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 Table of Contents  
Year : 2018  |  Volume : 6  |  Issue : 2  |  Page : 214-217

Evaluation of oral health awareness among public school children – A school-based study from Bhopal

1 Department of Oral Pathology and Microbiology, Peoples Dental Academy, Bhopal, Madhya Pradesh, India
2 Department of Oral Pathology and Microbiology, Peoples College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India

Date of Web Publication27-Dec-2018

Correspondence Address:
Dr. Monal B Yuwanati
C-Block, Department of Oral Pathology and Microbiology, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/amhs.amhs_86_17

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Background: Oral diseases such as tooth caries, gingivitis, and bad breath are still major dental health-care concern, especially in children in the developing countries. Oral disease prevalence is high in school-going children, and there is inadequate information regarding the awareness among them. To evaluate the level of oral awareness among school children, a study was carried out in middle school. Materials and Methods: The present questionnaire study included middle school children from different socioeconomic background of the socioeconomic group. The consent from the school as well as the parents/guardians of children was taken. The trained dental surgeon distributed questionnaire among the children. Completely answered questionnaire was collected. The observations were reviewed and analyzed. Results: The response rate for school children was 81.27%. It was observed the age group of 11–14 years was very well aware of oral hygiene care and maintenance 67% and 55%, respectively. Seventy percent were sure about dietary food items causing dental decay. Toothbrush and paste are the best teeth cleaning aids as per this study group analysis. Conclusion: The findings of the present study reveal different aspects specifically directed toward the current scenario of oral health awareness among middle school children. There is a need for comprehensive dental care plan for school children. School-based educational intervention should be established with a focus on oral self-care and oral health education.

Keywords: Attitude, awareness, oral health, school

How to cite this article:
Mhaske S, Yuwanati MB, Keswani H, Jain L. Evaluation of oral health awareness among public school children – A school-based study from Bhopal. Arch Med Health Sci 2018;6:214-7

How to cite this URL:
Mhaske S, Yuwanati MB, Keswani H, Jain L. Evaluation of oral health awareness among public school children – A school-based study from Bhopal. Arch Med Health Sci [serial online] 2018 [cited 2023 Mar 31];6:214-7. Available from: https://www.amhsjournal.org/text.asp?2018/6/2/214/248672

  Introduction Top

Oral diseases such as tooth caries, gingivitis, and bad breath are still major dental health-care concern, especially in children in the developing countries. The prevention of dental caries has been an impending challenge for the dental health profession since many decades. Scientific research continues to make progress in identifying the best practices for diagnosing, treating, and preventing dental caries. Newer strategies that emphasize caries prevention and conservation of tooth structure are slowly replacing decade's long traditional approaches for treating carious lesions in a surgical manner. Dental caries incidence in India is around 62.02%. Last few decades have seen a reduction in the severity and incidence of dental caries among the children in India as a result of improvement and advance in dental treatment and technology.[1] These changes are only observable in certain pockets of city or country. There are contradictory dental caries incidences among child population within the same locality irrespective of dental facilities. Numerous studies have conducted to find the attributes for the difference. The lower economic background is one of the attributes as indicated by some of the studies.[2] They have tried to correlate these differences to the lack of information about basic oral health care, especially at school level.[3] The level of oral health-care knowledge in the middle school children can play a very crucial role, as their dentition is in a transition phase as well as child see the development of cognitive abilities. Understanding of level of oral health knowledge can help oral health agencies to develop an oral health-care policy in the prevention of dental problems in very early stage. The collected information provides data for the future research and can be used in comparing the child's oral health attitudes at different school or state. The purpose of this cross-sectional study conducted at the middle school in Bhopal, Madhya Pradesh, was to evaluate the dental health-care knowledge and attitude.

  Materials and Methods Top

The cross-sectional study was conducted using questionnaire. The questions were framed to obtain information from the single middle school children about oral health. The experts from public health dentistry and oral pathology department reviewed the questionnaire for validation with the help of a pilot study. The Institutional Ethics Committee reviewed the study and permission was obtained. Approval of the school administration was obtained after the purpose of the study, and the procedures that would be followed during its conduct were explained to the principal of upper primary schools. The principal was requested to inform the students and their parents about the study, and a day was set to collect the data. The data were collected using questionnaire that included their perception about their own oral health status, oral health-care attitude, and oral disease prevention aspect.

Study design

A pilot study was carried out on 60 children, aged 11–14 years, from middle school to determine the feasibility of the study. Depending on the response rate (80%) obtained, 95% confidence level, and 5% margin of error, the sample size was determined to be 550. The total of 550 school children was selected with simple random sampling procedure.

