Journal of Isfahan Dental School

The Application of Structural Equation Modeling in the Investigation of Factors Affecting the Dental Caries Index of Children

Document Type : مقاله‌های پژوهشی

Authors

1 Assistant Professor, Department of Statistics, Tabriz Branch, Islamic Azad University, Tabriz, Iran

2 Assistant Professor, Department of Prosthodontics, School of Dentistry, Tabriz Medical Sciences, Islamic Azad University, Tabriz, Iran

3 Dental student, School of Dentistry, Islamic Azad University, Tabriz, Iran

4 Dental Student, School of Dentistry, Islamic Azad University, Tabriz, Iran

Abstract

Abstract




Introduction:

Structural equation modeling (SEM) is a class of multivariate statistical methods that combines the dimensions of factor analysis and regression to enable researchers to simultaneously examine the relationships between variables. This method has not been used in dental research until now. In this article, the effect of parents' awareness, attitude and performance on their children's dmft with the mediation of sugary substance consumption has been investigated using the SEM method.



Materials
& methods:

In this research, questionnaires about the knowledge, attitude and performance of parents were completed among 385 people in Tabriz city. These questionnaires are based on previous research and made by researchers. Cronbach's alpha coefficients obtained for them were 0.949, 0.943 and 0.801 respectively, which indicates their good reliability. Also, checking the validity of the questionnaires (content validity with confirmatory factor analysis, convergent validity with average variance criterion and face validity with experts' approval) shows the usefulness of the tool. Structural equation modeling method with partial least squares (PLS) was used to test the research hypotheses.



Results:

According to the results of statistical analysis, the effect of "parental awareness", "parental performance" and "children's consumption of sugary substances" on "dmft" and also the effect of "parental awareness", "parental attitude" and "parental performance" on " The consumption of sugary substances by children" is significant at the level of 0.01 (P-value<0.01). Also, the results of the analysis showed that the indirect effect of the variables "awareness", "attitude" and "performance" of the parents on "dmft" through the mediator variable "amount of consumption of sugary substances" is significant at the level of 0.01 (P-value<0.01). But the effect of "parental attitude" on "dmft" was not significant (P-value>0.05).



Conclusion:


In this study, it was shown that the knowledge, attitude and performance of parents have a significant effect on "dmft" through the variable of consumption of sugary substances.
 



Key words: awareness, attitude, dmft, Structural Equation Modeling, performance, sugar

