|Year : 2014 | Volume
| Issue : 3 | Page : 226-231
Knowledge, attitude, and practices toward oral health among school teachers in "Guntur city," Andhra Pradesh, India
Guntipalli M Naidu1, Viswanath2, K. V. N. R Prathap3, K Chaitanya Ram4, Garipineni Kiranmai5, Suresh Babburi6
1 Department of Public Health Dentistry, Drs. S and NR Siddhartha Institute of Dental Sciences, Chinaoutpally, Gannavaram, India
2 Department of Public Health Dentistry, SIBAR Dental College, Takkellapadu, India
3 Department of Public Health Dentistry, MAMATA Dental College, Khammam, Telangana, India
4 Department of Pedodontics and Preventive Dentistry, Drs. S and NR Siddhartha Institute of Dental Sciences, Chinaoutpally, Gannavaram, India
5 Department of periodontics, Guntur Medical College, Guntur, Andhra Pradesh, India
6 Department of Oral Pathology and Maxillofacial surgery, Drs. S and NR Siddhartha Institute of Dental Sciences, Chinaoutpally, Gannavaram, India
|Date of Web Publication||15-Nov-2014|
Guntipalli M Naidu
Department of Public Health Dentistry, Drs. S and NR Siddhartha Institute of Dental Sciences, Chinaoutpally, Gannavaram 521 101, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
Introduction: School teachers play an important role in the all-round development of children. Quite often, they play an important role in general health education as well as oral health education in children. To perform the above tasks, teachers should have required oral health knowledge and positive attitude about oral health. Objectives: The objective was to assess the knowledge, attitude, and practices about oral health among school teachers in Guntur city, Andhra Pradesh. Materials and Methods: A cross-sectional study was conducted, and data were collected with pretested self-administered questionnaire. A total of 248 school teachers was selected by simple random method from the list of primary and high school teachers working in Guntur city. Questionnaire consisted of seventeen questions on knowledge, attitude, and practice. Each favorable and unfavorable response was given a score of 1 and 0 respectively. Total score of 60% or more for each domain was considered "satisfactory" whereas < 60% as "unsatisfactory. Data were analyzed with SPSS-17 (Chicago Inc.,) and Chi-square, test was used to test the statistical significance among various variables. Results: A total of 248 school teachers was participated in this study, 64.9% of the teachers had satisfactory knowledge about oral health. About 194 (78.2%) had satisfactory attitude about oral health and around 191 (77%) teachers had satisfactory oral hygiene practice methods. Conclusion: Teachers required being further educated about oral health through an effective media to deliver oral health education to students.
Keywords: Attitudes, knowledge, practices, school teachers
|How to cite this article:|
Naidu GM, Viswanath, Prathap K, Ram K C, Kiranmai G, Babburi S. Knowledge, attitude, and practices toward oral health among school teachers in "Guntur city," Andhra Pradesh, India. J Indian Assoc Public Health Dent 2014;12:226-31
|How to cite this URL:|
Naidu GM, Viswanath, Prathap K, Ram K C, Kiranmai G, Babburi S. Knowledge, attitude, and practices toward oral health among school teachers in "Guntur city," Andhra Pradesh, India. J Indian Assoc Public Health Dent [serial online] 2014 [cited 2020 Mar 30];12:226-31. Available from: http://www.jiaphd.org/text.asp?2014/12/3/226/144808
| Introductio|| |
Schools provide an opportunity for learning new things that make them suitable for the presentation of oral health information. Foremost, is the fact that children, the potential recipients of such presentations, spend a considerable amount of time in this atmosphere. Moreover, children can be reached at a time when their health habits are forming, and programs can be made available to all the children, including those who may not have access to other sources of health information, like a dental clinic. 
Health education programs in the schools may be conducted by voluntary agencies such as public health agencies, Indian Dental Association, and private dental practitioners or be provided internally by school nurses and teachers. The advantages of using school teachers are the potential for improved continuity of instruction and lowered cost of the service. A possible disadvantage, however, is that such individuals may not have adequate preparation and knowledge to provide health education. 
