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 Table of Contents  
Year : 2021  |  Volume : 9  |  Issue : 1  |  Page : 2-4

Involvement of children and adolescents in dietary counseling carried out by dental health practitioners: Narrative overview

1 Department of Preventive and Community Dentistry, Faculty of Dentistry, Sebha University, Sabha, Libya
2 AFH, Jizan, KSA

Date of Submission30-Dec-2020
Date of Decision03-Feb-2021
Date of Acceptance12-Feb-2021
Date of Web Publication14-May-2021

Correspondence Address:
Wenisa Suliman Arrish
Head of Preventive & Community Dentistry Department, Faculty of Dentistry, Sebha University, Sabha
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/dmr.dmr_71_20

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The objective was to assess the extent of involvement of children and adolescents in dietary counseling (DC) performed by dental health practitioners. Two online databases PubMed and ERIC were searched using terms “dietary counselling” AND “children” AND “adolescents” AND “oral health” from 2001 to November 2020. Only two studies reported the involvement of children and adolescents in DC performed by dental health practitioners. Dental practitioners are still not prepared well to do dietary consultations with children and adolescents. Further research should be attempted to find the best ways that guarantee full involvement of children in dietary consultations carried out by dental practitioners.

Keywords: Children, counseling, dental hygienists, dentists, diet, oral hygiene

How to cite this article:
Arrish WS, Peeran SW. Involvement of children and adolescents in dietary counseling carried out by dental health practitioners: Narrative overview. Dent Med Res 2021;9:2-4

How to cite this URL:
Arrish WS, Peeran SW. Involvement of children and adolescents in dietary counseling carried out by dental health practitioners: Narrative overview. Dent Med Res [serial online] 2021 [cited 2022 Nov 27];9:2-4. Available from: https://www.dmrjournal.org/text.asp?2021/9/1/2/315971

  Introduction Top

Dietary counseling (DC) is a process by which a health professional with special training in nutrition provides individualized nutritional care by encouraging people to make healthy food choices and form healthy eating habits, thereby modifying their prior dietary habits.[1],[2] DC has been considered one of the preventive measures that should be undertaken for preventing dental diseases, especially dental caries.[3] There is some evidence that dietary behavior could be changed through one-to-one dietary interventions in dental settings.[4]

Children at high risk of developing diet-related diseases should undergo DC.[5] One of the main objectives of DC of children is controlled imparting of the right knowledge over time about healthy nutrition and food.[6] There are a number of studies that prove the potency of DC in improving the eating behaviors and health status of children. For example, one of these studies found that repeated individualized DC could reduce the accumulation of cardiometabolic risk factors in overweight young children and adolescents,[7] and other study found that long-term DC led to a decreased saturated fat intake and a positive outcome on the insulin resistance index in young children.[8]

Similar to other health encounters, the dominant approach of counseling children regarding their diet is conducted through a three-party encounter (health professional, parents, and child), in which the child is given little voice while a large part of the conservation occurs between counselor and parent.[9],[10] The concept of the involvement of children in DC came out as an extension to the new sociological perspective of childhood that looks at children as social actors, and also in accordance with children's rights that were adopted in a United Nations Convention that emphasized involving children in decision making.[11],[12],[13]

Recently, a growing emphasis is placed on the importance of involving children in consultations as the best way to understand their experience and improve their participatory role in health encounters. However, children are seldom involved in making decisions about their health and there is still fear, ambiguity, and contradictory views among health-care providers and parents about children's involvement in health consultations. This means that further research-based evidence is required to convince health professionals and parents about the benefits of the partnership with children and that it has no negative effects in the long run.[14],[15],[16]

Furthermore, the involvement of children in DC is important because it is thought to enhance children's compliance and adherence to dietary advice and thus lead to good health outcomes that are sought through the counseling.[10] However, there is a paucity in information regarding how the children are involved in DC and whether the contemporary view about children and their rights is applicable in this context.[9],[10] Thus, this review aims to review the studies describing dietary consultations conducted by dental practitioners involving children and adolescents.

