SCHOOL DENTAL HEALTH EDUCATION PRO GRAM AMONG SCHOOL CHILDREN OF 8-10 YEARS OLD WITH AND
WITHOUT PARENTAL GUIDANCE
Thesis submitted to
THE TAMILNADU Dr. M.G.R. MEDICAL UNIVERSITY
In partial fulfilment for the Degree of
MASTER OF DENTAL SURGERY
BRANCH VIII
PEDODONTICS AND PREVENTIVE DENTISTRY
2017- 2020
CHENNAI
DECLARATION BY THE CANDIDATE
I hereb y decl are that the dissertati on titl ed "CO MPARATI VE EVAL UTIO N O F EFFECTIVE NESS O F SCH OOL DENTAL HE ALTH EDUCAT ION PRO GRAM AMONG SCHOOL CH IL DREN O F 8 -10 YEARS OL D WIT H AND WITHO UT PARENT AL GUIDANCE " is a bonafi de and genuine research work c arried out b y m e under the gui dance of Dr. C. JOE LOUIS MDS Professor and Head, Departm ent of Pedodont ics and P reventi ve Dentistr y Chettinad Dental C oll ege & R es earch Ins titut e, Kel am bakkam, Chennai .
Dr. R.A.Sowmiya Sree, Post Graduate student
Department of Pedodontics and Preventive Dentistry Chettinad Dental College & Research Institute
Kelambakkam, Chennai.
Date :
Place : Kelambakkam, Kanchipuram District.
CHENNAI
CERTIFICATE
This is t o certi f y that the dissert at ion tit led "CO MPARAT IVE EVAL UTIO N O F EFFECTIVE NESS O F S CHOO L DE NTAL HE ALTH EDUCATIO N PRO GRAM AMO NG SCHOOL CHIL DREN O F 8-10 YEARS OLD WITH AND WITHOUT PARE NTAL GUI DANCE " i s a bonafide and genuine res earch work done b y Dr. R.A.Sowmiya S ree m y guidance duri ng her st ud y period bet ween 2017 -2020.
This diss ertation is submit ted to THE TAMIL NADU Dr. M.G.R.
MEDICAL UNIVE RSIT Y in parti al ful fillm ent for t he degree of Mas ter of Den tal Su rgery in th e Branch VIII - Pedod onti cs and Preventi ve Den tis try. It has not been s ubmitt ed (partial l y or ful l y) for t he award of an y other degree or diploma.
Date:
Place: Kelambakkam, Kanchipuram District.
Principal
Dr. P. RAJESH M.D.S., DNB, MNAMS, MFDSRCPS (Glasgow), Chettinad Dental College & Research Institute,
Kelambakkam, Kanchipuram District.
Guided By
Dr. C . J O E L O U I S M D S Professor and Head of the department Department of Pedodontics and Preventive Dentistry,
Chettinad Dental College & Research Institute, Kelambakkam, Chennai
CHENNAI
PLAGIARISM CERTIFICATE
This is to certi f y that this di ss ert ati on work titl ed "CO MPARAT IVE EVAL UTIO N O F EFFECTIVE NESS O F S CHOO L DE NTAL HE ALTH EDUCATIO N PRO GRAM AMO NG SCHOOL CHIL DREN O F 8-10 YEARS OLD WITH AND WITHOUT PARE NTAL GUI DANCE " of the candidate Dr. R.A.Sow mi ya S ree with regist rat ion num ber 241725303 for t he award of Mas ter of Den tal Surgery in the branch of Pedodonti cs and Preventive Dentist r y, I personall y verifi ed the urkund.com websit e for the purpos e of plagiarism check. I found that the uploaded thesis fi le cont ains from introducti on to conclusion pages an d res ult shows 11% of pl agi arism in the diss ert ati on.
Guid e & Sup ervis or sign wi th s eal Dr. C. JO E LO UIS M DS
Professor and Head,
Department of Pedodontics and Preventive Dentistry, Chettinad Dental College & Research Institute, Kelambakkam, Kanchipuram District.
Date:
Place: Kelambakkam, Kanchipuram District.
ACKNOWLEDGEMENT
Fi rst and foremost , I bow t o the al mi ght y for the man y undes erved bl essi ngs bes towed on m e without whi ch m y pos tgraduat e cours e would have st ill been a dream . Thi s thesi s appears in it s current form due t o the ass istance and gui dance of s everal peopl e. I woul d therefore li ke to offer m y sincere thanks t o all of t hem.
I t ake thi s opport uni t y t o s incerel y thank Dr. P. Rajesh M.D.S, DNB, MNAMS , MFDSRCPS, Principal, Chettinad Dent al College &
Res earch Institut e, for hi s support and guidance during m y post graduat e course.
I ex press m y heart f elt thanks t o our respectful Dr. C. Joe L ouis, M.D.S, Profes sor and Head, Gu ide, Departm ent of P edodontics and Preventive Dentist r y , Chettinad Dent al Colle ge & Research Inst itut e, for his val uable gui dance and moral support duri ng m y post graduate curri culum. He has alwa ys been a cons tant source of hardwork and pers everance.
I owe m y respectful gratitude t o Dr. Daya S rini vas an , M.D.S, Profes sor, Depart m ent of P edodonti cs and Preventi ve Dentist r y, Chetti nad Dent al College & Research Institut e , an excell ent clini ci an who has inspi red m an y i ncl uding me t o devel op a pas sion for t he subj ect. I t hank for her support through m y post graduat e period.
I owe m y deepest and respectful gratit ude to Dr. A.R. S en thil Eagappan , M.D.S, Profes sor, Department of P edodontics and Preventive Dentist r y , C hett inad Dental College & R es earch Instit ut e whos e int ell ectual insi ght and gui dance has been const ant through thi s diss ert ati on.
I ext end m y heartfelt t hanks to Dr. Divya Natrajan , M.D.S, Senior l ectu rer, Departm ent of P edodontics and Preventive Dentist r y, Chetti nad Dent al C ollege & R esearch Institut e for her const ant support and advi ce throughout m y post graduat e peri od .
I woul d als o li ke t o thank Dr. K. Devi Ch andrika , M.D.S, Senior l ectu rer, Departm ent of P edodontics and Preventive Dentist r y, Chetti nad dent al college & R esearch Institut e for her support and encouragem ent .
I sincerel y thank B huvana Krishnan Matricul ati on High er Secondary sch ool for permitti ng m e to undert ake t he stud y.
I extend m y sincere thanks to Dr. H. Cyril B enedi ct, for his val uable help in the stati sti cal anal ysi s.
I would like to t hank Nursi ng st aff Ms.Vani Kavi tha and Departm ent att ender Mrs. Uma, for t hei r help and support during the course.
I would like to t hank the xerox pri nters , net wa y print ers for thei r hel p and assis tance during the cours e.
I t hank m y batch m at e, Dr. V.Dhanal aksh mi and Dr. K. Jayan thi for her s upport and ins pi rat ion throughout t he course.
I thank all m y j uniors Dr. Anish a. S, Dr. As mith a. V, Dr. T. Shan mu gap riya , Dr. V. Sh ru thi , Dr S. Saraswathy Meena, Dr. R. Vi gneshwar for thei r support and encouragement during the
tenure.
I woul d like t o t hank all m y parti cipant s for thei r kind cooperation and pati ence throughout the stud y.
I t hank m y parents and m y i n laws for t heir l ove, underst andi ng, support and encouragem ent throughout t hes e years wit hout whi ch, I woul d not have reached so far.
