INTRODUCTION:

Oral health and Hygiene are one of the public health problems inboth developed and developing countries. Oral health related illness is very important contributor to overall health and quality of life for individual childrens^1,2. WHO, oral health is a state of being free from mouth and facial pain, oral and streptococcal sore throat, sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing and acquiring any of oral diseases or disorder affecting oral health³. Oral health related illness affects all childrens irrespective of location, country, nationality, and race or color ⁴. It is the fourth costliest disease to treat in developing country⁵. About 90% of the school children worldwide and most adults have experienced caries, with the disease being most prevalent in Asian and Latin American countries.⁶

Maintaining oral hygiene shouldn’t be underestimated in once lifestyle. It can be conceived as the method of keeping oral cavity free from pathological conditions that affect mouth like gum diseases, cavities, mouth sores and ulcers.⁷Good oral hygiene is essential for the well-being of an individual. However, lack of knowledge data, negative attitude and poor oral hygiene practices may predispose to oral related diseases^7,8. As oral health affect overall health of the children, it’s therefore of paramount importance to take care of oral hygiene among school going children. If community- school oriented oral health promotion programs are to be successful, the knowledge of the latest status of oral health of community is of vital importance³. This may ultimately contribute to the reduction of oral diseases with alarming global burden⁴and associated cardiovascular diseases, respiratory infections, stroke and nutritional problems⁵. To overcome the high prevalence of dental cavity in Bangalore, the necessity for school oriented preventive programs is emphasized.Oral health education is an important part of these programs. Oral health education is believed to be an economical method for promoting oral health and hygiene if done through schools, where all school children regardless of their socioeconomic status or ethnicity can be reached.⁹ To create such oral health education programe, the assessment of knowledge is very essential.¹⁰Knowledge means that the individual has all the necessary data to understand what is oral health and hygiene and how it create problems when childen not maintained proper oral hygiene in their day today life, as well as to understand the protective measures that need to be adopted. This knowledge will, in theory, lead to a change in attitude, which can successively lead the individual to form changes in their lifestyle.¹¹

Thus, within the case of dental caries, the individual knows that incorrect brushing may cause caries, and this information generates a positive attitude toward daily brushing, and changes in brushing behavior.

Evidence has showed that a rise in knowledge about risk factors for oral disease and powerful knowledge of oral health demonstrates better oral care practices that aim to promote market healthy habits.^11,12 Moreover, school children with inadequate oral health knowledge are twice as likely to have caries as school children with adequate knowledge.³Therefore, an efficient preventive program is desirable for these school children. However, it’s vital to gauge the present status of oral health knowledge before designing an efficient prevention program.

With the evaluation of the present status of oral health knowledge, several researchers clearly identified different sources of oral health information, like parents, school teachers, dentist, media, or relatives, which have an immediate influence on the oral health knowledge of school children,^13,14which successively influences their caries prevalence. Therefore, documentation the primary source of oral health information is very much required and school education programs will enable children to make decisions about oral health regarding their own children in the future or even their community.³Therefore, the evaluation of children's oral health knowledge and preventive practices is of great importance in the selected study areas, little is known about the oral health and hygiene knowledge among school going children. Hence, the purpose of this study was to assess the existing level of oral health hygiene knowledge to carry out an organized school dental health program and allows comparisons with children's oral health knowledge.

MATERIALS AND METHODS:

Study Design, Setting and Period:

A school based pre-experimental, one group pre-test and post-test design study was conducted in St. Philomena school in Kumaraswamy layout, Bangalorewith an objective to assess the effectiveness of planned teaching program on knowledge regarding oral hygiene among school age children and the study was conducted from June 1 to June 30, 2019.

Sample and Sampling Techniques:

Anon-probability convenient technique followed by purposive sampling method was used to take a total of 40 school going children between the age group of 6 to 12 years were selected using A non-probability convenience sample technique who were willing to participate in the study.The data collection instrument was developed by the investigators. The reliability and validity of the tool was done with the help of Nursing experts and statistician.

Data collection:

A pre test was conducted on knowledge regarding oral hygiene among school age children using 30 items Self –structured questionnaireprepared by referring various text book and research, after checking the reliability of tool. It had two sections such as (1) Demographic data, (2) Structured knowledge questionnaire.The knowledge part included the questions on the general knowledge on oral hygiene,Followed by administration of planned teaching program on oral hygiene among school age children. A post test was conducted by using the same questionnaire by lapse of 7 days.

Data Analysis:

After data collection each questionnaire was checked for completeness.Demographic data containing sample characteristic was analyzed using frequency and percentage. Knowledge score was analyzed in terms of frequency, percentage, mean and standard deviation. Chi – square test was computed for finding out the association between knowledge score with demographic variables, pre-test and post-test score. The significant difference between the mean pre-test and post-test knowledge scores was calculated using paired‘t’ test. The association between selected demographic variables and the pre-test knowledge scores regarding oral hygiene among school age childrens was determined by Chi-square test. Level of significance was set at a level of 0.05 to interpret the hypotheses and findings.

