INTRODUCTION:

The worldwide rapidly growing burden of chronic disease is closely linked to unhealthy environment and lifestyle that includes diets rich in sugar, widespread use of tobacco and excessive consumption of alcohol. Most oral disease is closely related to these factors and is also dependent on clean water adequate sanitation, proper oral hygiene and appropriate exposure to fluorides. (WHO - 2005). India is the sixth biggest country by its area but it is the second most populous country. The developing economy, lack of qualified dental manpower in rural areas and poor awareness towards oral health has contributed for steady raise in the prevalence of dental disorders in children in the last few decades.

There is a strong relationship between oral health and overall health of the individual. The mouth is a mirror that can reflect the health of the rest of our body. Numerous recent studies investigating the mouth body connection have suggested an association between oral health and general health. The World Health Organization defined oral health as ‘‘the retention throughout life of a functional, aesthetic and natural dentition of not less than 20 teeth and not requiring prosthesis”. There has been a tremendous increase in incidence and severity of oral health problems since the last few decades. So it is very much important to prevent the outbreak of dental disease among population of India. An individual may be considered as healthy if she or he has no dental caries or periodontal disease. However large majority of the population would be considered unhealthy as oral diseases are common and often untreated.

NEED FOR THE STUDY:

David Satcher- When children’s oral health suffers, so does their ability to learn. The high prevalence and incidence of oral diseases qualifies it as major public health problem. In all regions of the world, the greatest burden of the oral disease is on disadvantaged and socially marginalized population. But poverty the world over is not the sole factor limiting access to oral health care. In the developing world a shortage of economic resources often comes with the lack of reliable information on the available work force and the epidemiology of oral disease for health authorities to plan cost effective interventions to improve oral health. (world health organization) promoting oral health is a cost effective strategy to reduce the burden of oral disease and maintain oral health and quality of life. It is also an essential part of health promotion in general or oral health is a determinant of general health and quality of life. This is such a high proportion of the population. The dental diseases among children are increasing year by year. A very extensive and comprehensive national health survey conducted in 2004 throughout India has shown that dental caries in 51.9% in 5 years old children and 63.1% in 15 years old teenager.

PREVALENCE:

The National health survey (2004) reported that in Maharashtra approximately 79.7% of children under 5 years of age have dental caries. Currently, no data are available on caries prevalence or possible etiological factors for preschool children in Navi Mumbai, Maharashtra. Therefore, an investigation to gather information on caries prevalence and any possible associations with feeding habits and oral care practices was undertaken.

METHODOLOGY:

A Descriptive research approach was used in this study. Research design adopted was descriptive research design with one group pretest and post test method. The sample selected based on the inclusion and exclusion criteria in selected school. The sample size was adopted for the study is 60 children in VI, VII and VIII Standard. Sample technique used for the study random sampling by lottery method. Semi structured questionnaire was used to assess the knowledge of the school children. Questionnaire is considered as the most appropriate instrument to elicit the response from the literate subjects. The study proceeded after the sanction by institutional ethic committee and permission was opted from the government officials to conduct the study in selected school. Informed consent was taken from all the participants and confidentiality and anonymity was maintain throughout the procedure. Tool used for the study was divided under four sections with consent forms.

RESULTS:

Description of socio demographic variables of school childrens:

Age: 60 school children 35(58.3%) were in the age of 11-12 years, 25(41.66%) were within the age 13-14 years and none of them were above 14 years.

Sex: 60 subjects studied 30(50%) of school children were male and 30(50%) of school children were females.

Class in which studying: 60 school children studied all are equally distributed, 20(33.33%) in each class VI, VII, VIII.

Education of father: 7(11.66%) were illiterate. 12(20%) had primary education, 14(23.33%) studied up to high school and 13(21.66%) were studied up to higher secondary and 14(23.33%) were graduates.

Education of mother: 16(26.66%) were graduate, 15 (25%) were studied up to high school, 14(23.33%) has completed higher secondary, 9(15%) were studied up to primary education level and 6(10%) were illiterate.

