RAJIV GANDHI UNIVERSITY OF HEALTH

SCIENCES

BANGALORE, KARNATAKA.

A STUDY TO EVALUATE THE EFFECTIVENESS OF

STRUCTURED TEACHING PROGRAM ON DENTAL
HYGIENE
AMONG
5TH
STANDARD
SCHOOL
CHILDREN IN THE SELECTED GOVERNMENT
PRIMARY SCHOOL OF KOLAR DISTRICT IN
KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECTS

FOR DISSERTATION

MR.NARESH KUMAR SONI

A.E. & C.S. PAVAN COLLEGE OF NURSING
KOLAR- 563101(KARNATAKA)

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA.
PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION

1.

NAME OF THE CANDIDATE & ADDRESS

MR. NARESH KUMAR

SONI, AE&CS PAVAN
COLLEGE OF NURSING
KOLAR-563101
KARNATAKA

2.

NAME OF INSTITUTION

PAVAN COLLEGE OF
NURSING , KOLAR

3.

URSE OF STUDY AND THE SUBJECT

M.Sc.IN PAEDIATRIC
NURSING

4.

DATE OF ADMISSION TO COURSE

31/05/2007

5.

TITLE OF THE TOPIC:

CO

A STUDY TO EVALUATE THE EFFECTIVENESS OF STRUCTURED

TEACHING PROGRAM ON DENTAL
HYGIENE AMONG 5 TH
STANDARD SCHOOL CHILDREN IN THE SELECTED GOVERNMENT
PRIMARY SCHOOL OF KOLAR DISTRICT IN KARNATAKA

6. BRIEF RESUME OF INTENDED WORK

INTRODUCTION

There is a garden in every childhood, an enchanted

place where colors are brighter, the air softer,
and the morning more fragrant than ever again.
Elizabeth Lawrence

Healthy children are successful learners. School age children represent about 25% of
total population. The very size of the population suggests that health care of the
school children can contribute to the overall health status of the country. The health
and well being of school age children has become a high profile issue, lying at the
heart of numerous government initiatives and policies and receiving considerable
public attention. (1)
The goal of WHO Health for all by the year 2025 includes oral health also. (2)
The school age child has multitude of problems among them one of the most existing
problem is related to dental health. (1)
According to Osler
Oral cavity is a mirror of rest of the body.

(3)

Dental caries remain one of the commonest disorders affecting the teeth, starting right
from the early age. Hence the importance of preventing dental caries is at the school
age level.

Dental caries affects more than half of the school age children and is the most
common disease for that age group. School ages are lost because of dental problems
and dental visit, with poor children reporting almost 12 times restricted activity day
due to dental related illness than higher income children. Between 11% to 72% of
poor children have been found to have early childhood caries. One study found that
school age dental decay could be predicted in toddler by determining the frequency of
brushing and other variables. This suggests the importance of regular brushing or
young children. (4)
Bhat meghashyam, L Nagesh, A Ankola. (2007) Studied on
dental caries status and they wrote on discussion that about 82.8% of children of age
group between 5-14 years had dental caries residing in the costal areas of Karnataka
region in south India. (5)
Dental health is an important aspect of the personal health of individual teeth is
essential not only for mastication of food but also for good appearance and clear
speech.(6) The first permanent teeth erupt at about 6 years of age and so on in the
school age year good dental hygiene and regular attention to dental caries is vital part
of health supervision during this period.(7)
By the age of 7 years, the child is capable of assuming responsibility for
dental care including the use of dental floss.
Dental checkup are recommended every 6 months. Because only approximately 35%
of the population visits a dentist yearly. The school system should incorporate a
dental health educational programme into the curriculum. (8)

Todays children are tomorrows leaders. They form 38%-40% of general population.
One of the major health care concept faced by these promises of future are oral health
problems, more commonly dental caries.
This is the major concern of health care services in developing countries including
India. Adding to this illiteracy, poverty and over growing population made it
difficulty to render better health care service to all. Hence prevention seems to be the
only solution in promoting the oral health and thereby the overall healths 80% of the
children population have high levels of dental disease. School screening has a clear
role in identifying children with untreated disease and encouraging them to seek
dental care by informing them about their dental needs.(9)
The effectiveness of school based dental screening in many countries has come under
scrutiny in recent years. It has become proposed that dental screening of children in
their school achieves the aim of Encouraging dental attendance and demand for
care and serves as a mean of dental health and attention. (Mamta habbal, 2005) (10)

