Family Cohesion, Adaptability, and Oral Health in Indigenous Malaysian Children: A Pilot Study

Indigenous children in Malaysia face high oral disease burdens, yet family dynamics influencing their oral health remain poorly understood. They are considered an economically and socially marginalized population. Despite efforts to enhance their quality of life, they have a comparatively worse health state when compared to the overall population. Family cohesion is the degree of emotional intimacy among individuals within a family unit. It was highlighted as a factor influencing overall health. This pilot study aimed to examine the associations between family cohesion, family adaptability, and maternal oral health with the oral health status of Orang Asli children aged 5-12 years in Kampung Pelawan, Perak. Data collection was conducted after ethics approval. A total of 30 dyads of a parent and a child between the ages of 5 and 12 years old from an Orang Asli village in Perak were randomly chosen as participants. After giving consent, oral examinations were conducted, and caries were charted according to the decayed, missing, and filled teeth in permanent dentition/decayed and filled teeth in primary dentition (DMFT/dft) index. Family cohesion and adaptability were measured using the Family Adaptability and Cohesion Evaluation Scale-III (FACES-III). The participants consist of 30 mothers with a mean age of 35.67. The prevalence of caries among parents was 93.3% (mean DMFT=5). The prevalence of caries in primary teeth among children is 46.7% (mean dft=3.17). The family cohesion levels are disengaged (36.7%) and connected (33.3%), while 76.7% are chaotic. Mothers aged less than 40 years (RR=4.72; 95% CI:1.02-21.9) and a chaotic type of family adaptability (RR=6.85; 95% CI:1.09-42.89) were associated with higher caries in children. This pilot study suggests that younger maternal age and chaotic family adaptability are significant predictors of caries in primary teeth among Orang Asli children, while family cohesion did not show a direct association. Family-centered and culturally tailored interventions are needed to strengthen family functioning and address parental factors, with larger studies required to confirm these associations.