Date of Conferral

2022

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Vasileios Margaritis

Abstract

Dental disease is a highly preventable pediatric disease, and 70% of Native American/Alaskan Native (NA/AN) preschool children have a history of dental caries, which is 3.5 times higher than in the general population. This study aimed to conduct a meta-analysis examining the impact of oral health behaviors and attitudes of NA/AN parents and guardians on dental disease in NA/AN school-age children. The impact of frequency of flossing and brushing, consumption of sugary foods, dental visits, dental attendance reason, sealants, fluoride treatment, and oral health education by NA/AN parents and guardians on children’s caries and periodontal diseases status was explored. Additionally, the effect of gender, age, education, and income on the oral health behaviors/attitudes and dental disease in NA/AN school-aged children and their parents or guardians were investigated. The health belief model was the theoretical framework. Four studies met the criteria to be included in this meta-analysis and the effects of group type on outcomes were examined to determine the overall effect size. Heterogeneity between studies was evaluated by Q and I2 tests. Meta-analysis revealed an overall statistically significant effect of optimal oral health behaviors and attitudes on dental disease in NA/AN school-aged children (p < .001). Also, higher education and income levels were significantly associated with better oral health status in NA/AN school-aged children (p < .001). The positive social change implications and recommendations are to inform public health authorities about the behavioral and sociodemographic factors affecting oral health in NA/AN school-aged children, to develop customized oral health promotion and prevention programs.

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