Peer-reviewed article
Socioeconomic, Educational, Cultural, and Oral Health Practices Among Caregivers Declining Their Children's Participation in School-Based Oral Health Promotion Programs: A Cross-Sectional Study.
Silva GA, Cantão DAA, Sampaio VHG, Canevari LVT, Aranega AM et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined why caregivers decline their children's participation in school-based oral health programs. The most common reasons were administrative (not returning consent forms), beliefs about child age, and access to private care. Socioeconomic and educational differences significantly shaped oral health practices and attitudes: higher-income families had better preventive dental care habits, while lower-income families only sought dental care when problems arose. The findings show that social inequalities limit both children's access to school-based dental health programs and families' preventive oral health practices.
Key points
- 36.2% of caregivers failed to return consent forms or missed deadlines; 19.0% believed their child was too young
- Higher income was significantly associated with higher educational level, more frequent toothbrushing, shorter time since last dental visit, and less embarrassment about oral health
- Lower-income caregivers were more likely to seek dental care only when problems occurred
- Higher-income families were more likely to cite private dental care as their reason for non-authorization
- Socioeconomic and educational inequalities reduce preventive dental practices and limit children's authorization for school-based oral health programs
Limitations
The study was cross-sectional and examined only caregivers who declined participation, so it cannot show causation or describe outcomes for children who did participate. The country of the study is not identified, limiting generalisability to other contexts.
Abstract
Background/Objectives: Oral health promotion in early childhood depends strongly on caregivers' preventive care at home and educational centers. The aim of this study was to investigate socioeconomic, educational, cultural, and oral health factors associated with caregivers' decisions to decline their children's participation in school-based oral health promotion programs. Methods: Caregivers who did not authorize their children's participation in the project were identified through school records and contacted using available information (name, telephone number, and email address). Participants were selected through simple random sampling. Results: Among the 58 caregivers included in the study, the main reasons reported were failure to return the consent form or missing the deadline (36.2%), considering the child too young (19.0%), already receiving private dental care (13.8%), not understanding the consent form (13.8%), not having received the document (10.3%), lack of trust in the professional (3.4%), and other reasons (3.4%). Higher income was significantly associated with higher educational level (p = 0.002), increased toothbrushing frequency (p = 0.007), shorter time since the last dental visit (p < 0.001), and lower levels of embarrassment related to oral health (p < 0.001). Additionally, lower-income caregivers were more likely to seek dental care only in the presence of problems (p = 0.046), while higher-income families were more likely to report private dental care as a reason for non-authorization (p < 0.001). Conclusions: These findings associate socioeconomic and educational inequalities with adverse effects on family oral health among parents, by reducing the frequency of preventive dental examinations and daily oral hygiene practices; and among children, by limiting authorization to participate in school-based oral health promotion programs. This evidence underscores that successful promotion of children's oral health in educational settings requires addressing social disparities while strengthening caregivers' knowledge and motivation to support participation.