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ORIGINAL ARTICLE
Year : 2018  |  Volume : 16  |  Issue : 3  |  Page : 231-235

Knowledge about causes and prevention of oral diseases among higher secondary school students in Vellore District, Tamil Nadu, India: A cross-sectional survey


1 Department of Public Health Dentistry, Tagore Dental College and Hospital, Chennai, Tamil Nadu, India
2 Department of Periodontics, Tagore Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Submission01-Nov-2017
Date of Acceptance09-May-2018
Date of Web Publication6-Aug-2018

Correspondence Address:
Dr. Kumara Raja Balasubramanian
Tagore Dental College and Hospital, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaphd.jiaphd_147_17

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  Abstract 

Background: Awareness regarding oral diseases and its prevention aids in the development of correct oral health practices, thereby controlling oro-dental problems; hence, this study aimed to evaluate the level of oral health knowledge pertaining to its causes and prevention among higher secondary school students in Walajapet, Vellore district, India. Materials and Methods: The survey was carried out among 400 schoolchildren who were in the age group of 16–18 years studying in various schools of Walajapet in Vellore district. Data on knowledge about oral diseases were collected by means of self-administered questionnaire. The results were analyzed by descriptive statistics and Chi-square test using Statistical Package for the Social Sciences version 19. P < 0.05 was considered statistically significant. Results: A total of 400 secondary school students with an age range of 16–18 years and mean age of 17.2 ± 10.44 years participated in the study. About 324 (81.0%) secondary school students had adequate level of knowledge on causes and prevention dental caries, 267 (66.7%) school students were aware of causes and prevention of periodontal diseases, only 195 (48.7%) school students had awareness on cause and prevention of oral cancer, and 305 (76.2%) students were familiar with causes and prevention of dental malocclusion. Conclusion: Majority of schoolchildren showed adequate knowledge toward causes and prevention of dental caries, periodontal disease, and dental malocclusion but had inadequate knowledge toward oral cancer.

Keywords: Child, India, knowledge, periodontal disease


How to cite this article:
Francis DL, Balasubramanian KR, Durga R, Chandran CR. Knowledge about causes and prevention of oral diseases among higher secondary school students in Vellore District, Tamil Nadu, India: A cross-sectional survey. J Indian Assoc Public Health Dent 2018;16:231-5

How to cite this URL:
Francis DL, Balasubramanian KR, Durga R, Chandran CR. Knowledge about causes and prevention of oral diseases among higher secondary school students in Vellore District, Tamil Nadu, India: A cross-sectional survey. J Indian Assoc Public Health Dent [serial online] 2018 [cited 2018 Nov 17];16:231-5. Available from: http://www.jiaphd.org/text.asp?2018/16/3/231/238580


  Introduction Top


Oral health has been gaining equal importance as general health. Moreover, knowledge regarding oral health has been cited as an important factor that determines overall health.[1] Various oral diseases such as dental caries, periodontal disease, tooth loss, oral mucosal lesions, oropharyngeal cancers, human immunodeficiency virus/acquired immunodeficiency syndrome-related oral disease, and oro-dental trauma were considered to be major public health problems worldwide. Some of the oral diseases such as dental caries and periodontal disease have been considered as the most important global oral health burdens. Dental caries is still a major health problem in most industrialized countries as it affects 60%–90% of school-aged children and the vast majority of adults.[2]

Most of the people tend to ignore their impending oral problems, which later on multiply and affect the overall health.[3] These problems should be viewed against a background, in which there is a shortage of dental personnel for educating people regarding oral disease.[4]

Oral diseases affect children, adults, and families across the world every day although they are nearly 100% preventable.[5] Knowledge about the oral disease is important because it can act as a major vehicle for maintaining good oral health.[6]

Individuals who hold favorable oral health-related beliefs over time have better oral health in their later years than those who do not. This implies that changing beliefs should result in changes in behaviors.[7] Thus, it is important to review the knowledge of adolescents regarding oral health, with an objective of inculcating healthy lifestyle practices to last for their lifetime. Studies have also shown that oral cancer and gum diseases can be prevented if proper knowledge is provided at early stages.[8]

Oral health knowledge is considered to be crucial for developing healthy behaviors, and may author have document an association between increased knowledge and better oral health.[9] Studies have also showed that those who have assimilated this knowledge, feels a sense of personal control over their oral health and more likely to adopt healthy oral hygiene practices.[10] Schools were the only place where children are spending most of their time; hence, it can be considered a suitable place for conducting dental health educational programs.[11] Moreover, good oral health attitudes and practices can be brought about by giving adequate information to the schoolchildren regarding oral diseases.[12] To create good attitude and practices toward oral health, the assessment of oral health knowledge is essential.[13] Only few studies have assessed the oral health knowledge of secondary schoolchildren in this part of the country. With this background, the present study aimed to evaluate the level of oral health knowledge pertaining to causes and prevention of oral diseases among higher secondary school students in Walajapet, Vellore district, India.


