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ORIGINAL ARTICLE
Year : 2016  |  Volume : 14  |  Issue : 3  |  Page : 262-265

Impact of oral health education on periodontal and dental caries status of nursing students in Jodhpur city, Rajasthan, India: An interventional study


1 Department of Public Health Dentistry, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India
2 Department of Oral Medicine and Radiology, Rajasthan Dental College and Hospital, Jaipur, Rajasthan, India

Date of Web Publication28-Jul-2016

Correspondence Address:
Jitender Solanki
Department of Public Health Dentistry, Rajasthan Dental College and Hospital, N. H. 8, Ajmer Road, Bagru, Jaipur, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-5932.187171

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  Abstract 

Introduction: Oral health education is an integral part of dental health services and has been provided in various settings such as dental office and dental institutions, school, and other educational institutions, and workplace to improve oral health by increasing awareness and interest of the population toward their own oral health. Aim: To assess the impact of oral health education on the periodontal and dental caries status of the nursing students. Materials and Methods: A total of 1045 nursing students were selected out of them there were 502 males and 543 females. The study was conducted in two phases: first phase, oral examination and second phase, oral examination after imparting oral health education. Statistical analysis included descriptive and Chi-square analysis using SPSS. Results: It was found that both males and females were having highest community periodontal index score of 3 and 4, but after health education, the scores were statistically significant (χ2 = 789.751, P = 0.000, S), whereas the dental caries status remained same, there was an improvement in filled component of decayed-missing-filled teeth after health education, but no statistically significant results were found (χ2 = 735.497, P = 0.574, NS). Conclusion: In the present study, there was an improvement in the periodontal status after imparting oral health education. Therefore, oral health education is an integral part of maintaining dental health.

Keywords: Dental caries, nursing students, oral health, oral health education, periodontal status


How to cite this article:
Solanki J, Gupta S. Impact of oral health education on periodontal and dental caries status of nursing students in Jodhpur city, Rajasthan, India: An interventional study. J Indian Assoc Public Health Dent 2016;14:262-5

How to cite this URL:
Solanki J, Gupta S. Impact of oral health education on periodontal and dental caries status of nursing students in Jodhpur city, Rajasthan, India: An interventional study. J Indian Assoc Public Health Dent [serial online] 2016 [cited 2020 Dec 4];14:262-5. Available from: https://www.jiaphd.org/text.asp?2016/14/3/262/187171


  Introduction Top


Health is a state of complete physical, mental, and social well-being and not merely the absence of diseases or infirmity.[1] Practice of modern medicine has become a joint effort of many groups of health workers (medical, dental, and paramedical). Many health professionals working together constitute the health team to provide health care for the patient and the society at large. Often, it is the trained nurses on the wards, who teach oral health care to untrained nurses and health-care assistants. It is therefore important that health-care professionals caring for patients in hospitals and other venues have core knowledge of the dental care needs of their patients. Dentists as well as other health professionals realize that oral health cannot be divorced from the general health of the hospitalized patient. Optimally, total health care requires the combined efforts of the medical, paramedical, and dental professions.[2] The health-care professionals come across a number of patients in their daily practices. With adequate knowledge about oral health, they can play a vital role in providing oral health education of individuals and groups and act as role models for their patients, friends, families, and community at large.

There is a need to determine the status of their own oral health before being trained as paramedical, medical, and dental professionals.[3] Experts in the field rarely teach it, and it is found that qualified nursing staff and nursing students lack adequate knowledge related to oral health which in turn leads to poor oral care of patients in hospitals.[4] In nurses training, as oral care is often left to the patients themselves and it is a task that is largely delegated to untrained staff or considered to be the responsibility of dental staff members.[5] Currently, across the world, nondentist providers are being educated and used to perform many procedures that are restricted to the dentist in many health-care systems.[5]

Considering above points, the present study was undertaken with the aim to assess the impact of oral health education on the periodontal and dental caries status of the nursing students.


  Materials and Methods Top


The present study was conducted among nursing students of Jodhpur city (from January to March 2014). Ethical clearance was obtained from the Institute Ethical Committee. All the students were informed about the study in advance of the day and time of the study so as to attain maximum attendance. A total of 1045 study subjects were selected from all the six nursing institutes. A resident of Jodhpur since birth was included, and students suffering from any systemic disease were excluded from the study.