Occupation of father: 60 subjects studied 29(48.33%) were private employees, 18(30%) were farmers, 11(18.33%) were laborers, 2(3.33%) were government employees and none of them were unemployed.

Occupation of mother: 25(41.66%) of mothers of school children were unemployed, 12(20%) were farmers, 10(16.66%) were laborers, 9(15%) were doing private job and 4(6.66%) were government employees.

Monthly income of family: 20(33.33%) were in the category of Rs 2000- Rs 3000, 19(31.66%) were in the category of Rs 4000 and above, 11(18.33%) were Rs 3000-Rs 4000 and 10(16.66%) were below Rs 2000.

Place of residence: 51(85%) were from rural area and remaining 9(15%) from urban area.

Source of water supply: 60 schools going children by source of water supply. Of these 53(88.33%) were using well water, 7(11.66%) were using public water supply and none of them were using bore well water.

Oral hygiene: 60 subjects studied 22(36.66%), were received the information from parents, 19(31.66%), were received from teachers, 12(20%) from television, 4 (6.66%) from news papers and 3(5%) got the information from health workers.

Section- II Assessment of knowledge level of school children regarding oral hygiene before structured teaching programme.

Table1.1 Pertest knowledge level on oral hygiene among school Children. N=60

Knowledge level	Respondents
Knowledge level	Number	%
Inadequate (<50%)	27	45
Moderate (50-75%)	33	55
Adequate (>75%)	0	0
Total	60	100

The pretest knowledge level reveals inadequate, moderate, and adequate level. Table.1.1 Depicts that 33(55%) of respondents belongs to moderate level and 27(45%) belongs to inadequate level and none of them had adequate level of knowledge

Table 1.2 pretest knowledge score on oral hygiene among school children. N=60

Aspect	Max score	Range score	Respondents’ knowledge
			Mean	Mean (%)	SD (%)
Pre test	58	19-41	29	50	4.36

Table 1.2 depicts that the overall pretest knowledge score of school children regarding oral hygiene. It was found to be 50% with SD 4.36%.

Table 1.3 Aspect wise pretest mean knowledge score on oral hygiene among school children before structured teaching programme. N=60

S No	Aspects	Max score	Range score	Respondents’ knowledge
S No	Aspects	Max score	Range score	Mean	Mean (%)	SD (%)
1	Dentition	12	3-9	4.933	41.10	1.493
2	Oral hygiene	19	8-15	11.25	59.21	1.946
3	Oral problems and prevention	27	6-19	12.88	47.70	2.98
Combined		58	19-41	29	50	4.36

The above table 1.3 presents the pretest mean knowledge score on oral hygiene among school children before structured teaching programme. The mean, mean score percentage and standard deviation percentage based on maximum possible scores of each area before the structured teaching programme were explicated and displayed.

The pretest mean knowledge score regarding dentition before structured teaching programme was 4.933 with standard deviation 1.493%. The respondents had 11.25 mean knowledge score with standard deviation 1.946% regarding oral hygiene. The subjects had 12.88% of mean knowledge score with standard deviation 2.98% regarding oral problems and prevention. The pretest knowledge means score percent 41.10% regarding dentition, 59.21% regarding oral hygiene and 47.70% regarding oral problems and prevention.

Seection – III: assessment of knowledge level of school children regarding oral hygiene after structured teaching programme.

Table 2.1: Post test knowledge level on oral hygiene among school children. N=60

Knowledge level	Respondents
Knowledge level	Number	%
Inadequate (<50%)	-	-
Moderate (50-75%)	37	61.66
Adequate (>75%)	23	38.33
Total	60	100

The post test knowledge level reveals inadequate, moderate and adequate level. Table 2.1 depicts that 37 (61.66%) of respondents belongs to moderate level and 23 (38.33%) of respondents belongs to adequate level of knowledge.

Table 2.2: Post test knowledge score on oral hygiene among school children. N=60

Aspect	Max score	Range score	Respondents’ knowledge
			Mean	Mean (%)	SD (%)
Post test	58	31-52	43.11	74.32	4.69

Table 2.2 depicts that the overall post test knowledge score on oral hygiene among school children was 74.32% with SD 4.69%.

