Open Access Research article

Immigrant-native differences in caries-related knowledge, attitude, and oral health behaviors: a cross-sectional study in Taiwan

Chih-Chang Chen12, Shang-Jyh Chiou3, Chun-Chan Ting4, Ying-Chun Lin4, Chih-Cheng Hsu5, Fu-Li Chen6, Chien-Hung Lee7, Ted Chen8, Chin-Shun Chang9, Ya-Ying Lin10 and Hsiao-Ling Huang1*

Author Affiliations

1 Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan

2 Institute of Occupational Safety and Health, Council of Labor Affairs, Executive Yuan, New Taipei City, Taiwan

3 Department of Health Care Management, College of Healthcare Administration and Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan

4 School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

5 Institute of Population Health Sciences, National Health Research Institutes, Miaoli County 350, Taiwan

6 Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan

7 Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan

8 Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 70112 New Orleans, LA, USA

9 Global Center of Excellence for Oral Health Research and Development, Kaohsiung Medical University, Kaohsiung, Taiwan

10 Department of Nursing, Shu-Zen College of Medicine and Management, Kaohsiung, Taiwan

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BMC Oral Health 2014, 14:3  doi:10.1186/1472-6831-14-3

Published: 14 January 2014



With the growing number of transnational marriages in Taiwan, oral health disparities have become a public health issue. This study assessed immigrant-native differences in oral health behaviors of urban mothers and their children.


We used the baseline data of an oral health promotion program to examine the immigrant-native differences in caries-related knowledge, attitude, and oral health behaviors. A cross-sectional study was conducted to collect data from mothers in urban area, Taiwan. A total of 150 immigrant and 440 native mothers completed the self-report questionnaires. Logistic regression models analyzed the racial differences in oral health behaviors.


Approximately 37% of immigrant mothers used dental floss, 25% used fluoride toothpaste, and only 13.5% of them regularly visited a dentist. Less that 40% of immigrant mothers brush their children’s teeth before aged one year, 45% replaced child’s toothbrush within 3 months, and only half of the mothers regularly took their child to the dentist. Immigrant mothers had lower level of caries-related knowledge and attitudes than native mothers (p < .001). Compared to native group, the immigrant mothers were less likely to use of dental floss ([Adjusted odds ratio (aOR) =0.35], fluoride toothpaste (aOR = 0.29), visit a dentist in the past 2 years (aOR = 0.26), and take their children to regular dental check-up (aOR = 0.38); whereas, they were more likely to not consume sweeten beverages (aOR = 3.13).


The level of caries-related knowledge, attitudes and oral health behaviors were found lower in immigrant mothers than native ones. The findings suggested cross-cultural caries prevention programs aimed at reducing immigrant-native disparities in child oral health care must be developed for these immigrant minorities.

Attitudes; Behavior; Dental caries; Immigrants; Health care