Parental and professional oral health assessment of Brazilian preschool children

Objectives: To estimate dental caries prevalence and investigate parent-reported oral health status in children seeking treatment in a public primary health center in Rio de Janeiro, Brazil. Methods: This cross-sectional study enrolled 231 children, 12-48 months old, and their parents. The children's teeth were examined by two trained (Kappa=0.85) pediatric dentists using the International Caries Diagnosis and Assessment System to register dmfs indexes (number of decayed, missing and filled primary tooth surfaces) at the D1 (non-cavitated enamel lesion), D2 (cavitated enamel lesion) and D3 (dentin lesion) levels. Sociodemographic data and information on children's oral health status, oral health-related well-being, and interference with daily activities resulting from oral problems as perceived by their parents were obtained through face-to-face interviews. Results: Most children were male (53%), non-white (62%) and of low socioeconomic status (93%), with mean age 28.9 months (sd:10.6). Primary dentition caries estimates (dmfs) were 3.1 (95%CI:2.3;3.9), 1.8 (95%CI:1.2;2.4) and 1.7 (95%CI:1.1;2.2), at D1, D2 and D3 levels, respectively. Early childhood caries was diagnosed in 46% of participants and 28% already presented dentinal caries. During the 12 months before the interview, 10% had dental pain, 9.5% had difficulty eating any food and 8.5% had difficulty drinking cold or hot beverages. Only 5% of the parents rated their child's oral health as poor or very poor and 3% reported that their child's well-being was severely affected by oral problems. Parent's ratings of children's oral health were statistically associated with dental caries indexes (Kruskall-Wallis, p<0.01). Conclusion: Caries prevalence was high, and the disease was severe enough to produce some impact on children's lives. Despite this, most parents rated their children's oral health as good or very good. Our findings highlight the importance of implementing preventive measures targeted at controlling dental caries, including an educational program for parents, early in a child's life.