Exploring Socio-Cultural Factors Affecting Early Childhood Oral Health: A Mixed-Methods Study
DOI:
https://doi.org/10.6000/1929-4247.2026.15.04.3Keywords:
Child nutrition, early childhood caries, feeding habits, mixed methods, oral health, socio-cultural factors, sugar consumptionAbstract
Purpose: Early Childhood Caries (ECC) remains a major child health problem in Indonesia despite ongoing preventive efforts. ECC is closely associated with poor dietary habits, excessive and unmonitored sugar consumption, and even influences social and cultural aspects. This study aimed to explore socio-cultural, behavioral, and nutritional factors affecting early childhood oral health within Holistic Integrative Early Childhood Education (PAUD HI) settings in Padang City, Indonesia. Methods: A sequential mixed-methods study was conducted. The quantitative phase involved 258 parents of children aged 1–6 years selected from six PAUD HI institutions. Data were collected using questionnaires, and analysis was performed using univariate, bivariate, and multivariate logistic regression. Following this was the qualitative phase, in which 12 parents and 3 school representatives were asked to explain and contextualize the initial quantitative findings. In analyzing this data, Miles and Huberman's thematic approach was used.
Results: There was no statistically significant association between parental oral health behavior and knowledge (OR=8.607, p=0.165), attitude (OR=2.207, p=0.132), belief (OR=0.425, p=0.230), health information exposure (OR=2.512, p=0.186), healthcare support (OR=2.031, p=0.201), or access to health facilities (OR=5.330, p=0.126). The results reveal that no final multivariate regression model was obtained. Sociocultural factors strongly influence habits through family toothbrushing routines, parenting power dynamics, children’s emotional attachment, traumatic dental experiences, and inconsistent control of children's sugar consumption, which are all the results of influences within and outside family settings. These findings elucidate why there is a gap between what parents understand and how they actually implement oral health care practices properly on their children.
Conclusion: Risk factors for ECC do not only come from parents’ dental knowledge but also from children’s social and cultural environments. Implementing effective socio-cultural approaches reduces ECC risks, for example, by providing education to parents and children on proper nutritional habits and how to incorporate them into daily routines.
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