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Table of Contents
ORIGINAL ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 3  |  Page : 39-42

Oral health – Knowledge, attitude, and practices of primary school teachers in Shirur, Udupi District India


Assistant Professor, Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Ar Rass, Kingdom of Saudi Arabia

Date of Submission21-Aug-2020
Date of Acceptance06-Sep-2020
Date of Web Publication29-Sep-2020

Correspondence Address:
Dr. Mohammed Ali Habibullah
Department of Preventive Dentistry, College of Dentistry in Ar Rass, Qassim University, Ar Rass
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INPC.INPC_37_20

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  Abstract 


Background: Oral health is an integral part of the general health of an individual. Children spend a considerable period in schools and teachers are in an enviable position to influence and guide children. School-based oral health education (OHE) is valuable as children are guided when young during the formation of their oral hygiene habits.
Aim: This study was undertaken with the objective of assessing the oral health knowledge, attitudes, and practices of primary school teachers.
Materials and Methods: This cross-sectional survey was conducted among primary school teachers in Shirur village of Udupi district. A validated questionnaire was used, and a total of 103 teachers were assessed for their knowledge, attitudes, and practices regarding oral hygiene.
Statistical Analysis: Data description and statistical analysis were obtained using IBM SPSS Version 21-computer software (IBM Statistical Package for the Social Sciences, SPSS 21.0, Inc., Chicago, USA) in association with Microsoft Excel. Descriptive statistics were obtained, and the mean values and frequency distributions were calculated.
Results: All teachers (100%) were unanimous in their agreement that oral health was an integral part of general health and 95.3% (n = 102) agreed on the need for periodic dental check up. A majority (55.8%) of the teachers brushed twice daily and 32.7% of them visited their dentist once every 6 months. All teachers were interested in delivering OHE in schools.
Conclusions: School teachers can be effectively used for OHE in schools. There is a need for a comprehensive approach to include OHE in schools through activities such as dental examinations and demonstration of brushing techniques.

Keywords: Attitude, knowledge, oral health, practices, school teachers


How to cite this article:
Habibullah MA. Oral health – Knowledge, attitude, and practices of primary school teachers in Shirur, Udupi District India. Int J Prev Clin Dent Res 2020;7:39-42

How to cite this URL:
Habibullah MA. Oral health – Knowledge, attitude, and practices of primary school teachers in Shirur, Udupi District India. Int J Prev Clin Dent Res [serial online] 2020 [cited 2020 Dec 2];7:39-42. Available from: https://www.ijpcdr.org/text.asp?2020/7/3/39/296544




  Introduction Top


Oral health is both essential and integral to the general health of an individual.[1] It includes a healthy mouth, a general sense of well-being and does not merely mean the absence of pain or infection.[2] When good oral hygiene practices are introduced early in life, it can lead to a lifetime of good oral health.

In India, public health expenditure (combined spending of the central and state governments on health) has remained at about 1.3% of the gross domestic product (GDP) from 2008 to 09 till 2015–16 and increased to 1.6% of GDP in 2019–2020.[3] In such a scenario, the focus on disease prevention cannot be overemphasized. Prevention can be achieved through schools by utilizing the services of teachers for health promotion. The World Health Organization launched the Global School Health Initiative to emphasize the importance of oral health promotion in schools.[4] In India, the National Oral Health Program has a school dental program component concerning good oral habits for children involving parents and teachers.[5] School-based oral health education (OHE) is invaluable as children are guided along as their health hygiene habits are formed. School teachers, as oral health educators, have been successful as confirmed from improved oral health among school children in various studies.[6],[7],[8]

Although school teachers may be willing to impart OHE, a lack of knowledge or formal training may compromise their effectiveness as health educators.[8],[9] Therefore, the aim of this study was to evaluate the knowledge, attitude, and practices regarding oral hygiene among primary school teachers of the Shirur Village of Udupi district.


  Materials and Methods Top


This cross-sectional self-administered questionnaire-based study was conducted to assess the knowledge, attitude, and practices regarding oral hygiene among primary school teachers in Shirur village of Udupi district. The study was restricted to primary schools as children in this age group are impressionable, and teachers can positively reinforce oral hygiene habits as they are being established. With regular, timely reinforcements, this would lead to a lifetime of good oral health.

Shirur is a village in the Udupi district of Karnataka state, India. All schools located in the panchayath limits of Shirur village were included in the sample. All teachers present on the day of the study and willing to participate were included in the study. All necessary approvals and ethical clearance were obtained before the commencement of the study. The study questionnaire was checked for validation by two subject experts using content validity and was found satisfactory.

