Attitudes towards oral health among parents of 6-year-old children at risk of developing caries


  • William Stephenson, the inventor of Q-methodology, served as the last assistant to Charles Spearman, the inventor of conventional factor analysis.

J.H.(Erik) Vermaire, Department of Social Dentistry and Behavioural Sciences, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands Tel: +31 20 5188231 Fax: +31 20 5188233 e-mail:


Vermaire JH, Hoogstraten J, van Loveren C, Poorterman JHG, van Exel NJA. Attitudes towards oral health among parents of 6-year-old children at risk of developing caries. Community Dent Oral Epidemiol 2010; 38: 507–520. © 2010 John & Wiley & Sons A/S

Abstract – Objectives:  Parental attitudes are likely to play a role in achieving and maintaining a desired level of oral health in children. To be useful in individually delivered caries prevention programmes, parental attitudes should be identified at individual level. Q-methodology has been proved successful in identifying attitudes in a wide range of disciplines but in dentistry Q-studies are scarce. In this study Q-methodology was used to identify parents’ prevailing attitudes towards the oral health of their children.

Methods:  Thirty-nine parents ranked 37 statements regarding the dental health behaviour they apply to their 6-year-old child. They later explained their rankings during a short interview. In Q-methodology, rather than reporting one average composite attitude and opinion, various combinations of opinions and attitudes concerning these statements are identified using by-person factor analysis.

Results:  Based on their beliefs, attitudes and cognitions, five categories of parents were found: (i) conscious and responsible, (ii) trivializing and fatalistic, (iii) appearance-driven and open-minded, (iv) knowledgeable but defensive and (v) conscious and concerned.

Conclusions:  Q-methodology appears to be a fruitful way to structure the complexity of parents’ opinions and attitudes towards their children’s dental health. It appears that Q-methodology provides comprehensive clusters of individual attitudes, based on various levels of responses to a wide range of questions. The five identified profiles may be useful in developing tailor-made prevention strategies in caries prevention.