The oral examination of all the study subjects was carried out by two examiners who were trained and calibrated in the Department of Public Health Dentistry, at a private institute. The kappa score for decayed-missing-filled teeth (DMFT) in interexaminer was 0.86, respectively, for the two examiners, and that for community periodontal index (CPI) scores, the interexaminer reliability was found to be 0.90 (excellent).

The study was conducted in two phases. Phase one included the clinical examination of the nursing students for periodontal (CPI and loss of attachment [LOA]) and dental caries status (DMFT). Phase two included the reevaluation of the periodontal and dental caries status after 1 month. In between the two phases, oral health education was provided to the nursing students in the respective nursing colleges, which included maintenance of good oral hygiene, oral hygiene methods, and adverse oral habits (role plays, demonstration of brushing method, and pamphlets).

Clinical oral examinations were carried out by previously trained and calibrated dental surgeons who were assisted by the recorder while examining the subjects. Clinical examination was done using mouth mirror and the World Health Organization (WHO) probe for dental caries and periodontal status. The CPI and LOA index was used in the WHO Oral Health Survey Basic Methods (1997) for periodontal status.[6] The same procedure was followed during the second phase of the study 3 months after providing oral health education.

All the collected data were entered into the Microsoft Word Excel Sheet 2007 version analyzed using SPSS 18.0 version Inc., Chicago, IL USA. Analysis for each clinical parameter was done using kappa statistics, descriptive analysis, and Chi-square test P < 0.05 was considered statistically significant [Flow Chart 1].




  Results Top


On examination of nursing students before oral health education, it was noted that 171 (45.2%) male and 207 (54.8%) female subjects had CPI score 3, whereas 16 (23.18%) male and 53 (76.82%) female subjects had CPI score 4 [Table 1]. A total of 307 (43.8%) male and 393 (56.2%) female subjects had CPI score 0, whereas 8 (61.5%) male and 5 (38.5%) female subjects had CPI score 2 after oral health education [Table 2].
Table 1: Periodontal status among nursing students before oral health education

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Table 2: Periodontal status among nursing students after oral health education

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There were 139 (38.2%) male and 224 (61.7%) female subjects who had decayed teeth. Ten (40.0%) male and 15 (60.0%) female subjects had missing teeth. Seventeen (33.3%) male and 34 (66.7%) female subjects had filled teeth before oral health education [Table 3].
Table 3: Dental caries status among nursing students before oral health education

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When the nursing students were examined after oral health education, 73 (41.2%) male and 104 (58.7%) female subjects had decayed teeth, 2 (28.5%) male and 5 (71.5%) female subjects had missing teeth, and 91 (34.3%) male and 164 (65.7%) female subjects had filled teeth [Table 4].
Table 4: Dental caries status among nursing students after oral health education

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Paired t-test was used to compare dental caries status of study subjects before and after oral health education. A nonsignificant association was found between oral health education and dental caries status of the study subjects (P = 0.607, NS) [Table 5].
Table 5: Intragroup comparison among subjects before and after delivering health education

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  Discussion Top


The main objective of oral hygiene is to maintain good oral health that is comfortable, clean, moist, and free of infections.[7] In the present study, it was observed that the 13.4% of the females had healthy periodontal status, whereas only 7.1% had poor periodontal status, these findings coincide with the findings of Srinidhi et al.[8] There was a massive increase in the percentage of people with healthy periodontal health after receiving oral health education from 10.4% to 66.9%, the findings were similar to the findings of the Radha et al.[9] Before imparting oral health education, the highest percentage of the people was in the group of periodontal pocket 4–5 mm 36.1%, whereas after oral health education, the highest percentage of the healthy people was 66.9%, these findings are similar to those of Kawamura et al. on Japanese adults 31.5% and 59.8%, respectively.[10] About 6.60% of the population had deep pockets; the findings are similar to the findings of Kawamura et al. (9%). When the periodontal condition was assessed gender-wise, it was observed that males (92.9%) had poorer periodontal as compared to females (86.6%), respectively, these findings coincide with the findings of Sharda and Shetty.[2]