I would like to t hank m y husband, Dr. N. Sudeendar for being m y pil lar of st rengt h and m otivati ng m e. I s hal l forever be indebted to him for his love and understandi ng and als o overcoming the innum erabl e hardships that he had t o endure al one during this chall enging peri od.
I would also like to thank m y daught er S. Mi ri thigaa Sree for her love and affecti on and for all owi ng m e t o purs ue m y dream.
ABSTRACT
INTRODUCTION:
Good oral health in children is important to meet their general health needs. Oral diseases are major health problems, especially in children, owing to their high prevalence and incidence in all the regions of the world. Most of the oral diseases or conditions in children are preventable or treatable. So it is necessary to promote dental health education in schools. Dental health education helps in enriching knowledge and developing life-skills, positive values and attitudes in children. The health and well-being of school staff, families and community members can also be enhanced by programs based in schools. Dental care professionals believe that including parents in health education program result in reductions in caries risk among their children.
AIM:
The aim of the study was to determine the effectiveness of school dental health education program conducted at regular intervals for 8 -10 years old school children with and without parental guidance.
MATERIALS AND METHODS:
A total of 120 students of both genders aged 8-10 years were selected.
The study was conducted over a period of 36 weeks and sample were randomly selected and allocated into 2 groups without and with parents each group containing 30 boys and 30 girls. In addition Group II included 60 parents. The questionnaire was circulated before the start and end of the study to assess the knowledge and oral hygiene practice of the children. Tooth brush, tooth paste were distributed to the children during the entire period of the study. Oral health
examination was done using DMFT, deft and OHI-S Indices. Initial baseline data was collected. Dental health education was given using video, tooth models and pamphlets after the oral health examination. The children who required treatment were brought to the dental hospital and all their dental needs were treated. Dental examination was carried out again using OHI-S, DMFT and deft index and health education was given at 3rd, 6th and 9th month interval.
The result were analyzed using SPSS Software version 20.0
RESULTS:
Around 120 Students were screened. The mean score for pre assessment knowledge and oral hygiene practice score of Group I and Group II were 6.50±1.050, 6.55±1.268 respectively. The mean score for post assessment knowledge and oral hygiene practice score of Group I and Group II were 7.88±0.761, 8.03±0.843 respectively. At the baseline the mean score for DMFT, deft, OHI-S score of Group I and Group II were 0.27±0.686 and 0.25±0.680, 1.80±2.114 and 1.23±1.430, 1.265±0.642 and 1.405±0.635 respectively. At the end of 9th month mean score for DMFT, deft and OHI-S index for Group I and Group II were 0.57±0.81 and 0.30±0.696, 2.53±2.054 and 1.52±1.513, 1.082±0.338 and 0.537±0.370 respectively. This difference was found to be statistically significant for DMFT, deft and OHI-S index (P<0.001). The group without parental presence was showing higher significance due to increase in caries in children.
Keywords:
ORAL DISESES, SCHOOL DENTAL HEALTH EDUCATION, DENTAL CARE PROFESSIONAL, PARENTS.
S.NO TITLE PAGE NO
1 INTRODUCTI ON 1
2 AI M AND O BJECT IVES 7
3 REVIE W O F LITE RATURE 8
4 MATERIALS AND METHO DS 42
5 RESULTS 51
6 TABLES AND GRAPHS 55
7 DISCUSSIO N 61
8 SUMMARY 71
9 CONCLUS ION 74
10 BIBLIO GRAPHY 77
11 ANNEXURES 90
FI GURE NO
FI GURES
PAGE NO
1 ARMAMENTAR IUM 49
2 QUEST IONNAIR E DIS TR IBUT ION 49
3 DENTAL HEALTH EDUC AT ION 49
4
DIS TR IBUT ION OF PAMP HLETS, TOOTH BR USH AND TOOTH PAS TE
49
5 CONDUC TING THE EXAM INAT ION 50
6
CONDUC TING THE HEALTH EDUCAT ION PROGR AM FOR W ITH PARENTS GR OUP
50
7 TREATMENT DONE 50
TABLE NO
TITLE
PAGE NO 1. COMPARISON OF MEAN KNOWLEDGE SCORE AMONG BOTH
THE GROUPS OF WITHOUT PARENTS (GROUP I) AND WITH PARENTS (GROUP II)
55
2. COMPARISON OF MEAN DMFT INDEX SCORE IN GROUP I (WITHOUT PARENTS)
55
3. COMPARISON OF MEAN DMFT INDEX SCORE IN GROUP II (WITH PARENTS)
56
4 COMPARISON OF MEAN deft INDEX SCORE IN GROUP I (WITHOUT PARENTS)
56
5 COMPARISON OF MEAN deft INDEX SCORE IN GROUP II(WITH PARENTS)
57
6 COMPARISON OF MEAN OHI-S INDEX SCORE IN GROUP I (WITHOUT PARENTS)
57
7 COMPARISON OF MEAN OHI-S INDEX SCORE IN GROUP II (WITH PARENTS)
58
8 COMPARISON OF MEAN SCORE OF DMFT, deft AND OHI-S INDEX AMONG BOTH THE GROUPS WITHOUT PARENTS (GROUP I) AND WITH PARENTS (GROUP II)
58
9 DESCRIPTIVE STATISTICS CHANGE IN VARIABLES SCORE FROM BASELINE TO 9th MONTH AMONG BOTH THE GROUP WITHOUT PARENTS (GROUP I) AND WITH PARENTS (GROUP II)
59
GRAPH NO
TITLE PAGE NO
1 COMPAR ISON OF MEAN DM FT INDEX SCORES AT BASELINE, 3r d MONTH, 6t h MONTH AND 9t h MONTH AM ONG TWO GROUPS W ITHOUT PARENTS (GR OUP I) AND W ITH PAR ENTS (GR OUP II)
59
2 COMPAR ISON OF MEAN deft IN DEX SCORES AT BASELINE, 3r d MONTH, 6t h MONTH AND 9t h MONTH AM ONG TWO GROUPS W ITHOUT PARENTS (GR OUP I) AND W ITH PAR ENTS (GR OUP II)
60
3 COMPAR ISON OF MEAN OHI -S INDEX SCORES AT BASELINE, 3r d MONTH, 6t h MONTH AND 9t h MONTH AM ONG TWO GROUPS W ITHOUT PARENTS (GR OUP I) AND W ITH PAR ENTS (GR OUP II)
60
S.NO TITLE PAGE NO I
PARTIC IPANT INFORM AT ION S HEET (ENG LIS H)
90
I I
PARTIC IPANT INFORM AT ION S HEET (TAM IL)
91
I I I
PARTIC IPATION INFORMED C ONSENT
FORM
92
IV
PARTIC IPATION INFORMED C ONSENT
FORM IN TAM IL
93
V
CONS ENT FORM (FOR PARTIC IPAT ION LESS THAN 18 YEARS OF AGE)
94
V I
CONS ENT FORM (FOR PARTIC IPAT ION LESS THAN 18 YEARS OF AGE) IN TAM IL
95
VII
QUEST IONNAIR E TO EVALUATE THE
ASSESSMENT OF OR A L HYGIENE
PRACT ICE
96
V III
QUEST IONNAIR E TO EVALUATE THE
ASSESSMENT OF OR A L HYGIENE
PRACT ICE (TAM IL)
98
IX EXAM INAT ION FORM 100
X PERM ISS ION LETTER FROM THE SCHOO L 105 XI RESEARC H METHODO LOGY CERTIF IC ATE 106
LIST O F ABB REVI ATIONS
DMFT - Deca yed, Mis sing, Fi lled Teeth Index deft - deca yed, extract ed, filled t eet h Index OH I-S - Simplified Oral H ygi ene Index
SPSS - Statist ical P ackage for S oci al Sci ence WHO - World Health Organi zation
CDC - Cent re for Dis ease control OHE - Oral Heal th Education
1
INTRODUCTION
Healt h is a s tat e of compl et e phys ical , mental, and soci al well -being and not merel y the abs ence of dis eas e or infirmit y [WHO 1948]. In 1986, the WHO further cl ari fi ed that health is: "A resource for ever yd a y l ife, not the obj ective of l iving. Health is been a posit ive concept t hat em phasiz es the soci al and personal resources, and also ph ysi cal capaciti es. Socio -economi c environm ent, ph ysical envi ronment , person's i ndi vidual charact eri sti cs and behavi ors are t he m ai n det ermi nants of health.
