during infancy of which it comprises of the canines as well as the central and lateral incisors. These teeth are found on the front side. 5)Dentition refers to the teeth development from infancy to adulthood and the subsequent arrangement of the teeth in the mouth of an individual. It traverses from the arrangement of the teeth in the mouth, the kind, and the number of each type present in the mouth. 6)Visual diagnosis is the identification of a disease through observation; therefore, no tests are required. 7)Cavitation refers to the presence of a cavity in a given tissue or an organ (Merriam-Webster 2014, p.1). In our context of research, it entails the formation of tooth cavities specifically touching on children teeth. 8)Oral health behavior refers to the situation of an individual’s mouth based on the hygiene that is maintained in the mouth. Of essence in the behavior is the hygiene of someone’s teeth. 9)Epidemiological data refers to the information that is obtained from research based on some health parameters of a population. 10)Caries Prevalence refers to the chances that an individual will develop dental caries. The prevalence can be calculated in terms of a percentage. 11)Sample frame refers to all the components present in a sampling area from where the sample will be obtained from. The sample frame can be made up of a variety of components, all of which helps in getting the data required by a researcher. 12)Dental examination deals with an analysis of the situation of the teeth in order to identify any potential anomalies that may require to be corrected. It is one of the requirements for good oral health. Introduction The research paper by Rahul, June, and Alan, Socio-Behavioral Factors and Early Childhood Caries: A Cross-sectional Study of Pre-School Children in Central Trinidad explores the role of factors that are based on the behavior and social aspects in children, which help, promote the development of early childhood caries (ECC). The caries are detrimental to the growth and development of children hence requires to be confronted. The research endeavors to analyze the situation in order to understand the underlying health problem. In particular, the research addresses the chances of occurrence of ECC while analyzing the extent to which carries have advanced among the preschool children. In addition to the level of advancement of the dental condition, the research establishes a relationship between the condition and the socio-behavioral aspects within the specified community. The research covers the Central Trinidad region in West Indies. Previous research has indicated high prevalence of caries in other regions. For example, Anguilla reported up to 21% prevalence of caries among children aged between 36-71 months. In addition, severe conditions of ECC were reported on 17% of the sampled children. This research forms a background of oral health in Trinidad and Tobago, there being no other epidemiological data that has been able to support the oral health situation in the West Indies islands. However, according to various surveys, dental health among children has been shown to be high. A survey in Trinidad indicated that the prevalence of caries among children aged 6-8 was approximately 67%. Additionally, predisposing factors to poor dental health among children have been cited, including inadequate information, and poor preventive dental care sensitization. The authors of his research paper are distinguished academicians and researchers. Rahul Naidu is a professor in the Faculty of Medical Services in The University of the West Indies, St Augustine. It is one of the reputable institutions in Trinidad and Tobago. Besides, he has worked on previous health-related research projects. He has also previously taught at the School of Dental Sciences’ Trinity College Dublin in Dublin, Ireland together with his co-authors June Nunn and Alan Kelly. Additionally, Alan Kelly is a distinguished researcher and educationist at the Department of Public Health and Primary Care, Trinity College Dublin in Dublin, Ireland. All the authors have a common background having engaged in study and research of dental sciences. Theirs study is borrows greatly on national and regional research surveys as well as research from epidemiological despite having much of it based on areas outside the region under analysis, Central Trinidad. The research has borrowed information from a thirty-five sources. The research obtained its funding from The University of West Indies Research and Publication Fund. The title reveals the essence of the research. It is quite clear from the title that the variables under test are the prevalence of ECC in relation to socio-behavioral factors such as socio-demographics among preschool children. This is well capture in the title. In addition, the title captures the type of study that is to be done (cross-sectional study). On the other hand, the sample of population that will be used in the study is identified (preschool children). Subjects and Samples The Research took a cross-sectional approach where a survey was done on preschool children. The selection of the sample was done randomly from different preschools drawn from one of the highly populated regions, Caroni in Central Trinidad. Caroni was the ideal region based on the socio-economic diversity, which could inform on the socio-behavioral factors. There is a mix-up of both urban and rural lifestyles. The Institutions chosen for the study are registered with the ministry of education in Trinidad and Tobago. The study examined 251 children between ages 3 and 5, with an average age of 3.7 years. The cohort chosen comprised mainly of children that were from Indian origin. Samples were drawn from preschools with between 15 and 60 children. The sampling of the preschools was done from among 27 government preschools or those supported by the government while 57 private preschools. Among these, the sample considered comprised of 7 private preschools and 3 government-affiliated preschools. A sample of 251 children was drawn from these preschools based on a random selection. The research involved various instruments. Parents /caregivers filled questionnaires while the children’s behavior was assessed using Frankl Behavior Rating Scale. In addition, a single trained and calibrated examiner did the oral examinations to the children. The analysis of the clinical variables was done based on the criteria set in 1997 by the WHO. The research followed all the ethical requirements; first from the University Research Ethics Committee, then to the administration of the preschools as well as the parents/caregivers, who were further issue with self-administered questionnaires. Ultimately, the research data from the various sources was analyzed using version 16 of SPSS and the 2.13.1 version of the R statistical program. In addition, the reliability of the examinations done was affirmed through a reexamination, which yielded 0.9 in the kappa statistic for intra-examiner reliability. Methods and Outcome Measures The research was a cross-sectional study that analyzed socio-behavioral attributes of preschool children in relation to the prevalence of caries. Out of the nine schools chosen, the consent of the administration as well as that of parents/ caregivers were sought before the children were allowed to have the oral examination. Parents/caregivers were issued with self-administered questionnaires, which they were required to fill and return. On the other hand, the children went through an oral examination, which included various variables such as dentition, need for referral, and the need for