Among these personnel, teachers may be unprepared to instruct their students about health and be unfamiliar with current oral health concepts. Several investigators suggest possible reasons for the lack of preparedness of teachers and provide some supporting evidence. 
According to the World Oral Health Report 2003, dental caries and periodontal diseases are the two most common oral diseases worldwide.  Studies have shown that preventive dental care leads to better oral health outcomes and gains in quality-of-life.  School children form a vital priority group that can be targeted for preventive care, as they are receptive to new knowledge, and desirable attitudes and practices can be formed comparatively easily at that age.  Teachers play a vital role educating school children about oral health.
Recent survey conducted in Chennai reported that > 60% of the teachers visited dentist only if they experienced any tooth pain, and 98.6% of the teachers brushed their teeth at least once a day. 
Elementary schoolteachers in Kanpur could identify traditional dental concepts of brushing frequency and toothbrush placement, but lacked understanding of newer methods of plaque control.  In addition, respondents were less inclined to accept administrative responsibilities in school oral health programs. The limited literature that reports teachers' knowledge and attitudes suggests that a further investigation is warranted to confirm previous findings and to determine whether regional differences occur in the acquisition of oral health concepts by these individuals. Periodic surveys also can assess whether dissemination of new information about oral health is progressing or not. Hence, the objective of this study was to assess the knowledge, attitude, and oral health practices among school teachers of Guntur city, Andhra Pradesh.
| Materials and methods|| |
Data were collected using a self-administered questionnaire. A questionnaire was constructed using questions from a similar study conducted by Loupe and Frazier in1983.  Seventeen questions were included in the final study, that is, eight knowledge - related, seven practice - related, and two attitude - related. Internal validity of the final questionnaire is tested with Cronbach's α (0.78). Each favorable and unfavorable response was given a score of 1 and 0, respectively. In the present study, knowledge, attitude, and practice > 60% is considered good level, between 40% and 60% is considered as the average level and < 40% is considered poor. 
The list of schools and number of teachers in each school were obtained from the District Educational Officer. A total of 1186 school teachers was present in 61 private and 267 government schools in Guntur city. A pilot study was conducted to test the validity and reliability of the questionnaire and for calculation of the sample size. Final study required a sample of 240 teachers to have a statistical power of 80% with 95% confidence interval. Assuming that 5% rejection to participate or incomplete answers, 255 individuals were selected for the purpose of the investigation by simple random sampling; prior intimation was given to all the participants about the data collection. Questionnaires were handed over directly to all the participants and completed questionnaires were collected on the same day.
Of 255, a total of 248 completely filled questionnaires was included in the final analysis (5 persons rejected to participate in survey and 2 questionnaires are incomplete). Ethical clearance was obtained prior to the study from Institutional Ethical Committee.
Statistical analysis was done with SPSS software(SPSS Inc. Released 2008. SPSS statistics for Windows, version 17.0 chicago SPSS Inc., and Chi-square test was applied to assess statistical significance. P < 0.05 was considered as significant.
| Results|| |
Present cross-sectional self-administered questionnaire study was done on 248 school teachers of Guntur city, Andhra Pradesh.
[Table 1] shows the gender-wise distribution of the study population in both high and primary schools. There were more number of teachers in primary classes (160) when compared to those in the higher school (88). Male teachers were more in the high schools (64) whereas female teachers were more in primary school. [Table 2] shows age-wise distribution of study population in various schools. The highest percentage of the study population was in the age range of 35-44 years (37.5%) while the lowest was below the age of 25 years (8.1%).
|Table 1: Gender-wise distribution of high school and primary school teachers |
Click here to view
[Table 3] shows the response for knowledge- and attitude-related questions. About 48.8% of study population stated that pain is not the only symptom for tooth problem; 71.4% of study population stated the appropriate response for cause of tooth loss, only 11.7% of the study population gave an appropriate response when asked about the age of initiation of tooth brushing in children. Only 24.6% of teachers have given appropriate response on the cause of tooth decay. About 73.4% of the whole study population had no appropriate knowledge on the cause of bleeding gums; 71.4% of the whole study population did not feel it is necessary to visit the dentist. About 46.4% of the study population gave appropriate response reasons for bad breath. Only 17.3% of study population had the knowledge that a fallen/displaced tooth can be replaced back to a natural position; 81.9% of school teachers felt that the dental treatment was expensive.