6.1 NEED FOR STUDY

In the national survey almost 10% of low income children had a need for dental care.
More than 30% reported not seeing dentist in the preceding years. Between11% to
72% of poor children have been found to have early childhood caries. Financial
barrier and lack of knowledge lead to poor dental health values and adversely affects.
Use of dental service and consciention personal oral health care. Only 19% of the
children received preventive dental service under the Medicaid early and preventive
screening, diagnosis and treatment (EPSDT) program in1999. (4)
According to WHO globally 200,335,280 teeth are either decayed, missing due to the
caries. This is just for one year age group the 12-years-old and presented in database
in February 2004. (WHO organization) (11)
By the age 9 most children will have at least one cavity and by the age 15 this
proportion will be 60%.
Dental caries is a common disease during childhood in India. Over 40% of the
children in India are found to be affiliated with dental caries and a large percentage of
children reside in rural areas and most of them are in the need of dental care.(5)
In the United state, tooth decay is the single most common chronic disease of
childhood and affect one in four elementary school children.
According to US department of health 2,900 children under the age of 5 years were
hospitalized for tooth decay in 2005 in New York State alone.(12)
Christensen LB, Bhambal A, Petersen PE. (2003) studied that
implementation of community oriented oral health promotion program is needed in

order to increase the level of knowledge and to change attitude and practice in
relation to oral health among children.(13)
Rao SP, Bharambe MS. (1993) conducted a study on dental
caries and periodontal disease in wardha district of Maharastra in India on the habit of
using brushing material and brushing technique among urban, rural and tribal school
children of 12 years age including both sex. They stated that dental caries were more
prevalent about 22.8% among urban children and 15.5% in rural whereas 15% was in
tribal children and concluded that school oral health education should address dental
caries, Periodontal disease and the material that harm teeth.(14)
Van Wyk W, Stander I, Van Wyk I. (2001) stated in the study on
dental health of 12 years old children whose diet was including sweetened canned
fruit supplied from local factories and concluded that supply of sweetened canned
fruit was the added risk to dental health for the children.(15)
De Almeida CM, Petersen PE, Andre SJ, Toscano. (2003)
conducted a study to assess the oral health status of Portuguese school children aged 6
and 12 years. It was found that 46.9% children in the age group of 6 years and 52.9%
in the age group of 12 years had dental caries. It was also found that 17.8% children
aged 6 years had seen a dentist during the past years and whereas 58.3% in the age
group of 12 years.(16)
Hence awareness among the children to improve their knowledge & practice on the
dental hygiene, their dietary habits and bad effects of other eating material should be
given through education.

6.2 REVIEW OF LITERATURE

Review of literature involves the systematic identification, location & scrutinizing

summary of written material that contain information on the research problem.
(Polit1991)
The present study is to evaluate the effectiveness of structure teaching programme
(STP) regarding dental hygiene among 5th standard school children.(10 12 years)
The researcher presents their review under the following headings.
(A). Study regarding the dental health status.
(B). Study regarding the knowledge & practice on dental hygiene.
(C). Study regarding the prevalence of dental caries.
(D). Study regarding the dental caries in relation with sociodemographic &
Socioeconomic factors.
(E). Study regarding the importance of Health education to maintain dental
health.

(A). Study regarding the dental health status.

Simon C, Tesfaye F, Berhane Y. (2003) conducted a study on the
assessment of oral health status of school children in Addis Ababa on April 2000 the
study was cross-sectional by design and sample size consisted of 1736 children who
are 12 years. The school included was private, public and government. It was found
that there was 21.1% dental caries, 53.4% periodontal disease 23.7% malocclusion
and 1.6% dental fluorosis. (17)
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EL Jirari S, Dartigues C, Cherkaoui A, Ndoba-Epoy P,Miquel

JL. (2000) conducted a study on status of carious disease (Tooth decay) in the
Moroccans children, the sample consisted was 3004 children from 6 to 15 years of
age and it was found that the teeth decay was 3 among 5 children, 2 children for 3
have cariogenic dental plaque because of lack in dental hygiene and high sugar
consumption. (18)

(B). Study regarding the knowledge & practice on dental hygiene.

