KNOWLEDGE,
ATTITUDE AND PRACTICE OF ORAL HYGIENE AMONG PUPILS IN AHENEMA KOKOBEN
Oscar
Agyemang Opoku1*, Erica Yeboah2,
Okudzeto
Henry3,
Nancy Plange4,
Juliana
Nyarko5
University of Cape Coast,
Cape Coast,
Ghana1
SAMLEE Nursing College,
Kumasi, Ghana2
Dodowa Health Research
Center, Ghana3
Abura Dunkwa District
Hospital,
Ghana4
Sunyani Nursing Training
College, Ghana5
Email:
[email protected]*
|
KEYWORDS Knowledge; attitude; practice; oral hygiene |
ABSTRACT The study examined the knowledge, attitudes and practices of oral
hygiene among students in Ahenema Kokoben. The study employed descriptive
design of the quantitative approach. The study sampled 60 respondents of
which 85 was made up of students. The study employed questionnaire. With the
quantitative data, it was analysed using frequencies and percentages with the
aid of Statistical Package for Service Solution. The study found that
students were knowledgeable about oral hygiene. Students have good attitude
towards oral hygiene. They thought that brushing their teeth regularly will
help prevent oral problems; regular visit to dentist is relevant; and think
that maintaining good healthy teeth is an individual responsibility. Students
have good practice regarding oral hygiene. Respondents spend small time in
brushing their teeth while small respondents brush under the supervision of their
parents. It was recommended that students should be encouraged to continue to
visit the dentist regularly and not to wait till they have issue with their
teeth. Also, students should be encouraged to spend more time in brushing
their teeth regularly and also twice a day. Moreover, parents should be
encouraged to supervise their children when brushing their teeth, especially,
among students who have decayed teeth or oral problems. Students should be
educated or sensitize about the negative effect of sweet on their oral
health. Rinsing of their mouth after meals should be encouraged among
students to ensure proper oral hygiene. |
INTRODUCTION
Despite
worldwide initiatives to improve people's health, it is still widely
disregarded as a priority (Soni et al., 2014). The high
frequency and social effect of oral disorders remain a public health concern
despite the growing recognition of the importance of oral health to overall
health (Aggnur et al., 2014). Constant
exposure to external elements, such as mechanical, chemical, and bacterial
interactions, makes oral tissues susceptible to disease (Singh et al., 2012). Since
"knowledge is the precursor to action and behavior change" (Udoye & Aguwa, 2009), oral health
educators work to provide useful information about improving people's oral
health. The World Health Organization (WHO) recommends promoting children's
oral health in schools in order to increase students' awareness, understanding,
and practice of good oral hygiene (Petersen, 2003). Dental
caries and periodontal disorders can be prevented, but only if people change
their bad habits (Selwitz et al., 2007; Reisine & Psoter, 2001). As
lifestyle habits formed in childhood greatly affect adult health, early
intervention is critical during childhood (Cohen-Carneiro et al., 2010).
Better
oral health knowledge is related to better oral health habits (Smyth et al., 2007), and better oral
health knowledge influences positive attitudes (Ab Murat & Watt, 2006). Prevention of
dental caries and periodontal disease relies heavily on self-care routines like
brushing and flossing (Ab Murat & Watt, 2006). It is
recommended that you brush your teeth at least twice a day (Löe, 2000) to keep your gums
and teeth healthy. In addition, females are more likely to stick to proper
brushing procedures than males are (Maes et al., 2006). Different
studies (Farsi et al., 2004) show, however,
that school-aged youngsters still don't floss very often.
Taking
care of one's teeth is an example of health activity that contributes to
overall wellness (Steptoe et al., 2008). Due to the close
relationship between oral and systemic health, it is crucial for dentists and
doctors to work together (Base
et al., 2008; Mumtaz & Khan, 2009; Usman et
al., 2007). Oral health is
defined as the absence of oral and face pain, cancer of the mouth and throat,
ulcers in the mouth, cavities, tooth loss, and other oral problems by the World
Health Organization (WHO, 2018). The state of one's oral health has
far-reaching consequences for one's general health and quality of life, and
this is true across the lifespan (Zusman et al., 2016).