[Table 4] shows the response for oral health-related practice questions. About 94.8% have given an appropriate response on what cleaning aids one is to use to maintain oral hygiene. Only 18.5% were aware that the toothbrush is to be changed after a specific duration; 36.7% of study population brush their teeth more than once a day.
[Table 5] shows the overall comparison of knowledge, attitude, and practices between primary and high school teachers.
|Table 5: Comparison of mean scores related to knowledge, attitude, and practices between primary and high school teachers |
Click here to view
[Table 6] shows that the overall assessment of knowledge in the study population. The study showed that 51 (20.6%) had poor knowledge 161 (64.9%) had average knowledge, and 36 (14.5%) had good knowledge about oral health. An overall assessment of attitude of the study population showed that 28 (11.3%) had poor, 194 (78.2%) had an average attitude, and 26 (10.5%) good attitude toward oral health. On the overall assessment of oral hygiene (health) practices in the study population, the results showed that 25 (10.1%) had poor, 191 (77%) had an average, and 32 (12.9%) followed good oral hygiene practices.
[Table 7] and [Table 8] show that age group of 35-44 years had more knowledge, better attitude level than other age groups. The finding was statistically significant. The fact that 35-44 age group has a better attitude toward oral health is evident from the result which is statistically highly significant with (P < 0.00l).
|Table 6: Distribution according to levels of knowledge, attitude, and practices in the entire study population |
Click here to view
|Table 7: Distribution in the level of knowledge according to age groups |
Click here to view
|Table 10: Comparison of the percentage distribution of knowledge between males and females |
Click here to view
[Table 9] shows the distribution of the overall level of oral hygiene practices according to different age groups. The table indicates that, 35-44 years age group had good oral hygiene practices when compared to other age groups. The result obtained has high statistical significance (P < 0.001).
[Table 10] shows that there is no sexual predilection when the level of knowledge was compared (P < 0.09). Males had better the attitude when compared to the female population with (P < 0.609) but the finding is not statistically significant.
| Discussion|| |
Oral diseases are one of the most commonly and extensively effecting diseases of mankind, regardless of age, sex, location, or employment of an individual.  School teachers are being used as one of the best health personnel available worldwide to instruct their students about health and be familiar with the current oral health concept. ,,
The present cross-sectional self-administered questionnaire study was conducted in order to obtain data regarding the oral health knowledge, attitude, and oral hygiene practices among the school teachers of Guntur city as there were no available data so far.
The results of the current study showed that among the study population, the level of knowledge of high school teacher was 9.68 ± 3.32 compared to primary school teachers which was only 7.45 + 2.64. This finding is statistically significant (P < 0.001). The probable reason for this could be the level of education as high school teachers are graduates whereas primary school teachers are only diploma holders. The finding is in accordance with the study conducted by Al-Beiruti in which the teachers with higher education had a better knowledge on the oral hygiene practices than the teachers with diploma education. 
The attitude level among the study population in the present study showed statistically significant difference (P < 0.001) between high school (3.99 ± 1.66) and primary school teachers (3.08 ± 1.61) which is in concurrence with the study findings of studies by Vinaya Pai et al.  and Goel and Shetty.  The probable reason for this could be the socioeconomic status, psychosocial development of the study population where high school teachers are better when compared to that of higher primary school teachers.
In the present study, the oral hygiene practices among the study population varied significantly between higher primary school teachers (5.59 ± 1.92) and that of the high school teachers (6.77 ± 2.12). The difference has high statistical significant (P < 0.001) which is in accordance with the study results of the study by Petersen et al. 
Anything > 60% was considered good level, between 40% and 60% was considered as the average level and < 40% was considered poor in the present study. 
The current study showed that about 51 (20.6%) had poor, 161 (64.9%) average, and 36 (14.5%) had good knowledge about the oral health. The probable reasons could be literacy level which always plays an important role especially in a country as massively populated as India.
