|Year : 2012 | Volume
| Issue : 2 | Page : 293
|Oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India
Abhishek Mehta1, Gurkiran Kaur2
1 Department of Public Health Dentistry, Dr. H.S. Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh (U.T.), India
2 Department of Oral and Maxillofacial Pathology, Gian Sagar Dental College and Hospital, Banur, Distt. Patiala, Punjab, India
Click here for correspondence address and email
|Date of Submission||12-Aug-2010|
|Date of Decision||26-Nov-2010|
|Date of Acceptance||09-May-2011|
|Date of Web Publication||3-Sep-2012|
| Abstract|| |
Oral health is fundamental to general health and well being. Schools can provide a supportive environment for promoting oral health. School policies and education on health-related matters are imperative for the attainment of good oral health and control of related risk behaviors.
Aim: This study was conducted to assess oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India. The ultimate goal was to implement an oral health-promotion program in this area.
Materials and Methods: A total of 440 children (216 males and 224 females) from 12 schools were included in this study. All the participants were requested to complete a 13-question closed-ended questionnaire. The statistical significance of any difference between the two genders was determined using the Chi-square test.
Results: Only 25% of the participants said that they cleaned their teeth more than once in a day. Thirty-two percent did not clean their teeth daily. Over the preceding 1 year, 45.5% of the childern had had some problem with their teeth and/or gums, but only 35.9% visited the dentist. Among these children, 8.2% used tobacco in some form. Oral health-related knowledge of girls was significantly better than that of boys.
Conclusion: Based upon the findings of the present study, the knowledge, attitude, and practices of the surveyed children with regard to oral health is poor. Hence, there is a need for regular oral health education of the children, as well as their parents and school teachers.
Keywords: Attitude and practices, India, oral health-related knowledge, Panchkula, rural schoolchildren
|How to cite this article:|
Mehta A, Kaur G. Oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India. Indian J Dent Res 2012;23:293
Oral health is an integral part of the general health and well-being of an individual. Oral diseases continue to have high prevalence despite the decline in dental caries in developed countries.
|How to cite this URL:|
Mehta A, Kaur G. Oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India. Indian J Dent Res [serial online] 2012 [cited 2019 Jun 26];23:293. Available from: http://www.ijdr.in/text.asp?2012/23/2/293/100446
Oral health promotion through schools is recommended by the World Health Organization (WHO) for improving knowledge, attitude, and behavior related to oral health and for prevention and control of dental diseases among schoolchildren.  Improvement in oral health-related knowledge is considered to be an essential prerequisite for improving oral health in a community. Very few studies have been done to assess the level of oral health-related knowledge and the attitudes and practices of children in developing countries, especially those residing in rural areas, as compared to that of children in developed countries. Therefore, the present study was done with the objective of assessing the knowledge, attitudes, and behavior of children in rural Panchkula. We intended to use this information for planning a school-based oral health program.
| Materials and Methods|| |
This study was conducted to assess oral health-related knowledge, attitudes, and behavior among 12-year-old rural schoolchildren in Panchkula, India.
Panchkula is a district of Haryana state in north India having population of 468411, with a literacy rate of 74%. Rural dwellers comprise 55% of the total population.  As most of the private dental clinics are located in the urban areas, the rural population is almost entirely dependent upon the dentists present in primary health centers (PHC) and community health centers (CHC) for dental care. There is one PHC per 30000 population and one CHC per 100000 population. There are two private dental colleges in Panchkula, and these colleges also provide oral health care to the rural population.
Study population and sample size calculation
The study population comprised 12-year-old schoolchildren studying in various government-aided schools in rural Panchkula. Only government schools were included in the study to ensure that the participants would all be from the same social class.
For sample selection we first divided the rural areas of whole district into four blocks as done by the education department of state.  Schools were randomly selected from each block, with the number of schools selected from a block depending upon the total number of schools present in that block. We estimated that there would be a total of 5000 children of 12 years of age studying in the schools of these four blocks. Total sample calculated was 357 at 95% confidence interval. Based upon this figure, the required sample size calculated was 357 at 95% confidence interval and 5% confidence level.
Thus, 12 schools were selected and a total of 440 children were studied. Our sample comprised 216 males and 224 females. Permission to carry out the study was obtained from the respective Block Education Officers and the principals of the schools. All 12-year-old children present on the day of the data collection were included in the study. No principal refused us permission to carry out the study and no child who was eligible for inclusion refused to participate in the study. Data collection was completed in 1 month.
All the participants were requested to complete a closed-ended questionnaire. The questionnaire included 13 questions designed to evaluate oral health-related knowledge, attitudes, and practices [Appendix 1]. The questions were translated into the local language, i.e., Hindi. The translated questionnaire was pretested on 30 children to check its reliability as well as to assess the children's ability to understand the questions and answer them without any help. The questionnaire was completed under the supervision of the investigators. It took a child around 15 minutes to finish answering the questionnaire.