Due to
dietary changes and other variables, the prevalence of oral illnesses is
expected to rise in low- and middle-income countries (WHO, 2018). Many
countries, especially those with lower-middle incomes, lack the resources to
treat oral disorders because of their high cost. Due to a lack of oral health
specialists and suitable services, access to primary oral healthcare is
restricted in certain areas (WHO). The World Health Organization (WHO) has
identified oral health promotion in schools as a crucial technique for
addressing these issues and preventing oral illnesses. As poor dental hygiene
can lead to serious health problems, it is essential that people understand the
importance of maintaining good oral health (Gopikrishna et al., 2016).
Children's overall health and well-being can be improved with early
instillation of oral health care practices such brushing, flossing, and
frequent dental visits (Suga et al., 2014). Teachers, as
children's first point of contact, have an important responsibility to instill
in them lifelong healthy oral hygiene practices (Amin & Al‐Abad, 2008).
To sum up,
maintaining good oral hygiene is crucial in the fight against tooth cavities
and periodontal disease. Too few people in many cultures understand the need of
good oral hygiene, and many people still use outdated techniques like using
salt water to rinse their mouths after eating (Gopikrishna et al., 2016). Having a
parent present during a child's daily oral care routine is important for the
child's dental health (Amin & Al‐Abad, 2008). Despite this,
primary school students in Ghana know relatively little about oral health,
which is why it's important to gauge students' perspectives on the topic (Al‐Omiri et al., 2006). This study
attempts to fill that void by investigating elementary school students' oral
health-related knowledge, attitudes, and behaviors in Ahenema Kokoben.
RESEARCH
METHOD
The study was conducted using a descriptive research
design. As noted by Cheruiyot (2018), descriptive study embraces collecting data to answer
questions about the contemporary situation of the study. This research design
was chosen because it helps to find suitable answers to the research question
regarding the attitude, knowledge and practices of oral hygiene among students.
The
study was conducted in Ahenema Kokoben. The school is a public school that is
located at Ahenema Kokoben, south of Anyinam and northeast of Brofoyeduru in
the Atwima-Kwanwoma district of the Ashanti Region. The general population of this study comprises of
students in Ahenema Kokoben. Basic students in Ahenema Kokoben (JHS 1-JHS 3) were included
while students who were found between class 1 to 6 were excluded. Simple random sampling technique was
used to select sixty (60) students to formed part of the study. Prior
the data collection exercise, an introductory letter was obtained from the
Head, nursing training college to allow the researchers to introduced
themselves to the management of the school. Following that, the researcher
sought permission from the respondents. With their consent, the researcher
assured them that the study was for academic purposes only and that their
responses would be kept strictly confidential and secret. Teachers of various
pupils signed the informed consent for on behave on their pupils and ensured
that their pupils were by no means harm during and after the research
activities. Overall, the students were given 20 minutes to fill the items on
the questionnaires and were immediately collected at the spot which allowed the
researcher to carefully checked for any missing information.
Data were
gathered from the respondents through the administration of questionnaire. Data
were cleaned and coded before actual data analysis. Data entered were saved on
the removable disk and kept in a drawal which is locked. This prevented anyone
from getting access to the data of the study. All the responses for each item in the questionnaire were
then entered, processed and analysed with the help of Statistical Product for
Social Science (SPSS) and with the results presented using descriptive
statistical tools such as frequencies, percentages, mean and standard
deviation. For
instance, frequencies, percentages and tables were used to analyse the
demographic information of respondents
whereas means and standard deviation were also used to analyse the
research objectives. After the
data analysis, the data was discarded from the removable disk and permanently
deleted from the computer.