Table 2.3 aspect wise posttest mean knowledge score on oral hygiene among school children after structured teaching programme. N=60

Aspects

Max score

Range score

Respondents’ knowledge

Mean

Mean %

SD (%)

Knowledge on dentition

4-12

8.65

72.08

1.93

The post test mean knowledge score regarding dentition after structured teaching programme was 8.65 with standard deviation 1.93 %. The respondents had 15.75 of mean knowledge score with standard deviation 1.62% regarding oral hygiene. The subjects had 18.65% of mean knowledge score with standard deviation 1.01% regarding oral problems and prevention. The post test knowledge means score percent 72.08% regarding dentition, 82.89% regarding oral hygiene and 69.07% regarding oral problems and prevention.

Section IV: Comparison of Knowledge Level of School Children Regarding Oral Hygiene Before and After Structured Teaching Programme

Table 3.1 pre and post test knowledge on oral hygiene among school children before and after structured teaching programme.

N=60

Aspect	Respondents’ knowledge
	Pretest		Post test
	No	%	No	%
Inadequate	27	45	-	-
Moderate	33	55	37	61.66
Adequate	-	-	23	38.33
Combined	60	100	60	100

Fig1.1 pre and post test knowledge on oral hygiene among school children before and after structured teaching programme.

Table 3.1 and figure 1.1 shows the respondents knowledge level before and after structured teaching programme. In pretest 27(45%) had inadequate knowledge but 0 % in post test. 33(55%) were moderate in pretest, 37(61.66%) in post test.

Adequate level 0% in pretest but in post test it increased to 23(38.33%).

Table 3.2 pre and post test knowledge score on oral hygiene among school children before and after structured teaching programme.

N=60

Aspect	Max score	Range score	Respondents’ knowledge			Paired t Test
Aspect	Max score	Range score	Mean	Mean %	SD (%)	Paired t Test
Pre test	58	19-41	29	50	4.36	20.22*
Post test	58	31-52	43.11	74.32	4.69
Enhancement	58	12-11	14.11	24.32	0.33

Fig 1.2 pre and post test knowledge score on oral hygiene among school children before and after structured teaching programme.

Significant at 5% level, t (0.05, 59 df) = 2.00

The table 3.2 and figure 1.2 shows that the overall knowledge score on oral hygiene among school children in pretest and post test which reveals the post test mean knowledge score found higher 74.32 with SD of 4.69% when compared with pretest mean knowledge score value which was 50 with SD of 4.36%.

The statistical paired t test implies that the difference in the pretest and post test knowledge score found statistically significant at 5% level p<0.05. The paired‘t’ test worked out be 20.22 reveals that there exist a statistical significance. The enhancement score indicating the impact of effectiveness of structured teaching programme.

Fig 1.3 Aspect wise pre and post test mean knowledge score on oral hygiene

Depicts the aspect wise mean knowledge score of pre test and post test. In the aspect of dentition pre test mean score 41.10% and the post test mean score 72.08% with an enhancement in the knowledge by 30.96%. Regarding oral hygiene pre test mean score was 59.21% and the post test mean score was 82.89% with an enhancement in the knowledge by 23.688%. Regarding oral disease and prevention pre test mean score was 47.70% and the post test mean score was 69.07% with an enhancement in the knowledge by 21.37%. The statistical paired t test incites that the enhancement in the mean knowledge score found to be significant (p<0.05) revealing the effectiveness of structured teaching programme for all aspects.

Table 3.4. Outcome of paired t test analysis.

S. No	Variable	Differences In Mean	t- Value	df	P-Value
1	Knowledge	24.32	20.22	59	0.05

In view of inferring the statistical significance of increase in the knowledge of school children regarding oral hygiene, the paired t test worked out to compare the pre and post test knowledge, was observed to be 20.22 which was statically significant (t value = 20.22, df= 59) at 0.05 level, i.e. significant. It implies the effectiveness of structured teaching programme in gaining the knowledge on oral hygiene among school children. There by the research hypothesis H₁ is accepted.