All the teachers were met at their respective schools for the data collection. Informed consent was obtained after discussing the need and purpose of the study. Participants were also assured regarding the confidentiality of all the information collected. Questionnaires were distributed and collected, allowing sufficient time for the recording of responses. The Principal investigator was available at the school during this process to provide any clarifications if required.

Inclusion criteria

All primary school teachers of schools in Shirur village of Udupi district present on the day of the study and willing to participate were included.

Exclusion criteria

Teachers absent on the day of the study were excluded.

Incomplete questionnaires were excluded from the study.


  Results Top


The results were tabulated and presented as percentages from which conclusions were drawn.

The sociodemographic characteristics of the sample are mentioned in [Table 1]. A total of 107 school teachers were included in the study by total population sampling.
Table 1: Sociodemographic characterstics of the study population

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The knowledge of school teachers regarding oral health is presented in [Table 2]. All teachers (100%) were unanimous in their agreement that oral health was an integral part of general health. When asked if bleeding gums is a sign of gum disease, disappointingly, 27.1% (n = 27) of the teachers surveyed were unaware of this and 4.7% (n = 5) replied in the negative. About 95.3% (n = 102) agreed on the need for periodic dental checkup and 96.3% (n = 103) recognized the relation between tobacco and oral cancer.
Table 2: Knowledge of school teachers regarding oral health

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The attitude of school teachers toward oral health is described in [Table 3]. About 91.6% (n = 98) of teachers agreed that periodic dental checkup helps prevent oral diseases. The oral hygiene practices of teachers are illustrated in [Table 4]. More than half (55.8%) of the teachers brushed twice daily, 29.9% of teachers brushed once daily and 16.8% brushed after every meal. About 32.7% of the teachers visit their dentist once every 6 months, and another 10.3% doing so every 3 months. However, the majority, 57% (n = 61), visited the dentist only in case of pain or discomfort. A majority of the teachers n = 60 (55.8%) use toothbrush and paste only to clean their teeth, 27 (25.1%) use mouthwash, and 4 teachers each use floss or tongue cleaner in addition to toothbrush and toothpaste.
Table 3: Attitudes of school teachers regarding oral health

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Table 4: Practices of school teachers regarding oral health

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  Discussion Top


Teachers are respected and play a significant role in shaping behaviors in children especially the young. Therefore, their awareness regarding oral health is important for both their own oral health and that of the children they teach.[10]

This study used self-administered questionnaires which are not without limitations. Self-reporting of information can lead to response and recall bias. We attempted to overcome by assuring participants confidentiality of individual responses. Anonymity was also assured by not recording the name of the teachers in their questionnaires. Hence, the reliability of data collected through this method is adequate.

About 68% of schoolteachers surveyed in our study knew that bleeding on brushing is a sign of gum disease. This is in contradiction to the study by Maganur et al.,[11] where only 14.7% attributed gum disease to irregular brushing. All teachers agreed that oral health is an essential component of general health. This is encouraging as awareness is usually the first step to the attainment of changed or improved oral health practices. Ninety-six percent of the teachers were aware of the relationship between tobacco and oral cancer. Our findings compare favorably with a study by Mangalore et al.[12] where the awareness was 92.7%.

Although 91% of the teachers were aware that periodic dental check-up helps in the prevention of oral diseases, it was disappointing to note that over half (57%) of teachers surveyed visited a dentist only in case of pain or discomfort. This proves that knowledge or awareness may not routinely translate into practice, and there may be a need for motivation in this regard. These findings are similar to studies by Maganur et al.[11] and Almas et al.[13] The frequency of tooth brushing in our study [Table 4] was lower compared to studies by Maganur et al.[11] and Al-Mansour and Al-Zarea.[14]

The American Dental Association recommends changing your toothbrush every 3–4 months or as soon as bristles tend to fray.[15] This timeline is arbitrary as the amount of wear and tear of a toothbrush dependent on many factors such as bristle hardness and duration of brushing. In our study, about 60% of the teachers changed their brush in 3 months or less. It is interesting to note the remaining used their brushes for 6 months or longer. The most commonly used oral hygiene aids were toothbrush and toothpaste (55.8%). In addition to the above 25.1% used mouthwashes and only 3.7% used floss or a tongue cleaner. Ten percent of the teachers preferred toothpowder and brush for cleaning their teeth.

