|Year : 2018 | Volume
| Issue : 2 | Page : 120-124
Oral health awareness in school-going children and its significance to parent's education level
Apurva Mishra1, Ramesh Kumar Pandey1, Heena Chopra1, Varuni Arora2
1 Department of Pediatric and Preventive Dentistry, Crowns and Bridges, Faculty of Dental Sciences, King George Medical University, Lucknow, Uttar Pradesh, India
2 Department of Prosthodontics, Crowns and Bridges, Faculty of Dental Sciences, King George Medical University, Lucknow, Uttar Pradesh, India
|Date of Web Publication||2-Jul-2018|
Ramesh Kumar Pandey
Department of Pediatric and Preventive Dentistry, Faculty of Dental Sciences, King George Medical University, Lucknow - 226 003, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: The oral health imparts a major impact on one's quality of life. Since last decades, there is an increase in the prevalence of dental afflictions which can be avoided by the knowledge of simple preventive measures. Aim: The aim of this study was to assess the oral health status of children and to analyze its association with the education level of their parents. Materials and Methods: Two randomly schools were selected and all the children from 5–15 years willing to participate in the present cross-sectional study were assessed for oral health status using the World Health Organization for the oral health awareness in children, 2004. Both child and parents were directly interviewed to avoid any bias in understanding the questionnaire. Statistical Package for the Social Sciences (16.0) was used for data analysis. Chi-square/Fisher's exact test was used to compare the dichotomous variables. Results: A total of 210 (133 males and 77 females) children were assessed along with their parents for the awareness of child's oral health condition. Totally 134 (63.3%) children were of age group 5–10 years, while 76 (36.7%) children were of age group 11–15 years. Children with uneducated parents have often experienced toothache, brushes once a daily and frequently visits the dentist for toothache compared to children of educated parents, and this association was observed to be statistically significant (<0.001). Conclusion: The oral health status of children was average. However, education level and awareness of parents regarding oral health preventive measures play a key role in determining the oral health of children.
Keywords: Dental health awareness, dietary habits, oral health, parents' educational level
|How to cite this article:|
Mishra A, Pandey RK, Chopra H, Arora V. Oral health awareness in school-going children and its significance to parent's education level. J Indian Soc Pedod Prev Dent 2018;36:120-4
|How to cite this URL:|
Mishra A, Pandey RK, Chopra H, Arora V. Oral health awareness in school-going children and its significance to parent's education level. J Indian Soc Pedod Prev Dent [serial online] 2018 [cited 2020 Dec 5];36:120-4. Available from: https://www.jisppd.com/text.asp?2018/36/2/120/235672
| Introduction|| |
The health of a child is a result of an amalgamation of his family's culture, beliefs and knowledge, social surroundings, and physical conditions. Dental caries and periodontal disorders are the most common global health burden of the modern era. The World Oral Health Report 2003 illustrated that dental caries affect 60%–90% of school-going children in Asian countries. To reduce the global burden of oral disorders, the World Health Organization (WHO) recommends oral health promotion at the school level to develop a knowledge, attitude, and behavior related to oral health problems. The development and implementation of such programs demand the assessment of existing oral health awareness at grassroots level. Bandura's social cognitive theory suggests that behaviors of parents have a large impact on social and health practices of a child. Therefore, the present study was carried out to evaluate the oral health awareness of children and their existing oral health practices.
| Materials and Methods|| |
The present observational cross-sectional study was conducted in the two randomly selected government schools in Lucknow. The study design was approved by the Institutional Ethical Committee. The rationale behind the study was explained to the school's principles, and their permission was obtained to conduct the study. All the children from 5 to 15 years of age were assessed based on the questionnaire developed by the WHO for the oral health awareness in children, 2004. All the children along with their parents willing to participate in the present study were enrolled after signing an informed consent. Children suffering from any chronic systemic disease (based on the parents reporting) were excluded from the present study. The education level of parents below high school level was considered to be uneducated. The questionnaire was filed by the direct questioning from the child and parents during their school visit. The questionnaires half filed or incomplete were not included in the present study.
