Parents’ perceived barriers and enablers to providing optimal infant oral care

Background Early childhood caries (tooth decay) can adversely affect child growth, development and well-being and is a leading cause of preventable hospitalisation for pre-school aged children. This necessitates the introduction of preventive measures in infancy, including twice daily toothbrushing and timely dental visits. This study explored the barriers and enablers parents face in providing optimal oral care for their young children.

Methods We interviewed Australian parents with 0-36-month-old children about two key behaviours related to their child’s oral health: (1) the timing of first dental visit and (2) twice daily toothbrushing. Parents were recruited via social media advertising and all interviews were conducted online via Zoom. Interviews were based on a semi-structured interview guide mapped to the Theoretical Domains Framework (TDF). All interviews were audio recorded and transcribed. Data was coded to the TDF, summarised, and categorised as a barrier or enabler before being grouped into themes and sub-themes using framework analysis.

Results Fifteen interviews were completed between May 2022– May 2023. Thirteen of the 14 TDF domains were represented in the data. The three most dominant TDF domains across the dataset were social influences, environmental context and resources, and knowledge. Four themes were developed from the data: (1) Conflict, (2) Family and social norms, (3) Wanting a positive oral health experience, and (4) Uncertainty. These themes represent both barriers and enablers to optimal infant and young children’s oral care. Parents face complex decision-making challenges regarding their young children’s oral health care, particularly managing actual and perceived conflicts with their child. Knowledge and social and family norms influence their approach to managing these barriers.

Conclusions The key influences enabling or preventing optimal infant oral care identified in this study lay the foundation for interventions to target these behaviours. To encourage a timely first dental visit, parents need consistent messaging from dental and other health professionals. To encourage twice daily toothbrushing, parents need more support in managing their child’s behaviour and competing priorities.