  Methods Top

Two online databases PubMed and ERIC were searched using terms “dietary counselling” AND “children” AND “adolescents” AND “oral health” from 2001 to November 2020 by a single researcher. Only manuscripts in English were included.

  Results Top

The search of the online databases PubMed and ERIC retrieved only two papers in which children and adolescents were involved in dietary dialogues [Table 1].
Table 1: Involvement of children and adolescents in dietary counseling

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The first study was by Hausen et al.; [17] a randomized controlled trial in which 497 children were randomly divided into two groups. The experimental group received DC from trained dental hygienists, while the control group received health education about dietary and oral hygiene habits along with the application of fluoride varnish. The discussions between dental hygienists and children were about snacking times and the importance of reducing the consumption of sugars. However, the study did not report how these diet-related discussions were done, the approaches that were used and the protocols and guidelines followed in the process. All of these questions need to be explored to achieve effective DC that involves children actively in the dialogue. The study found that the dietary habits of children did no change at the end of the study and the author of the study attributed this to the difficulty in influencing dietary behaviors.

Another study, a randomized control trial by Wu et al.,[18] was included in the review. It is a randomized control trial that compared the effectiveness of conventional health education talk with face-to-face individual motivational interviewing (MI) and online MI in enhancing oral health behaviors (diet and toothbrushing) among adolescents. The study included 512 adolescent subjects who were divided into three groups randomly. A group received conventional health education, the second group received a face-to-face MI, while the third group received online MI. The authors mentioned that the dietary talks were with adolescents and they used MI as an approach for behavior change. They found that MI is more effective in bringing about a positive change by reducing the snacking frequency than conventional health education.

  Discussion Top

This review sheds light on the need for active participation of children and adolescents in DC for oral health conducted by dental health practitioners. The results of the literature review revealed that there is a scarcity of scientific literature dealing with DC in oral health-related studies except for those aforementioned. It also shows that those studies included in this review were also conducted by dental hygienists and not dentists. This might be explained by the assumption that many health practitioners still prefer to discuss treatment decisions with parents to save time generally. It might also be that the dental fraternity at large is still not convinced by the concept of involving children in decision-making.[16],[19],[20] Furthermore, in the two studies, the dietary discussions were done by dental hygienists; this can be because many dentists think it is difficult to change patient's dietary behavior through DC and they do not have the time and skills needed to provide such intervention.[21],[22],[23]

On the other hand, the diet discussions carried over in the study done by Hausen et al.,[17] may have failed to change the oral health behaviors of children because they had used the conventional approach in DC. Moreover, it also highlights the need for concerted effort to enhance the counseling and motivational skills of dentists, dental hygienists, dental nurses, and dental students. Further, they should also be taught to involve communication with children and adolescents in matters of their health concern including their DC.[9]