Oral healt h is mi rror of t he general health; oral ti ssue is usuall y s ensit ive i ndi cat ors. Si r William Osl er (a C anadian Ph ysi ci an) call ed the oral cavit y a mi rror of t he rest of the bod y.
Good oral health i s the basi c for general health i n children. In worldwide, over the past t wo decades preval ence rat e and patt ern of oral di seas e h ave changed drasti call y. In count ri es where comm unit y and s chool based preventive education programs on oral h ygi ene i s not given there is hi gher incidence of dental cari es .1
The l east t reat ed oral diseas es in chil dhood are dental caries and gingival dis eases. Dental cari es preval ence is i ncreasing over a period and thi s m a y be due to increased avail abilit y of processed foods whi ch contai ns refined sugars. It s progressive natur e has becom e more compl ex over ti me. Dent al Caries occurs as a result of
2 com plex fact ors li ke soci al, cultural, behavioural , di et ar y and biological ri sk factors. The m ajor caus e of dent al cari es are feeding habits in infant’s, inadequate exposure to fluor ide, decreased saliva, poor oral h ygi ene and hi gh m agnitude of cari ogeni c mi croorganism.
An oral di seas e whi ch leads to t ooth los s and pain affects t he general appearance of children, nutrit ion, qualit y of life growth and devel opm ent . Most of t he oral dis eases in children are prevent abl e diseas e wit h simpl e treatm ent modal ities. 80% of s chool children are affect ed with dent al cari es al l over the globe, i n whi ch the preval ence of dent al cari es in Indi a was 32.6% and 42.2% at 12 to 15 years, gi ngivitis was 8 4.37%.2 But the cost of treating dent al cari es al one can overwhelm a count r y's health care expenditure. The personal , s oci al and financi al st at us of the pati ent has di rect i mpact in negl ect of the dental diseases in devel oping countri es like Indi a.3
Inadequat e or improper oral health care has an advers e effect on children’s school performance and their success in later life.
When there is no proper knowl edge about the oral health there wi ll be del a y in t reatm ent whi ch aggravat es the condi tion and directl y affects the qualit y of life for e.g. abil it y to chew, t hei r s election of food, t hei r appearance and comm uni cati on. Children with poor oral health are 12 tim es more li kel y t o have more restrict ed -activit y da ys than thos e who do not. Due t o poor oral heal th t hey l ack concent ration and miss t hei r school. Pai n in oral cavit y can
3 com promis e thei r concentrati on towards school , thereb y affecti ng not onl y t heir education but also pl a y and development and ful l benefits of s chooli ng.4 Due t o oral diseas es 50 m illion hours are los t annuall y from s chool. It i s cruci al for t he young children t o gain knowledge and practices to m ai ntain good heal th, including oral health. So it is mandator y t o promot e oral health educat ion in schools children.
Cent re for dis eas e control (CDC ) defines healt h education as a planned, s equent ial, curri cul um t hat address es t he phys ical , ment al, em otional, and soci al dim ensi ons of heal th. The methodol ogy is desi gned to m otivat e the children to i mprove thei r health and prevent diseases and also reduce t he health -rel at ed ri sk fact ors . It enabl es s tudents to devel op knowl edge regarding health rel at ed iss ue, it s approach and practi ces.
The m ain aim of health education is to prevent healt h problems from happening or re -occurring b y organizing health programs , to begi n health poli ci es and conducting res earch.5 Thes e actions m a y be on t he part of indi viduals, fam ili es, i nstit uti ons or comm uniti es . Knowl edge gai ned b y indi viduals m a y enable t hem t o take meas ures t o protect th ei r healt h. Dent al health educati on has been considered to be an import ant and i ntegral part of dent al health servi ces and it i s delivered to individuals, group such as schools, da y-care cent res and residenti al settings for adults.
4 Over the l ast few decades; dentis ts are graduall y invol ving i n health prom otion pri nci ples. Thei r st rat egy i s to reduce current oral diseas e st atus and ensuring equal opport uniti es enable all peopl e to achi eve t hei r fullest health potenti al. Hencefort h, healt h educational intervent ions began to focus as a core com ponent of thos e healt h prom otion st rat egi es . In order t o prevent the devel oping countries with oral dis eas es the y have adopt ed school based oral health education (OHE). Its aim is t o improve oral heal th in chil d popul ati on, development of healt h y habits and t o creat e health y environm ent in schools and fami lies.6
Schools have proven a powerful s et ting for s econdar y soci aliz ation. A more essenti al element i n educati on is t o cul tivat e positi ve values and view to develo pi ng t hem health y li fe st yl e. The goals of the int erventions is broad, s o that knowl edge, atti tudes , intentions, beli efs and use of dent al servi ces, oral healt h st atus have all been target ed for change.7 The W orld Health Organi zation (WHO) recommends oral heal th prom oti on should be i ncl uded into its curri cul ar activit i es i n t he schools.
Children’s habit can be intercepted as well as prevented and modi fied in s chool environm ent as i t is more s uit abl e and com fort abl e rather than an unfri endl y at mosphere li ke dental clini c.
Schools provi de effective wa y of prom oti ng oral healt h because t he y cover wi de range of chil dren worldwide. Oral healt h professionals
5 have a responsi bilit y to educat e chi ldren about oral dis eas es and thei r preventi on . C hildren ma y additi ona ll y be equi pped wit h personal skil ls that alter them t o m ake health y decisions, to adopt a health y li fest yl e. Children are particul arl y receptive during thi s period and it was suggest ed t hat sooner t he oral heath rel ated behaviour were initi at ed in li fe, h i gher probabilit y for s uccess ful long term mai nt enance.8
Children under the age of 12 years generall y s pend most of thei r tim es with parent and guardi an, especial l y mot hers referred as
“primary socialization”. In these early years child acquires habits, incl udes di et ar y habit s and health y behaviours . Studi es hav e suggest ed that i ncreas ed i ncidence of dental caries among children whi ch is mai nl y due to poor att itude of parents towards thei r chil d oral healt h.9 The health and well -bei ng of school st aff, famili es and comm unit y m embers can also be enhanced b y program s based in schools . Dent al care professional also beli eves that improvi ng knowledge in parent s towards oral healt h behaviour will res ult in reductions i n cari es risk among t heir child.
Educational st rategi es focused on parents are hi ghl y valuabl e, since t hei r behaviour regarding oral healt h has a di rect i nfl uence on the num ber of dent al cari es of thei r children. P arents perform a cent ral role in t he transference of i nform ation rel at ed t o the health and t o the healt hy behaviour of their chi ldren. Mot hers a re
6 considered as rol e model to be foll owed as the y t rans fer good val ues and attit udes that are accept ed for their children. S chool dental health educat ion program s houl d be expanded to t hei r parents and responsibl e adults. Thus, the int ervent ions di rected at parent ’s beli efs and attit udes about oral healt h ma y be beneficial in the preventi on of oral probl ems such as dent al cari es. Parent ’s att itudes have a positive impact on the state of children’s oral health;
becaus e the parents control toot h brus hi ng an d sugar consumption, the children devel op positive oral heal th habit s. The parents are primarily responsible for almost all their children’s health problems.