Pandit K, Kannan AT, Sarna A, Aggarwal K. (1986) performed
a study in four primary school of Mehrauli block of rural Delhi on 458 school
children in the age group of 5 to14 years of both the sexes. It was observed that
39.19% of children were affected by dental caries. The study also showed that teeth
cleaning habits of school children in terms of regularity and associated caries
prevalence. Regular teeth cleaning group showed significantly less caries while
Not regular and Never cleaning group had higher dental caries prevalence.(19)

Petersen PE, Bhambal A, Christensen LB. (2003) conducted a

cross-sectional study of 599 children among 11-14 years old children in Bhopal India
to assess the knowledge and practice in relation to oral health and oral health
behaviors. It was found that caries prevalence proportion in both the dentitions was
57% and 2.5time higher in slum areas compared to children living in rural areas, 75%

of the children reported tooth brushing once a day, 31% used a plastic tooth brush and
general level of knowledge on dental health was low.(13)

(C). Study regarding the prevalence of dental caries.

Venugopal T ,Kulkarni VS, Nerurker RA, Damle SG,
Patnekar PN. (1998) conducted a study on the prevalence pattern of dental caries in
cooper municipal general hospital, Mumbai and taken sample consisted of 2000
children in age group of 1-14 years attending pediatric OPD, school clinic and well
body clinic. The study found 35.6% children had dental caries. The prevalence was
low in well nourished children and in those taking vegetarian type of diet. Caries
prevalence was low in those children using tooth brush than in using tooth powder,
Neem datum and rinsing mouth with water after food.(20)

Saravanan S, Madivanan I, Subashini B, Felix JW.(2005)

studied in urban area of Pondicherry to assess the pattern of prevalence of dental
caries in the primary dentition among 5 years old children of both sexes and taken
sample consisted of 527 boys and 482 girls. It was found that the dental caries was
prevalent 44.9% among the study population, being higher in the boys.(21)

Goyal A, Gauba K, Chawala HS, Kaur M, Kapur A. (2007)

conducted a study on the prevalence of dental caries in 6,9,12&15 years old school age
children of chandigarh used Molar criteria. They found that prevalence of dental

10

caries was 80% because of lack of fluoride toothpaste, 98% because of knowledge
deficiency and 30% because of frequently sugar consumption. (22)

Bonnarde V, Bouaziz N, Coulomb E (1988) conducted a study in 5

department of south of France on school children aged 6-15 years to assess the oral
condition of 771 children and It was found that dental caries was higher in age at
6,7,and 15 years. (23)

(D) Study regarding dental caries in relation with sociodemographic and

Socioeconomic factors.
David J, Wanj NJ, Astrom AN, Kuriakose S. (2005) conducted a
study in 12 years old school children in Thiruvanthapuram, Kerala in India to describe
the dental health status and to identify sociodemogrphical factors, oral health behavior,
attitude and knowledge related to dental caries experiences. Dental caries was measured
using World health organization criteria, the factors were assessed by self administered
questionnaire.
The study found 27% dental caries prevalence in permanent dentition. Dental
caries was higher in those children who did not use a tooth brush, consumed sweet.
Study indicated that urban living condition were associated with more dental caries. (24)

Sogi GM, Bhaskar DJ (2002) studied in Davangere town to

determine the relationship of dental caries and oral health status with socioeconomic
status. The sample consisted of 2007 children of 13 -14 years age of both sex. It was

11

concluded that the dental caries experience and oral health status of children was
strongly correlated with socioeconomic status. (25)

(E) Study regarding the importance of health education to maintain dental

health.
Szezurek D (1996) performed a questionnaire study to evaluate the
efficacy of the selected programme in the field of oral cavity, hygiene, dental caries,
and periodontal disease as well as to correct hygiene habit in 7-8 years old children.
Sample consisted of 255 pupils of two elementary schools in Szczecin. The clinical
evaluation was done on the basis of 18 months long observation of the increase in the
number of teeth and dental surface with caries status of periodontium, state of
hygiene, brushing method were observed.
The questionnaire studies were employed for estimating the change in
health consciousness and hygiene habit. The 3 selected programs were implemented
in three groups of studied children. Program I was based on individual, motivating
instructions of tooth brushing. Program II and III included educational activity
among children and parents. Additionally with cleaning of teeth, sealing and
conservative treatment. After 18 month it was found that programme I was effective
with regard to improving hygiene. Program II and III were found to be effective
with respect to the improvement of hygienic status of gum and reduction of caries.(26)

12

PROBLEM STATEMENT
A study to evaluate the effectiveness of structured teaching program on
Dental hygiene among 5th standard school children in selected government
primary school of kolar district in Karnataka.

