Changes in Oral Health-Related Behaviors and Oral Health of Children in Early Childhood during Social Isolation Caused by COVID-19

Laís Canêdo Martins; Stefânia Werneck Procópio; Maisa Costa Tavares; Camila Faria Carrada; Flávia Almeida Ribeiro Scalioni; Saul Martins Paiva; Rosangela Almeida Ribeiro

Authors

Laís Canêdo Martins
Stefânia Werneck Procópio
Maisa Costa Tavares
Camila Faria Carrada
Flávia Almeida Ribeiro Scalioni
Saul Martins Paiva
Rosangela Almeida Ribeiro

Keywords:

Oral Health, Parents, COVID-19

Abstract

Objective: To assess changes in oral health-related behavior and oral health status in Brazilian children in early childhood perceived by their parents/caregivers during social isolation caused by COVID-19. Material and Methods: A cross-sectional study with parents/caregivers of children in southeastern Brazil aged 0-5 years who responded to an online questionnaire about sociodemographic data, dietary changes, oral hygiene, and oral health status of children during the COVID-19 pandemic. Results: Of the 119 parents/caregivers, 54.60% did not observe any changes in eating habits, and 81.50% maintained their children's oral hygiene. Associations were observed between the impact of the pandemic on the family income and changes in eating habits (p=0.02) and between lower family income and dental caries perceived by parents/caregivers (p=0.05). Z tests with Bonferroni correction showed that families with drastic income reduction were more likely to consume lower-cost foods (62.50%) than families with no impact or slight reduction on family income. Parents/caregivers did not identify dental caries (89.10%), toothache (92.40%), and dental trauma (92.40%) in their children. Conclusion: Parents/caregivers of children in southeastern Brazil aged 0-5 years observed behavioral changes in the dietary habits of families whose income was impacted by the pandemic, and their perception of dental caries was significantly associated with family income.

References

World Health Organization. Coronavirus disease (COVID-19). Available from: https://www.who.int/health-topics/coronavirus#tab=tab_ [Accessed on 26 April, 2023].

World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19. 2020. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020. [Accessed on 26 April, 2023].

Wu Y, Kang L, Guo Z, Liu J, Liu M, Liang W. Incubation period of COVID-19 caused by unique SARS-CoV-2 strains: a systematic review and meta-analysis. JAMA Netw Open 2022; 5(8):e2228008. https://doi.org/10.1001/jamanetworkopen.2022.28008

Baptista AS, Prado IM, Perazzo MF, Pinho T, Paiva SM, Pordeus IA, et al. Can children's oral hygiene and sleep routines be compromised during the COVID-19 pandemic? Int J Paediatr Dent 2021; 31(1):12-19. https://doi.org/10.1111/ipd.12732

López-Bueno R, López-Sánchez GF, Casajús JA, Calatayud J, Gil-Salmerón A, Grabovac I. Health-related behaviors among school-aged children and adolescents during the Spanish Covid-19 confinement. Front Pediatr 2020; 8:573. https://doi.org/10.3389/fped.2020.00573

Carroll N, Sadowski A, Laila A, Hruska V, Nixon M, Ma DW, et al. The impact of COVID-19 on health behavior, stress, financial and food security among middle to high income Canadian families with young children. Nutrients 2020; 12(8):2352. https://doi.org/10.3390/nu12082352

Aquino EM, Silveira IH, Pescarini JM, Aquino R, Souza-Filho JA, Rocha, AS, et al. Social distancing measures to control the COVID-19 pandemic: potential impacts and challenges in Brazil. Ciênc Saúde Colet 2020; 25(Suppl 1):2324-2446. https://doi.org/10.1590/1413-81232020256.1.10502020

Campagnaro R, Collet GD, Andrade MP, Salles JP, Fracasso MD, Scheffel DL, et al. COVID-19 pandemic and Pediatric Dentistry: Fear, eating habits and parent’s oral health perceptions. Child Youth Serv Rev 2020; 118:105469. https://doi.org/10.1016/j.childyouth.2020.105469

Di Renzo L, Gualtieri P, Cinelli G, Bigioni G, Soldati L, Attinà A, et al. Psychological aspects and eating habits during COVID-19 home confinement: Results of ehlc-covid-19 Italian online survey. Nutrients 2020; 12(7):2152. https://doi.org/10.3390/nu12072152

Docimo R, Costacurta MC, Gualtieri P, Pujia A, Leggeri C, Attinà A. Cariogenic risk and COVID-19 lockdown in a paediatric population. Int J Environ Res Public Health 2021; 18(14):7558. https://doi.org/10.3390/ijerph18147558

Liu C, Zhang S, Zhang C, Tai B, Jiang H, Du M. The impact of coronavirus lockdown on oral healthcare and its associated issues of pre-schoolers in China: An online cross-sectional survey. BMC Oral Health 2021; 21:54. https://doi.org/10.1186/s12903-021-01410-9

Oliveira MJ, Dias VO, Santos KK, Rodrigues QF, Paiva ER, Martins RD. Knowledge of dental trauma of parents/caregivers of children treated at UNIMONTES pediatric clinic. Pesqui Bras Odontoped Clin Integr 2013; 13(2):189-196. https://doi.org/10.4034/PBOCI.2013.132.08

Pederielli S, Mirelli C, Pozzi F, Giannì AB, Biagi R. Dental trauma at a University Dental Clinic in Milan including the SARS-CoV-2 Period. Dent J 2021; 9(12):145-156. https://doi.org/10.3390/dj9120145