treatment. The examination took place with the school environment where the children were examined from their classes. Despite 314 preschool children having the consent from their parents to take part in the survey, 27 disagreed with their parents by refusing to have the examination while 36 did not turn up to school on that day. Those that demonstrated either ‘positive’ or ‘definitely positive’ behavior reached 251 and that is the number that was used for the research. In addition to monitoring the prevalence of the carries among the children, the researcher also focused on the socio-behavior of the children, for example, those that refused to have the examination were rated as having negative behavior. To ensure that the methodology was not exposed to errors, the researcher ensured that the questionnaires were self-administered to the parents while the agreement to have the children have oral examination was done by parents, administrators, and the children. The involvement of the preschool children in giving consent ensured that the research obtained data that was based on socio-behavior. In addition, the use of qualified health personnel to conduct the dental examination ensured that there were no chances of errors in identifying the prevalence of caries among the children. The analysis of the data was done using both bivariate and multiple variate models. In the bivariate analysis the research data was analyzed using the Pearson Chi-square where the presence of caries was identified. In addition, the standard deviation, mean and the confidence levels of the data was elucidated in the analysis. For the multiple variate analysis, the Poisson generalized linear mixed model was used. In order to establish the intra-examiner reliability, the Kappa statistic was used. Results Out of the sample of 9 schools, the required parental consent was approximately 92%. The turnout by the preschool children to be examined reached a lesser figure of the expected by 11.5%. In addition, the results indicate that 8.6% of the children refused to have the examinations. The number of children that successfully went through the oral examination were three hundred and fifty one. The examination revealed that the 29.1% of the children demonstrated some experience pf having caries while the rest of the children did not show any signs of having caries. For the cases of severe ECC, 17.5% of the children had some traces that pointed at the presence of caries occurring during their early years of growth. It was evident from the results that there was a need for treatment for up to 29.9% of the children. Out of these children, there was an urgent need for 40% (30 children) of them to have treatment due to the severity of their conditions. The social and behavior factors of the children were analyzed using bivariate as well as the multiple variate models. These results as presented by the authors are statistically significant since they give a significant percentage of the prevalence of caries in Trinidad. Critical Evaluation The method used takes more of an approach that may not substantively describe the cause of dental carries in the population. Instead of using the questionnaires, the research could take a more qualitative approach; in this case, the researcher should have interviewed the parents so that he is able to correlate the socio-behavior from the home setup to the prevalence of caries. The questionnaires are very rigid hence the results obtained are biased on the basis of what the researcher thought was the problem, which may or may not be the case. The study derives a major strength in that researchers that have widespread knowledge in oral health matters found it. However, having two of the researchers being from universities outside Trinidad and Tobago is a major setback since they are likely to rely heavily on the local researcher. The dental examination done to the children was the most accurate strategy of identifying the prevalence of dental caries since it provided first-hand information. The results of the research indicate that there is a possibility that the socio-behavior having influence on the prevalence of caries among the preschool children. However, the research does not categorically adopt a sample size that may not be representative. This is because, the sample s relatively small as well as being inclined to random selection instead of selecting a criteria in which the choice of institutions were considered. The self-administration of questionnaires also leaves the parents with the option of being biased towards the researcher’s anticipations. The research could have been more effective if the samples were not localized in a certain region. It would have been more appropriate if the chosen preschools were spread across the entire Trinidad. Therefore, it is difficult to translate the results to the entire country without being biased. The cross-sectional approach used for the study possesses various strengths. First, it is quick and does not involve complicated processes. The oral examination was straightforward; it had clear identifiable findings. On the other hand, the self-administered questionnaires did not present much challenges to the researcher since it involved a less tedious process. The data was gathered from the same point hence the research was cheap to conduct. The cross-sectional study also serves as the best approach of eliciting the prevalence of caries among the preschool children. On the contrary, the cross sectional study is limited by the view that the research shows a relationship between caries and socio-behavior but it does not substantiate the causation of the variables. It is possible that some other variables outside the socio-behavior that are likely to play a bigger role in the development of caries. Another setback is the prevalence of Neyman bias in the study. In this case, the accuracy of the parents filling the questionnaires can record all the questions that are captured in the questionnaire with absolute accuracy. Contribution of Research to Medical Science The results of this research helps build up on the prevailing body of knowledge that exists on dental health in Trinidad especially among young children. On the other hand, the findings indicate the severity of the health status in the region, hence facilitating the adoption of early interventions. The research has also helped affirm the prepositions by previous research and surveys, which have indicated that the prevalence of caries in the region among the children is high courtesy of poor dental hygiene. Based on the findings, the future researchers will have a basis of establishing more parameters surrounding the dental hygiene in the country. The research indicates that early interventions are required in order to ensure that oral hygiene is sustained in Trinidad. This will facilitate the development of interventions that guide on the social aspects that contribute to the deteriorating oral health in Trinidad. References CDC (2004) An introduction to epidemiology, retrieved from http://www.cdc.gov/excite/classroom/intro_epi.htm Kail, R. (2011) Children and their Development. Englewood Cliffs, N.J: Prentice Hall. 6 ed. Merriam-Webster, (n.d) Cavitation, retrieved from http://www.merriam-webster.com/dictionary/cavitation Naidu, R., Nunn, J. & Kelly, A. (2013) Socio-behavioral factors and early childhood caries: a cross-sectional study of preschool children in central Trinidad, BMC Oral Health, 13:30 NIH (2014) Behavioral and social sciences (BSSR) definition, retrieved from http://obssr.od.nih.gov/about_obssr/BSSR_CC/BSSR_definition/definition.aspx Read More