|Ahead of print publication
Assessment of parents' involvement and the awareness of oral hygiene practices among 10–12-year-Old schoolchildren in Pune City
Sujata Dinkar Pinge1, Saudamini G More1, Suyog Savant1, Rajani Komble1, Sayali More2
1 Department of Public Health Dentistry, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
2 Department of Oral Medicine and Radiology, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
|Date of Submission||15-Oct-2022|
|Date of Acceptance||10-Dec-2022|
|Date of Web Publication||03-Mar-2023|
Sujata Dinkar Pinge,
Department of Public Health Dentistry, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra
Source of Support: None, Conflict of Interest: None
Introduction: It is observed that poor oral health knowledge plays a major role in the prevalence of dental diseases. Our society in its attitude towards dental health has been giving it less importance as compared to general health. Schoolchildren are at a greater risk of dental problems. Materials and Methods: A cross-sectional questionnaire-based survey was done among schoolchildren of Pune city. Schoolchildren aged 10–12 years reporting to the Department of Public Health Dentistry for preventive treatment were interviewed using a self-designed, validated questionnaire. Results: Among 311 children that participated, it was observed that a considerable number of them were aware of the importance of oral hygiene practices and followed the required practices. Conclusion: Schoolchildren nowadays show good knowledge regarding dental health and oral hygiene practices. This could be on account of exposure to media involvement of schools in health education programmes.
Keywords: Adolescents, knowledge, practice, primary prevention
|How to cite this URL:|
Pinge SD, More SG, Savant S, Komble R, More S. Assessment of parents' involvement and the awareness of oral hygiene practices among 10–12-year-Old schoolchildren in Pune City. Adv Hum Biol [Epub ahead of print] [cited 2023 Mar 31]. Available from: https://www.aihbonline.com/preprintarticle.asp?id=371229
| Introduction|| |
The most common oral health non-communicable disease affects an estimated half of the world's population. Approximately 2.4 billion people suffer from caries of permanent teeth and 486 million children suffer from caries of primary teeth. Untreated cavity caries in deciduous teeth was the 10th most prevalent condition globally in 2010, affecting 621 million children, with a global population prevalence of 9%. Although dental caries is prevalent across all countries, the severity was lower in higher-income countries versus lower-middle-income countries.
The 'pedodontic triangle', which is equally divided between the child, the parents and the dentist, requires interaction between all three components. It is a must to ensure effective dental care delivery. Young schoolchildren are ideal for imparting healthy lifestyle practices as they can be accessed in their formative years of growth and development. Dental decay and gingival problems are the two most common oral diseases in children.
Thus, the present study was planned to assess parents' involvement and awareness of oral hygiene practices among schoolchildren in the age group of 10–12 years of Pune city.
| Materials and Methods|| |
A cross-sectional study was conducted among schoolchildren belonging to the age group of 10–12 years from Pune city. Ethical approval was obtained from the institutional ethics committee before beginning the research (Registration number ECR/328/Inst/MH/2016) during a meeting on April 05, 2019. Schoolchildren in the age group of 10–12 years reporting to the Department of Public Health Dentistry for preventive treatment were the data source. Students who satisfied this inclusion criterion were selected. Data were collected from October 2019 to December 2019. Permission was obtained from the principal of the schools. Written informed consent was obtained from the parents of participants, and child assent was obtained from the students. It was explained to them that this study was non-invasive and survey-based, and the personal information collected would be kept anonymous. Sample size calculation was calculated using the standard formula for observational studies (that is, n = 4pq/d2, considering prevalence as 25% and standard error as 5). Thus, a sample size of 300 was required. A total of 311 students were enrolled from three different schools using convenience sampling. Data were entered in a Microsoft Excel sheet and analyzed using SPSS version 23.0 for windows (IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY, USA: IBM Corp.). Data were expressed as frequencies and percentages.
Details of the questionnaire
A well-structured English language questionnaire having 20 questions was made for the purpose of this study. It was translated into the Marathi language and again back-translated into the English language. Questionnaire validation was done by eight subject experts (the content validity index obtained for each item was 0.82 or above). Reliability was assessed using the test-retest method. The children were interviewed by two interviewers trained and calibrated in the Department of Public Health Dentistry of the institute. The questionnaire had 20 close-ended questions addressing domains of knowledge and attitude regarding oral health, awareness of dental diseases among children and parents' involvement in oral hygiene maintenance. The responses were tabulated, the percentage was calculated and conclusions were drawn.
| Results|| |
A total of 311 schoolchildren participated in the study. Fifty-three per cent of students brush once daily, 45% of students brush twice a day, 2% of students brush more than twice and only <1% of students said they brush less than once a day. Ninety-seven per cent of students use toothbrushes and toothpaste while brushing. Fifty-seven per cent of students brush their teeth in the morning, and 44% brush in the morning and before bedtime. [Table 1] shows the knowledge and attitude of schoolchildren in the age group of 10–12 years regarding dental health.
