Associations between Maternal Education and Child Nutrition and Oral Health in an Indigenous Population in Ecuador

Bharathi Chinnakotla; Sita Manasa Susarla; Deepika Chandra Mohan; Bathsheba Turton; Hannah M Husby; Cecilia Paz Morales; Karen Sokal-Gutierrez

doi:10.3390/ijerph20010473

Associations between Maternal Education and Child Nutrition and Oral Health in an Indigenous Population in Ecuador

Int J Environ Res Public Health. 2022 Dec 28;20(1):473. doi: 10.3390/ijerph20010473.

Authors

Bharathi Chinnakotla¹, Sita Manasa Susarla¹, Deepika Chandra Mohan¹, Bathsheba Turton², Hannah M Husby¹, Cecilia Paz Morales³, Karen Sokal-Gutierrez¹

Affiliations

¹ School of Public Health, University of California, Berkeley, CA 94704, USA.
² Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA.
³ General Dental Practice, Quito 170513, Ecuador.

Abstract

The global nutrition transition has increased the prevalence of childhood dental caries. Greater understanding is needed of the impact of social determinants—including maternal education—on child oral health. This is a cross-sectional analysis of a convenience sample of families of 458 indigenous Ecuadorian children aged 6 months through 6 years from 2011−2013. Data was collected by mother interviews and child dental and anthropometric examinations. Multivariate logistic and Zero-Inflated-Poisson regression analyses assessed associations between years of maternal education and maternal-child oral health practices and child oral health outcomes. Each additional year of maternal education was significantly (p < 0.05) associated with some healthier practices including greater likelihood of mothers and children drinking milk daily (OR 1.20; 95% CI 1.08, 1.34); and less healthy practices including greater likelihood of bottle-feeding children with sugary liquids (OR 1.14; 95% CI 1.06, 1.22) and to older age, giving children sweets daily, calming children with a bottle or sweets, and less likelihood of helping brush their children’s teeth (OR 0.93; 95% CI 0.88, 0.98). Each year of maternal education had a small but statistically non-significant influence on increasing the odds of children being among those who are cavity-free (OR 1.03; 95% CI 0.92, 1.16). Interventions to improve health outcomes should focus not just on maternal education but also address social and commercial determinants of health through nutrition and oral health education, as well as policies to reduce sugar and ensure universal access to oral health care.

Keywords: early childhood caries; ecuador; maternal education; maternal-child health; nutrition; oral health; public health; social determinants of health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Dental Caries* / epidemiology
Ecuador / epidemiology
Female
Humans
Indigenous Peoples
Oral Health*

Grants and funding

There was no funding for this analysis. Funding for the collection of the original data used in this analysis was supported by small grants from American Academy of Pediatrics I-CATCH and Rotary International, UC Berkeley Undergraduate Research Apprenticeship Program, and donations to the Children’s Oral Health and Nutrition Project charitable fund at UC Berkeley.