It has been found that the more positi ve i s the parents att itude towards dentist r y, t he bet ter wi ll be t he dent al health of their children. Young children’s oral hygiene and its outcomes are influenced by their parent’s knowledge. Without basic knowledge of cari es risk fact ors, import ance of the deciduous t eeth, and oral maint enance, it i s difficult t o prevent oral dis ease in chil dren.1 0 Parent’s knowledge and positive attitude towards good dental care are very important in preventive cycle. Therefore, parent’s role is fundam ental in raisi ng chil dren to pract ice preventi ve oral health throughout thei r lives.1 1
7
AIM AND OBJECTIVES
AI M:
To det ermine the effectiveness of school dent al healt h education program conduct ed at regul ar i ntervals for 8 -10 yea rs ol d school children with and wi thout parent al guidance.
OBJECTI VES :
1. To ass es s the knowl edge, attitude and p ractices of 8 -10 year s old s chool goi ng chil dren t hrough pre t est ed questi onnai res.
2. To as sess the oral health s t atus of 8 -10 year ol d school going chil dren.
3. To ass es s the effectiveness of oral health education among 8-10 years ol d s chool goi ng chi ldren.
4. To as sess if parental presence has got an y infl uence on th e out com e of school dent al educati on program .
8
REVIEW OF LITERATURE
John L ee (1976)1 2 This st ud y is bas ed on the P arent al Att endance at a School Dent al P rogram and Its Impact upon the Dent al Behavi our of the Chil dren. One hundred and fi ve children had t hei r parents in att endance and were desi gnat ed experim ent al group A; 211 did not and were des i gnat ed cont rol group B. Behavi oural variabl es com pared included dent al vis its, routi ne oral h ygi ene, and the use of fluori de paste and ri nse at t he ses sions. Dental exam s bot h a priori and a pos teriori allowed an ass es sment of the dentition and gingival tissue of both groups. R esul ts showed a si gnifi cantl y greater improvement in both the dent al behaviour and dent al health of th e chil dren whose parents att ended the s essi on. Thes e result s gi ve vali d evidence to the advant age of involving parent s in a s chool bas ed dent al program.
Anthon y S. Blinkh orn et al (1987)1 3 This stud y ex amined one thous and and sixt y-s even S cotti sh s chool chil dren com pl eted a two - year dent al health educati on and prevent ion programm e. The dental cari es was m easured using a DMFT index. The h ygi enist group had a 20% lower inci dence of dental deca y. B oth acti ve groups ha d si gni fi cantl y (P < 0.01) less gingiviti s than the cont rol group at the end of t he t wo - year stud y. Neither of t he educational programm es achi eved marked success, but the act i ve groups, especial l y t he h ygi eni st group, had a greater unde rs tanding of how fl uori de worked, realised that controlling the frequenc y of sweet -eat i ng was important and knew how to cont rol gingi vitis. The teacher -based
9 programm e was approxim atel y two -t hi rds cheaper than t he one organiz ed b y t he h ygi enist. Neither sc heme, unl ess m odi fi ed, could be recomm ended either clini call y or economicall y.
Kay EJ and locker D (1996)1 4 This st ud y examined 143 papers rel ati ng t o dent al health educati on interventi on from 1982 to 1984.
Each paper was s cored b y two independent res earch ers according to twent y predetermi ned vali dit y crit eri a. The result s of thi s anal ys is suggest t hat further efforts to s ynt hesis current i nform ati on about dental healt h educat i on, in a s yst ematic wa y are required along wit h maint enance of ri gorous sci entifi c st andards in eval uat ion res earch Van Pal ens tein Helderman et al(1997)1 5 Conduct ed a st ud y to evaluat e the Effecti veness of an oral health education program me among prim ar y s chool chil dren between the age group of 9 and 14 years in prim ar y s chools i n Ta nzania. This st ud y aim ed to ass ess the clini cal oral health outcom e effect s among school children parti cipating i n a school -based oral h ealt h education (OHE) programm e. In tot al, 309 children from t he parti ci pati ng s chools and 122 children from t he non -parti cipati ng schools were avail able for the evaluation. The mean DM FT val ue at baseline was 0.4 and 3 years l ater 0.9 in both the parti cipating and cont rol schools. In concl usion, the pres ent stud y shows that the im pl ement ed s chool - bas ed OHE program me did no t result in si gni fi cant reductions of the clini cal param eters measured.
Red mond CA et al (1999)1 6 Invest i gat ed the val ue of the school based dent al healt h educati on program in t erm s of changes in
10 knowledge, reported behaviours and pl aque scores b y using a clust er random ized cont rol s tud y desi gn i nvol ving 2678 pupils wit h a mean age of 12.1 years att ending 28 schools. The res ult report ed frequenc y of brushi ng did not change, but the group who had received 12 months of t he int erventi on were more li kel y (P <. 05) to brush for over a mi nute. At six mont hs t he earl y intervent ion group had a stat i sti call y si gnificant , 13% reduction in the mean proport ion of sit es wi th pl aque compared with the lat e int erventi on group (P=.043).Hence thi s trial dem onst rat ed that the int ervention program res ult ed in an improvem ent in knowl edge of dent al diseas es and an increas e in the durati on of brus hing. Hence there is a positi ve ass ociat ion bet ween t he oral hygi ene import ance and reduction in gi ngival bl eeding.
Vigild M et al (1999)1 7 Conduct ed a s tud y to ass ess the Oral healt h behaviour of 12 - yea r-old children i n Kuwai t. The s ample included 500 12- year-old s chool children (250 boys and 250 gi rls ) s el ect ed from s chools i n Kuwai t. The results are as follows: During the previous 12 m ont hs , 28% of t he children had experi enced oral health problems ± toothache (10%), or had fel t discom fort (18%) either oft en or occas ionall y. The chil dren report ed t hat the y needed oral h ygi ene i nst ruct ion (71%), filli ngs (32%) and tooth extraction (23%). For 53% of the children the reas on for the most recent visit to a denti st was pai n or problems wit h t eeth or gum s. At t heir last dental visit 26% of the chil dren had undergone a t ooth extraction.
The consumption of sugar y foods and drinks was extrem el y hi gh.
11 Oral healt h education and oral health care program mes should be est abli shed in secondar y schools i n Kuwai t to influence t he oral health behaviour of the chil dren and to avoid further det eri oration in thei r oral healt h.
Mellanby et all (2000)1 8 criti call y reviewed avail able com parati ve researc h regardi ng peer -l ed and adult -led school healt h education.
The authors have evaluat ed school based healt h education programs whi ch have set out t o compare t he effect s of peers or adults deliver y the s am e m ateri al. The aut hors conclude that identified s tudi es indi cat ed that peer l eaders were at l east as, or m ore, effecti ve that adults but also s uggests extensive research in this area for definitive ans wers
Okada et al (2002)1 9 The st ud y was done to exami ne t he simult aneous int er -rel ati ons hips bet ween parents ’ oral health behaviour and t he oral health st atus of thei r school chil dren. The child’s dental examination was performed using the World Health Organizati on (WHO) cari es di agnosti c cri teri a for deca yed te eth (DT) and filled teeth (FT). The Oral Rating Index for Children (OR I- C ) was used for the chi ld’s gi ngival healt h exami nati on.