It was observed that 57.9% of students had healthy teeth (zero DMFT score), among them, 55.4% were males and 44.5% females. The decayed component of DMFT before imparting oral health education was observed in 34.7% of the students, the findings of the present study coincide with the findings of Kawamura et al.[10] When the dental caries status before providing oral health education was assessed according to gender, it was observed that more number of females had dental caries (Decayed component) than males 61.7% and 38.2%, respectively, similar to the findings of Radha et al.[9] After the oral health education was imparted to the students, the decayed component was reduced to 16.9% and the filled component improved to 25.3% from 4.8%, these results are similar to the findings of Srinidhi et al.,[8] this sudden change can be attributed to the oral health education that was provided to the students after which they went to dentist to get the decayed teeth restored. The results of the present study suggest that imparting oral health education improved the periodontal and dental caries condition of the nursing students, which will help them in providing the same oral hygiene habit in their day-to-day patients.

There is a scarcity of data about attitude toward oral health care among the health-care providers in hospitals and nursing homes. There is a need of hour to develop a sound strategy for improving the oral health among paramedical staff. For this, additional studies need to be conducted in various health-care setups such as public hospitals, private medical hospitals, private hospitals, nursing homes, and large medical cities. With improved oral health knowledge, attitude, and practices, health professionals can contribute to community oral health educational programs in places where there is a shortage of dental workforce for fulfilling the oral health needs of the society.

Educating the students was chosen as the method of intervention as good knowledge about the importance of oral health will lead to beneficial effects in long term, not only will the students start practicing good oral hygiene but also this will lead to lower the prevalence of deteriorated oral health. In the present study, only oral health education improved the oral health of the students which establishes its importance as a mode of intervention. Comparison with other paramedical staff would have shown better results. Larger sample size can be taken into consideration.


  Conclusion Top


There was an improvement in the oral health status after imparting the oral health education among people. Therefore, we suggest and recommend that oral health awareness among various health professionals should be improved, for that health professional should work collectively develop a “sound strategy.” Oral health education topics should be integral components of the paramedical staff training and education program. There is a need to stress upon basic preventive dentistry topics during the training and education of the health professionals. Medical education should include oral health topics for health professionals to improve their knowledge of oral health.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
World Health Organization. Basic Documents. 104th ed. Geneva: OMS; 1960.  Back to cited text no. 1
    
2.
Harris NO, Godoy FG. Primary preventive dentistry in hospital setting. In: Godoy FG, editor. Primary Preventive Dentistry. 6th ed. New Jersey: Julie Levin Alexander Publisher; 2004. p. 605-36.  Back to cited text no. 2
    
3.
Sharda AJ, Shetty S. A comparative study of oral health knowledge, attitude and behaviour of non-medical, para-medical and medical students in Udaipur city, Rajasthan, India. Int J Dent Hyg 2010;8:101-9.  Back to cited text no. 3
[PUBMED]    
4.
Longhrust RH. A cross sectional study of the oral health care. A competitive study of registered nurses, nursing assistants and home care aides. Gerodontology 1997;14:28-32.  Back to cited text no. 4
    
5.
Eadie DR, Schou L. An exploratory study of barriers to promoting oral hygiene through carers of elderly people. Community Dent Health 1992;9:343-8.  Back to cited text no. 5
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6.
WHO. Basic Oral Health Survey. 4th ed. Geneva: WHO; 1997.  Back to cited text no. 6
    
7.
Coelho Rde S, Gusmão ES, Jovino-Silveira RC, Caldas Ade F. Profile of periodontal conditions in a Brazilian adult population. Oral Health Prev Dent 2008;6:139-45.  Back to cited text no. 7
    
8.
Srinidhi S, Chaly PE, Ingle NA. Oral health status and treatment needs among the nursing students and nursing staff in Chennai. J Oral Health Community Dent 2012;6:79-85.  Back to cited text no. 8
    
9.
Radha G, Ali KH, Pushpanjali K. Knowledge, attitude and practice of oral health among nursing staff and nursing students of Bangalore city. J Indian Assoc Public Health Dent 2008;11:17-21.  Back to cited text no. 9
    
10.
Kawamura M, Sasahara H, Kawabata K, Iwamoto Y, Konishi K, Wright FA. Relationship between CPITN and oral health behaviour in Japanese adults. Aust Dent J 1993;38:381-8.  Back to cited text no. 10
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  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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