RESULTS AND
DISCUSSION
Demographic
Information of Respondents
About 65
percent of the respondents were females while 35 percent was males. This shows
that most of the respondents were females. Most of the respondents were above
15 years of age while small proportion was below 15 years of age. Also, about
10 of the respondents where found below 12 years of age. It was found that majority
of the respondents were Christians, followed by moslem while few of the
respondent was traditionalist. About 26 of the respondents were found in JHS1,
followed by JHS2 while few of the respondents were found in JHS 3. More than
half of respondents stayed with their parents while about 42 percent of the
respondents do not stay with their parents.
Knowledge of Students on Oral Hygiene
Objective
one sought to examine the knowledge of students on oral hygiene. Therefore,
data were gathered on different issues concerning oral hygiene and the results
are presented in Table 1.
Table 1. Knowledge of students on Oral
Hygiene
|
Statements
|
Yes
|
No
|
Don’t
know |
|
Teeth is an important
part of your body |
60(100) |
0 |
0 |
|
Oral health has an impact
on general health |
59(98.3) |
0 |
1(1.7) |
|
We should brush our teeth
twice daily |
59(98.3) |
0 |
1(1.7) |
|
Brushing your teeth
regularly will prevent oral problems |
60(100) |
0 |
0 |
|
Irregular tooth brushing
causes tooth ache |
54(90) |
0 |
6(10) |
|
Sweets negatively affect
teeth |
16(26.7) |
0 |
44(73.3) |
|
Fizzy drinks negatively
affect teeth |
52(86.7) |
0 |
8(13.3) |
|
Teeth cleaning prevents
dental caries |
56(93.3) |
0 |
4(6.7) |
|
Use of Fluoride is
essential for teeth |
56(93.3) |
0 |
4(6.7) |
|
Improper cleaning of
tongue results in bad breath |
52(86.7) |
0 |
8(13.3) |
|
Sweets/Fizzy drinks
causes oral problem |
54(90) |
0 |
6(10) |
|
Mouth rinsing after
having meals , sweets and drinks
prevents oral problems |
52(86.7) |
0 |
8(13.3) |
|
Maintaining a good oral
hygiene prevents tooth decay |
60(100) |
0 |
0 |
|
Decayed/caries teeth
affect the teeth appearance |
57(95) |
0 |
3(5) |
|
The dentist examines the
patients and inform about dental problem |
60(100) |
0 |
0 |
|
The appearance of decayed
teeth affects human |
53(88.3) |
0 |
7(11.7) |
|
The regular visits to
dentist are essential |
57(95) |
0 |
3(5) |
Table 1 shows that
all the respondents (100%) know that their teeth is an important part of their
body and therefore, bushing their teeth regularly will prevent oral problems.
About 98 percent of the respondents agreed that oral health has an impact on
their general health and therefore believed that they should brush twice a
day.
Also, majority of the respondents (86.7%)
believed that fizzy drinks negatively affect teeth, 93 percent said that teeth
cleaning prevents dental caries and use of fluoride is essential for teeth, and
about 86 percent of the respondents believed that improper cleaning of tongue
results in bad breath. However, only about 26 percent of the respondents were
aware that sweet negatively affect their teeth.
Moreover, all the respondents agreed that
maintaining a good oral hygiene prevents tooth decay and see a dentist as a
professional who examine the patients and inform about dental problems.
Furthermore, about 95 percent of the respondents agreed that regular visit to
dentist are essential. This is very important since most of the people only
visit the dentist when they have oral problems.
Attitude of Students on Oral Hygiene
Objective two sought to examine the
attitude of students on oral hygiene. Therefore, data were gathered on different
issues concerning oral hygiene and the results are presented in Table 2.