  Conclusion Top

This is the first review to the best of our knowledge that discusses the involvement of children and adolescents in DC. The paper shows DC involving children and adolescents can have a positive effect on the dietary behavior of the subjects. It also shows a general scarcity of scientific literature that investigates the benefits of involvement of children and adolescents in DC. It also shows that dental practitioners need to be imparted the necessary skills to carry dietary consultations with children and adolescents. Further research should be attempted to find the best ways that guarantee full involvement of children in dietary consultations carried out by dental practitioners and to examine the benefits they can have on individual dietary behavior.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Elia M, Smith TR. Nutritional support: In the home setting. In: Caballero B, editor. Encyclopedia of Human Nutrition. 3rd ed. London: Academic Press; 2013. p. 269-77.  Back to cited text no. 1
NCI Dictionary of Cancer Terms. Published February 2, 2011. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/dietary-counseling. [Last accessed on 2021 Feb 03].  Back to cited text no. 2
Ndiokwelu E, Ndiokwelu C. Dietary counseling in the prevention and control of oral diseases – A review. Afr J Oral Health 2006;2:26-36. [doi: 10.4314/ajoh.v3i1-2.57023].  Back to cited text no. 3
Harris R, Gamboa A, Dailey Y, Ashcroft A. One-to-one dietary interventions undertaken in a dental setting to change dietary behaviour. Cochrane Database Syst Rev 2012;(3):CD006540.  Back to cited text no. 4
Snetselaar LG. Nutrition Counseling Skills for the Nutrition Care Process. London: Jones & Bartlett Learning; 2009. Available from: https://play.google.com/store/books/details?id=1P8HlsxIhbkC.  Back to cited text no. 5
Samour PQ, King K. Handbook of paediatric nutrition, 3rd edn. Sudbury: Jones & Bartlett Publishers, 2005.  Back to cited text no. 6
Hakanen M, Lagström H, Pahkala K, Sillanmäki L, Saarinen M, Niinikoski H, et al. Dietary and lifestyle counselling reduces the clustering of overweight-related cardiometabolic risk factors in adolescents. Acta Paediatr 2010;99:888-95.  Back to cited text no. 7
Kaitosaari T, Rönnemaa T, Viikari J, Raitakari O, Arffman M, Marniemi J, et al. Low-saturated fat dietary counseling starting in infancy improves insulin sensitivity in 9-year-old healthy children: The Special Turku Coronary Risk Factor Intervention Project for Children (STRIP) study. Diabetes Care 2006;29:781-5.  Back to cited text no. 8
Pyörälä E. The participation roles of children and adolescents in the dietary counseling of diabetics. Patient Educ Couns 2004;55:385-95.  Back to cited text no. 9
Savage E, Callery P. Clinic consultations with children and parents on the dietary management of cystic fibrosis. Soc Sci Med 2007;64:363-74.  Back to cited text no. 10
Convention on the Rights of the Child. OHCHR. Available from: https://www.ohchr.org/EN/ProfessionalInterest/Pages/CRC.aspx. [Last accessed on 2021 Jan 31].  Back to cited text no. 11
Fernandez E. Child inclusive research, policy and practice. Child Youth Serv Rev 2011;33:487-9.  Back to cited text no. 12
Dockett S, Perry B, Kearney E. Promoting children's informed assent in research participation. Int J Qual Stud Educ 2013;26:802-28.  Back to cited text no. 13
Dixon-Woods M, Young B, Heney D. Partnerships with children. BMJ 1999;319:778-80.  Back to cited text no. 14
Alderson P. Children as researchers:The effects of participation rights on research methodology. In:Christensen P,James A,editors. Research with Children: Perspectives and Practices.2nd ed. London: Routledge;2000.  Back to cited text no. 15
Coyne I. Children's participation in consultations and decision-making at health service level: A review of the literature. Int J Nurs Stud 2008;45:1682-9.  Back to cited text no. 16
Hausen H, Seppa L, Poutanen R, Niinimaa A, Lahti S, Kärkkäinen S, et al. Noninvasive control of dental caries in children with active initial lesions. A randomized clinical trial. Caries Res 2007;41:384-91.  Back to cited text no. 17
Wu L, Gao X, Lo EC, Ho SM, McGrath C, Wong MC. Motivational interviewing to promote oral health in adolescents. J Adolesc Health 2017;61:378-84.  Back to cited text no. 18
Hobcraft G, Baker T. Special needs of adolescent and young women in accessing reproductive health: Promoting partnerships between young people and health care providers. Int J Gynaecol Obstet 2006;94:350-6.  Back to cited text no. 19
Benzian H, Garg R, Monse B, Stauf N, Varenne B. Promoting oral health through programs in middle childhood and adolescence. In: Bundy DA, de Silva N, Horton S, Jamison DT, Patton GC, editors. Child and Adolescent Health and Development. London: The International Bank for Reconstruction and Development/The World Bank; 2018.  Back to cited text no. 20
Duggal MS, van Loveren C. Dental considerations for dietary counselling. Int Dent J 2001;51:408-12.  Back to cited text no. 21
Yokoyama Y, Kakudate N, Sumida F, Matsumoto Y, Gilbert GH, Gordan VV. Dentists' dietary perception and practice patterns in a dental practice-based research network. PLoS One 2013;8:e59615.  Back to cited text no. 22
Kelly SA, Moynihan PJ. Attitudes and practices of dentists with respect to nutrition and periodontal health. Br Dent J 2008;205:E9.  Back to cited text no. 23


  [Table 1]


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