Parental Oral Health Knowledge and Behavior Among American Indians

Objectives: Investigate American Indian parents’ oral health knowledge and behaviors as part of a clinical trial to reduce oral health problems among young children on a single Northern Plains reservation using a culturally appropriate motivational interviewing intervention.

Methods: Pilot questionnaire data were collected from 146 American Indian parents/guardians of children age 3 years or younger using an Audio Computer-Assisted Self-Interviewing (ACASI) system. Survey questions were presented visually on a computer screen and verbally via narration by a tribal member. The survey included 13 items assessing parent/guardian oral health behavior and 18 items on parent/guardian knowledge of critical oral hygiene behaviors. Responses were examined for each item and overall measures of knowledge and behavior computed. Overall knowledge was measured as the percentage of items answered appropriately. Overall behavior was measured as the percentage of items reflecting behavior consistent with accepted recommendations for optimal oral health. 

Results: Average participant age was 29 years, 86% were female, and 61% had at least a high school education or equivalent. Children of survey participants were on average 2.1 years of age and 50% were female.  Survey participants identified the best answer for 72% of the knowledge items (SD=14).  Forty-eight percent of participants did not know eating after brushing teeth and before going to bed is bad for teeth; 44% did not know drinking from a sippy cup at bedtime is bad for teeth; 83% indicated children can begin brushing their own teeth between ages 1-3 years.  Participants engaged in 58% of optimal oral health behaviors examined (SD=19). Sixty-three percent do not brush their child’s teeth before bed every night; 33% do not use fluoride toothpaste; 31% always help their child brush.

Conclusions: Tailored guidance using motivational interviewing will be beneficial to enhance oral health knowledge and encourage behavior change among American Indian parents/guardians.