Assessment of participant's oral health-related attitude included items on self-perceived oral health status and number of visits to a dentist for treatment of dental problems in the last 1 year. Assessment of a participant's oral health-related practices included questions on frequency of cleaning, cleaning aids used, and tobacco use. Assessment of a participant's oral health-related knowledge included questions on benefits of fluoride, necessity of regular dental visits, the role of sugar in causing dental caries, and the importance of teeth in the body.
The collected data was analyzed using SPSS® version 11. The statistical significance of differences between the two genders was determined using the Chi-square test. The level of significance was set at P≤.05.
| Results|| |
A total of 440 children participated in the study. Among the participants, 224 were girls and 216 were boys; this difference was not statistically significant.
Self-perceived oral health status
[Table 1] presents the self-perceived oral health status of the study participants. Fifty percent of the participants considered their oral health to be very good. There was significant difference between the two genders, with more girls (58.9%) being satisfied with the present condition of their teeth and gums as compared to boys (40.9%).
Oral health practices
[Table 2] shows the oral health practices of the participants, with a comparison between the genders. Among the participants, 41.8% cleaned their teeth at least once in a day, and 25% cleaned their teeth more than once in a day. There was a significant difference between the genders, with a larger proportion of girls (37.5%) cleaning their teeth more than once a day as compared to boys (12%).
The majority of the children (71.4%) used toothbrush and toothpaste for cleaning their teeth; there was no significant difference between boys and girls with regard to use of toothbrush/toothpaste. Around 17.3% used neem twigs to clean their teeth. Only a small proportion used other oral hygiene aids, e.g., toothpowder (8.6%) or finger (1.4%).
Recording dental history helps in judging the overall attitude of a person towards his/her oral health and dentistry. [Table 3] summarizes the responses to these questions. When asked whether they had suffered from any problem in their teeth and gums in last 1 year, 45.5% of the participants responded positively. However, out of these, only 35.9% had visited the dentist for their problems.
Fear of dental treatment was the main reason of not visiting the dentist (15.5%), followed by high cost of dental treatment (12.3%). There was no statistically significant difference between the genders as far as dental history was concerned.
Harmful oral habits
Among the children 8.2% used tobacco in some form. This habit was significantly more prevalent in boys as compared to girls (P<.05) [Table 4].
Oral health-related knowledge
The oral health-related knowledge of children was assessed by asking five questions to which participants had to respond with 'true' or 'false' or 'don't know' [Table 5].
Among girls, 85.7% thought that teeth are an important part of the body, whereas only 72.2% of boys thought so; this difference was statistically significant (P<.001). When asked whether visiting the dentist helps to keep teeth in a healthy condition, 69.5% participants responded positively. Girls (74.1%) were significantly more aware of this fact than boys (64.8%) (P<.05).
Daily cleaning of teeth can prevent dental caries was the opinion of the majority of the participants (83.2%). Only 41.8% children felt that the statement, 'eating or drinking sweet things does not cause caries,' was false. There was no significant difference between the responses of boys and girls. Only 17.6% knew that usage of fluoridated toothpaste can prevent tooth decay, and there was no significant difference between the two genders with regard to the response to this question.
| Discussion|| |
This study assessed oral health-related knowledge, attitudes, and practices of 12-year-old schoolchildren residing in rural areas of Panchkula district of Haryana state. In the present study, 440 students were given a closed-ended questionnaire consisting of 15 pretested questions, which they had to answer without any external help.
Perceived oral health status
In the present study, 10.9% of the total participants considered their oral health to be poor [Table 1]; the percentage is comparable to that in the studies conducted by Grewal et al.  and Harikiran et al.  on Indian schoolchildren. When compared with studies from other countries this percentage is relatively low. This may be due to lack of knowledge among children regarding what constitute good oral health.
Oral health practices
The proportion of children who cleaned their teeth more than once a day was 25%. This is figure less than that found by the study done by Zhu et al.  but comparable to that in the study done by Harikiran et al.  Around 32% of the participants did not clean their teeth daily, showing the lack of awareness regarding oral health care in both parent and children in this population group [Table 2].
Most of the children (71.4%) used toothbrush and toothpaste for cleaning their teeth, which is consistent with findings from other studies from around the globe. In the present study, we found that females performed better than males with regard to oral health practices, which is similar to the findings from the study done by El-Qaderi and Taani.  This difference between the genders shows that females are more concerned about personal hygiene and oral health.
Though a high percentage of study participants (45.5%) had suffered pain or discomfort due to disease of their teeth or gums in the preceding year, very few of them had consulted a dentist. This finding is similar to that in the study by Varenne et al. 