6.3 OBJECTIVE OF THE STUDY

1). To assess the knowledge and practice of children regarding dental hygiene.
2). To assess the effectiveness of structure teaching program on dental hygiene
among Children.
3). To associate pre and post test knowledge and practice score of 5th standard
school children.

6.4 OPERATIONAL DEFINITION

Effectiveness:Effectiveness is a measure of the ability of a program, project or task to produce a
specific desired effect or result that can be qualitatively measured. (Glossary of
Project Management terms)
Here it refers to the outcomes of STP assessed by difference in pre & post test
scores of the knowledge and practice on dental hygiene.

Primary school children:According to Mosbys Dictionary the term primary school children refers to a young
human being below the age of full physical development.

13

In this study it refers to children of 5th standard (age group between 10-12 years).

Dental Hygiene: According to The Mosbys Dictionary the term Dental hygiene refers to procedure to
keep mouth clean and healthy.
In this study it refers to the practice of keeping the mouth, teeth, and gums clean
and healthy to prevent disease, as by regular brushing and flossing and visits to a
dentist.

Structured teaching Program:According to oxford advanced learners dictionary the term structured teaching
program is forming a planned series of event in order to provide instruction.
In this study it refers to a well planned instructional material designed to provide
information regarding selected aspects of Dental hygiene. Here after this will be
referred as STP.

Evaluation:From Wikipedia, the free encyclopedia "Evaluation" is the systematic determination

of merit, worth, and significance of something or someone.
In this study it refers to firmly to the effectiveness of Structured teaching Program on
Dental hygiene.

14

6.5 HYPOTHESIS:
1. The post test knowledge score regarding Dental hygiene will be significantly higher
than the pretest knowledge score of Primary school children who attended STP.
2. The post test practice score regarding Dental hygiene will be significantly higher
than the pretest practice score of Primary school children who attended STP.
3. There will be significant association between post test knowledge and practice
score of the experimental group and selected variables such age, sex, educational
status, type of

family, religion, life style, previous exposure of information

regarding Dental hygiene.

6.6 ASSUMPTION :1) Adequate knowledge on dental hygiene will help in adopting positive attitude
towards practices.
2) Health education promotes early health seeking behavior.
3) Group teaching will provide opportunity for active learning among the
participants.
4) Knowledge and practice of the people have a strong influence on adoption of
healthy behavior.
5) Awareness regarding Dental hygiene is poor among Primary school children.

15

6.7 VARIABLES UNDER STUDY

6.7.1 Dependent variables: - Knowledge and practice regarding dental hygiene.
6.7.2 Independent variables: - Structured teaching program on dental hygiene.
6.7.3 Attributed variables: - It includes the Age, Sex, Educational status, Type of
family, Religion, Previous exposure of information regarding Dental hygiene,
Socioeconomic and Demographical factors, and Life style.

7. MATERIAL AND METHODP

7.1 Source of data:Selected 5th standard school children of primary government school in kolar district
7.2 Method of data collection:Structured questionnaire consisted of 40 questions on knowledge & practice.
7.2.1 Research design:Quasi-experimental design to be used.
7.2.2 Setting:The study will be conducted in Yallama and Hiraiya Government primary school
Jaynagar, Tekkal road in kolar district among 5th standard school children.
7.2.3Population:School children of both the sexes who are in 5th standard. (Age group 10-12 years)
7.2.4 Sampling size:100 samples will be taken.

16

7.2.5 Sampling technique:Non randomized convenient sampling technique will be used for study based on
inclusive criteria and exclusive criteria.
7.2.6 Sampling criteria:Inclusive criteria:1). Children studying in 5th standard are included
as sample.
2). School children available during the period of
data collection of both the sexes.
3). Children willing to participate in the program.
Exclusive criteria:1) Children not available during the period of
data collection.
2) Children are not willing to participate in the
Program.
3) The primary school children are below 5th standard.

7.2.7 Tools of Research:The tool for this study includes two parts that are as follows.
1). The questionnaire will be used to collect data.
2). The questionnaire will be administered to the sample to assess their knowledge and
practice prior to the Structured teaching Programme.

17

7.2.8 Method of data collection:The structured questionnaire will be prepared and distributed among subjects as a pre test
on the knowledge and practice separately. Gap will be given of 45 minutes in between
the knowledge and practice test, followed by STP and after 7 days post test will be taken
to collect data to assess the effectiveness of STP.