Study setting

A questionnaire-based cross-sectional study was conducted in the middle school children. Five hundred and fifty students between 11 and 14 years were approached to participate. The consent was obtained in the presence of school teachers and parents. The questionnaire written in English had questions about oral health-care perception and knowledge. Questionnaires were distributed, filled, and the information data were carefully tabulated and analyzed.

Inclusion criteria

  • Children's between 11 and 14 years
  • Can read and write English language
  • Consented to participated.

Exclusion criteria

  • Not able to read and write English language
  • Unwilling to consent.

Date collection

Of 550 children asked to participate, 447 children have filled and returned the forms. The data were checked for completeness and transferred to data sheet.

  Results Top

The response rate was 81.27%. The study sample included 236 females (42.90%) and 314 males (57.09%). Participants' mean age was 13.5 years [Table 1].
Table 1: Demographic data and questionnaire response

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Oral health perception and knowledge

Sixty-seven percent children's said that they think that their teeth and gums are good and 55% feels it necessary to maintain teeth and gums in good condition. Children were also worried about foul breath (78%) but not worried about change in color of teeth (45%) even after seeing yellowish or white sticky deposits (63%). Seventy percent said that they are aware of what causes tooth decay which includes chocolates and sweet foods.

Oral health prevention

Seventy-one percent said that cleaning keeps the teeth and gums in good condition. Thirty-five percent said that they know the correct brushing technique and 55% said that parent has told them correct technique. Eighty-three percent clean their teeth using tooth brush-paste, whereas 17% use finger and powder. Forty percent cleaned their teeth more than once daily.

Oral health-care attitude

Only 30% of participants inform parents about change in the appearance of teeth or gums. About 20% of participants feel that there is a need to visit dentist regularly for routine dental checkup. Most of participants (77%) find it difficult to follow dentist advice in case they visit to dental clinic.

  Discussion Top

Dental caries is the prevailing dental disease of childhood. Despite recent scientific advances and the fact that caries is preventable, the disease continues to be a major public health problem. Due to changing trends in eating and dietary habits, the caries incidence is markedly increasing in the developing countries.[4] Children need proper guidance and information about oral health and preventive measures to reduce the caries prevalence at an early stage of childhood. Several studies reported the prevalence of dental caries among the school children's as high as 63.2%–85%.[5]

In interpreting the findings of the present study, it is important to acknowledge possible limitations. As this is a self-reporting study, we cannot ascertain the impact of their knowledge and perception on oral health status. Despite limitations, it can give insight to the level of oral health-care knowledge of school children.

The child's perception of his/her own oral health is a significant factor for influencing the parent's attention toward the child's oral health need. A study observed that 50% think that it is necessary to maintain. Children are aware of the importance of oral health care. About 57% of students considered their oral health to be very good which is similar to the findings in a study conducted in by Mehta et al. in 2012.[6] Data collected from the questionnaire reflect that students are well aware of the oral hygiene. Majority students have emphasized on the routine dental checkup for the prevention of oral health problems.

Regarding the prevention of dental caries, majority were sure about toothbrushing as method of preventing tooth decay. It was higher in other studies.[7],[8]

Thirty-two percent of the children brush teeth twice daily which was significant as compared to other studies.[9],[10] This is significantly more than that found by the study done by Mehta et al.[10] and Harikiran et al.[11] but also comparable to the study done by Zhu et al.[12] Around 15% of the participants did not clean their teeth daily which is also much less than Mehta et al. study which may be due increase in awareness regarding oral health care in both parents and children in this population group.

Majority of children reported that they use toothbrush and paste. In the present study, most of the school children 81% (71.4%) used toothbrush and toothpaste for cleaning their teeth, which is consistent and comparable with findings from other studies by El-Qaderi and Taani et al.[13] and Mehta et al.[10] The use of other recommended oral hygiene methods such as dental floss and mouthwash was rare. Similar observations were reported among north Jordanian school children.[7] This could be attributed to the lack of oral health education. There was good awareness among the children regarding the importance of regular toothbrushing for caries prevention (83.2%); this finding is similar to that in the study of Varenne et al.,[12] Ramroop et al.,[14] and Mehta et al.[10]

Children informed less frequent visit to the dental clinic. It was contrast to the findings of Gauri Kakatkar et al.[7] and El-Qaderi et al.[15] However, children (86%) also had a positive attitude toward dentist visit regularly to keep their teeth healthy. Children (76%) were not fearful to visit to the dentist. They were responsive and curious in listening to the advice regarding the oral hygiene/health maintenance. The finding was consistent with other studies.[10],[16] The awareness of the children regarding the fluoride or fluoridated toothpaste (26.5%) was slightly high to that from the study done by Mehta et al.,[10] Varenne et al.,[16] and Wyne et al.[17],[18] According to Al-Omiri et al.,[7] fluoride awareness was 77%–87%. It was higher as compared to our study (12.6%). Wong et al.[8] found between 16% and 37% among Chinese children.

