Original Article

Complementary and Supportive Practices Used for Children with Dental Pain by Parents


  • Sevinç Polat
  • Ayşe Şener Taplak
  • Ayşe Gürol

Received Date: 19.06.2022 Accepted Date: 01.09.2022 Meandros Med Dent J 2022;23(3):406-412


This study aimed to determine the complementary and supportive practices used by parents for their children with dental pain.

Materials and Methods:

The sample of this cross-sectional study consisted of 1,551 parents who had 6–12-year-old children, and whose children had previously experienced dental pain. The data were collected using questionaries prepared by the researchers. Data were analyzed by descriptive statistics and regression analysis.


In all, 61.7% of parents used only complementary, 18.4% only supportive, and 19.9% both complementary and supportive practices to deal with their children dental pain. Child age, previous dental experience, age at developing the habit of tooth brushing, fear of the dentist, father’s employment status, and number of children in the family were statistically significant predictive factors on using only complementary practices by parents.


Parents should be informed about the harmful practices that their children use to cope with dental pain and should be directed to methods whose benefits have been proven by evidence-based studies.

Keywords: Child, dental pain, parent, complementary and supportive practices


Dental pain is one of the common causes of pain during childhood that negatively affects the performance of activities of daily living and the quality of life in children and adolescents (1,2). Uncontrollable pain leads to deterioration in sleep quality, psychological problems, suppression of the immune system, and prolonged recovery time (3,4). Additionally, dental pain experienced by children negatively affects their families and leads to disruptions in the parents' physical, social, and psychological activities, and has a negative effect on the financial status of the family (5). Therefore, keeping the pain experienced due to orodental problems under control is important for both the child and the family.

In recent years, interest in complementary or supportive methods to protect health and remedy health problems has also been increasing in the field of orodental health (6). However, when not followed responsibly, these methods may exert more harmful than beneficial effects on children’s health (7). For parents, the pain, anxiety, and fear experienced by their children are alarming. Therefore, parents resort to various methods that mostly are not based on a scientific basis, and that they know of based on their culture, see in their families, or are recommended by their immediate friends’ circle to reduce their children’s pain (8).

Management of dental pain among school-age children is crucial for the protection and development of children’s health. One of the primary roles of nurses is to identify practices that directly affect children’s health and to instill healthy lifestyle behaviours among children. Therefore, it is very important that nurses recognize such methods used by society and know the practices that will affect the health behaviour of individuals so that they can provide effective healthcare services (9,10). To the best of our knowledge, there is a gap in the literature that investigate complementary and supportive care practices used for the management of dental pain among children. This research aimed to determine the complementary and supportive practices used by parents for coping with dental pain of their children.

Materials and Methods


This study was carried out as a cross-sectional study in 2017-2018 and 2018-2019 academic years. Before starting the study, approval was obtained from the institution, Bozok University Non-Invasive Clinical Research Ethics Committee (date and decision number: 2017-04/01), and written consent from the participants.

The population of the study consisted of 1,600 parents who were registered in the 10 Family Health Centers (FHCs) in a provincial center, and who applied under the school health screening program to FHCs on the specified dates. The parents who had 6-12 year old children, whose children had previously experienced dental pain, and who agreed to participate in the study were included in the sample. In this regard, 49 parents who did not meet the inclusion criteria, were excluded from the study and the sample of the study occurred of 1,551 parents.

Data Collection

The questionnaires were prepared by researchers in accordance with the relevant literature (7,11). Firstly, a pilot study was conducted with participants who were not included in the study, and the questionnaires were finalized. Afterward, questionnaires were filled out during face-to-face interviews, and the interviews took a median of 20 minutes. The data collection tools were following;

Introductory information form: The form consisted of questions regarding the sociodemographic characteristics of parents, and childrens’ orodental health and dental pain history, etc.

Complementary and supportive practices form: The form included questions on complementary and supportive practices used for the management of dental pain among children, whether they received information from health personnel before using it, whether they found the practice useful, etc.

Statistical Analysis

IBM SPSS Statistics 22.0 (IBM Corp., Armonk, New York, USA) package program was used to evaluate the data. Number and percentage values were used to assess the descriptive data. Factors that were considered to influence using only complementary practices were evaluated using simple binary logistic regression analysis. Hosmer and Lemeshow test was used in the final model (chi-square=6.843, df=8, p=0.554). Significant variables were evaluated using multiple binary logistic regression analysis with backward wald elimination. P<0.05 was considered statistically significant in all the analyses.

Limitation of the Study

The data obtained is limited to the questions asked in the questionaries. The methods used are limited to children aged 6-12 years.


According to the introductory characteristics of parents, the age distribution of mothers and fathers was 28 years and under (n=292, 18.8%; n=137, 8.8%), 29-39 age group (n=745, 48.0%; n=615, 39.7%), and 40 years and above (n=514, 33.2%; n=799, 51.5%). The educational status of mothers and fathers was literate (n=55, 3.5%; n=19, 1.3%), primary school (n=443, 28.6%; n=255, 16.4%), secondary school (n=300, 19.4%; n=272, 17.5%), high school (n=438, 28.2%; n=580, 37.4%), university (n=315, 20.3%; n=425, 27.4%). In all, 31.6% of the mothers (n=490) and 92.6% of fathers (n=1436) were employed, and 68.4% of the mothers (n=1061), and 7.4% of fathers (n= 115) were unemployed. Number of children in the family were one child (n=385, 24.8%), two children (n=652, 42.0%), and three children and above (n=514, 33.2%). Further, a total of 41.2% of the children were between  6-9  and 58.8% of them were between 10-12 years included in this study.

