Sociocultural Determinants of Children’s Oral Health Among Immigrants

Objectives: This study aimed to develop a conceptual model to predict immigrant children’s oral health through examining parental acculturation level and perceived social support using structural equation modeling.
Methods: First-generation immigrant parents and their children aged 2-12 years were recruited by multilingual community workers. Parents completed a validated questionnaire gathering information on demographics, child’s oral health (OH) behaviors, parental acculturation, and parental Perceived Social Support (PSS). Dental examinations determined children’s caries experience using DMFT/dmft index. Structural equation modeling (SEM) was used to analyze the data.
Results: A total of 336 families participated in this study. The average parental acculturation level was 10.46 with a maximum of 15 and the average PSS was 63.27 with a maximum of 75. SEM showed that 77% of the variance of DMFT/dmft scores in children was explained by parental PSS, acculturation level, predisposing and enabling factors, and children’s OH behaviors. The direct effect of parental PSS was associated with a significantly reduced rate of dental caries (β= -0.076, P-value= 0.008) and lower sugar consumption (β= -0.17, P-value= 0.04). While the mediation effect of parental acculturation on PSS was associated with positive OH behaviors of children (e.g. toothbrushing frequency and dental care utilization), the indirect effect increased caries rate (β= 0.77, P-value= 0.00).
Conclusions: Parental PSS direct effect showed an increase in favorable oral health behaviors and reduced the rate of dental caries while the mediation effect of acculturation increased the rate of dental caries. The impact of socio-cultural determinants on immigrants’ oral health is a complex process and needs to be further investigated.