Ethical Consideration

The projectwas approved by Institutional research committee, College of nursing sciences,school of health sciences,Dayananda sagar University,Bangalore. A formal letter of cooperation waswritten to theSt Philomena English School, Kumaraswamy layout, Bangalore, Karnataka. Verbal and written consents was obtained from the study subjects parents after explaining the study objectives and procedures and their right to refuse to participate in the study at any time they want. For this purpose, a one-page consent letter was attached to the cover-page of each questionnaire stating about the general purpose of the study and issues of confidentiality which was discussed by data collectors before filling the questionnaire and proceeding with the interview.

RESULTS AND DISCUSSION:

Sociodemographic Characteristics of Participants: A total of 40 school age children were participatec in the study making response rate 100%,It revealed that in the pre test group majority 32(80%) belonged to the age 8-10 years, 6(15%) in 10-12years and 2(5%) belong to age 6-8years.Regarding the gender in pre test group 20(50%) were male and 20(50%)female childrens.While depicting data of religion, majority of respondents 30(75%) belongs to Hindus in religion, 5(12.5%) belonged to Muslim, 4(10%) belonged to christen and 1(2.5%) belonged to other. Among the study subject 40(100%) place of residence was in urban. Regarding father’s education 29(72.5%) had studied PUC,6(15%) had studied primary,3(7.5%) was illiterate 2(5%) had studied secondary.

Section I: Sociodemographic characteristics of mother

Table 1 represents the sociodemographic characteristics of mother and Majority of mother’sstudied Pre-University Course, twenty-four (60%), five (12.55) had completed degree and above, four (10%) had completed secondary and only four (10%) was illiterate and three (7.5) had studied primary. Occupation of father fifteen (37.5%) were daily wages, nine (22.5%) were govt. employees, eight (20%) were private employee and eight (20%) were self-employee. Occupation of mother in thirty-one (77.5%) were house wife, six (15%) were private employee, two (5%) were govt employee and one (2.5%) were self employee. The family monthly income among the study subjects were twenty-three (57.5%) had below Rs.10,000, Eight (20%) had Rs11,000-20,000, five (12.5%) had Rs 21,000-30,000, four (10%) had above.

Table 1: Socio demographic characteristics of school children and parents N=40

Demographic variables		Frequency (f)	(%)
Age in Years	6-8 years	2	5.0
	8 – 10 years	32	80.0
	10-12 years	6	15.0
Gender	Male	20	50
Gender	Female	20	50
Religion	Hindu	30	75
	Muslim	5	12.5
	Christian	4	10
	Others	1	2.5
Education level of children	5^th	0.0	0.0
	6^th	0.0	0.0
	4^th	40	100
Type of diet	Vegetarian	12	30
Type of diet	Mixed	28	70
Father’s education	Illiterate	3	7.5
	Primary	6	15
	Secondary	2	5
	PUC	29	72.5
	Illiterate	3	7.5
Mother’s education	Illiterate	4	10
	Primary	3	7.5
	Secondary	4	10
	PUC	24	60
Father’s occupation	Govt. employee	9	22.5
	Private employee	8	20
	Self-employee	8	20
	Daily wages	15	37.5
	Govt. employee	9	22.5
Mother’s occupation	Govt. employee	2	5
	Private employee	6	15
	Self-employee	1	2.5
	House wife	31	77.5
Family income per month	Below 10,000	23	57.5
	11,000-20,000	8	20
	21,000- 30,000	5	12.5
	Above 30,000	4	10
How many time are you are brushing daily	1 times	13	32.5
	2 times	24	60
	3 times	3	7.5
	1 time	13	32.5
Have you undergone any oral health/hygiene related program	Yes	5	12.5
Have you undergone any oral health/hygiene related program	No	35	87.5

Table 2: Analysis of Pre-test and Post-testknowledgescores regarding oral hygiene among school age childrens before and after Planned teaching programme. N=40

Level of Knowledge	Respondent Knowledge
Level of Knowledge	Pre test		Post test
	Frequency (f)	Percentage (%)	Frequency (f)	Percentage (%)
Inadequate (0-30%)	25	62.5	2	5
Moderate (31-60%)	14	35	15	37.5
Adequate (61-100%)	1	2.5	23	57.5

Table 2 shows the pre-test and post-test knowledge scores, majority of respondents, twenty five (62.5%) of the school going children had inadequate knowledge, fourteen (35%) of the school going children had moderate knowledge, while only one (2.5%) of them had adequate knowledge in the pretest regarding oral hygiene among school age children.The data in table 3 also shows the post- test shows that twenty three(57.5%) respondents had adequate knowledge regarding oral hygiene, followed by fifteen (37.5%) respondents who had moderate knowledge, two(5%) had inadequate knowledge regarding oral hygiene.

Table 3: Overall Mean and standard deviation percentage of the pre-test and post-test knowledge scores

Aspects of knowledge	Statements	Max. Score	Range Score	Respondents Knowledge
Aspects of knowledge	Statements	Max. Score	Range Score	Mean	SD	Mean (%)
Pre test	25	25	7-9	6.5	2.17	26.6
Post test	25	25	6-16	15.35	4.86	61.4

The table 3 reveals that the total mean percentage of the pre-test knowledge scores was 26.6% with total mean and standard deviation of 6.5 and 2.17 respectively. The post test knowledge score was 61.4% with the total mean 15.35 and 4.86 respectively.

