|Year : 2014 | Volume
| Issue : 4 | Page : 312-316
Knowledge on management of traumatic dental injuries among school-teachers in Lucknow
Sourav Sen1, Sabyasachi Saha2, GV Jagannatha2
1 Department of Public Health Dentistry, Sharad Pawar Dental College, Wardha, Maharashtra, India
2 Department of Public Health Dentistry, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
|Date of Web Publication||24-Dec-2014|
Sharad Pawar Dental College, DMIMS, M 5/5, Meghdootam Apartment (Staff Quarter), Sawangi (Meghe), Wardha 442 004, Maharashtra
Source of Support: None, Conflict of Interest: None
Introduction: Dental trauma is one of the most important oral health problems in children. Most of the time these unwanted situations occurred in school premises. Hence, school teachers are the first to attend these incidents. Aim: To evaluate the knowledge of school-teachers in Lucknow with regard to emergency management of dental trauma. Materials and Methods: This cross-sectional study included a total of 162 teachers from different private and public schools of Lucknow, which was divided into 4 zones. Two schools were randomly selected from each zone. Questionnaire was used to collect information regarding teachers' educational background, gender, type of school, attitude and practices about dental trauma. The reliability of the questionnaire was tested by the Cronbach α coefficient. Chi-squire test was used to assess the association between the overall knowledge score and demographic profile of school-teachers. Results: Majority of participants had received tertiary education. Maximum (80%) school teachers in the age group of 30-40 years had "fair" knowledge regarding implantation. Only 31% female-teachers had "good" knowledge about cleaning of avulsed tooth. Nearly, two-third of public school teachers (73%) had a "fair" overall knowledge, whereas approximately half (52%) of school teachers in private school had an overall "good" knowledge regarding the management of traumatic dental injuries. Conclusion: Majority of the school teachers have "fair" level of knowledge regarding the management of dental trauma. With more of educational campaigns like teachers training programs, there can be further enhancement of the knowledge that in turn can help teachers to handle these kinds of situations in a much better way.
Keywords: Dental trauma, knowledge, school-teachers
|How to cite this article:|
Sen S, Saha S, Jagannatha G V. Knowledge on management of traumatic dental injuries among school-teachers in Lucknow. J Indian Assoc Public Health Dent 2014;12:312-6
|How to cite this URL:|
Sen S, Saha S, Jagannatha G V. Knowledge on management of traumatic dental injuries among school-teachers in Lucknow. J Indian Assoc Public Health Dent [serial online] 2014 [cited 2019 Sep 23];12:312-6. Available from: http://www.jiaphd.org/text.asp?2014/12/4/312/147676
| Introduction|| |
Dental trauma remains one of the important oral health problems in childhood and can cause much pain and distress. It is important to provide immediate emergency care to reduce such outcomes.  It has been suggested that dental trauma may overtake dental caries and periodontal disease as the most significant threat to dental health among young people.  Dental traumas can pose significant consequences to various health related aspects and subsequently on children's daily life. 
Since children do not have enough experience of dental traumas and they cannot manage these accidents by themselves, the extent and amplitude of parents' and teachers' awareness can play an essential role in preventing them.  In a study conducted by Sae-Lim and Lim in Singapore, it was found that 63% of teachers had no knowledge of dental traumas.  It has been shown that when a child attains school age, accidents in the school environment in the form of falls are very common and are the main cause of traumatic tooth injuries.  Dental trauma can vary from a minor enamel chip to extensive maxillofacial damage involving the supporting structures and displacement or avulsion of teeth. It can result in functional and esthetic disturbances that are of concern for both the patients and their parents. 
The prognosis of traumatized teeth depends on prompt and appropriate treatment, which often relies on lay people such as the children's parents and their school teachers who are present at the site of accident, prior to the initial dental contact.  If the treatment for a traumatized teeth is delayed, it might lead to a reduction in the pulp vitality that cannot be regained back even if treatment is given at a later stage.  The majority of dental injuries involve the anterior teeth, which may lead to restriction in biting, speech difficulties and psychological trauma due to impaired esthetics.  Anterior permanent tooth fracture makes an undesirable memory and dealing with it needs adequate skills and experience. Due to lack of knowledge of parent, delayed treatment of dental trauma may result in some side effects like discoloration, infection, mobility, resorption and loss of tooth root. 