DISCUSSION:

Programme on knowledge regarding oral hygiene among school children and the basic aim of the present study was to evaluate the effectiveness of structured teaching to find out the relationship between pretest knowledge score with selected demographic variables. the discussion is delineated and formulated in accordance with the outlined objectives of the research, under the following headings. socio demographic variables. analysis of effectiveness of structured teaching programme. association between socio demographic variables with pretest knowledge. socio demographic variables 58.33% of the subjects were below 13 years, of age and 41.66% of the subjects were above 13 years. in this study 50% were male and 50% of the subjects were females.among the subjects 33.33% were selected from vi, vii and viii standards.most of the subject’s fathers (88.4%) were literate and 11.66% were illiterate.most of the subject’s mothers (90%) were educated and 10% were uneducated.in this study 51.66% of the subjects were working in government and private sector and 48.33% were laborers.more than half of the subject’s mothers (58.34%) were employed and 41.66% were unemployed. 51.66% of the subjects had monthly income less than rs 3000/- month and 48.33% of the subjects had monthly income more than Rs 3000/-.

Majority of the subjects (85%) were residing in rural area and where as 15 % of the subjects were residence of urban area. Most of the subjects 88.33% were using well water where as 11.66% were using public water supply.Majority of the subjects 93.33% had previous knowledge on oral hygiene and 6.66% not had previous knowledge on oral hygiene.It was observed that 2.66% of the subjects received the information from news papers and television and 73.33% of the subjects received the information from parents, teachers and health workers. Analysis of effectiveness of structured teaching programme in pretest 27(45%) had inadequate knowledge but 0 % in post test. 33(55%) were moderate in pretest, 37(61.66%) in post test. Adequate level 0% in pretest but in post test it increased to 23(38.33%). School children had inadequate knowledge regarding oral hygiene. Structured teaching programme increased the knowledge of school children regarding oral hygiene.The mean knowledge score percentage of pretest was 50%.The mean knowledge score percentage of post test was The post tests mean score percentage of knowledge was higher than the pretest mean score.The paired t test was significant (p<0.05) i.e., the intervention was effective in increasing knowledge. The paired t test was significant (p<0.05) i.e., the intervention was effective in increasing knowledge.

CONCLUSION:

The conclusion drawn from the findings of the study. The subjects had inadequate knowledge regarding oral hygiene. The structured teaching program about structure of teeth, dentition and importance of oral hygiene, methods of brushing, diets for oral health, oral problems and its prevention was found to be effective in improving the knowledge of school children regarding oral hygiene. School children had inadequate knowledge regarding oral hygiene.Structured teaching programme increased the knowledge of school children regarding oral hygiene.The mean knowledge score percentage of pretest was 50%.The mean knowledge score percentage of post test was The post tests mean score percentage of knowledge was higher than the pretest mean score.The paired t test was significant (p<0.05) i.e., the intervention was effective in increasing knowledge. The paired t test was significant (p<0.05) i.e., the intervention was effective in increasing knowledge.

ACKNOWLEDGEMENT:

The researcher would like to acknowledge the ethical committee and selected colleges and all the participants for their support in the study.

CONFLICT OF INTEREST:

There are no conflicts of interest.

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5. Salunke, Subhash; Shah, Vinod; Ostbye, Truls; Gandhi, Anjali; Phalgune, Deepak, Ogundare, Matilda Olajumoke; Sable, Vaidehi. Prevalence of Dental Caries, Oral Health Awareness and Treatment-Seeking Behavior of Elderly Population in Rural Maharashtra. Indian Journal of Dental Research. 2019; 30(3): 332-336 DOI: 10.4103/ijdr.IJDR_356_17 Available from URL: https://journals.lww.com/ijdr/fulltext/2019/30030/prevalence_of_dental_caries,_oral_health_awareness.3.aspx

Received on 09.11.2024 Revised on 14.12.2024

Accepted on 13.01.2025 Published on 18.02.2025

Available online from March 10, 2025

Int. J. of Advances in Nursing Management. 2025;13(1):55-60.

DOI: 10.52711/2454-2652.2025.00012

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