The authors declare that they have no competing interests.
EHS, MT and KM made substantial contributions to conception and design. EHS performed the interviews. EHS and JG analysed and interpreted the data. All authors contributed to drafting the article or revising it critically for important intellectual content; and had final approval of the version to be published.
The purpose of this study was to explore the attitudes and beliefs of adolescents towards dental caries and their use or non-use of caries prevention regimens.
Adolescents aged 16 years from four state-funded secondary schools in North West of England (n = 19). Purposive sampling strategically selected participants with characteristics to inform the study aims (gender, ethnicity, and caries status). Semi-structured interviews were transcribed verbatim and analysed using a framework approach.
14 codes within five overarching themes were identified: “Personal definition and understanding of oral health”; “Knowledge of oral health determinants”; “Influences on oral health care”; Reason for oral health behaviours”; and “Oral health in the future”. Adolescents conceptualise oral health as the absence of oral pathology and the ability to function, which included an aesthetic component. Appearing to have healthy teeth was socially desirable and equated with positive self-image. The dominant influence over oral health behaviours was habitual practice encouraged by parents from a young age, with limited reinforcement at school or by dental practices. At this transitional age, participants recognised the increasing influence of peers over health behaviours. Self-efficacy pertained to diet modification (reduction in sugar-ingestion) and oral hygiene behaviour (tooth-brushing). A lack of understanding of caries aetiology was evident. Behaviours were mitigated by a lack of environmental support; and a desire for immediate gratification often overcame attempts at risk-reducing behaviour.
Parents primarily influence the habitual behaviours of adolescents. With age, the external environment (availability of sugar and peers) has an increasing influence on behaviour. This suggests that to improve adolescent health, oral health promoters should engage with parents from early childhood and create supportive environments including public policy on sugar availability to encourage uptake of risk-minimising behaviours.
Pitts N, Chadwick B, Anderson T. Report 2: Dental Disease and Damage in Children England, Wales and Northern Ireland. Children’s Dental Health Survey 2013. Online: National Statistics Office; 2015.
Tsakos G, Hill K, Chadwick B, Anderson T. Children’s Dental Health Survey 2013 Report 1: Attitudes, Behaviours and Children’s Dental Health England, Wales and Northern Ireland, 2013 In: Children’s Dental Health Survey 2013. National Statistics. 2015. http://www.hscic.gov.uk/catalogue/PUB17137/CDHS2013-Report1-Attitudes-and-Behaviours.pdf. Accessed 19.03.2015.
The Dental Observatory. Regional Dental Health. 14 year olds 2002/03. In: Dental Profiles. The Dental Observatory,. 2004. http://www.dental-observatory.nhs.uk/Default.aspx?crumb=00020007015810E000BB. Accessed 20.03.2015.
Kobus K. Peers and adolescent smoking. Addiction. 2003;98:37–55. PubMed
Petersen P, Kwan S. Evaluation of community-based oral health promotion and oral disease prevention – WHO recommendations for improved evidence in public health practice. Community Dent Health. 2004;21:319–29. PubMed
Ostberg A. Adolescents’ views of oral health education. A qualitative study. Acta Odontol Scand. 2005;63(5):300–7. PubMed
Communities and Local Government. The English Indices of Deprivation 2010. Online: Department for Communities and Local Government; 2011.
NPEU Tools. IMD Postcode search tool. University of Oxford, Online. 2013. http://tools.npeu.ox.ac.uk/imd/.
BASCD. Oral Health Survey of 12 year old children in England 2008/2009. National protocol. NHS Dental Epidemiology Programme 2009.
Fitzgerald R, Thomson W, Schafer C, Loose M. An exploratory qualitative study of Otago adolescents’ views of oral health and oral health care. N Z Dent J. 2004;100(3):62–71. PubMed
Bergstrom E, Skold U, Birkhed D, Lepp M. Adolescents’ experiences of participating in a school-based fluoride varnish programme in Sweden. Swed Dent J. 2012;36(3):133–41. PubMed
Mays N, Pope C. Rigour and qualitative research. Br Med J. 1995;311(46):109–12.
