The higher that mothers score on a measure of appraisal support, which is defined as “the perceived availability of someone to talk to about problems,” the less likely her children are to have a lot of cavities, according to the West Virginia University (WVU) School of Dentistry.
“One of the things we do in educating students in dentistry and dental hygiene is to encourage them to look beyond the oral cavity,” said Daniel McNeil, PhD, a clinical professor in the Department of Dental Practice and Rural Health.
“There’s a person attached to the mouth, and there’s a broader life circumstance that that person is in,” said McNeil, who also is a professor of clinical psychology in the university’s Department of Psychology.
McNeil and his colleagues wanted to know if perceived social support among mothers with high amounts of tooth decay was associated with the number of cavities their children had. They interviewed 250 mothers with a considerable amount of tooth decay based on a dental exam and whose children were under the age of six.
Specifically, the researchers guided the mothers through the Interpersonal Support Evaluation List (ISEL), a 40-question assessment of the social resources people feel they have. In addition, the children had their own dental exam.
All of the participants visited dentist offices between 2002 and 2009 in one of five counties: Nicholas and Webster counties in West Virginia and Allegheny, McKean, and Washington counties in Pennsylvania.
“These counties were selected because they were representative of north central Appalachia broadly,” said McNeil.
Overall, 27% of the children who participated in the study had what the researchers deemed a high number of cavities. The odds of children having a high number of cavitied was lower by 7% for every one-point change on the 30-point ISEL appraisal score.
“If the mother of a young child has social support—somebody to talk to outside of that immediate family or even another adult within the immediate family—then there are lots of things that happen, including the giving of information,” said McNeil.
“For example, the mother might say, ‘I think my son is drinking too much soda,’ and the person who’s providing social support might say, ‘Yeah, my son did that, too, and I just told him he could only have one a week,’” said McNeil.
McNeil also suspects the emotional validation that social support provides may indirectly improve children’s oral health outcomes as well.
“It’s a wonderful challenge, raising children,” he said. “If I have somebody to talk to about that, I may feel more empowered, more sure of myself. I may have better self-esteem, better self-appraisal. I think that can translate into my being an even more effective parent in terms of managing my kids’ health behaviors.”
The project was part of the Center for Oral Health Research in Appalachia (COHRA), a collaboration launched in 2000 among researchers at WVU, the University of Pittsburgh, and the University of Michigan.
COHRA explores factors that contribute to the burden of dental problems and oral health disparities in West Virginia and across Appalachia. The National Institute of Dental and Craniofacial Research funds the initiative.
“The WVU School of Dentistry is the only dental school in West Virginia. We play a critical role in delivering necessary dental care to those in need within the state through our Rural Dental Clinic Network,” said Fotinos Panagakos, PhD, DMD, MA, MBA, associate dean of research for the school.
“Our students spend six weeks treating patients in these clinics, delivering care that would otherwise not happen. Our focus is to improve the oral health of the patient, which will have a positive cascading effect by improving overall wellness and well-being,” said Panagakos.
McNeil’s findings may influence how dentists and dental hygienists interact with their patients.
“I think what this study might do is to encourage them to think, not only about diet and tooth brushing, but more broadly about how things are going for their patients at home,” said McNeil.
If the situation warrants, dental professionals could refer patients to other services such as support groups for parents.
“You might think, ‘Well, is that a dental recommendation?’ Absolutely,” he said. “I think the findings would suggest that we need to look beyond the tooth, to look at the social support that our patients have.”
Just as dental professionals can look “beyond the tooth” to consider how a patient’s quality of life including her social support network affects her oral health, researchers can reflect on the ways poor oral health can affect someone’s quality of life.
“The importance of oral health goes well beyond one’s mouth,” said Lindsay Allen, PhD, MA, an assistant professor in the WVU School of Public Health, whose research informed the West Virginia Kids Count Data Book.
“In addition to physical health, untreated oral disease has economic consequences, often causing patients to miss school or work. There are also social consequences. Research has found links between poor dental health and self-esteem in adolescents,” said Allen.
“Dr. McNeil’s study offers insight about what types of policies might help improve rates of dental care among children” Allen said.
The study, “Mother’s Perceived Social Support and Children’s Dental Caries in Northern Appalachia,” was published by Pediatric Dentistry.
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