In all, 45.1% developed the habit of brushing their teeth between the ages of 4 and 6 years. Moreover, 51.7% feared the dentist and 50.5% had previous dental experience. The cause of dental pain was tooth eruption in 46.2%, tooth decay in 32.0%, tooth abscess in 8.3%, and unknown in 13.5% of the children (self-reported). In this sample, 61.7% of parents used only complementary, 18.4% followed only supportive, and 19.9% used both complementary and supportive practices together (mixed methods) for managing dental pain (Table 1).

As an only supportive practice, 50.2% of parents used mouthwash, 26.7% increased their child’s tooth-brushing frequency, and 23.1% used floss for their children. In terms of complementary practices, rubbing poppy (Papaver somniferum), onions, garlic, potatoes, and cloves on the tooth, and using saltwater mouthwash were most commonly used methods. Further, 30.5% of the parents obtained the result they expected from the practice, whereas two-thirds did not see any benefit or did not obtain the expected result, and the rate of the side effects were 1.4% (Table 2).

Table 3 shows the results of multiple binary logistic regression analysis. In the final model, child age, previous dental experience, age at developing the habit of tooth brushing, fear of the dentist, father’s employment status, and number of children in the family were statistically significant predictive factors on using only complementary practices. According to wald statistics, the most important factor influencing the practice of using only complementary practices was developing the habit of brushing teeth between the ages of 7 and 12 years (Table 3).


This study was conducted to determine the complementary and supportive practices employed by parents to deal with dental pain in their school-age children. The results showed that the most common causes of dental pain were tooth eruptions and decay (dental caries) (Table 1). A systematic review and meta-analysis emphasized that dental pain could occur among children and adolescents because of various reasons such as eruption, exfoliation, carious teeth, dentinal hypersensitivity, and abscess (12). In another study, dental caries was detected in 2,218 of 2,358 children aged 4-15 years (13).

In this study, mouthwash and floss were used as supportive practices for dental pain among children (Table 2). Mouthwashing, flossing, and tooth brushing to improve oral hygiene are recommended as supportive oral care practices, as they help with mechanical cleaning, such as tongue cleaning (14). In the present study, increasing the frequency of tooth brushing was another supportive care practice employed by the parents. Regarding oral health habits and behaviors, Honkala et al. (15) observed that toothbrushing less than once a day increases the likelihood of dental pain.

In the present study, the complementary practices most used to deal with dental pain among children included applying poppy (Papaver somniferum), onions, garlic, potatoes, and cloves on the tooth and using saltwater mouthwash (Table 2). Some practices reported in the previous studies were similar to those in the present study. Efe et al. (7), found that mothers rubbed aspirin on the aching teeth; used mouthwash with salt or lemon salt; put cotton soaked with vinegar, alcohol, or cologne; or placed raw garlic or onions on the aching tooth to alleviate dental pain. Gürsoy and Gürsoy (16) reported the widespread use of thyme, garlic, mint, sage, chamomile, and cloves for a toothache. Owing to its antibiotic or anti-inflammatory properties, garlic  and clove may have been used reducing the bacteria causing incidence of tooth decay and periodontal disease activities (17-19). However, further studies are needed before toothpaste or dental preparations containing herbs can be used among children (20).

Some methods used by parents can have harmful effects. In the present study, 1.4% of the parents reported side effects (Table 2). Especially, as plants contain active substances with very different and significant pharmacological effects, there is a serious risk of toxicity because of the variety of active substances and the possibility of drug-drug interactions when mixed with other plants (21,22). Some plants interact with certain drugs through various mechanisms, causing hepatotoxicity, renal toxicity, abnormal bleeding, and circulatory system problems. The use of garlic increases the risk of bleeding among people using aspirin (22). Therefore, parents should not follow complementary care practices without the advice of health professionals. Doing so without professional advice may put their children in danger.

In this study, the previous dental experience, and fear of dentists were predictors of following complementary care practices to alleviate dental pain (Table 3). Dental anxiety among children with previous dental experience or fear of dentists may delay seeking medical help and lead the family to consider using alternative methods. In a study conducted in Brazil with children aged 8-11 years, children with toothache had significantly higher levels of dental anxiety than children without toothache (23). Dental anxiety observed during childhood can persist until adulthood, causing people to avoid dental treatments and, as a result, may negatively affect oral dental health. In addition, having more children and father’s employment status were found to be predictors of following complementary care practices to alleviate dental pain. It was attributable to the fact that families have insufficient finances to go to the dentist and thus resort to complementary methods initially.


This study is important in terms of revealing the individual methods used by parents in coping with the dental pain of their children. To protect and improve children’s health, parents should be directed to evidence-based methods when dealing with dental pain and problems. In line with the results of this study, identifying risk groups through organized home visits by family nurses and increasing the awareness and knowledge levels of both parents and school-age children regarding dangerous and harmful practices are recommended.


Ethics Committee Approval: The study was approved by the Bozok University Non-Invasive Clinical Research Ethics Committee (date and decision number: 2017-04/01).

Informed Consent: Cross-sectional study.

Peer-review: Externally peer-reviewed.

Authorship Contributions

Concept: S.P., A.G., Design: S.P., A.G., Data Collection or Processing: S.P., A.Ş.T., A.G., Analysis or Interpretation: S.P., A.Ş.T., Literature Search: S.P., A.G., Writing: S.P., A.Ş.T., A.G.

Conflict of Interest: No conflict of interest was declared by the authors.

Financial Disclosure: This study was supported by Yozgat Bozok University Project Coordination Application and Research Center with the project code 6602a-SY/17-101.


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