EC Paediatrics

Dental caries has been considered a public health problem insofar as it constitutes a source of burden, pain, and aesthetics with implications for the general well-being of the individual. It is essential to understand, analyse and characterize the mental representation of children about this concept, to contribute to the (re)conceptualization of oral health education in terms of the aetiology of caries. Two studies (Phase I and II) were carried out with the aim of characterizing the mental representation of an (Un)Healthy Tooth, associated with the concept of dental caries mentally internalized by children. This paper presents the results of an exploratory study divided into two distinct phases (Phase I: n = 880/4 - 9 years; Phase II: n = 812/6 - 12 years) that involved a total of 1692 children, recruited at the schools of the municipality of Lisbon and at Egas Moniz University Clinic. Data was collected for two moments: M1, where the child was asked to draw a healthy tooth on a sheet of paper and M2, where the child was asked to draw an unhealthy tooth on another sheet using only a pencil of graphite, totalling 3384 drawings. Subsequently, the child was asked to answer to an open-ended questionnaire, composed by three different questions, with the aim to evaluate the mental representation of the concept of: a) Dental decay, b) Healthy tooth and c) Unhealthy tooth. In the data from the content analysis of the drawings, that has been made by 4 - 12 year-old children, the symbolism category of the teeth that were drawn, tends to increase with chronological age between 4 - 6 years old, denoting a higher frequency of an unrealistic teeth category, drawn from phase I to phase II, and at the same time from 10 years old onwards   there is a marked decrease in this pictorial (Un)Realism. Most children in both phase I and phase II associate a healthy tooth with a clean tooth with a smooth surface; In contrast, to the mental representation of an unhealthy tooth in both phases, in which the caries category is represented at the level of the categories: Stains, fractures and cavitation. Analysis of the pictorial contents of the drawings made by the participating children denotes significant discrepancies, inherent to the illustration profiles of healthy tooth versus unhealthy tooth. Such discrepancies bear implications at the level of oral health promotion and prevention, suggesting the need to create ludic-pedagogic instruments for oral health education in very early development stages.

 Keywords: Oral Health Education; Drawings; Dental Decay; Healthy Tooth; Unhealthy Tooth; Mental Representation

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