A qualitative study of the views of adolescents on their caries risk and prevention behaviours

Abstract

BackgroundThe purpose of this study was to explore the attitudes and beliefs of adolescents towards dental caries and their use or non-use of caries prevention regimens.MethodsAdolescents aged 16 years from four state-funded secondary schools in North West of England (n = 19). Purposive sampling strategically selected participants with characteristics to inform the study aims (gender, ethnicity, and caries status). Semi-structured interviews were transcribed verbatim and analysed using a framework approach.Results14 codes within five overarching themes were identified: “Personal definition and understanding of oral health”; “Knowledge of oral health determinants”; “Influences on oral health care”; Reason for oral health behaviours”; and “Oral health in the future”. Adolescents conceptualise oral health as the absence of oral pathology and the ability to function, which included an aesthetic component. Appearing to have healthy teeth was socially desirable and equated with positive self-image. The dominant influence over oral health behaviours was habitual practice encouraged by parents from a young age, with limited reinforcement at school or by dental practices. At this transitional age, participants recognised the increasing influence of peers over health behaviours. Self-efficacy pertained to diet modification (reduction in sugar-ingestion) and oral hygiene behaviour (tooth-brushing). A lack of understanding of caries aetiology was evident. Behaviours were mitigated by a lack of environmental support; and a desire for immediate gratification often overcame attempts at risk-reducing behaviour.ConclusionsParents primarily influence the habitual behaviours of adolescents. With age, the external environment (availability of sugar and peers) has an increasing influence on behaviour. This suggests that to improve adolescent health, oral health promoters should engage with parents from early childhood and create supportive environments including public policy on sugar availability to encourage uptake of risk-minimising behaviours.

Socioeconomic and ethnic inequalities in oral health among children and adolescents living in England, Wales and Northern Ireland

“…Very young children's tooth brushing behaviours are often supervised by their parents, whereas adolescents brush their teeth with varying degrees of skill or commitment. Moreover, peer group and mass media become more relevant during adolescence . The availability and consumption of sugary food and drinks is greater in adolescence .…”

“…Moreover, peer group and mass media become more relevant during adolescence . The availability and consumption of sugary food and drinks is greater in adolescence . Alongside these changes in oral health behaviours during adolescence, there are changes in the ethnic and socioeconomic differences in these behaviours.…”

A longitudinal study of the relationship between dental caries and obesity in late childhood and adolescence

“…To explore whether the relationship between obesity and caries really does change in adolescence , future research could include residual confounding variables (caloric intake, sugar‐ and carbohydrate‐intake, frequency of soft drinks, and BMI category at baseline) or effect modifiers (access to dental service and total fluoride exposure). This is particularly relevant as children move into adolescence and assume autonomy for their own behaviors and health modifiers .…”

The Prevalence and Risk Factors of Dental Caries of Permanent Teeth among 12-year-old Students in Guangdong, South China

“…Parents constituted the main influence on oral health behaviours among adolescents, while peers have an increasing impact on behaviour with maturity [5]. Given that both diet and dentition change as students progress through school and the young permanent teeth are vulnerable to caries in the age range, prevention measures are of great importance [6].…”