1- Hair Jr JF, Hult GTM, Ringle CM, Sarstedt M, Danks NP, Ray S. Partial least square structural equation modeling (PLS-SEM) using R. New York, NY: Springer Cham; 2021. p. 1-47.
2- Halvani N, Bahrololoomi Z, Moradi OM, Zarebidaki Z. Evaluation of knowledge, attitude and practice of parents referred to dental clinics toward importance of the primary teeth and space maintaining of them in city of Yazd in 2018 [in Persian]. J Shahid Sadoughi Uni Med Sci 2021; 29(1): 3375-88.
3- Shafizadeh M, Abdal K, Ebadollahi H. The evaluation of awareness and function of 6-7-years-old children parents of childhood caries and the preventive procedure in parents in Ilam in 2018 [in Persian]. Iran J Pediatr Dent 2020; 15(2): 51-61.
4- Tumarian L, Rahimluy Barabi A. Investigating the awareness of parents in the field of oral and dental health of 7-year-old children in Tehran [in Persian]. JDS 2002; 19(2): 125-34.
5- Sofiyani-Qadim M, Kalantar SA, Maehdipour A, Asayesh H. Evaluation of parents’s awareness of eruption of the first permanent molar tooth and caries prevention methods in individuals referring to health centers in Qom City, 2017 (Iran) [in Persian]. Qom Univ Med Sci J 2018; 12(7): 51-9.
6- Zouashkiani T, Mirzakhan T. Parental knowledge about presence of the first permanent molar and its effect on health of the this tooth in 7-8 years-old children (2006) [in Persian]. Mashahad 2006; 30(3,4): 225-32.
7- Fornell C, Larcker DF. Evaluating structural equation models with unobservable variables and measurement error. J Mark Res 1981; 18(1): 39-50.
8- Gefen, D, Straub DW. A practical guide to factorial validity using PLS-Graf: Tutorial and annotated Example. Commun Assoc Inf Syst 2005; 16(1): 91-109.
9- Chin WW. The partial least squares approach to structural equation modeling. In Marcoulides GA. Modern methods for business research. Mahwah, NJ: Lawrence Erlbaum; 1998.
10- Gholami Fesharaki M. Structural equation modeling and its application in psychological studies: A review study [in Persian]. Clin Psychol Person 2018; 16(1): 253-65.
11- Mohammadi M, Vaisi Raygani A, Jalali R, GHobadi A, Salari N. The prevalence of dental caries in deciduous and permanent teeth in Iranian children: A systematic review and meta-analysis [in Persian]. J Res Dent Sci 2018; 15(3): 180-9.
12- Jafari F, Sadjadi Askouee J, Jafari S, Talebi M. Evaluationof DMFT and dmft indexes and affecting factors in students of Hashtrood city in 2013-2014 [in Persian]. J Ilam Univ Med Sci 2017; 25(4): 179-86.
13- Yousofi M, Behrouzpour K, Kazemi S, Afroughi S. Dental caries and related factors among 7-12 year-old school children in Yasuj [in Persian]. Armaghane Danesh 2015; 20(9): 836-47.
14- Kameli S, Mehdipour A, Montazeri Hedeshi R, Nourelahi M. Evaluation of parental knowledge, attitudes and practices in preschool children on importance of primary teeth and some related factors among subjects attending Semnan University of Medical Sciences dental clinic [in Persian]. Koomesh 2017; 19(1): 191-8.
15- Beyzaei P, Seyfi N. Evaluation of parent's knowledge and attitude toward dental trauma in 7-12 years old children referred to pediatric department of Dental School, Golestan University of Medical Sciences [in Persian]. Iran J Pediatr Dent 2022; 17(2): 1-11.
16- Khoramiyan Tusi S, Farhadi A, Jafari A, Najafi GA. Knowledge, attitude and practice of students’ parents about fissure sealant [in Persian]. Iran J Pediatr Dent 2018; 13(2): 1-10.
17- Gläser-Ammann P, Lussi A, Bürgin W, Leisebach T. Dental knowledge and attitude toward school dental-health programs among parents of kindergarten children in Winterthur. Swiss Dent J 2014; 124(7-8): 770-83.
18- Gonzalez E, Perez-Hinojosa S, Alarcon JA, Peñalver MA. Knowledge of Andalusian pediatricians and parents about early-onset tooth decay [in Spanish]. An Pediatr (Barc) 2015; 82(1): 19-26.
19- Valles A, Lluch C, Munne C, Veloso A, Paglia L, Guinot F. Comparison of knowledge between Italian and Spanish parents about the oral health of their preschool children. Eur J Paediatr Dent 2022; 23(3): 194-200.
20- Ramakrishnan M, Banu S, Ningthoujam S, Samuel V. Evaluation of knowledge and attitude of parents about the importance of maintaining primary dentition - A cross-sectional study. J Family Med Prim Care 2019; 8(2): 414-8.
21- Patil AN, Karkare S, Jadhav HS, Damade Y, Punjari BK. Knowledge, attitude, and practice of parents toward their children's oral health and its influence on the dental caries status of 5-10-year-old schoolchildren in Nashik, Maharashtra: A cross-sectional study. Int J Clin Pediatr Dent 2022; 15(Suppl 2): S126-30.
22- Lakshmanan L, Gurunathan D. Parents' knowledge, attitude, and practice regarding the pit and fissure sealant therapy. J Family Med Prim Care 2020; 9(1): 385-9.
Journal of Isfahan Dental School
Volume 19, Issue 4 - Serial Number 4
December 2022
Pages 288-302