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Int. J. Environ. Res. Public Health 2017, 14(8), 907; doi:10.3390/ijerph14080907

Maintaining Traditions: A Qualitative Study of Early Childhood Caries Risk and Protective Factors in an Indigenous Community

1
School of Medicine, University of California, San Francisco, CA 94101, USA
2
School of Public Health, University of California, Berkeley, Berkeley, CA 94720, USA
3
Department of Biostatistics and Epidemiology, Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85721, USA
4
Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, CA 94118, USA
*
Author to whom correspondence should be addressed.
Received: 4 July 2017 / Revised: 1 August 2017 / Accepted: 5 August 2017 / Published: 11 August 2017
(This article belongs to the Special Issue Epidemiology and Determinants of Dental Caries in Children)
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Abstract

In lower middle-income economies (LMIE), the nutrition transition from traditional diets to sugary foods and beverages has contributed to widespread early childhood dental caries. This qualitative study explores perceived risk and protective factors, and overall experiences of early childhood nutrition and oral health in indigenous Ecuadorian families participating in a community-based oral health and nutrition intervention. Dental exams of 698 children age 6 months through 6 years determined each child’s caries burden. A convenience sample of 18 “outlier” families was identified: low-caries children with ≤2 carious teeth vs. high-caries children with ≥10 carious teeth. Semi-structured in-depth interviews with parents/caregivers explored the child’s diet, dental habits, and family factors related to nutrition and oral health. Interviews were transcribed and thematically analyzed using grounded theory. In the high-caries families, proximity to highway and stores, consumption of processed-food, and low parental monitoring of child behavior were identified as risk factors for ECC (early childhood caries). In the low-caries families, protective factors included harvesting and consuming food from the family farm, remote geography, and greater parental monitoring of child behavior. The study results suggest that maintaining traditional family farms and authoritative parenting to avoid processed foods/drinks and ensure tooth brushing could improve early childhood nutrition and oral health. View Full-Text
Keywords: caries; nutrition transition; early childhood caries; Ecuador; Positive Deviance caries; nutrition transition; early childhood caries; Ecuador; Positive Deviance
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Levin, A.; Sokal-Gutierrez, K.; Hargrave, A.; Funsch, E.; Hoeft, K.S. Maintaining Traditions: A Qualitative Study of Early Childhood Caries Risk and Protective Factors in an Indigenous Community. Int. J. Environ. Res. Public Health 2017, 14, 907.

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