Cultural significance of primary teeth for caregivers in Northeast Brazil

Abstract

This anthropological study critically evaluates Brazilian caregivers' symbolic production and significance of their malnourished offspring's primary teeth, as well as their own, and describes popular dental practices. From January to June 2004, ethnographic interviews of 27 poor, low-literacy mothers were conducted at a public Malnutrition Treatment Center in Fortaleza, Ceará State. Participant observation of clinical pathways and home environments supplemented the data. Content analysis was performed. Results confirm that primary teeth are imbued with cultural significance in Northeast Brazil. Mothers examine mouths, perceive signs of decay, associate primary with permanent tooth healthiness, identify ethnodental illnesses, seek assistance, and perform rituals with exfoliated teeth. The mother's motivation to care for primary teeth is sparked by her memories of past toothache and attempts to avoid stigma and discrimination. Social determinants, not mothers' beliefs or behaviors, are the most critical obstacles to effective dental care. Legitimizing lay knowledge and empowering caregivers and children can improve oral health in Northeast Brazil.

Maternally Perceived Barriers to and Facilitators of Establishing and Maintaining Tooth-Brushing Routines with Infants and Preschoolers

“…There is now a growing body of published research, specifically qualitative research that has examined influences on the emergence of toothbrushing throughout childhood [2,3,4,5,6]. This research has identified that a number of influences may be associated with how dyadic tooth-brushing routines may be established, including child temperament and behaviour parental cognitions such as parental self-efficacy (PSE) [2,3,5].…”

“…Although previously published studies of dyadic tooth-brushing have not aimed to explore influence from infancy [2,3,4,5,6], they have fruitfully used qualitative interview methods to explore in detail potential influences on dyadic tooth-brushing with children who have developed beyond the period of infancy. Therefore, using a similar qualitative interview methodology may also provide unique insights into caregiver’s self-reported experiences of establishing tooth-brushing as a dyadic process from infancy , in dyads containing novice caregivers and first-borns.…”

Importance of Deciduous Teeth: Maternal Perceptions and Early Childhood Caries

“…Although some mothers have basic knowledge about oral health, they usually do not consider the deciduous dentition important, valuing more the permanent dentition, having as background the fact that the deciduous teeth will be replaced in short space of time [15]. Thus, the hypothesis of the present study was that mothers of children with CPI had less knowledge about eating habits and oral hygiene, as well as, a less knowledge about the importance of deciduous teeth.…”

Saúde Bucal na Ação Programática da Criança: indicadores e metas de um Serviço de Atenção Primária à Saúde

“…A study conducted in Araraquara (Brazil) showed that 43% of mothers felt their children should have their first dental visit in the first year of life, 44% felt that this visit should occur between the ages of one and three years, 7% believed they should start at age three and 6% said that children should only go to the dentist in emergency situations 15 . Other factors such as fear and anxiety, low importance given to teeth and the buccal cavity, leading to a low perception of need for treatment, and past experiences, related to humiliation and discrimination, are also factors that hinder access to dental services, with direct consequences on the oral health of children 16,17 . In relation to the fact that a considerable percentage of children visited the dentist in the first year of life (35%), this may be due to children going to health units more often for pediatric visits; mothers having received prenatal care in these units and established a link with the team; and that visits are free.…”