Data analyses were carried out using Statistical Package for the Social Sciences (SPSS) 16.0 version (Chicago, Inc., USA). Chi-square/Fisher's exact test was used to compare the dichotomous variables.
| Results|| |
A total of 210 (133 males and 77 females) children were assessed along with their parents for the awareness of child's oral health condition. Totally 134 (63.3%) children were of age group 5–10 years, while 76 (36.7%) children were of age group 11–15 years. [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7] and [Figure 1] depict the various parameters assessed in the questionnaire. The quantitative part of analysis reveals that 73.3% and 68.6% of the sample population have average health for teeth and gums, respectively. Almost 66.7% of the population visited the dentist once. The pain was the main reason for visit to dentist in 71% of the sample population while only 20.5% of the population went for a routine checkup. Nearly 18.1% of the sample population brushes twice daily whereas 80% brushes once daily. About 97.1% of the population uses toothpaste as the medium for cleaning teeth, while the rest 2.9% uses powder/charcoal and its products to clean the teeth. Almost 98.1% of the population was unaware of fluoride. About 22.4% of the children were not satisfied with their appearance of teeth, 15.2% of them avoid smiling/laughing publicly due to unesthetic appearance of their teeth, and 18.1% of the population missed classroom/daily activities due to toothache, while 9.5%–10% of the population has difficulty in biting and chewing. Confectionary items including biscuits and cakes were the most common form of sugar intake every day followed by milk/tea with sugar. A statistically significant association was found between educated mothers and good health of teeth and gums. No significant association was observed between literacy of fathers and health of teeth of their children [Table 8].
|Table 8: Association of health of teeth and gum with education of parents|
Click here to view
Children with uneducated parents have often experienced toothache compared to children of educated parents, and this association was observed to be statistically significant, P ≤ 0.001 [Table 9]. Dental visits for the routine checkup were more observed in the cases of educated parents, but the association was not statistically significant [Table 10]. A statistically significant association was evident regarding the frequency of teeth cleaning and literacy of parents. Children of educated parents clean their teeth twice daily whereas there were no data recorded for twice daily brushing habit in cases of uneducated parents in the present sample population [Table 11].
|Table 10: Association of reasons for the last visit to the dentist with the education of parents|
Click here to view
|Table 11: Association of frequency of cleaning teeth with education of parents|
Click here to view
| Discussion|| |
The awareness of parents regarding oral health practices creates a preventive barrier thus, promoting and establishing a sound oral health status of a child. In the present study, we observed that educational level of parents had a major impact on the child's oral health. This is in concurrence with the findings in the literature.,, In the present sample population, good oral health was observed in children with educated parents, while toothache was a common finding in cases of uneducated parents. The reason postulated behind this was economic restraints, limited availability of information, and limited access to health-care professionals. Routine dental checkup of the child was also observed to be more in cases of educated parents compared to uneducated parents.
The preventive measures for dental caries are accessed by monitoring the frequency of tooth brushing and the type of toothpaste used. In the present study, the frequency of brushing/cleaning teeth twice daily was observed only in the children of educated parents and 18.1% of the study population. This value is much lower than reported by Mathur and Gupta (35.8%) and Costa et al. (68%). In cases of uneducated parents, none of the children reported brushing twice daily. This contradicted the brushing statement given by the American Dental Association “Two minutes, twice a day” which was advocated to maintain a good oral hygiene. Awareness for the fluoridated toothpaste was nil for the 98.1% of the study population. Vallejos-Sánchez et al. have suggested that children's frequency to brush teeth is directly link to the educational level of their parents. This is in agreement with the findings of the present study. Razmienė et al. observed that incidence of dental caries is influenced by the frequency of tooth brushing. In the present study, the children of uneducated parents were observed in the habit of irregular brushing, so more prone to toothache and more frequently visited the dentist for toothache problems.
However, our preventive measures should not be merely restricted to oral health care and oral hygiene practices for an individual. In the present study, we observed an increase in daily intake of sugar in the form of cakes, creams, sweets, and candy by the children compared to fruits in a majority of the study population. This increase in the frequency of intake of the carbohydrate can be accounted for two reasons: first, they are easy accessible to the mass population in the form of processed food and children are driven toward them through their colorful appearance and advertisements. Another reason for excessive intake of the sugar items and processed food could be the working conditions of the parents. If both the parents are working, children are mainly dependent on packed food, which are easy to cook and take less time. Children, during their leisure time, eat sweets/sugary food to compensate for food.