Ostberg A, Jarkman K, Lindblad U, et al. Adolescents’ views of oral health education. A qualitative study. Acta Odontol Scand. 2005;63(5):300–7. PubMed
Adair PM, Petersen PE, Douglass C, Burnside G, Nicoll AD, Gillett A, et al. Developing explanatory models of health inequalities in childhood dental caries. Community Dent Health. 2004;21(Supple 1):86–95. PubMed
Harker R, Morris J. Children’s Dental Health in the United Kingdom, 2003. Summary Report. London: Office for National Statistics; 2005.
NHS. NHS Dental Epidemiology Programme Survey of 12-year-old children, 2008/09. Supplementary Report. Reporting measures of plaque, self-perception of enamel opacities, self-reporting of symptoms and impact on quality of life.2011.
Levine R, Nugent Z, Rudolf M, Sahota P. Dietary patterns, tooth-brushing habits and caries experience of schoolchildren in West Yorkshire, England. Community Dent Health. 2007;24(2):82–7. PubMed
PHE. Delivering better oral health: an evidence-based toolkit for prevention 3rd Edt.2014 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/367563/DBOHv32014OCTMainDocument_3.pdfAccessed 20/11/14.
Ritchie J, Spencer L. Analyzing qualitative data. In: Bryman A, Burgess R, editors. Qualitative data analysis for applied policy research. London: Routledge; 1994. p. 173–94.
Bower E, Scrambler S. The contributions of qualitative research towards dental public health practice. Community Dent Oral Epidemiol. 2007;35(3):161–9. PubMed
PHE. Child Health Profile: Blackburn with Darwen. PHE, 2014.
Lader D, Chadwick B, Chestnutt I, et al. Children’s Dental Health in the United Kingdom, 2003. Summary Report. London: Office for National Statistics; 2005.
Rooney E, Davies G, Neville J, Robinson M, Perkins C, Bellis M. NHS Dental Epidemiology Programme for England. Oral health Survey of 12 year old Children 2008/2009. Summary of caries prevalence and severity results. 2010.
Ostberg A, Jarkman K, Lindblad U, et al. On self-perceived oral health in Swedish adolescents. Swed Dent J. 2002;155:1–87.
PHE. Tackling poor oral health in children Local government’s public health role. Local Government Association; 2014.
PHE. Local authorities improving oral health: commissioning better oral health for children and young people. An evidence-informed toolkit for local authorities. London: Public Health England; 2013.
NICE. Oral health: approaches for local authorities and their partners to improve the oral health of their communities2014 October
Bergstrom E, Skold U, Birkhed D, et al. Adolescents’ experiences of participating in a school-based fluoride varnish programme in Sweden. Swed Dent J. 2012;36(3):133–41. PubMed
46. Arthur S, Barnard M, Day N, Ferguson C, Gilby N, Hussey D et al. Evaluation of the National Healthy Schools Programme: Final Report: Department of Health 2011.
Ostberg A, Jarkman K, Lindblad U, Halling A. Adolescents’ perceptions of oral health and influencing factors: a qualitative study. Acta Odontol Scand. 2002;60(3):167–73. PubMed
Harris R, Gamboa A, Dailey Y, Ashcroft A. One-to-one dietary interventions undertaken in a dental setting to change dietary behaviour. Cochrane Database of Systematic Reviews 2012 doi: 10.1002/14651858.CD006540.pub2.
Cooper A, O’Malley L, Elison S, Armstrong R, Burnside G, Adair PM et al. Primary school-based behavioural interventions for preventing caries. Cochrane Database of Systematic Reviews 2013 doi: 10.1002/14651858.CD009378.pub2.
- A qualitative study of the views of adolescents on their caries risk and prevention behaviours
- BioMed Central
Neu im Fachgebiet Zahnmedizin
Mail Icon II