The use of mouthwashes was relatively low in our study in comparison to Mota et al.[16] and Maganur et al.[11] However, they are still used far more frequently than floss and tongue cleaner. This could possibly be attributed to the extensive media promotions[16] backed by effective marketing at pharmacies as mouthwash is a over the counter product.

A total of 16 teachers (15%) were smokers, 7 used paan/Gutka and 3 had both these habits. Since teachers are such effective role models, these habits could negatively influence the children at a young age.

The effectiveness of OHE delivered by teachers cannot be overemphasized. Studies, however, have elaborated multiple barriers in effective implementation of OHE, and these include busy academic schedules, multiple responsibilities, academic workload which are most often cited when new extracurricular programs like health education are recommended.[17] In addition, inadequate administrative support and lack of training and resources are other important barriers.[18]


  Conclusions Top


All teachers in this study unanimously expressed interest in delivering OHE in schools. Based on and within the limitations of this study, we recommend.

  1. A need for a more comprehensive approach to include OHE in schools through activities such as dental examinations, demonstration of brushing techniques with adequate scientific support such as posters, presentations, and educational print materials
  2. A concerted effort to overcome barriers by the involvement of school authorities, policymakers, and health-care professionals.


Acknowledgment

I wish to acknowledge Dr. Sham S. Bhat, Professor and Head and Dr. Sundeep Hegde K. Professor, Department of Pedodontics and Preventive Dentistry Yenepoya Dental College, Yenepoya Deemed to be University, Mangalore, India, for all assistance received in the planning of this study, manuscript editing, and review.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
George B, John J, Saravanan S, Arumugham IM. Oral health knowledge, attitude and practices of school teachers in Chennai. J Indian Assoc Public Health Dent 2010;8:85.  Back to cited text no. 1
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World Health Organization. Global School Health Initiative. World Health Organization; 1995. Available from: http://www.who.int/school_youth_health/gshi/en. [Last Accessed on 2019 Dec 19].  Back to cited text no. 4
    
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7.
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Mwangosi IE, Nyandindi U, Matee M. Participation of primary school teachers in oral health education in Rungwe District, Tanzania. East Afr Med J 2001;78:662-5.  Back to cited text no. 8
    
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Lang P, Woolfolk MW, Faja BW. Oral health knowledge and attitudes of elementary schoolteachers in Michigan. J Public Health Dent 1989;49:44-50.  Back to cited text no. 9
    
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Ahmad MS. Oral health knowledge and attitude among primary school teachers of Madinah, Saudi Arabia. J Contemp Dent Pract 2015;16:275-9.  Back to cited text no. 10
    
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Maganur PC, Satish V, Marwah N, Vishwas TD, Dayanand MC. Knowledge, attitudes, and practices of school teachers toward oral health in davangere, India. Int J Clin Pediatr Dent 2017;10:89-95.  Back to cited text no. 11
    
12.
Mangalore S, Venkata PK, Basavantappa JS, Preetha S. Knowledge about prevention of oral cancer and gum disease among school teachers in Dharwad, India. Indian J Dent Res 2013;24:279-83.  Back to cited text no. 12
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13.
Almas K, Al-Malik TM, Al-Shehri MA, Skaug N. The knowledge and practices of oral hygiene methods and attendance pattern among school teachers in Riyadh, Saudi Arabia. Saudi Med J 2003;24:1087-91.  Back to cited text no. 13
    
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Al-Mansour M, Al-Zarea B. Caries status, hygiene and fluorosis of primary school teachers in Riyadh, urban area. An Internship Seminar. Riyadh (KSA): KSUCD; 1999.  Back to cited text no. 14
    
15.
ADA Website. Available from: https://www.ada.org/en/member-center/oral-health-topics/toothbrushes. [Last Accessed on 2020 Feb 21].  Back to cited text no. 15
    
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Mota A, Oswal KC, Sajnani DA, Sajnani AK. Oral health knowledge, attitude, and approaches of pre-primary and primary school teachers in Mumbai, India. Scientifica (Cairo) 2016;2016:1-8.  Back to cited text no. 16
    
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Tikare S, AlQahtani NA. Oral health knowledge and attitudes of primary school teachers toward school-based oral health programs in Abha-Khamis, Saudi Arabia. Saudi J Oral Sci 2017;4:72-7.  Back to cited text no. 17
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Ramroop V, Wright D, Naidu R. Dental health knowledge and attitudes of primary school teachers toward developing dental health education. West Indian Med J 2011;60:576-80.  Back to cited text no. 18
    



 
 
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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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