The knowledge of population is necessary to develop and restructure the educational program for children at the school level. Prevention first starts form the home and family, so it is of prime importance to evaluate and assess the cultural beliefs, dietary habits, and awareness of parents or guardians regarding oral health procedure before implementation of the program. Therefore, the tailored educational program would increase the knowledge and awareness of parents and would be an adjunct in shaping the values and behavior in children.
The limitations of the present study were as follows: questions were restricted to parents so under-reporting could not be ignored, especially in the cases of uneducated parents. Furthermore, the present study discussed the retrospective dental status of the child, so memory bias could be a confounding variable affecting the results of the study. More longitudinal study should be conducted at school level with a larger umbrella to include parents too, as parents play a key role in transfer of information and belief, to the healthy behavior practices of the child. Training of parents along with child at school level will help to establish more effective preventive measures, reducing the cost burden for complex dental treatment.
| Conclusion|| |
The status of oral health of the children in the present study was average. Majority of the children suffered from toothache problem in spite of regular brushing habits. Parents lack in awareness regarding preventive measures and dental visits. Therefore, the prime objective of a dentist should first assess the information and awareness needs of the target population instead of frequently carrying out dental school camps.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Petersen PE. The World Oral Health Report: Continuous improvement of oral health in the 21st
century – The approach of the World Health Organization Global Oral Health Programmer. Community Dent Oral Epidemiol 2003;31 Suppl 1:3-23.
Petersen PE. World Health Organization global policy for improvement of oral health – World health assembly 2007. Int Dent J 2008;58:115-21.
Okada M, Kawamura M, Kaihara Y, Matsuzaki Y, Kuwahara S, Ishidori H, et al.
Influence of parents' oral health behaviour on oral health status of their school children: An exploratory study employing a causal modelling technique. Int J Paediatr Dent 2002;12:101-8.
Isong IA, Zuckerman KE, Rao SR, Kuhlthau KA, Winickoff JP, Perrin JM, et al.
Association between parents' and children's use of oral health services. Pediatrics 2010;125:502-8.
Van den Branden S, Van den Broucke S, Leroy R, Declerck D, Hoppenbrouwers K. Effects of time and socio-economic status on the determinants of oral health-related behaviours of parents of preschool children. Eur J Oral Sci 2012;120:153-60.
Camargo MB, Barros AJ, Frazão P, Matijasevich A, Santos IS, Peres MA, et al.
Predictors of dental visits for routine check-ups and for the resolution of problems among preschool children. Rev Saude Publica 2012;46:87-97.
Mathur A, Gupta T. Oral health attitude knowledge behavior and consent towards dental treatment among school children. J Orofac Res 2011;1:6-10.
Costa C, Pereira M, Passadouro R, Spencer B. Higiene oral na criança: boca sã, família vigilante? Acta Médica Portuguesa 2008;21:467-74.
Vallejos-Sánchez AA, Medina-Solís CE, Maupomé G, Casanova-Rosado JF, Minaya-Sánchez M, Villalobos-Rodelo JJ, et al.
Sociobehavioral factors influencing toothbrushing frequency among schoolchildren. J Am Dent Assoc 2008;139:743-9.
Razmienė J, Vanagas G, Bendoraitienė E, Vyšniauskaitė A. The relation between oral hygiene skills and the prevalence of dental caries among 4 – 6-year-old children. Stomatologija 2011;13:62-7.
Mattos MC, Nascimento PC, Almeida SS, Costa TM. Influence of advertisements in the food choices of children and adolescents. Psychology: Theory and practice 2010;12: 34-51.
Trindade F, Valente A, Andrade M, Tannure P, Antonio A, Fidalgo T. Knowledge and practices of parents and guardians regarding the oral health of children from a shelter and a university in Rio de Janeiro, Brazil. Pesqui Bras Odontopediatria Clin Integr 2014;14:293-302.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11]