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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Oral Health 1/2015

Establishing oral health promoting behaviours in children – parents’ views on barriers, facilitators and professional support: a qualitative study

BMC Oral Health > Ausgabe 1/2015
Denise Duijster, Maddelon de Jong-Lenters, Erik Verrips, Cor van Loveren
Wichtige Hinweise
Denise Duijster and Maddelon de Jong-Lenters contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

Conception and study protocol (DD, EV, CvL), study implementation and data collection (DD, MdJL), data analysis (DD, MdJL, EV, CvL), interpretation of findings (DD, MdJL, EV, CvL), drafting of the initial manuscript (DD, MdJL), revision of the manuscript (DD, MdJL, EV, CvL), agreed to the final version of the manuscript (DD, MdJL, EV, CvL).



The prevention of childhood dental caries relies on adherence to key behaviours, including twice daily tooth brushing with fluoride toothpaste and reducing the consumption of sugary foods and drinks. The aim of this qualitative study was to explore parents’ perceptions of barriers and facilitators that influence these oral health behaviours in children. A further objective was to explore parents’ views on limitations and opportunities for professional support to promote children’s oral health.


Six focus group interviews were conducted, including a total of 39 parents of 7-year old children, who were recruited from paediatric dental centres in The Netherlands. Interviews were held with Dutch parents of low and high socioeconomic status and parents from Turkish and Moroccan origin. Focus group interviews were conducted on the basis of a pre-tested semi-structured interview guide and topic list. Content analysis was employed to analyse the data.


Analysis of interview transcripts identified many influences on children’s oral health behaviours, operating at child, family and community levels. Perceived influences on children’s tooth brushing behaviour were primarily located within the direct family environment, including parental knowledge, perceived importance and parental confidence in tooth brushing, locus of control, role modelling, parental monitoring and supervision, parenting strategies and tooth brushing routines and habituation. The consumption of sugary foods and drinks was influenced by both the direct family environment and factors external to the family, including the school, the social environment, commercials and television, supermarkets and affordability of foods. Parents raised several suggestions for professional oral health support, which included the provision of clear and consistent oral health information using a positive approach, dietary regulations at school and a multidisciplinary approach among dental professionals, child health centres and other institutions in providing parental support.


In conclusion, this qualitative study provided detail regarding parental views on the influences on children oral health behaviours and their opinions on what further support is needed to promote children’s dental health. Parents’ suggestions for professional oral health support can guide the development or improvement of caries preventive interventions.
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