|Table 1: Knowledge and attitude of schoolchildren in the age group of 10-12 years regarding dental health|
Click here to view
Forty-two per cent of students brush their teeth for more than 2 min, 39% brush for 2 min, 15% brush for 1 min and only six per cent brush for <1 min. Eighty-five per cent of students have tongue cleaning habits. Ninety-three per cent do not use tobacco in any form. Forty-eight per cent of students can identify caries from the appearance of a black, brown spot. Nineteen per cent of students by not being able to eat, whereas 18% of students feel experiencing pain is an indication of a carious tooth, and 15% of students by seeing a cavity. Forty-three per cent of students feel they should visit a dentist once a year, 33% of students feel that only on having difficulty in eating they should visit a dentist, 21.3% see a dentist in case of pain and 3% feel they should visit a dentist when gums start bleeding. Ninety-six per cent of children know getting a regular dental checkup is necessary. Ninety per cent of children know that teeth should be protected while playing. Seventy-eight per cent answered that in case of trauma to teeth, they would see a doctor, but 6% said they would ignore it if there is no pain, 12% said they would try home remedies and 4% said they would take advice from a chemist. Eighty-six per cent are aware that cold drinks have an adverse effect on our teeth. [Figure 1] shows the responses of schoolchildren to parental involvement in the brushing routine. [Figure 2] shows the response of schoolchildren regarding tooth problems. [Figure 3] shows knowledge about dental professionals. [Figure 4] shows treatment preferences among schoolchildren in case of tooth decay.
|Figure 1: Responses of schoolchildren to parental involvement in brushing routine (in %).|
Click here to view
|Figure 4: Treatment preference among schoolchildren in case of tooth decay (in %).|
Click here to view
| Discussion|| |
Almost 90% of schoolchildren and most adults are affected by dental caries. The WHO's Global School Health Initiative (1995), highlights that schools constantly strengthen their capacity as a healthy setting for living, learning and working. Besides this, there is better access to schoolchildren during their early years of growth and development. Oral health is crucial to general health. Oral diseases present a major public health problem. Schoolchildren are at a greater risk of dental problems. It is observed that a lack of knowledge about oral health knowledge plays a major role in the aetiology of dental diseases. Acquiring good oral health depends on good dietary habits and oral hygiene practices. Our society has overlooked dental health for a long as compared to general health.
The Alma Ata meeting in 1978 proposed that health for all should be attained by 2000. Yet the vision remains challenging to achieve in developing countries. Primary health care highlights placing peoples' health in their own hands. Schoolchildren in our study belonged to the 'the early adolescence stage'. This period of life marks a critical phase of human development, wherein the foundations of good health are laid. According to the dental calendar, these years mark the mixed dentition stage. It refers to the transition period and bridges the gap from childhood to adulthood.
Health education remains an important cornerstone of primary prevention. Having adequate knowledge of oral hygiene maintenance will empower schoolchildren to achieve optimal oral and dental health. The study presented a comprehensive overview of the awareness status and oral hygiene practice among schoolchildren aged 10–12 years in Pune. It also envisaged the component of parental involvement in their oral hygiene practices.
Oral diseases are commonly a result of poor oral hygiene practices. These practices, such as brushing, flossing and periodic dental visit, should be developed early in childhood. It has been found that a considerable number of children in developing countries have limited knowledge of the causes and prevention of oral disease. The traditional behaviour change model states that imparting knowledge will enhance attitude and health-related behaviour. Children are the ideal target group for early intervention because healthy behaviours and lifestyles developed at a younger age are more sustainable. The introduction of modern culture and urbanisation among Indian children is almost similar to that of Western children, but their oral hygiene practices have not changed.
Most children use toothbrushes and toothpaste as cleaning aids. This could be attributed to the growing awareness of dental hygiene amongst schoolchildren since all were residing in urban areas. Similar findings were reported by a study conducted in Chhattisgarh. In this study, it was found that 45.2% of children brushed twice a day, and 1.7% of children brushed more than twice. However, in a study by Kamath et al., it was found that 52% of children brush more than twice a day.
An Iranian study showed that parents' knowledge was significantly associated with better oral health. The present study showed that many children were not monitored but advised about the correct method of brushing. A considerable number of children informed their parents or dentists in the event of traumatic injury to the teeth.
A study conducted in Chennai, India, showed that 99% of adolescents knew about the ill effects of smoking and would refrain from it. They also reported that smoking was not done in their households. The present study showed that most children did not use tobacco. Studies have shown that appropriate oral health education could help to cultivate healthy oral health practices. Behavioural modelling by authority figures in a child's life, such as a teacher, dentist, auxiliary or sibling, can be a powerful tool.
A healthy mouth enables an individual to talk, eat and socialise without experiencing active disease, discomfort or embarrassment. Dental care has been systematically organised to improve dental health attitudes among children and the young. Schoolchildren report to our department regularly for preventive treatment procedures; therefore, the thought of making them a part of our study was considered. It is essential for dental professionals to educate the public and children to enhance awareness and impart a positive attitude towards oral health.
