Rural Latino immigrant caregivers' conceptions of their children's oral disease.
OBJECTIVE
The aim of this study was to examine Latino immigrant caregivers' explanatory models of the causes of early childhood caries (ECC).


METHODS
In a rural area, we conducted 71 open-ended qualitative interviews with 26 Mexican immigrant and 12 Salvadoran immigrant caregivers of children under 6 about the causes of ECC. Two researchers independently read each interview and classified each interviewee's response.


RESULTS
Caregivers mentioned three biomedical causes of oral disease (sweets, poor oral hygiene, and bottle-feeding) and two lay or popular causes (lack of milk consumption and "bad" genes). Although caregivers were aware that the consumption of sweet foods causes decay they expressed particular confusion about how bottle-feeding causes decay. Nineteen caregivers attributed decay specifically to bottle-feeding, yet 14 believed the cause of decay was the bottle's nipple. Seven Mexican immigrant caregivers attributed their children's decay specifically to a lack of calcium, and six immigrant caregivers to "bad teeth genes."


CONCLUSIONS
Conceptions of oral disease derived from the caregivers' own dental experiences, their conceptions of the body, and interactions with dental professionals. The fact that biomedical explanations dominate the list of causes of caries for both groups indicates that the caregivers' explanatory models of oral disease are powerfully shaped by interactions with health professionals. Immigrant caregivers' mistaking of the baby bottle's nipple as the source of decay indicates the need for more effective oral health promotion. Yet the Mexican immigrants' conceptions of a lack of calcium as a major factor in their children's decay may illustrate a strong cultural link between teeth and milk.
Horton
Sarah
S
Department of Preventive and Restorative Dental Sciences, University of California San Francisco, 94143-0850, USA. sarah.horton@ucsf.edu
Barker
Judith C
JC
D000818:Animals; D001903:Bottle Feeding / Q000009:adverse effects; D002118:Calcium / Q000172:deficiency; D002140:California; D002675:Child, Preschool; D003469:Culture; D003710:Demography; D003731:Dental Caries / Q000209:etiology / Q000523:psychology*; D019422:Dietary Sucrose / Q000009:adverse effects; D004544:El Salvador / Q000208:ethnology; D054242:Emigrants and Immigrants / Q000523:psychology*; D005796:Genes; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D017058:Mexican Americans / Q000523:psychology; D008892:Milk; D012424:Rural Population; D012959:Socioeconomic Factors; D014099:Toothbrushing / Q000706:statistics & numerical data
D019422:Dietary Sucrose; D002118:Calcium