Hiroshim a Univers it y Dent al Behavioural Inventor y (HU -DBI) was used for the assessment of the parents’ oral health behaviour. A parent– chi ld behavioural model was t est ed b y t he li near struct ural rel ati ons ( LISR EL) programm e. Thi s stud y concluded that parent’s oral health behaviour could influence thei r chil dren’s gingival
12 health and dent al caries di rectl y and/ or i ndirectl y t hrough its effect on children’s oral health behaviour.
Peters en PE et al (2004)2 0 conducted a s tud y among primar y school chil dr en in Hongshan Dis tri ct , Wuhan cit y, Central Chi na. The parti cipant s were 803 children and thei r mothers, and 369 teachers were included at bas eline. Aft er three ye ars, 666 children and their mothers (respons e rate 83%), and 347 teachers (res ponse rat e 94%) rem ai ned. In experiment al schools, m others showed si gnifi cant benefi cial oral healt h devel opm ent s, whi le t eachers s howed hi gher oral h ealth knowl edge and m ore posi tive att itudes , also bei ng satis fi ed wit h t raini ng workshops, m ethods appli ed, mat eri als us ed and involvem ent wi t h children in OHE. The authors concl uded that the program me had positi ve effects on gingival bleeding score and oral health behavi our of chil dren, and on oral healt h knowledge and attit udes of m others and t eachers. No positive effect on dent al cari es incidence rat e was dem onst rat ed by the OHE programm e.
Carlos Alb erto Con rado et al (2004)2 1 The mai n purpos e of this stud y was to evaluat e the preliminar y res ults of a school -bas ed oral health educati onal st rat egy adopted in public prim ar y s chools from the cit y of Maringa, Stat e of Parana, Brazil. The stud y s ample was com pos ed b y 556 children and adol escents aged 6 t o 17 year s ol d, 124 s choolt eachers and a group of 55 mothers. A stati sticall y si gni fi cant i mprovement in thei r oral hygi ene i ndex (p<0.001) was recorded. The res ul ts achi eved suggest an encouraging tendenc y towards the im provement i n the l evels of oral health c are am ong the
13 school -age youths studi ed. The y also point out the need of intensi f ying the preparati on of schoolteachers in oral healt h topi cs, as well t he ins tructi ons t o t he mothers for thei r oral healt h care.
Moreover, the y hi ghli ght the import ance of th e conti nuous implementation of s chool -based programs to promot e t he oral health Bondarik El ena et al (2004)2 2 Conduct ed a stud y to coll ect basi c dat a of dent al st at us of 6 and 12 years old in Belarusian urban and rural areas and monitori ng of dent al s tatus , to anal yz e oral health habits of s chool chi l dren and mot hers according to urbanizati on and to find out the relation between mother’s educational back - ground and children’s oral health habits and also impact on their own dental knowledge, attitudes and p ract ices . Results of pres ent investi gati on show that adult’s oral health habits and level of dental knowledge are ke y inform ati on in realizati on of chi ldren oral health programm e.
Al-O mi ri M.K et al (2006)2 3 conduct ed a stud y among 10 to 16 year ol d school goi ng chil dren in Nort h J ordan to ass ess t he Oral Healt h Attit udes, Knowl edge and Behaviour Am ong S chool going Children. S chool chi ldren (n=557) of an average age of 13.5 years att endi ng publi c s chools in North Jordan were recruit ed i nt o this stud y. The s tud y populati on showed hi gher awareness of cari es t han periodont al conditi ons. The children in this st ud y als o recognized the im portance of oral healt h to the well -being of the rest of th e bod y. P arents were not proact ive in making sure t hat t heir children received regular dental care. Parents’ knowledge and attitudes about
14 the im port ance of oral health care and their fears about dent al treatment influenced their children’s dental care. The results of this study indicate that children’s and parents’ attitud es toward oral health and dent al care need t o be improved. C omprehensi ve oral health educational programs for both chi ldren and thei r parents are requi red t o achi eve t his goal.
Yee et al (2006)2 4 The m ain purpos e of this stud y was to evaluat e the oral cleanliness of s chool chil dren in the Dis tri ct of S uns ari , Nepal . A t ot al of 600, 12 -13 - year -old and 600 15 - year -ol d school chil dren were exami ned b y t rained exam iners using the sim plifi ed oral h ygi ene index (OH I -S ). The mean OHI-S for urban 12 -13- year - old s ch ool children was 0.98 compared t o 1.34 for school children of rural t owns and 1.44 for school chil dren of rural vill ages and thes e di fferences in mean OH I-S were st atist icall y si gni ficant (P <0.005). In t he 15 - year-ol d age group, urban s chool chil dre n had a m ean OH I-S score of 1.00 compared t o 1.37 for rural t owns and 1.43 for rural vill ages. The variance i n the m ean OHI -S s cores were stati sti cal l y s i gni fi cant (P <0.005).
Sagheri D et al (2007)2 5 condu ct ed a st ud y t o as sess the oral health of s chool age chil dren and the current s chool bas ed dent al s creeni ng programm e in Freiburg , German y among 6 – 12 year ol d school going children. The aim of thi s cross -sectional stud y was t o report on the dent al cari es levels of s chool -age chil dren s trati fi ed into thes e three different school t ypes at secondar y s chool l evel to enabl e oral healthcare personnel to adm inist er a focused, school -
15 bas ed dent al s creening and educat ion programme according t o patients’ needs rather than a uniform dental e xamination. Results: A total of 322 12 - year-old chi ldren parti cipat ed. The mean DM FT was 0.69. An ex aminati on of the dist ribut ion of the DM FT score reveal ed that its distribut ion is posi tivel y skewed. The non - paramet ri c Krus kal -Wallis H -t est showed a hi ghl y s i gnifi cant difference bet ween medi an s cores across the di fferent school t ypes (P-val ue = 0.004). The si gnificance was a result of the ‘G ym nasi um ’ distribut ion of DM FT scores which di ffered markedl y from the other two school t ypes .
Nash D et al (2008)2 6 compil ed a profile of the oral healt hcare team in countri es wi th em erging Economi es . The y concluded t hat
1. Oral healt h is a criti cal and int egral dimension of general health and well -being.
2. Gaining and mai ntai ning the benefit s of oral health is a social good and should be an entitl em ent ensured b y a s oci et y for all of its citiz ens.
3. Povert y and i gnorance are si gni fi cant barri ers to achi evi ng oral health in a popul ation.
4. An i nadequat e oral health workforce is an additional barrier t o achi eving oral healt h. Therefore, developing a well -educat ed/ well - trained oral healt hcare team is essent ial to effecti ng oral health for a nation’s population.
5. Each count r y must develop a st rategic plan for t he oral health o f the publi c that is based on th e unique demographics of t he countr y
16 and the epidemi ol ogy of its oral diseas es. Public heal th professi onals have a unique role t o pla y in devel opi ng such a plan.
When thes e individuals are not avail abl e in an emergi ng econom y, advice and consult at ion wi ll have to be gained from i nternational experts in t he fiel d.
6. A comprehensive oral health t eam consists of: dentist s, s pecial ist dentists , dent al therapists and dent al h ygi enis ts (or a com binat ion of the t wo – an oral health t herapist ), denturis ts, expan ded functi on dental assi st ants/ dent al nurses and communit y oral health workers /ai des.
7. The profil e of the oral healthcare team, and the numbers em erging econom y, should reflect t he specifi c needs and circumst ances of the countr y.