Systematic community-orientated oral health promotion programmes are needed to target lifestyles and the needs of schoolchildren. Furthermore, information regarding oral health should be disseminated on a wider basis in the school curriculum in an attempt to prevent and control dental diseases. In this background, oral health promotion programme has to involve the partnership of school authorities, parents and dental-care providers such as dental colleges or public health departments and funding agencies.
Through this study, we have gained information on how aware they are of oral hygiene and its importance. This study focuses on oral health awareness and practices but does not include any finding of dental disease to correlate between the practice and occurrence of dental disease.
| Conclusion|| |
This study gives an insight into the level of oral health-care knowledge of schoolchildren aged 10–12 years. Our study shows that oral hygiene practices and knowledge regarding oral health exist appreciably among schoolchildren. A strong knowledge helps incorporate good oral health practices into the day-to-day routine of children. Parental involvement in oral hygiene practices positively affects the maintenance of oral health. Children can be provided with the knowledge to make healthy choices, adopt a healthy lifestyle and deal with conflicts.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Akinyemiju TF, Al Lami FH, Alam T, Alizadeh-Navaei R, et al
. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016: A systematic analysis for the global burden of disease study. JAMA Oncol 2018;4:1553-68.
Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of untreated caries: A systematic review and metaregression. J Dent Res 2015;94:650-8.
Venkataraghavan K, Shah J, Kaur M, Trivedi K, Shah S, Virda M. Pro-activeness of parents in accepting behavior management techniques: A cross-sectional evaluative study. J Clin Diagn Res 2016;10:ZC46-9.
Khurana C, Priya H, Kharbanda OP, Bhadauria US, Das D, Ravi P, et al
. Effectiveness of an oral health training program for school teachers in India: An interventional study. J Educ Health Promot 2020;9:98.
Priya M, Devdas K, Amarlal D, Venkatachalapathy A. Oral health attitudes, knowledge and practice among school children in Chennai, India. J Educ Ethics Dent 2013;3:26. [Full text]
Suprabha BS, Rao A, Shenoy R, Khanal S. Utility of knowledge, attitude, and practice survey, and prevalence of dental caries among 11- to 13-year-old children in an urban community in India. Glob Health Action 2013;6:20750.
Abed R, Bernabe E, Sabbah W. Family impacts of severe dental caries among children in the United Kingdom. Int J Environ Res Public Health 2019;17:109.
Tadin A, Poljak Guberina R, Domazet J, Gavic L. Oral hygiene practices and oral health knowledge among students in Split, Croatia. Healthcare (Basel) 2022;10:406.
Badrasawi MM, Hijjeh NH, Amer RS, Allan RM, Altamimi M. Nutrition awareness and oral health among dental patients in Palestine: A cross-sectional study. Int J Dent 2020;2020:3472753.
Rifkin SB. Alma Ata after 40 years: Primary Health Care and Health for All-from consensus to complexity. BMJ Glob Health 2018;3:e001188.
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Division of Behavioral and Social Sciences and Education; Board on Children, Youth, and Families; Committee on Applying Lessons of Optimal Adolescent Health to Improve Behavioral Outcomes for Youth; Kahn NF, Graham R, editors. Promoting Positive Adolescent Health Behaviors and Outcomes: Thriving in the 21st
Century. Washington (DC): National Academies Press (US); Normative Adolescent Development. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554987/
[Last accessed on 2019 Dec 12].
Ravinthar K, Gurunathan D. Applicability of different mixed dentition analyses among children aged 11-13 years in Chennai population. Int J Clin Pediatr Dent 2020;13:163-6.
Weiss-Laxer NS, Crandall A, Hughes ME, Riley AW. Families as a cornerstone in 21st
century public health: Recommendations for research, education, policy, and practice. Front Public Health 2020;8:503.
Vishwanathaiah S. Knowledge, attitudes, and oral health practices of school children in Davangere. Int J Clin Pediatr Dent 2016;9:172-6.
Rad M, Shahravan A, Haghdoost AA. Oral health knowledge, attitude, and practice in 12-year-old schoolchildren in Iran. J Int Soc Prev Community Dent 2015;5:419-24.
Kamath A, Patil V, Walimbe H, Bijle MN. Oral hygiene awareness among school children of rural Mangalore. J Dent Res Rev 2014;1:7. [Full text]
Agrawal R, Shrivastava S, Reche A, Wasnik M, Sangha K, Patil S. Assessment of degree of dental awareness in schoolchildren aged 10–15 years in Bilaspur District, Chhattisgarh: A cross-sectional study. J Indian Assoc Public Health Dent 2021;19:224. [Full text]
Khodadadi E, Niknahad A, Sistani MM, Motallebnejad M. Parents' oral health literacy and its impact on their children's dental health status. Electron Physician 2016;8:3421-5.
Kumaresan GD, Kumar S. Awareness among school going children's in Chennai about dental health care. J Oral Health Community Dent 2016;10:74-9.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]