Oral health status of rural-urban migrant children in South China

Abstract

With massive rural-urban migration in China, health needs of migrant children require attention. However, the oral health of this special population is poorly understood. Objectives: This pilot study aimed to profile the oral health status and behaviors of migrant children in South China and to identify the socio-demographic/behavioral determinants of their oral health. Methods: A convenience sample of migrant children (n=138) aged 5-6 years were selected. Dental caries was registered according to the World Health Organization criteria. The oral hygiene status was evaluated with the Simplified Debris Index (DI-S). A questionnaire was completed by parents to collect information on socio-demographic background, parental knowledge/attitude and children's practice on oral health, and the impact of children's oral health on their quality of life (QoL) assessed by the Early Childhood Oral Health Impact Scale (ECOHIS). Results: With an 86% caries rate and a mean (SD) dmft of 5.17 (4.16), the caries prevalence among the migrant children was higher than those national statistics for both rural and urban areas (p<0.05). Oral hygiene was satisfactory (DI-S<1.0) in 3% of children, with the mean (SD) DI-S as 1.81 (0.49). Oral health impacts on QoL were considerable; 60% reported one or more oral health impacts. The mean (SD) ECOHIS score was 10.33 (8.91). Bedtime sweets, irregular toothbrushing, poor dental attendance, and poor parental attitudes to oral health were common. A multivariate model explained 58% of variance in children's carious teeth (dmft), with the determinants of “non-local-born”, “low education of parents”, “bedtime feeding”, “parental unawareness of fluoride's effect and importance of child's teeth”, and “poor oral hygiene” (all p<0.05). “Non-local-born” and “dmft” indicated poor oral health-related QoL (both p<0.05), accounting for 32% of the variance. Conclusion: Oral health is poor among rural-urban migrant children. The findings suggest an urgent need for cost-effective behavioral interventions among sub-groups of migrants.