Exploring dental behaviours of carers: psycho-social factors

Background: People with physical and intellectual disabilities (PID) depend on their carers for oral care. Carers' psycho-social factors on the oral health care of their care recipients (carer dental efficacy, carer oral health competency, and carer activation measure) may be associated with the ability of carers to provide good oral care to their care recipients. Objectives: To describe and compare psycho-social factors on oral health care among carers, and assess any associations with preventive dental behaviours for their care recipients. Methods: The research was a follow-up study of carers of adults with PID living in Adelaide. Data were collected (February 2009 - April 2010) through a structured face-to-face interview of 100 carers. Carers' dental efficacy (CDE) was measured using five items on oral care behaviours. Carers' perceived oral health competence (COHC) was measured using five items on competency in managing oral health behaviours. Carers' activation measure (CAM) was used to determine capability or readiness to engage in desired oral health behaviours. CAM included 13 items across three subscales: Knowledge; Skills; and Confidence. The key outcome measures were toothbrushing and dental visiting pattern. Results: After adjusting for carer and care recipient characteristics, multivariate analysis showed that twice a day toothbrushing was significantly associated with higher CDE [OR= 4.2 (1.5, 11.6)]. Regular dental visit among the care recipients was significantly associated with higher CDE [OR= 4.7 (1.3, 17.2)], COHC [OR= 5.7 (1.4, 23.4)], and CAM-Skills [OR= 4.1 (1.2, 15.9]. Conclusions: Psycho-social factors (CDE, COHC, CAM-Skills) were associated with preventive dental behaviours. These psycho-social factors may be enhanced by providing encouragement and positive reinforcement to carers, and by specific support and guidance that match their level of preparedness. Providing such support and guidance may improve carers' ability to provide appropriate oral health care for their care recipients.