In Lucknow, there have been no attempts by the government or the various dental authorities and associations to educate the school teachers on the management of dental trauma, nor have there been any studies to ascertain the knowledge of them about the management of dental injuries. Hence, the aim of the present study was to evaluate the level of knowledge among school teachers in a large urban area located in Lucknow city, Uttar Pradesh.
| Materials and methods|| |
A cross-sectional study was conducted in between July and August 2012. List of schools, both private and public, located within the Lucknow municipality was obtained from District School Officer. In the first stage, Lucknow city was divided geographically into four zones, that is, North, South, East and West. In the second stage, from each zone 2 schools were randomly selected.
Ethical clearance was obtained from the Institutional Ethical Committee of Sardar Patel Post Graduate Institute of Dental and Medical Sciences to conduct the study. Necessary permission was obtained from the Heads of the schools. Written informed consent was taken for each study participant prior to the study.
The questionnaire consisted of questions on personal and professional profile of the respondents, questions on the immediate management; self-assessed knowledge, and services and priority of management of dental trauma. The questionnaire was pretested in a pilot survey among twenty school teachers which were later not included in the main study. Teachers were requested to complete the questionnaire on two different occasions separated by 7 days. The questionnaire was found suitable for application among the study population as there was high concurrence with the answers to the questions on both occasions. Cronbach's alpha was applied for the reliability of the questionnaire and was found to be 0.84.
The calculation of sample size was performed to seek the results at 95% confidence level for which the size of the sample comes out to be 153. All the school teachers who present on the day of the study and gave informed consent were included. Out of a total of 183 school teachers, 162 participated in the study.
Method of data collection
Present study was conducted by single investigator. The knowledge was evaluated by the use of a structured, closed ended questionnaire. The questionnaire was translated in local languages (in Hindi). Translation involved two independent, forward translations by bilingual translators that was compared their versions to identify discrepancies indicative of ambiguous wording within the original survey or other problems.  During the synthesis, a third bilingual person mediated a discussion between the two translators to develop one version of the survey.  Another person blind to the original survey then back translated the new survey into the source language and compared it to the original document to check the validity of the translation.  The questionnaire contained 15 questions.
Each question was evaluated using a five-point Likert scale with numerical value 0= "not at all," 1= "a little," 2= "somewhat," 3= "strongly," and 4= "very strongly." The possible scores thus ranged from 0 to 60. For ease of understanding and to obtain a substantiated result this five-point Likert's scale of individual question was divided into three grades that is, Good (response 4), Fair (response 2 and 3) and Poor (response 0 and 1). To assess the "overall knowledge", the total score was divided into three grades that is, Good (41-60), Fair (21-40) and Poor (1-20).
Oral health education lecture regarding dental trauma and its management was given to all the teachers at the end of the day's procedure.
The data were coded and tabulated. Software SPSS version 17 (IBM, Chicago, U.S.A.) was used to analyze the data. Chi-squire test was used to assess the association between the overall knowledge score and demographic profile of school-teachers. P <0.05 was considered statistically significant.
| Results|| |
Majority of the school teachers in all the age groups have a "fair" knowledge about the topic. Among the three groups (<30 years, 31-40 years and >40 years) there was no statistically significant difference in the knowledge of the school teachers (P = 0.13) [Figure 1].
|Figure 1: Distribution of overall knowledge response of school teachers according to their age|
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Majority of school teachers irrespective of their gender belongs to "fair" knowledge about the topic. Females are little more knowledgeable about the topic. Among the two groups (male and female school teachers), the response of school teachers was not statistically significant (P = 0.22) [Figure 2].