8. Prevent ion of oral disease is an ultim ate goal and is to be desi red above therap y. Therefore, an em ergi ng econom y shoul d gi ve priorit y considerati on t o funding and impl ementi ng all appropri at e preventi ve st rategies for i ts populat ion.
Tai B-J Jiang et al (2009)2 7 Conducted a stud y t o as s ess t he out com e of oral health prom otion i n s chool chi ldren over a 3 - year period i n Yichang Ci t y, Hubei , China. Data on dent al caries, plaque accumul ation, and sulcus bleeding were coll ect ed b y cl inical examinati on, whi l e behavioural dat a were gathered by s el f - admi nist ered questi onnaires. There was no st atisti call y s i gni ficant difference observed in the 3 - year net m en DMFT increm ent score bet ween the t wo stud y group (P>0.05). The 3 - year net mean DMFS
17 increment score was 0.22 in t he int erventi on school s and 0.35 in the control schools (P < 0.013). A statistically significant difference in mean plaque (P < 0.013) and sul cus bl eeding (P < 0.005) increm ent scores aft er 3 years was found between t he two groups . The stud y suggest s that the school -bas ed oral health promoti on was an effective wa y to reduce new cari es i ncidence, im prove oral hygi ene and est abl ish positi ve oral heal th behavi oural practi ces i n the targeted s chool children.
Jurgens en N (2009)2 8 conduct ed a cross sectional s urve y to ass ess the Oral health and the impact of s ocio -behavioural fact ors of 12 - year ol d school chil dren in Laos . The aims of this st ud y were to:
assess the l evel of oral health of Lao 12 - year -ol ds in urban and semi urban s ettings; study the i m pact of poor oral health on qualit y of life; anal yz e t he ass oci ati on between oral heal th and soci o - behavioural factors; investi gat e t he rel ation bet ween obesi t y and
oral heal th. R esul t s are as follows: Mean DM FT was 1.8 (SEM = 0.09) whil e car i es preval ence was 56% (C I95 = 52 -60).
Preval ence of gingi val bl eedi ng was 99% (C I95 = 98 -100) wit h 47%
(C I95 = 45-49) of present teeth affected. Traum a was observed in 7% (C I95 = 5 -9) of the children. Hi gh deca y was seen in children with dent al vis its and frequent consumpti on of s weet dri nks . Miss ed school class es, t oot h ache and s everal impai rm ents of dail y l ife activiti es were as soci at ed with a hi gh dD -component. No associ ati ons were found bet ween Bod y Mass Index (BMI) and oral health or comm on ri sk fact ors. The mult ivari ate anal yses revealed
18 hi gh ri sk for caries for children with low or moderat e at titude towards healt h, a histor y of dent al vis its and a preference for drinking sugar y dri nks duri ng school hours. Although the cari es level i s low it caus es c onsiderabl e negative im pact on dail y life.
School bas ed health prom otion should be impl em ent ed focus ing on skills bas ed l earning and attit udes t owards heal th.
Rosa Amali a et al (2012)2 9 Conduct ed a stud y to as ses s the effectiveness of a school bas ed dental programm e (S BDP) i n controlling cari es b y measuri ng the relat ionship bet ween t he SBDP perform ance and cari es experi ence in children aged 12 in Yogyakarta Province, Indonesia, by taking into account influencing fact ors . C aries was ass essed us ing WHO crit eri a whereas behaviour and socio -dem ographic factors were coll ected us ing a questi onnaire administered to the children. The decayed, missed, and filled teeth (DM FT) of chil dren in good S BDPs (2.8 ± 2.4) was lowe r t han that of the count erparts (3.8 ± 3.4). The stud y suggests that t he differences in DM FT of children in good and poor performance SBDPs were caus ed b y rel ation t o social factors rather t han b y rel ati on to oral healt h s ervice acti viti es.
Abdul Hal eem et al (2012)3 0 Conduct ed a stud y t o compare the effectiveness of dentist -l ed, teacher-l ed, peer -l ed and s el f -learning strat egi es of oral health education. A t wo - year clust er randomized controlled t ri al foll owing a parall el desi gn was conduct ed. The pres ent paper di scusses the fi ndings of t he stud y pert ai ni ng to the baseli ne and fi nal outcome exami nat ion. All the three educator -l ed
19 strat egi es of OHE had statisti call y hi gher m ean of oral health knowledge (OHK), oral health behaviour (OHB), Oral h ygi ene stat us (OHS ) and combined knowl edge, behaviour and oral h ygi ene stat us (KBS) scores than sel f -l earni ng and control groups(p<0.001).
The mean OHK, OHS, KB S scores of t he three educator -l ed strat egi es did not differ si gni fi cantl y. The peer -l ed strat egy was , however, found to have a s i gni fi cantl y bett er OHB score t han the respective s core of the t eacher -l ed strat egy (p<0.05). The s el f - learning group had s igni ficantl y hi gher OHB than t he cont rol group (p<0.05) but t he OHK, OHS, KBS scores of the t wo groups were not si gni fi cantl y di fferent. The peer -l ed st rategy, howe ver, is al most as effective as the denti st -l ed st rategy and com parativel y more effective than the teacher -l ed and sel f-l earning st rategi es in improving the oral health behaviour .
Aline Rogeri a Freire de Casti lho et al (2012)3 1 Conducted a stud y to revi ew current models and s ci ent ifi c evidence on t he influence of parents’ oral health behaviours on their children’s dental caries. A total of 218 citations were retri eved, and 13 arti cles were i ncl uded in the anal ys is. The studi es we re eli gibl e for review if t he y m at ched the following i ncl usion crit eria: (1) t he y evaluat ed a possibl e association between dental caries and parents’ oral -health-related behaviours, and (2) the st ud y methodol ogy i nclu ded oral clinical examinati on. This st ud y concluded that parents’ dental healt h habit s influence their children’s oral health. Oral health education programs aim ed at preventi ve actions are needed to provide children
20 not onl y wi th adequate oral healt h, but better qualit y of li fe. S peci al att enti on s hould be given t o t he entire fam il y, concerning thei r lifest yl e and oral health habi ts.
Jurgens en et al (2012)3 2 Conduct ed a st ud y to revi ew the range of school -bas ed approaches to oral health and des cribes what is meant b y a Health P rom oting S chool. The Ottawa C hart er for Healt h Promotion noted that schools can provide a supporti ve envi ronm ent for promoting children’s health. However, while a number of well - known st rat egies are bei ng appli ed, the full range of health prom oting act ions is not bei ng use d gl oball y. A great er em phasis on integrat ed health promotion i s advis ed in pl ace of narrower, diseas e - or proj ect -s peci fic approaches. Recomm endati ons are m ade for im proving t his si tuati on, for further res earch and for specif yi ng an operati onal fram ework for s hari ng experi ences and res earch.
Mazah S alah Mud athir et al (2012)3 3 Conduct ed a stud y t o ass ess knowledge about tooth deca y and practi ce towards oral health education among basic school t eachers . Als o t o det ermine their deca yed, mis sed and filled too th index (DM FT) and Oral hygi ene index (OHI). S ubj ects and C ross -sectional st ud y am ong 184 bas ic school t eachers, working i n school s in Khartoum province. An intervi ew questi onnaire consisti ng of 15 questions covering t hei r oral h ygi ene habits, basi c knowl edge about tooth deca y, will i ngness to part ici pate i n s chool based oral healt h programs. R es ult showed that the m ean DMFT index was 11.59±5.09. The oral hygi ene condition was ass essed vi a OH I -S impli fied, 53.3% had good oral
21 h ygi ene, 44% fai r and 2.7% poor. Knowledge ass essm ent revealed that 54.9% t hought that dent al cari es is caus ed m ainl y b y bacteri a and sugars and 31.0% beli eved t hat tooth deca y cannot be prevented. Significant association was found between teachers’ age and their source of inform ation ab out oral health (p=0.036).