  Materials and Methods Top


This cross-sectional survey was conducted in March 2016 to assess the level of oral health knowledge among secondary school students in Walajapet, Vellore district, Tamil Nadu, India. This survey was approved by the Institutional Review Board and Ethics Committee of Tagore Dental College and Hospital.

The list of recognized schools in the Walajapet town was obtained from the Walajapet Municipality Office by the researcher, and there were about 14 schools distributed in and around Walajapet, Vellore district, Tamil Nadu. Using stratified random sampling method, schools were divided into four zones, and then, one school was selected from each zone by lottery method. Sample size required for estimating proportion was calculated using the formula: N = Z2pq/d2 where P is the knowledge toward oral diseases which was calculated from a pilot study among 50 school students and was found to be 0.60. The final sample size was estimated to be 361 considering 5% allowable error. However, sample of 400 school students were included for higher accuracy. School students of both sexes with age range between 16 and 18 years were included in the survey as they were a little older to understand and complete the questionnaire by themselves and students who were present on the day of the survey were included in the survey.

All students were informed about the aim and protocol of the survey and given assurance regarding confidentiality of their responses. Consent form was given to all participants before the start of the study that to be duly filled by their parents and the participants only with parent's consent on the day of an examination were included in the study. The original version of the questionnaire was prepared in English and had been translated into Tamil (local language) by an independent and expert translator. Finally, this questionnaire was back-translated into English and verified with the original English questionnaire by five subject experts who were well versed in these languages. The questionnaire was tested for reliability by test–retest method before conducting the study. The questionnaire was distributed to 25 secondary school students and collected back on two different days by the investigator. Reliability was assessed by split-half reliability coefficient test (ρ = 0.81, good reliability).

This survey was carried out under the supervision of the principal investigator and co-investigators encouraged the participants to approach him whenever they needed clarification of any point. The survey instrument was self-administered with two parts; the first part began with a brief explanation of the aim of the study and contained items concerning the patient's sociodemographic data (age, gender, standard, last dental visit, and area of residence). The second part dealt items related to the student's knowledge regarding causes and prevention toward oral diseases. The survey tool consisted of 32 knowledge-based items which was grouped into four domains; each domain contained eight items assessing knowledge on dental caries, periodontal disease, oral cancer, and dental malocclusion.

Responses to the questions were either “yes,” “no,” or it contained four possible responses with one or more correct answers. For analysis purpose, the “no” responses were coded as 0 and the yes were coded as 1; similarly, correct answers were coded as 1 and incorrect answers were coded as 0. The total knowledge score was calculated by adding the scores for all eight items in each domain. The same procedure was applied for all domains to access knowledge toward prevention of oral diseases (dental caries, periodontal disease, oral cancer, and malocclusion). Thus, the knowledge score ranged from 0 to 8 for each domain. A student was regarded as knowledgeable if more than half the items of domain were correctly answered and were regarded as not knowledgeable only if less than half of the questions in the domains were correctly answered.[14] The collected data for each question were numerically coded, and data were entered into the Microsoft Excel sheet. The Statistical Package for the Social Sciences (SPSS) software 19.0 version (SPSS Inc., Chicago, IL, USA) was used for analysis. For descriptive presentation of data, frequency distributions and percentages were used. Chi-square test was used to determine the associations between independent variables (age, gender) and dependent variable (knowledge). The significance level was set at P < 0.05.


  Results Top


A total of 400 secondary school students with an age range of 16–18 years and mean age of 17.2 ± 0.44 years participated in the study.

