SMJ Current Issue

Parents’ attitude towards children’s first dental visit in the College of Dentistry, Riyadh, Saudi Arabia
  Thakibe A Al-Shalan,  Basim A Al-Musae,  Abdulmoniem M Al-Khamis

Objectives: The objectives of this study were to evaluate parents’ awareness about the timing of the first dental visit for their children, the parents’ attitude toward behavior modification for their children at the first dental visit, and to determine the main reasons for bringing the child to the dentist in the first visit among the Saudi parents attending the dental school at the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Methods: A self-administered questionnaire consisting of 12 items was distributed to any adult patient reporting at the Registration Appointments and Records Division of King Saud University, College of Dentistry, Riyadh, Kingdom of Saudi Arabia, during the year 2001. The questionnaire response rate was 96.5%.
Results: Some parents reported that their child’s first dental visit should be in the 3rd year (42%) while others thought it should be in the 6th year (34.4%). Seventy-three percent of the parents prefer behavior modification during the first dental visit. Regular visit (40.3%) and emergencies (28.1%) were the main reasons to bring the children to the dentist.
Conclusions: These data indicate that there is a relatively low level of parents’ knowledge about the timing of a child’s first dental visit. The dental profession and pediatricians have major responsibilities to change this concept.

Saudi Medical Journal 2002; Vol.  (9): 1110-1114 doi:


Primary teeth are not less important than the permanent teeth. Once the primary teeth start to erupt, dental plaque that is considered the major cause of dental diseases which begins to adhere to the teeth and regular dental care for the child becomes essential. It is the parents’ responsibility to take care of their children’s teeth in combination with the dentist’s advice. This is because the child at that age lacks the awareness of the importance of the teeth, the knowledge in dental health care, and the ability to maintain the required oral health. Some parents think that there is no need to bring the child to the dentist as long as the permanent teeth are not yet erupted. In addition, some parents consider the pain as a predictor for the first dental visit for their children. Review of records for patients, who visited the dentist under the age of 4 years, revealed that 51.9% of them were due to injuries and only 25.4% for preventive services.1P>

In the United States of America, previous epidemiological studies have confirmed significant decrease in the overall caries prevalence.2,3 However, studies showed that caries prevalence in 3 to 5-years-old is relatively high.4 O’Sullivan and Tinanoff5 reported that 16% of 3-4 year old Head Start Children in Connecticut have dental caries. In the United Arab Emirates, it has been shown that the decayed missing and filled teeth (DMFT) was 5.82.6 In the Kingdom of Saudi Arabia (KSA), it has been reported that the mean dmft for 6-year-old boys was 4.14 and for girls was 3.43.7 Additionally, a study carried out in Jeddah, KSA, showed that the prevalence of Nursing Bottle Syndrome (NBS) is 20%, and 67% of them had the most severe form.8 Due to significant relationship between caries in primary teeth and caries incidence in the permanent teeth,9 it is important to increase all possible preventive measures in the early stage of a child’s life to decrease the caries incidence in the permanent teeth. Early dental visit is one of the possible preventive measures. It was recommended that the children’s first dental visit should be by the age of 3 years.10 It was claimed that a child less than 3 years lacks the ability to cooperate with the dental staff.11 After full understanding of the disease process and the possibility that dental diseases affect the primary teeth before 3 years of age, the American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) recommend that the children should have their first dental visit at approximately the time of eruption of the first tooth or at the latest age of 12 months.12 This visit is non-threatening and few if any infants by that age have an oral problem that requires treatment.12 Furthermore, the children will become familiar with the dental staff and makes the future dental treatment less anxious for them. In addition, the dentist can give advice to the parents (Anticipatory Guidance). Wyne et al13 in a survey in Adelaide, South Australia showed that only one in 10 children had visited the dentist at or before the age of 12 months.P>

Previous studies indicate that there is lack of parents’ awareness about the importance of the primary teeth, the early dental visit for their children and dental health knowledge.14-17 Therefore, the purpose of this study was to evaluate the knowledge of the Saudi parents attending dental clinics in the College of Dentistry, King Saud University, Riyadh, KSA about the first dental visit for their children as regard to timing, behavior modification and reasons for bringing children to the dentist.P> FONT>

Methods.FONT> FONT>A questionnaire, consisting of a cover page, personal data and 12 questions was designed to be used in this study. The cover page includes invitation of the parents to participate in


From the Department of Preventive Dental Sciences (Al-Shalan) and Interns Clinic (Al-Musa, Al-Khamis), College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia.

Received 3rd April 2002. Accepted for publication in final form 21st May 2002.

Address correspondence and reprint request to: Dr. Thakib A. Al-Shalan, Assistant Professor, Department of Preventive Dental Sciences, College of Dentisty, King Saud University, PO Box 60169, Riyadh 11545, Kingdom of Saudi Arabia. Tel. +966 (1) 4676648. Fax. +966 (1) 4678545. E-mail.


Acknowledgment.FONT> FONT>The authors are grateful to Dr. Nazeer Khan, Biostatistician in College of Dentistry Research Center (CDRC), King Saud University, Riyadh, Kingdom of Saudi Arabia, Mr. K. Al-Numair, Mr. S. Tabor and the booking personnel in DUC and Miss. W. Al-Harthy and the booking personnel in MUC. This research was registered in CDRC, as NF 1858.P>FONT>


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