Regarding practi ce towards oral heal th 60.3% of the t eachers cl aim ed spending ti me promoti ng for oral healt h. Basi c school teachers were generall y wel l inform ed about tooth deca y but some defi ciencies were noticed.
Aurangjeb AM (2013)3 4 The main purpose of the stud y is t o find the effect of parent’s education on child’s oral health. This study was done to assess the relation between parent’s education and their child’s oral health. Parents of children aged 3 -12 years, attending the Dhaka P roj ect School Dokkin Khan, Uttara Dhaka were invit ed to part ici pate in t he stud y. The s ampl e com pri sed of 251 parents either mother or fat her, wit h the m ean age of chil dren being 5.65 years. M ean pl aque index 1.60, calcul us index 1.30, Gi ngi viti s index 1.11, deca yed teeth index1.69, mi ssing t eeth i ndex 0.22 and fill ed teet h was 0.07. Parent s with hi gher educati onal quali fi cation and information gai ned through dentist had a bett er knowledge about child’s oral health.
Viany Ku mar Bh ardwaj et al (20 13)1 The stud y has been undert aken to evaluat e the impact of oral health education on the stat us of plaque, gingi val health and dental cari es am ong 12 and 15 years old children at tending governm ent school in Shim la cit y. Two
22 hundred and s event y six school chi ldren participated in the stud y.
Plaque, gingival and cari es st atus was as sess ed b y using Sil ness and Loe pl aque index, Loe and Silness gi ngi val index and WHO modi fied DM FT index, respect ivel y. Data was anal yz ed usi ng the soft ware SPSS versi on 15. Paire d t‑t est and Wilcoxon si gned rank
sum test were us ed appropri at el y for statisti cal comparisons . P val ue ≤0.05 was considered stati sti call y si gnificant. C oordi nati ng
efforts should be enhanced between s chool pers onnel, parents and health professionals to ensure l ong term benefits of such program.
John BJ Asokan S et al (2013)3 5 conduct ed a stud y to ass ess the impact of three different health education met hods among pre- school ers. The stud y group incl uded 100 pre-s chool ers of the sam e soci o-economi c stat us randoml y select ed and divi ded i nt o four groups . Debris index (DI -S ) was recorded for all chil dren followed b y t he dent al healt h education. Group A received dent al heal th education from t he Dentist; Group B from the cl ass teacher trained b y the Dentist and Group C from t he dent al resident s dress ed mimicking cart oon charact ers. Group D acted as the cont rol group.
Post-i nt ervention eval uati on program was carried out after 3 months. Comparison of pre - and pos t-i nt ervention data s howed that ther e was a st atist i call y si gnificant im provem ent in the (DI -S) scores in all groups except the cont rol group. Group C s howed a si gni fi cant improvement compared to the other Groups A, B, and D (P<0.04). Conclusi on: Dram a as a m et hod of healt h educati on can hav e a bi gger i mpact on t he oral health at titude and practi ces of t he
23 pre-school ers. Thes e modes can serve to rei nforce as well as improve the oral health pract ices am ong pre -school children.
Elham Bozorgmehr et al (2013)3 6 The m ain purpos e of the st ud y to ev aluat e t he rel ati onship between oral health behaviour of parents and oral health st atus and behaviour of t hei r chi ldren in a s ample of pres chool chil dren in Iran. About 222 parents and chil dren parti cipat ed in the stud y. There was a si gnificant rel at ionshi p bet ween hist or y of having dent al problem s in parents and dm ft index in thei r children (P =0.01). There was a si gni ficant rel ati ons hip bet ween parent al frequenc y of tooth brushi ng and chil d frequenc y of toot h brushi ng (P =0.05); however there was no si gni fi cant rel ati ons hip between parent al frequenc y of dent al visits and thos e of t hei r children (P =0.01). The stud y concl uded that som e important health behaviours in parents , such as tooth brushing habits are important det erminant s of thes e behavi ours in t hei r young chil dren. So promot i ng parent knowl edge and attitude could affect thei r chi ldren oral health behavi our and st atus .
Rubeni ce Amaral d a Silva (2013)3 7 Conduct ed a stud y to eval uat e mothers who part ici pat ed in an educational and preventive program for infant s in relation to thei r knowl edge on oral health practi ces.
The oral caviti es of the infants were al so exami ned regarding: level of plaque, gingi val bl eedi ng, and dental cari es . Then, educational lectures were m ini stered and, aft er a year of follow -up, new intervi ews and cl ini cal examination were perform ed. For st atistical anal ys is, t he chi -square and Fisher exact tests were applied, bei ng
24 si gni fi cant p<0.05. Before t he educati onal l ectures, 93% of the mothers perform ed oral h ygi ene of thei r babi es and 57.3%
perform ed it at dayt i me and ni ght ti me. After t he lectures, all mothers perform ed t he oral h ygi ene (p>0.02) and 74.7% performed it at da yti me and ni g ht tim e (p=0.01). There were no di fferences regarding the consumption of cari ogeni c food i n t he initi al and final questionnaires (p>0.05). Initi all y, 5.6% of dental s urfaces had cari es; 29.7%, pl aques; and 11.9%, gi ngival bl eeding. After t he lectures, onl y 0.4% of the dent al surfaces had caries (p<0.0001);
2.4%, pl aque (p<0.0001); and 10.61%, gingival bl eeding (p<0.0001). Knowl edge acqui sition is ess ent ial t o improve oral health conditions.
Ragh avendra Shanbhog et al (2013)3 8 Conduct ed a st ud y to det ermine t he preval ence and severit y of oral condi tion rel at ed to untreat ed dental caries with P UFA index and to rel at e peri od of institutional st a y, oral h ygiene practi ce and diet of orphan children to cari es experi ence rati o. The overall preval ence of P UFA was 37.7%. 31.1% children s howed one or m ore pulpall y involved toot h in their oral cavit y. Correl ati on bet ween periods for bei ng t he chil d in the institut e t o DMFT showed negati ve val ue indi cti ng decreas e in DM FT as the duration of st a y in orphanage increas es . T he result show oral health conditi on i n orphan chi ldren was negl ected.
Children from this disadvant aged background have s hown a hi gh preval ence of dental caries with low dental care uti lizati on. PUFA
25 index is an effective index in evaluati ng cli nical cons e quences of untreat ed caries.
Byalak ere Rud raiah Chandrashek ar et al (2014)3 9 The objective of thi s stud y was t o com pare the oral h ygi ene, pl aque, gingival, and dental caries st atus among rural children receiving dent al healt h education by qualified dentists and school teachers with and without suppl y of oral h ygi ene aids . The oral h ygi ene, pl aque, gingi val, and dental caries st atus was assess ed at baseline and 6 m onths followi ng the int ervention. S PSS 16 was us ed for anal ys is. The pre - intervent ion and post -intervent ion com parison withi n each group reveal ed a subst ant ial reducti on in m ean oral h ygi ene i ndex - simplified (OHI-S), plaque index (PI), and gingival index (GI) at post -int erventi on compared to baseline i n group 4 (1.26, 0.87, and 0.74, respectivel y) fol l owed b y group 3 (0.14, 0.37, and 0.12, respectivel y). The OHI -S, P I, and G I s cores increas ed in group 1 (0.66, 0.37, and 0.34, respect ivel y) and group 2 (0.25, 0.19, and 0.14, res pecti vel y) . Mean deca yed, mi ssing, fill ed surfaces score bet ween the groups was not statisti call y si gni fic ant at basel i ne and post -int erventi on. The dram ati c reduct ions in t he OH I -S, P I, and G I scores in the group suppli ed with oral h ygi ene aids call for supplying low cost fluoridated toothpastes along with toothbrushes through the school s ys tems i n rural areas .