Table 4: Difference betweenpre - test and post - test scores of knowledge regarding oral hygiene among school age children N=40

Aspect of knowledge

Pre test

Post test

Paired ‘t’value

P value

Mean

Overall result of Knowledge on oral hygiene among school going children

6.65

2.18

15.35

4.86

11.90*

P<0.05 (1.96)

The above table 4 represent the mean (6.65) of pre and post test (2.176) of oral hygiene, the paired ‘t’ test (11.90*) was carried out and it was found to be significant and P<0.05 level. Hence null hypothesis is rejected and research hypothesis was accepted. It is evidence that planned teaching programme was significantly effect on improving the knowledge regarding oral hygiene among school going children.

DISCUSSION:

In the pre-test the majority of the respondents, 25 (62.5%) had inadequate knowledge regarding oral hygiene among school-age children with the total mean percentage of the pre-test knowledge scores being 26.6% with a total mean and standard deviation of 6.65 and 2.17 respectively.The findings of the present study are consistent with the study findings conducted inBangalore India on the effectiveness of Structured Teaching Programme on Knowledge Regarding Oral Hygiene among School Childrens. The study revealed that among 30 school children, 2(6.66%) school children had adequate knowledge, 28(93.33%) school children had moderately adequate knowledge and there was no inadequate knowledge found in the post-test score. The mean pre-test knowledge score of school children was 10.1, whereas the mean post-test knowledge score was 18.8. The obtained ‘t” value was 10.48 which was found statistically significant at 0.05 levels.¹⁴

Another study findings were comparable and consistent and revealed that the result of the post-test score revealed that the structured teaching program had an impact on improving the level of knowledge regarding dental hygiene among middle school children. The overall mean score ofpre-tests was 14.91 with an S.D. 3.84, whereas in post-test the overall mean score of 23.01 with S.D. of 3.72. The t-test value was -8.1* which is statistically significant at p<0.005 level of significance. After the structured teaching program 68% of the students had average, 32% had a good level of knowledge and no one had poor level of knowledge regarding dental hygiene. The studyFinding implied that education had a vital role in improving the knowledge of school childrenregarding dental hygiene.¹⁵

A similar study was conducted on the effectiveness of a Planned Teaching Programme Regarding Dental Hygiene on Knowledge, Practice, and Selected Dental Indices among Primary School Children in Selected Schools at Kollam.The study result showed that the mean post-test of knowledge was 14.67 which was higher than the pre-test scores. Post-test score on practice was 15.15 which was higher than pre-test and score and the calculated‘t’ values of knowledge and practice were greater than table value, which concludes that there iseffectiveness of the planned teaching program on knowledge and practice among primary school children. On commuting‘t’ value for oral hygienic status including dental indices, calculated’ values were higher than table value.¹⁶

The findings of the study were also significant with an, Effectiveness of Planned Teaching Programme on Knowledge and Practices of oral Hygiene among School Children.Majority of the school children (67%) had unhealthy practice and the remaining 33% had healthy practice and in practice Majority of the school children (70%) had poor practice and the remaining 40% had good practice regarding oral hygiene among school children. The mean post-test knowledge (Mean±SD) 24.24±4.714 was significantly higher than the mean pre-test 13.05±3.546 score, t = 23.099, p<0.05 level. The mean post-test practice 1 (regarding oral hygiene) (Mean±SD) 47.86±6.462 was significantly higher than the mean pre-test 37.60±5.805score, t = 23.122, p<0.05 level. The mean post-test practice 2 (brushing technique) (Mean±SD) 7.94±1.613 was significantly higher than the mean pre-test 4.85±1.336 score, t = 17.290p<0.05 level. ¹⁷

LIMITATIONS:

The study was conducted in a single school with small sample size so its findings cannot be generalized to all schools in Bangalore.

CONCLUSION:

Good oral health and hygiene is very essential for childrens to maintain overall nutrition and general health.In the present study, the knowledge on oral hygiene was found to be inadequate before giving the planned teaching programme among school age children.Health education and planned teaching programmes regarding the importance of maintaining good oral health and hygiene and following proper routine practices like night brushing, diet modification with an increased intake of vegetables, fruits and reduction of sugar made item consumption and periodic dental check up to all the school children will play a very major role in the prevention of dental health problems and promotion of oral health and also Based on the findings of the study the following recommendations are forwarded

RECOMMENDATIONS:

· A similar study can be conducted by using experimental and control group.

· A similar study can be conducted using a large sample.

· A survey /Cross sectional study can be conducted by using large population including all other course students from health science stream.

ACKNOWLEDGEMENTS:

Authors are thankful to all the school children and parents and also school management for supporting to conduct study.

CONFLICT OF INTEREST:

ETHICAL APPROVAL:

The study was approved by the Institutional Ethics Committee.

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Received on 25.08.2021 Modified on 29.12.2021

Int. J. Nur. Edu. and Research. 2022; 10(4):305-309.

DOI: 10.52711/2454-2660.2022.00070