About 28 (11.3%) had poor, 194 (78.2%) average, and 26 (10.5%) had a good attitude toward the oral health. The reasons attributed to this finding are that the economic status, social factors, their cultural background, and the importance they give to oral health.
The overall oral hygiene practices among the study population showed that majority of the study population (77%) had an average attitude toward oral hygiene practice. This could be due to the level of accessibility for dental care, affordability, availability, and acceptability of the oral hygiene practices among the study population.
In the present study, it was found that the overall knowledge, attitude, and oral hygiene practice levels are better in high school teachers when compared to that of primary school teachers. The probable reason for this could be due to the educational level, socioeconomic level, and psychosocial characteristics of the study population which is in agreement with the study results of Loupe and Frazier, Dileep et al. 
| Conclusion|| |
Even though the study had showed that the teachers in the study population had a fair knowledge, attitude, and oral hygiene practices, but the knowledge about oral health and current methods of prevention is incomplete and need to be educated and update their knowledge to bridge the gap between the dentist and the child.
| References|| |
Lang P, Woolfolk MW, Faja BW. Oral health knowledge and attitudes of elementary schoolteachers in Michigan. J Public Health Dent 1989;49:44-50.
Walia T, Tewari A, Chawla HS, Goyal A. Effect of training school teachers on KAP and dental caries of 7-9 year old school children. J Indian Soc Pedod Prev Dent 2000;18:47-53.
Petersen PE. The World Oral Health Report 2003: Continuous improvement of oral health in the 21 st
century- the approach of the WHO Global Oral Health Programme. Community Dent Oral Epidemiol 2003;31 Suppl 1:3-23.
Chachra S, Dhawan P, Kaur T, Sharma AK. The most effective and essential way of improving the oral health status education. J Indian Soc Pedod Prev Dent 2011;29:216-21.
Sathe PV, Mali A. Oral Health Education. Textbook of Community Dentistry. 2 nd
ed. Hyderabad: Paras Publishing; 2001. p. 210-22.
Bengley G, Joseph J, Saravanan S, Arumugham IM. Oral health knowledge, attitude and practices of school teachers in Chennai. J Indian Assoc Public Health Dent 2010;15:85-90.
Dileep CL, Basavaraj P, Jayaprakash K. A survey on knowledge and attitudes and practices of oral hygiene practices among school teachers in Kanpur city. J Indian Assoc Public Health Dent 2006;8:57-60.
Loupe MJ, Frazier PJ. Knowledge and attitudes of schoolteachers toward oral health programs and preventive dentistry. J Am Dent Assoc 1983;107:229-34.
Hartayu TS, Mi MI, Suryawati S. Improving of type 2 diabetic patients' knowledge, attitude and practice towards diabetes self-care by implementing Community-Based Interactive Approach-diabetes mellitus strategy. BMC Res Notes 2012;5:315.
Casamassimo PS. Dental disease prevalence, preventon, and health promotion: The implications on pediatric oral health of a more diverse population. Pediatr Dent 2003;25:16-8.
Sgan-Cohen HD, Saadi S, Weissman A. Dental knowledge and attitudes among Arab schoolteachers in northern Israel. Int Dent J 1999;49:269-74.
Goel P, Shetty V. Knowledge, attitude and practice of dental caries and periodontal disease prevention among primary school teachers in Udupi municipality. J Indian Soc Pedod Prev Dent 1997;15:124-9.
Mwangosi IE, Nyandindi U. Oral health related knowledge, behaviours, attitude and self-assessed status of primary school teachers in Tanzania. Int Dent J 2002;52:130-6.
Al-Beiruti N. Oral health behaviour among a sample of schoolteachers, physicians and nurses in the Syrian Arab Republic. East Mediterr Health J 1997;3:258-62.
Pai V, Sequeria P, Rao A, Kundabala M. Dental awareness among Kannada and English medium primary school teachers in Mangalore city. J Indian Assoc Public Health Dent 2006;7:7-12.
Petersen PE, Danila I, Samoila A. Oral health behavior, knowledge, and attitudes of children, mothers, and schoolteachers in Romania in 1993. Acta Odontol Scand 1995;53:363-8.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10]