Oral health knowledge
There was good awareness among the children regarding the importance of regular tooth brushing for caries prevention (83.2%); this finding is similar to that in the study of Varenne et al.  Participants also had a positive attitude regarding visiting a dentist regularly in order to keep their teeth healthy (69.5%) but the actual frequency of such visits was low (35.9%). This finding is consistent with the findings of other studies. The awareness of the children regarding the benefits of fluoridated toothpaste (17.6%) and the relationship between consumption of sugary products and dental caries (41.8%) was low; this finding is comparable to that from the study done by Varenne et al.  and Wyne et al. 
| Conclusion|| |
To conclude, based upon the findings of the present study, the knowledge, attitudes, and practices with regard to oral health of the surveyed children is poor. Hence, there is a need to improve their knowledge by regular oral health education of the children, as well as their parents and teachers. This can be done by initiating an oral health promotion program covering all the schools of this area. Such a program will require the support of school authorities, dental colleges, and the public health department. The findings of this questionnaire survey provide baseline information that can be useful for initiating such a program.
| Appendix 1|| |
Q1. How would you describe the health of your teeth and gums?
- Very good
- Very poor
- Don't know
Q2. How often do you clean your teeth?
- Once in a week
- Many times in a week
- Once in a day
- More than once in a day
Q3. Which material/s do you use for cleaning your teeth?
- Neem twig
- Tooth powder
- Tooth brush and toothpaste
- Any other aid…
Q4. How often in last 12 months did you experience pain or discomfort in your teeth and gums?
- Many times
- Don't remember
Q5. How often did you visit the dentist in the last 12 months?
- More than two times
Q6. If answer is never for Q5, what is the reason for not visiting the dentist?
- Fear of dental treatment
- No dentist available nearby
- Cost of treatment is high
- No pain or discomfort in teeth or gums
Q7. Do you use any of these tobacco containing products?
- Paan masala
- Paan with tobacco
- Any other ….
Q8. If yes, how often do you use it
- Once in a month
- Once in a week
- Many times in a week
- Once in a day
- Many times in a day
Q9. Select the correct answer for the following sentences
- Teeth are an important part of your body
- Daily cleaning of teeth can prevent dental caries
- Regular visit to dentist helps to keep your teeth in a healthy state
- Consuming sweetened food products or drinks does not cause dental caries
- Using fluoridated toothpaste is good for your teeth
| References|| |
|1.||Peterson PE. World Health Organization global policy for improvement of oral health. Int Dent J 2008;58:115-21. |
|2.||Ministry of Health and Family Welfare,Govt. of India available from: http://www.mohfw.nic.in [Last cited on 2010 July 25]. |
|3.||Board of school education, Haryana. Available from: http://www.hbse.nic.in [Last cited on 2010 July 25]. |
|4.||Grewal N, Kaur M. Status of oral health awareness in Indian children as compared to western children (a pilot study). J Indian Soc Pedod Prev Dent 2007;25:15-19. |
|5.||Harikiran AG, Pallavi SK, Hariprakash S, Ashutosh, Nagesh KS. Oral health related KAP among 11-12 year old schoolchildren in a government aided missionary school of Bangalore city. Indian J Dent Res 2008;19:236-42. |
|6.||Zhu L, Peterson PE, Wang HY, Bian JY, Zhang BX. Oral health knowledge, attitude and behaviors of adults in China. Int Dent J 2005;55:231-41. |
|7.||El - Qaderi, Taani DQ. Oral health knowledge and dental health practices among schoolchildren in Jerah district -Jordan. Int J Dent Hyg 2004;2:78-85. |
|8.||Varenne B, Peterson PE, Ouattara S. Oral health behavior of children and adults in urban and rural areas of BukinaFasa, Africa. Int Dent J 2006;50:61-70. |
|9.||Wyne AH, Chohan AN, Al-Dosari N, Al-Dokheil M. Oral health knowledge and sources of information among Saudi schoolchildren. OdontoStomatol Trop 2004;27:22-6. |
Department of Public Health Dentistry, Dr. H.S. Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh (U.T.)
Source of Support: None, Conflict of Interest: None
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]
|This article has been cited by|
||Oral and Hand Hygiene Behaviour and Risk Factors among In-School Adolescents in Four Southeast Asian Countries
| ||Karl Peltzer,Supa Pengpid |
| ||International Journal of Environmental Research and Public Health. 2014; 11(3): 2780 |
|[Pubmed] | [DOI]|
| Article Access Statistics|
| Viewed||12070 |
| Printed||240 |
| Emailed||14 |
| PDF Downloaded||646 |
| Comments ||[Add] |
| Cited by others ||1 |