7.2.9 Data analysis and interpretation:On the day of assessment pre-test and after 7 days post test to be conducted then data to
be analyzed using descriptive and inferential statistics.
Interpretation will be done using various tables and diagrams etc.

7.3 Does the study requires any investigation to be conducted on other or animals?
The study involves noninvasive intervention, i.e. planned health teaching education
program will be implemented to the school children studying in 5 th standard (age group
10-12 years) by conducting pre and post test.

7.4 Has ethical clearance has been obtained from concerned authorities?
Prior to the study permission will be taken from concern authorities to conduct the study
and also from research committee of Pavan College of Nursing, Kolar. The purpose of
the study will be explained to the respondents.

18

8. LIST OF REFERENCES :1). Kerala Nursing Forum Journal, Vol 2, No-1, Jan-March, (2007), P-32.
2). WHO Magazines, Oral Health for Healthy Life, (1994).
3). Dr. Vidya Rattan, Hand book of preventive & Social medicine Community
Publisher, New Delhi, 1994, P-255
4). Allender Spradley, Williams & Wilkins, Community Health Nursing Promoting and
Projecting the public Health, 6 edit, Lippincott compolny, 2005, P-630,652.
5). West India Medical Journal, Dental caries status and treatment need of
Children, (2007), Jan; Vol-56, No-1.
6). K Park, Essential of Community Health Nursing, 3rd edit, M/s Banarsidas Bhanot
Publisers, 2000, P-32 .
7). Marry A Nies, Melanie Mecwen, Community Health Nursing Promoting the Health
of Population , 3rd edit ,Saunders Company ,2007, P-709.
8). Dorthy R,Marlow et al, Text book of Pediatrics Nursing, 6 edit, WB Saunders
Company, Elsevier Science, (2002), P-1026.
9). Curzon Mej Robert Kodnes St Louis Pediatric Operative Dentistry Lippincot
Company, (1996).
10). Mamta Hebbal, Ramesh Nagarajappa, Journal of Dental Education, American
Dental Education Association, (2005), 69 (3), P 382-386.
11). www. WHO. org (Feb report 2004)
12). www. Prasad. org.
13).Christensen LB, Petersen PE, Community dental health, (2003) Sep; 20(3), P 153158
19

14). Roa.Sp, Bharambe.MS, Dental caries and periodontal disease, Indian Pediatrics,
(1993), Jun 30;(6) P 759-764.
15). Van Wyk W, Stander I, Journal of South African dental association, (2001) Nov;
56(11) P 533-537.
16). De Almeida CM, Journal of Community Dental Health, (2003) Dec20 (4), P 211216.
17). Simon C, Ethiopian Medical Journal, (2003) Jul; 41(3), P 245-256.
18). Dartigues C, The status of carious disease, Tropical Dental Journal, (2000) March,
23 (89), P 11-13.
19). Pandit K, International Journal of Epidemiology,(1986), Dec 15(4), P 581-583.
20). Venugopal T, Study on Dental caries, Indian Journal of Pediatric, (1998), NovDec 65 (6), P 883-889.
21). Saravanan S, Indian Journal of Dental Research, (2005), Oct-Dec16 (4), P 140-146
22). Goyal A, Gauba K,Journal of Indian Society of Pedodontics & Preventive Dentistry,
(2007); Vol 25, P 115-118
23). Bonnarde V, Bouaziz N, Journal Biologic Buccale, (1988), Dec; (4), P 225-230.
24). David J, Wang NJ, International Journal of Pediatric Dentistry (2005);Nov 15(6), P
420-425.
25). Sogi GM, Journal of the Indian Society of Pedodontics & Preventive Dentistry,
(2002), Dec; 20 (4), P 152-157.
26). Szezurek D, Annales Academics, Medical Stetinensis (1996); 42, P 223-235.

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9.

SIGNATURE OF THE CANDIDATE

10.

REMARKS OF THE GUIDE

11.

NAME AND DESIGNATION OF

11.1 GUIDE

11.2 SIGNATURE

11.3 CO-GUIDE

11.4 SIGNATURE

11.5 HEAD OF THE DEPARTMENT

11.6 SIGNATURE

12.

12.1 REMARKS OF THE CHAIRMAN

& PRINCIPAL

12.2 SIGNATURE

21