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Caries

325 - Caregiver Education, Oral Health Behaviors, and Childhood Caries

Saturday, May 24, 2025
12:45 PM - 1:00 PM MDT
Has Audio

    Presenting Author(s)

  • Ysabella J. Gallo, DDS Candidate

    Dental Student
    University of North Carolina at Chapel Hill Adams School of Dentistry
    University of North Carolina at Chapel Hill
    Chapel Hill, North Carolina, United States

    • Co-Author(s)

  • PS

    Poojan Shrestha, PhD, MSc, BDS

    University of North Carolina at Chapel Hill Adams School of Dentistry

  • Miguel A. Simancas-Pallares, DDS, MS, MSc

    Associate Professor, Predoctoral Program Director in Pediatric Dentistry
    University of North Carolina at Chapel Hill Adams School of Dentistry
    Department of Pediatric Dentistry and Dental Public Health, Adams School of Dentistry, The University of North Carolina at Chapel Hill, North Carolina, United States

  • JG

    Jeannie Ginnis, DDS

    University of North Carolina at Chapel Hill Adams School of Dentistry

  • Kimon Divaris, DDS, PhD

    Professor
    UNC-Chapel Hill
    University of North Carolina-Chapel Hill
    Chapel Hill, North Carolina, United States

    • Research Mentor(s)

  • Kimon Divaris, DDS, PhD

    Professor
    UNC-Chapel Hill
    University of North Carolina-Chapel Hill
    Chapel Hill, North Carolina, United States

    • Program Director(s)

  • SC

    Scott W. Cashion, DDS, MS

    Associate Professor and Program Director
    University of North Carolina, Chapel Hill
    Chapel Hill, North Carolina, United States

Caregiver Education, Oral Health Behaviors, and Childhood Caries
Gallo Y, Shrestha P, Simancas-Pallares MA, Ginnis J, Divaris K
University of North Carolina at Chapel Hill, Chapel Hill, NC

Purpose: Caregivers’ education has a major influence on children’s oral health, yet the intermediary roles of modifiable oral health behaviors (OHBs) underlying this relationship remain unexplored. We sought to examine associations between caregiver education, early childhood caries (ECC), and modifiable OHBs, and determine whether these associations differ by race/ethnicity.

Methods: We used questionnaire (n=7,850) and clinical data (n=6,404) collected in the context of a community-based, epidemiologic study of oral health among children ages 3-5 (mean age=51 months) in North Carolina. OHB information was available for children’s tooth brushing, dietary habits, and having a dental home. ECC was quantified using the dmfs index defined at the ICDAS≥3 level. We used bivariate association testing and multi-level, mixed-effects Poisson regression modeling to quantify relationships between low education (defined as some elementary or some high school education vs. higher), OHBs, and ECC, overall and by strata of race and ethnicity.

Results: Children of caregivers with low education had 42% (95% CI=30-55%) higher mean dmfs compared to their higher education counterparts, with this association being weakest for Hispanics (22%) and strongest for non-Hispanic whites (58%). Furthermore, they were more likely to report infrequent toothbrushing, nighttime bottle-feeding, and less fluoridated toothpaste use. Accounting for these OHBs in adjusted models did not appreciably modify the association between caregiver education and ECC.

Conclusions: Low caregiver education is a strong risk factor for ECC, and its effects vary by race/ethnicity. Small differences in modifiable OHBs between education levels suggest that other upstream or proximal factors associated with education may be at play.

Research supported by the 2024-2025 Grover C. Hunter DDS Short-Term Research Fellowship from the University of North Carolina at Chapel Hill Adams School of Dentistry.