One of the limitations of the study was sample size. Furthermore, even after all possible measures to standardize the presentations, it is possible that factors such as barriers of communication and efficiency of educators could have had an effect on the outcome of the study.

  Conclusion Top

It may be concluded that the present study showed oral health awareness among the school children is good which could be attributed to easy accessibility to the dental health-care facility. Few rural areas still need further push to decrease the prevalence of dental caries and oral disease by incorporating the oral health education of the school children and the development of school-based dental health programs.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization. Resolution WHA60.17 Oral Health: Action Plan for Promotion and Integrated Disease Prevention. Geneva, Switzerland: World Health Organization; 2007.  Back to cited text no. 1
White DA, Chadwick BL, Nuttall NM, Chestnutt IG, Steele JG. Oral health habits amongst children in the United Kingdom in 2003. Br Dent J 2006;200:487-91.  Back to cited text no. 2
Chhabra N, Chhabra A. Parental knowledge, attitudes and cultural beliefs regarding oral health and dental care of preschool children in an Indian population: A quantitative study. Eur Arch Paediatr Dent 2012;13:76-82.  Back to cited text no. 3
Bagramian RA, Garcia-Godoy F, Volpe AR. The global increase in dental caries. A pending public health crisis. Am J Dent 2009;22:3-8.  Back to cited text no. 4
Moses J, Rangeeth BN, Gurunathan D. Prevalence of dental caries, socio-economic status and treatment needs among 5 To 15-year-old school going children of Chidambaram. J Clin Diagn Res 2011;5:146-15.  Back to cited text no. 5
Mehta A, Kaur G. Oral health-related knowledge, attitude, and practices among 12-year-old school children studying in rural areas of Panchkula, India. Indian J Dent Res 2012;23:293.  Back to cited text no. 6
al-Tamimi S, Petersen PE. Oral health situation of school children, mothers and schoolteachers in Saudi Arabia. Int Dent J 1998;48:180-6.  Back to cited text no. 7
Wong MC, Lo EC, Schwarz E, Zhang HG. Oral health status and oral health behaviors in Chinese children. J Dent Res 2001;80:1459-65.  Back to cited text no. 8
Currie C, Gabhainn SN, Godeau E, Roberts C, Smith R, Currie D, et al., eds. Inequalities in young people's health: HBSC international report from the 2005/06 Survey. Health Policy for Children and Adolescents, No. 5. Copenhagen, Denmark: WHO Regional Office for Europe; 2008.  Back to cited text no. 9
Gill P, Chestnutt IG, Channing D. Opportunities and challenges to promoting oral health in primary schools. Community Dent Health 2009;26:188-92.  Back to cited text no. 10
Harikiran AG, Pallavi SK, Hariprakash S, Ashutosh, Nagesh KS. Oral health-related KAP among 11- to 12-year-old school children in a government-aided missionary school of Bangalore city. Indian J Dent Res 2008;19:236-42.  Back to cited text no. 11
[PUBMED]  [Full text]  
Varenne B, Petersen PE, Ouattara S. Oral health behaviour of children and adults in urban and rural areas of Burkina Faso, Africa. Int Dent J 2006;56:61-70.  Back to cited text no. 12
El-Qaderi SS, Taani DQ. Oral health knowledge and dental health practices among school children in Jerash district/Jordan. Int J Dent Hyg 2004;2:78-85.  Back to cited text no. 13
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. 14
Kakatkar G, Nagarajappa R, Bhat N, Prasad V, Sharda A, Asawa K, et al. Parental beliefs about children's teething in Udaipur, India: A preliminary study. Braz Oral Res 2012;26:151-7.  Back to cited text no. 15
Zhu L, Petersen PE, Wang HY, Bian JY, Zhang BX. Oral health knowledge, attitudes and behaviour of adults in China. Int Dent J 2005;55:231-41.  Back to cited text no. 16
Wyne AH, Chohan AN, Al-Dosari K, Al-Dokheil M. Oral health knowledge and sources of information among male Saudi school children. Odontostomatol Trop 2004;27:22-6.  Back to cited text no. 17
Wyne AH, Al-Ghorabi BM, Al-Asiri YA, Khan NB. Caries prevalence in Saudi primary school children of Riyadh and their teachers' oral health knowledge, attitude and practices. Saudi Med J 2002;23:77-81.  Back to cited text no. 18


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