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Maintaining Traditions: A Qualitative Study of Early Childhood Caries Risk and Protective Factors in an Indigenous Community

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  • Ana Levin

    (School of Medicine, University of California, San Francisco, CA 94101, USA)

  • Karen Sokal-Gutierrez

    (School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA)

  • Anita Hargrave

    (School of Medicine, University of California, San Francisco, CA 94101, USA)

  • Elizabeth Funsch

    (Department of Biostatistics and Epidemiology, Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA)

  • Kristin S. Hoeft

    (Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, CA 94118, USA)

Abstract

In lower middle-income economies (LMIE), the nutrition transition from traditional diets to sugary foods and beverages has contributed to widespread early childhood dental caries. This qualitative study explores perceived risk and protective factors, and overall experiences of early childhood nutrition and oral health in indigenous Ecuadorian families participating in a community-based oral health and nutrition intervention. Dental exams of 698 children age 6 months through 6 years determined each child’s caries burden. A convenience sample of 18 “outlier” families was identified: low-caries children with ≤2 carious teeth vs. high-caries children with ≥10 carious teeth. Semi-structured in-depth interviews with parents/caregivers explored the child’s diet, dental habits, and family factors related to nutrition and oral health. Interviews were transcribed and thematically analyzed using grounded theory. In the high-caries families, proximity to highway and stores, consumption of processed-food, and low parental monitoring of child behavior were identified as risk factors for ECC (early childhood caries). In the low-caries families, protective factors included harvesting and consuming food from the family farm, remote geography, and greater parental monitoring of child behavior. The study results suggest that maintaining traditional family farms and authoritative parenting to avoid processed foods/drinks and ensure tooth brushing could improve early childhood nutrition and oral health.

Suggested Citation

  • Ana Levin & Karen Sokal-Gutierrez & Anita Hargrave & Elizabeth Funsch & Kristin S. Hoeft, 2017. "Maintaining Traditions: A Qualitative Study of Early Childhood Caries Risk and Protective Factors in an Indigenous Community," IJERPH, MDPI, vol. 14(8), pages 1-11, August.
  • Handle: RePEc:gam:jijerp:v:14:y:2017:i:8:p:907-:d:107962
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    References listed on IDEAS

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    1. McDade, Thomas W., 2001. "Lifestyle incongruity, social integration, and immune function in Samoan adolescents," Social Science & Medicine, Elsevier, vol. 53(10), pages 1351-1362, November.
    2. Falbe, J. & Thompson, H.R. & Becker, C.M. & Rojas, N. & McCulloch, C.E. & Madsen, K.A., 2016. "Impact of the Berkeley excise tax on sugar-sweetened beverage consumption," American Journal of Public Health, American Public Health Association, vol. 106(10), pages 1865-1871.
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    Cited by:

    1. Brianna F. Poirier & Joanne Hedges & Lisa G. Smithers & Megan Moskos & Lisa M. Jamieson, 2022. "Child-, Family-, and Community-Level Facilitators for Promoting Oral Health Practices among Indigenous Children," IJERPH, MDPI, vol. 19(3), pages 1-19, January.
    2. Chloe Tsang & Karen Sokal-Gutierrez & Priya Patel & Brett Lewis & Debbie Huang & Kristina Ronsin & Ashmita Baral & Aparna Bhatta & Nehaa Khadka & Howard Barkan & Sidhanta Gurung, 2019. "Early Childhood Oral Health and Nutrition in Urban and Rural Nepal," IJERPH, MDPI, vol. 16(14), pages 1-11, July.
    3. Eleonor Vélez-León & Alberto Albaladejo & Katherine Cuenca-León & Magaly Jiménez-Romero & Ana Armas-Vega & María Melo, 2022. "Prevalence of Caries According to the ICDAS II in Children from 6 and 12 Years of Age from Southern Ecuadorian Regions," IJERPH, MDPI, vol. 19(12), pages 1-10, June.

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