Yatish Ku mar Sanadhya (2014)4 0 This stud y as ses ses the effectiveness of oral health educati on on oral healt h knowledge, attit ude, practi ces and oral h ygi ene st atus among 12 –15- ye ar -ol d
26 school chi ldren of fisherm en of Kutch d istrict , Guj arat, In dia. A before -and -after experim ent al stud y was conduct ed am ong all (n = 205) the 12 – 15 year old chil dren from two s chools of Bhadreshwar vil lage of Mundrat aluka of Kut ch di stri ct , Gujarat, Indi a from J anuar y 2013 to December 2013 . At baseline, children were ass es sed for oral healt h knowl edge, attitude and practices using a s el f-adminis tered structured questionnai re and oral hygi ene was as sess ed using Oral H ygi ene Index -Simpli fi ed (OH I-S ). Oral health educati on was provided aft er b as eli ne ass es sment , at 3 months and at 6 m onths. Foll ow up stud y was done aft er 1 year from bas eli ne. St atisti cal tests appli ed were Independent t t est, paired t test and M cNem ar test. The results of the stud y reflects the accomplis hm ent of upgrading oral health knowledge, attitude, practices and oral h ygi ene status of fisherm en children t hrough school oral heal th education programm e.
Maryam Amin et al (2014)4 1 This stud y evaluat es the impact of an educational works hop on parent al knowl edge, atti tude, and percei ved behavioural cont rol regarding thei r child’s oral health.
The im pact of the workshop was evaluat ed b y a ques ti onnaire devel oped bas ed on the t heor y of pl anned behaviour . A total of 105 parents parti cipat ed in this stud y. P art ici pants were m ai nl y m others (mean age 35.03 ± 5.4 years) who came to C anada as refugee (77.1%) and had below high school education (70%). Parents’
intention to take t hei r child to a denti st withi n six months si gni fi cantl y alt ered aft er the workshop (P val ue < 0.05). A one -
27 time hands -on t rai ning was effective in im proving parent al knowledge, att itude, perceived behavioural cont rol , and int enti on with respect to their child’s oral health and preventive dental visits in African immi grant s.
Peters en et al (2014)4 2 Conducted a t wo - year st ud y as ses sed t he benefit of an enhanced oral healt h promotion program combined with a cl os el y s upervised tooth brushing program in s chool s . The DMFT and DMFS increments (“enamel and dentine”) were 1.19 and 1.91 for the cont rol group and 1.04 and 1. 59 for the int ervention groups . These repres ent 12.6% and 16.8% reductions i n caries respectively. The DMFT and DMFS increments (“dentine threshold”) were 0.26 and 0.44 for the control group and 0.19 and 0.29 for the i nterventi on group, represent ing 26.9%, and 34.1%
reductions i n cari es incidence respectivel y. This stud y documents the positive effect from use of fluoridated toothpas te (1,450 ppm F - and 1.5% argini ne) admi nist ered b y schoolt eachers and undert aken via an enhanced s chool oral health program. O pt imizing oral health intervent ions for young children in Thai s chools m a y have a si gni fi cant im pact on cari es i ncidence resulting in reductions of up to 34% reductions i n caries for all s chool s included i n t he stud y and up to 41% for the most cooperative.
Anupri ya et al (2014)4 3 The st ud y was taken up wit h the aim to evaluat e the oral health st at us and t reatm ent need i n the School going children of Nagrota Bagwan Block of Kangra Di stri ct, Him achal Pradesh. A tot al number of 3069 school children in the
28 age group of 5‑12 years stud yi ng i n 96 governm ent prim ar y s chools of stud y area were surve yed t o find out the Oral H ygi ene Index simpli fi ed (OH I‑S ) scores , communi t y peri odont al index (CP I) scores, dent al cari es and treatm ent need using dentit ion st at us and treatm ent need index (WHO diagnos tic cri teri a, 1997). The overall cari es prevalence of subj ects was 58.4% with hi gh caries preval ence in femal es as compared to mal es and in 9‑12 year’s age group as com pared t o 5‑8 yea rs age group. The mean dmft/DM FT was 2.05 ± 4.13 and 2.56 ± 4.20 in 5‑8 years and 9‑12 years age group, respectivel y. Treatm ent need obs erved was 62.3% and 75.3% in 5‑8 and 9‑12 year ’s age group, respectivel y. The s tud y demonstrat ed that s chool chi ldren in Nagrota Bagwan, Kangra dis tri ct suffer f rom hi gh preval ence of dental cari es and have hi gh t reatm ent need as wel l as poor oral h ygiene and gi ngi val health st atus .
Sunil Lingaraj Ajagannavar et al (2014)4 4 The aim was to ass ess the ass ociation of Dent al Negl ect (DN) with dental cari es and oral h ygi ene am ong adolescents i n Vi raj pet, In dia. Oral health st at us was clini call y ass ess ed using simpli fi ed oral h ygi ene i ndex (OH I -S) and dental caries through dentiti on st atus as per WHO crit eria. The pres ent stud y reveal ed t hat variat ions i n DN exist in rel at ion to soci o-demographi c charact eristi cs and pattern of dent al att endance.
In addit ion, oral health status was s i gni ficantl y ass ociated wi th DN among adolescents.
RuiHou et al (2014)4 5 This stud y is conduct ed t o ident if y t he oral health practi ces and acc ess for care of graduati ng senior hi gh school
29 Tibetan students i n Shannan prefecture of Tibet. The dent al cari es preval ence (39.96%) and m ean DM FT (0.97) were hi gh i n Ti bet an students . In comm unit y peri odontal indexes, the det ect ion rat e of gi ngi vitis and dental cal cul us were 59.50% and 62.64%
respectivel y. Oral hygi ene index Simpl ified was 0.69 wit h 0.36 and 0.33 i n debris index – simplifi ed and cal culus i ndex -sim plifi ed, respectivel y. Comm unit y dent al fl uorosis index was 0.29, with 8.13% in prevalence rat e. The ques tionnai re showed students had poor oral health practi ces and unawareness for t heir needs for oral health s ervices . Tibet an student s had higher preval ence of dent al diseas es and lower awareness of oral heal th promoti on and education and Oral heal th educat ion and local dentis t t rai ning shoul d be st rengt hened to get effect ive prevention of dental diseas es .
Deni se Dui js ter et al (2015)4 6 The objective of t his qualitati ve study was to explore parents’ perceptions of barriers and facilitators that i nfl uence t hese oral health behaviours in chi ldren. Focus group intervi ews were conduct ed on the basis of a pre -t est ed semi - struct ured intervi ew guide and topi c li st. Anal ys is of int ervi ew transcripts identified many influences on children’s oral health behaviours, operati ng at chi ld, famil y and communit y levels . Perceived influences on children’s tooth brushing behaviour were prim aril y l ocat ed wi thin the direct fami l y envi ronm ent, incl uding parent al knowl edge, perceived im portance and parent al confidence in tooth brushing, locus of control, role modelling, parent al
