Family Relationships as an Explanatory Variable in Childhood Dental Caries: A Systematic Review of Measures

Abstract

It is widely acknowledged that parental beliefs (self-efficacy) about oral health and parental oral health-related behaviours play a fundamental role in the establishment of preventative behaviours that will mitigate against the development of childhood dental caries. However, little attention has been given to the wider perspective of family functioning and family relationships on child oral health. For oral health researchers, exploration of this association requires the use of reliable, valid and appropriate assessment tools to measure family relationships. In order to promote methodologically sound research in oral health, this systematic review aims to provide a guide on self-report psychometric measures of family functioning that may be suitable to utilize when exploring childhood dental caries. This systematic review has identified 29 self-report measures of family functioning and evaluated them in terms of their psychometric support, constructs measured and potential utility for oral health research. The majority of the measures reported adequate levels of reliability and construct validity. Construct evaluation of the measures identified five core domains of family functioning, namely ‘communication', ‘cohesion/engagement', ‘control', ‘involvement' and ‘authoritative/rigid parenting style'. The constructs were subsequently evaluated with respect to their potential relevance to child oral health. Herewith this review provides a framework to guide future research to explore family functioning in furthering our understanding of the development of childhood dental caries.

The impact of oral health literacy and family cohesion on dental caries in early adolescence

“…This is a useful indicator for estimating the quality of family relations and investigating the effect of such relations on health outcomes in specific populations. Little attention, however, has been paid to this issue, which can exert a negative impact on integrated health actions . In the present study, early adolescents from families classified as ‘disengaged’, ‘separated’ or ‘connected’ had more cavitated lesions than did early adolescents from families classified as ‘enmeshed’.…”

“…The only protective effect seems to be in the ‘enmeshed’ category only. A previous study reports that a lower level of family cohesion can contribute to the occurrence of behavioural problems and dental caries in children . Based on these findings, early adolescents should remain dependent on their parents/guardians, as the capacity to schedule dental appointments and recognize the urgency of maintaining oral health has not yet sufficiently developed to enable complete autonomy at this age.…”

Correlation between siblings in caries in Norway. A quantitative study

“…Recent research has focused on family functioning with special reference to parent–child and sibling–sibling interactions. These interactions capture dimensions such as communication, organization, control, engagement, conflict and task accomplishment. For example, a supportive family environment could lead to the adaptation of favourable dental health behaviour so that the siblings would benefit equally.…”

Sociodemographic, Socio-economic, Clinical and Behavioural Factors Modifying Experience and Prevalence of Dental Caries in the Permanent Dentition

“…It is widely acknowledged that parental beliefs about oral health and parental oral healthrelated behaviours play a fundamental role in the establishment of preventative behaviours that will mitigate against the development of childhood dental caries (32). The mother's attitude toward oral health showed inconclusive results, compared to what has been published in the literature (20,33).…”