Luzzi V, Ierardo G, Bossù M, Polimeni A. Paediatric oral health during and after the COVID-19 pandemic. Int J Paediatr Dent 2020; 31(1):20-6. https://doi.org/10.1111/ipd.12737

Brondani B, Knorst JK, Tomazoni F, Cósta MD, Vargas AW, Noronha TG, et al. Effect of the COVID-19 pandemic on behavioral and psychosocial factors related to oral health in adolescents: A cohort study. Int J Paediatr Dent 2021; 31(4):539-546. https://doi.org/10.1111/ipd.12784

Goswami M, Grewal M, Garg A. Attitude and practices of parents toward their children’s oral health care during COVID‐19 pandemic. J Indian Soc Pedod Prev Dent 2021; 39(1):22-28. https://doi.org/10.4103/jisppd.jisppd_478_20

Gotler M, Oren L, Spierer S, Yarom N, Ashkenazi M. The impact of COVID-19 lockdown on maintenance of children’s dental health: A questionnaire-based survey. J Am Dent Assoc 2022; 153(5):440-449. https://doi.org/10.1016/j.adaj.2021.10.004

Manohar N, Hayen A, Do L, Scott J, Bhole S, Arora A. Early life and socioeconomic determinants of dietary trajectories in infancy and early childhood - results from the HSHK birth cohort study. Nutr J 2021; 20(1):76. https://doi.org/10.1186/s12937-021-00731-3

Costa VP, Bertoldi AD, Baldissera EZ, Goettems ML, Correa MB, Torriani DD. Traumatic dental injuries in primary teeth: severity and related factors observed at a specialist treatment center in Brazil. Eur Arch Paediatr Dent 2014; 15(2):83-88. https://doi.org/10.1007/s40368-013-0068-x

Ilyas N, Green A, Karia R, Sood S, Fan K. Demograpgics and management of pediatric dental-facial trauma in the ‘lockdown’ period: a UK perspective. Dent Traumatol 2021; 37(4):576-582. https://doi.org/10.1111/edt.12667

Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33(1):159-174.

Xiong J, Lipsitz O, Nasri F, Lui LM, Gill H, Phan L, et al. Impact of COVID-19 pandemic on mental health in the general population: a systematic review. J Affect Disord 2020; 277:55-64. https://doi.org/10.1016/j.jad.2020.08.001

Costa Al, Pereira JL, Franco L, Guinot F. COVID-19 lockdown: impact on oral health-related behaviors and practices of Portuguese and Spanish children. Int J Environ Res Public Health 2022; 19(23):16004. https://doi.org/10.3390/ijerph192316004

Loveren CV. Sugar restriction for caries prevention: amount and frequency. Which is more important? Caries Res 2019; 53(2):168-175. https://doi.org/10.1159/000489571

Schwendicke F, Dörfer CE, Schlattmann P, Foster L, Thomson WM, Paris S. Socioeconomic inequality and caries: a systematic review and meta-analysis. J Dent Res 2015; 94(1):10-18. https://doi.org/10.1177/0022034514557546

Gomes MC, Clementino MA, Pinto-Sarmento TCA, Costa EMMB, Martins CC, Granville-Garcia AF, et al. Parental perceptions of oral health status in preschool children and associated factors. Braz Dent J 2015; 26(4):428-434. https://doi.org/10.1590/0103-6440201300245

Felipak PK, Menoncin BL, Reyes MR, Costa LR, Souza JF, Menezes JV. Determinants of parental report of dental pain and discomfort in preschool children – The Dental Discomfort Questionnaire. Int J Paediatr Dent 2020; 30(4):436-444. https://doi.org/10.1111/ipd.12614

Costa VP, Amaral CC, Goettems ML, Pinheiro RT, Demarco FF. Maternal perception of the occurrence of traumatic dental injuries in children: a cohort study of south Brazil. Int Dent J 2016; 66(3):163-168. https://doi.org/10.1111/idj.12215

Patidar D, Sogi S, Patidar DC, Malhotra A. Traumatic dental injuries in pediatric patients: A retrospective analysis. Int J Clin Pediatr Dent 2021; 14(4):506-511. https://doi.org/10.5005/jp-journals-10005-2004

Goswami M, Rahman B, Singh S. Outcomes of luxation injuries to primary teeth-a systematic review. J Oral Biol Craniofac Res 2020; 10(2):227-232. https://doi.org/10.1016/j.jobcr.2019.12.001

Seow WK. Environmental, maternal, and child factors which contribute to early childhood caries: a unifying conceptual model. Int J Paediatr Dent 2012; 22(3):157-168. https://doi.org/10.1111/j.1365-263X.2011.01186.x

Phantumvanit P, Makino Y, Ogawa H, Rugg-Gunn A, Moynihan P, Petersen PE, et al. WHO global consultation on public health intervention against early childhood caries. Community Dent Oral Epidemiol 2018; 46(3):280-287. https://doi.org/10.1111/cdoe.12362

Carreiro DL, Souza JGS, Coutinho WLM, Haikal DS, Martins AMEBL. Acesso aos serviços odontológicos e fatores associados: estudo populacional domiciliar. Cien Saude Colet 2019; 24(3):1021-1032. https://doi.org/10.1590/1413-81232018243.04272017 [In Portuguese].