A statistically significant result (P < 0.001) was found when assessed for oral health knowledge regarding causes and prevention of dental caries among age and gender of schoolchildren [Table 1].
Table 1: Oral health knowledge regarding causes and prevention of dental caries according to age and gender

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Oral health knowledge regarding prevention of periodontal disease by the age of students showed that knowledge improved as students' age increased and the results were statistically significant (P = 0.016) [Table 2].
Table 2: Oral health knowledge regarding causes and prevention of periodontal disease according to age and gender

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Regarding oral health knowledge toward the prevention of oral cancer according to the gender of students, it was observed that majority of male students (147, 73.5%) had adequate knowledge compared to female counterparts and the results were statistically significant (P < 0.001) [Table 3].
Table 3: Oral health knowledge regarding causes and prevention of oral cancer according to age and gender

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Oral health knowledge regarding the prevention of dental malocclusion showed females (195, 97.5%) having adequate knowledge compared to their male counterparts and the results were statistically significant (P < 0.001) [Table 4].
Table 4: Oral health knowledge regarding prevention of dental malocclusion according to age and gender

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  Discussion Top


Society has a responsibility to educate its youngsters concerning the scientific knowledge about measures for preventing oral diseases.[15] In this context, it is the role of healthcare providers to start oral health education for students in their regular curriculum at school level. This helps in creating awareness regarding oral diseases and aids in the development of correct oral health practices, thereby to control oro-dental problems.[16] In many countries, a large number of children and parents have limited knowledge on the causes and prevention of the most common oral diseases.[17] Therefore, the present study aimed to evaluate the level of oral health knowledge pertaining to the prevention of oral diseases among higher secondary school students in Walajapet, Vellore district, India.

In the present study, nearly three-fourth (324, 81.0%) of the students had adequate knowledge on causes and prevention of dental caries. This finding is in agreement with Carneiro et al.,[14] but Peter et al.[18] reported that majority of the subjects in their study had average knowledge on the prevention of dental caries.

This could be a result of either oral health knowledge that they might have learned while at primary school or acquired through the media or an outcome of wanting to please the researchers.[14]

In the present study, it was also observed that more number of female students had more knowledge regarding dental caries compared to males and these findings were similar with other studies.[19],[20],[21]

In the present study, more than half (267, 66.7%) of the students had adequate knowledge on causes and prevention of periodontal disease. This finding is in agreement with that of studies reported by Carneiro et al.,[14] Togoo et al.,[21] and Taani and Alhaija,[22] but some contrasting results were reported by Lian et al.[23] and Priya et al.[24] They found that oral health knowledge about periodontal disease was low among the surveyed children. Since the schoolchildren in our study were elder enough to retain and recall the acquired knowledge as they grow, this difference in knowledge was found when compared with other studies.

Only 195 (48.7%) schoolchildren had adequate knowledge regarding causes and prevention of oral cancer, but a contradictory finding was reported by Carneiro et al.,[14] Komu et al.,[25] and Warnakulasuriya et al.[26]

Since most of the schools in this part do not advocate awareness regarding oral cancer in their curriculum, this marked difference was observed. Hence, this lack of awareness among schoolchildren needs to be addressed by oral healthcare professionals by including important aspects of oral cancer and its related risk habits in their oral health education messages when delivering health education among school students. However, interestingly, majority of male students (147, 73.5%) had more knowledge regarding oral cancer compared to females, and it would be possible that this knowledge might be obtained from the media such as television, newspaper, and advertisements. In addition, oral health knowledge regarding dental malocclusion was observed more among females compared to males and this knowledge might be due to increased interest among female students in improving and maintaining their facial esthetics compared to male students.

Since oral health knowledge of students was evaluated on the basis of a self-reported questionnaire, it might have led to memory errors and measurement errors due to misinterpretation of questions. Moreover, survey tool used in this study contained only close-ended options; hence, the assessment of knowledge might have been affected. Furthermore, causal inference was not obtained due to the cross-sectional study design. In spite of these limitations, this study included a representative and unbiased sample of schoolchildren from each zone, making it generalizable to the entire schoolchildren in that district.

In general, schoolchildren are spending more hours in the school; hence, schools can be made an advisable platform for educating and promoting oral health care for children. Comprehensive school-based oral health promotion program should be organized on wider basis in the school curriculum in an attempt to prevent and create awareness regarding oral diseases.


  Conclusion Top


Majority of schoolchildren showed adequate knowledge toward causes and prevention of dental caries, periodontal disease, and dental malocclusion but inadequate knowledge toward oral cancer.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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