The experiences and practices of oral health promotion for children in Cape Town: an exploratory descriptive qualitative study

Abstract

Background: In South Africa, oral diseases are a significant public health concern. The Western Cape has a high prevalence of dental caries, with rates increasing from 82% to 84% in 6-year-olds over a 13-year period. This study explored the experiences of oral hygienists, children and their parents to generate insights that can inform the design of a new approach to oral health promotion (OHP). Aim: This exploratory descriptive qualitative study was conducted within an interpretivist paradigm using semi-structured individual interviews with three groups of participants: oral hygienists, children aged 8–12 years and their parents. Setting: The study was conducted at the dental public health facilities in the Western Cape Metropole. Methods: The transcripts were thematically analysed using ATLAS.ti software and guided by the Ritchie and Spencer framework approach to thematic analysis. Results: Seven main themes were identified: oral health promotion approaches and effectiveness, professional development, barriers and challenges, children and parents’ oral health knowledge, attitudes and practices, parental influence and family dynamics, cultural and socio-economic considerations and engagement between oral hygienists, parents and children. Resource limitations within the public dental healthcare system had a negative effect on the hygienists’ ability to deliver effective OHP services. Conclusion: Although oral hygienists employ diverse methods, including practical demonstrations and interactive techniques, current OHP strategies remain inadequate to address the high burden of dental caries. These findings support the development of an alternative approach to OHP in this setting. Contribution: The study contributes to understanding the role of family dynamics in reducing the burden of oral diseases among children in the Western Cape.