Majority of school teachers are belonged to "fair" knowledge about the topic. The knowledge of the topic and hierarchy of their educational level was observed proportional. Among the three groups (high school, bachelors and masters), the response of school teachers was not statistically significant (P = 0.21) [Figure 3].
|Figure 2: Distribution of overall knowledge response of school teachers according to their gender|
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|Figure 3: Distribution of overall knowledge response of school teachers according to their level of education|
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Majority of school teachers are belonged to "fair" knowledge about the topic. But regarding the "good" knowledge of the topic private school teachers are a step ahead than public school teachers. Among the two groups (private and public school teachers), the response of school teachers was statistically significant (P = 0.0034) [Figure 4].
|Figure 4: Distribution of overall knowledge response of school teachers according to their types of school|
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| Discussion|| |
Previous reports  indicated that some influence of teachers on immediate management of traumatized teeth may lessen trauma cases in schools. Hence, teachers assume responsible roles both in their daily activities and health related issues. Therefore, there is an urgent need to increase the dental awareness of teachers. 
In the present study, the age group of school teachers between 31 and 40 years showed the maximum overall response as "fair" (P = 0.13). Similar studies , found that teachers between the age group 30-39 years showed more knowledge regarding a child's health care with special importance to dental trauma. It is hence considered that the middle age group (31-40 years) is more familiar with dental trauma management due to modern facilities as well as experience.
Among the two groups (male and female), the female participants were little more knowledgeable regarding the topic though the result was not statistically significant (P = 0.22). This finding was found to be in accordance with studies , wherein the female participant were found to be more knowledgeable. This may be due to females are more affectionate and spent more time with children.
Higher the educational level of school teachers, the more favorable their responses were, though the result was not statistically significant (P = 0.21). Similar studies ,,, also found that a major proportion of the population investigated were qualified with tertiary education and thus get better responses. This could be attributed to the fact that an individual with higher educational backgrounds are better informed and more knowledgeable when it concerns with a child's health.
In the present study, the overall response of the private school teachers was significantly better (P = 0.0034). It could be due to the fact that the private school teachers must have been being better equipped with modern day technology and facilities and are well versed regarding the management of traumatic dental injuries in school setup.
| Conclusion|| |
Majority of the school teachers have "fair" level of knowledge regarding the management of dental trauma. With more of educational campaigns like teachers training programs, there can be further enhancement of the knowledge that in turn can help teachers to handle these kinds of situations in a much better way.
| References|| |
Al-Jundi SH, Al-Waeili H, Khairalah K. Knowledge and attitude of Jordanian school health teachers with regards to emergency management of dental trauma. Dent Traumatol 2005;21:183-7.
Mesgarzadeh AH, Shahamfar M, Hefzollesan A. Evaluating knowledge and attitudes of elementary school teachers on emergency management of traumatic dental injuries: A study in an Iranian urban area. Oral Health Prev Dent 2009;7:297-308.
Qajari FM, Haghighatdoost E. Evaluation of primary school teachers' knowledge of dental traumas in students, Tehran-2003. Beheshti Univ Dent J 2005;22:21-5.
Sae-Lim V, Lim LP. Dental trauma management awareness of Singapore pre-school teachers. Dent Traumatol 2001;17:71-6.
Chan AW, Wong TK, Cheung GS. Lay knowledge of physical education teachers about the emergency management of dental trauma in Hong Kong. Dent Traumatol 2001;17:77-85.
Marcenes W, al Beiruti N, Tayfour D, Issa S. Epidemiology of traumatic injuries to the permanent incisors of 9-12-year-old schoolchildren in Damascus, Syria. Endod Dent Traumatol 1999;15:117-23.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the Cross-Cultural Adaptation of Health Status Measures. Rosemont (IL): American Academy of Orthopedic Surgeons. Available from: http://dash.iwh.on.ca/system/files/X-CulturalAdaptation-2007.pdf. [Last revised on 2007 Jun 12].
Caglar E, Ferreira LP, Kargul B. Dental trauma management knowledge among a group of teachers in two south European cities. Dent Traumatol 2005;21:258-62.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]