Table 2. Attitude of Students on Oral
Hygiene
|
STATEMENTS
|
Yes
|
No
|
Don’t
know |
|
Do you think it’s
important to brush your teeth twice daily? |
59(98.3) |
0 |
1(1.7) |
|
Do you think brushing
your teeth regularly will prevent oral problems |
60(100) |
0 |
0 |
|
Do you think improper
cleaning of tongue results in bad breath? |
58(96.7) |
0 |
2(3.3) |
|
Do you think poor oral
hygiene prevents you from smiling & laughing with friends? |
49(81.7) |
0 |
11(18.3) |
|
Do you think oral
problems force you to miss school? |
25(41.7) |
2(3.3) |
33(55) |
|
Do you think maintaining
healthy teeth are an individual responsibility? |
59(98.3) |
0 |
1(1.7) |
|
Do you think school plays
an important role in maintaining oral hygiene? |
59(98.3) |
0 |
1(1.7) |
|
Do you think regular
visit to dentist is necessary? |
56(93.3) |
0 |
4(6.7) |
|
Do you think dentist
helps to maintain oral health? |
56(93.3) |
0 |
4(6.7) |
|
Do you think your parents
are the cause for your visit to dentist? |
7(11.7) |
0 |
53(88.3) |
|
Do you think pain or
discomfort is the only reason for you to visit a dentist? |
9(15) |
0 |
51(85) |
Table 2 revealed that all the respondents
(100%) agreed that brushing their teeth regularly will help prevent oral
problems and therefore, maintaining good healthy teeth is an individual
responsibility. Also, about 98 percent of the respondents believed that school
has a role when it comes to oral hygiene, 93 percent of the respondents thought
that regular visit to dentist is necessary; and dentist helps to maintain oral
health.
Moreover, about 41 per cent of the
respondents thought that oral problems force children to miss school and about
15 percent of the respondents though that children visit dentist only due to
pain or discomfort.
Practices of Students on Oral Hygiene
Objective three
sought to examine the practice of students on oral hygiene. Therefore, data
were gathered on different issues concerning oral hygiene and the results are
presented in Table 3, 4, 5, 6, 7, 8 and 9.
Table
3. How often
do you brush your teeth regularly
|
|
Frequency |
Percent |
|
Once
|
27 |
45 |
|
Twice
|
33 |
55 |
|
Total
|
60 |
100 |
Table 3 shows
that about 27 of the respondents brush only once in a day while 33 respondents
claimed that they brush twice in a day. Thus, a little beyond half of the
respondents brush twice daily. This is a good practice and therefore, more
children should be encouraged to do same for proper oral hygiene.
Table
4. What
do you use to brush your teeth regular
|
|
Frequency
|
Percent
|
|
Tooth
paste and tooth brush |
45 |
75 |
|
Tooth
powder |
1 |
1.7 |
|
Mouth
wash |
14 |
23.3 |
|
Total
|
60 |
100 |
Table
4 shows that about 45 respondents used tooth paste and tooth brush in brushing
their teeth often, followed by 14
respondents who used mouth wash sometimes. However, only a respondent used
tooth powder to brush his/her teeth. It can be deduced that majority of the
respondents used the right materials or things to brush their teeth. However,
just mouth wash is not advisable, especially, when it is used daily in the
morning without proper brushing.
Table
5. Do you
brush in front of your parents
|
|
Frequency |
Percent |
|
Yes
|
20 |
40 |
|
No
|
40 |
60 |
|
Total
|
60 |
100 |
Data were
gathered on the supervision of the parents on children during their teeth
brushing period. Table 5 shows that about two-thirds of the respondents brush
without the presence of their parents while about 40 percent of the respondents
do so before their parents. This shows that most of the respondents brush their
teeth without any supervision form their parents while small proportion always
need supervision and guidance in brushing their teeth.
Table
6. How often
do you change your brush
|
|
Frequency |
Percent |
|
Every
month |
17 |
28.3 |
|
Every
2 months |
15 |
25 |
|
Every
3 months |
13 |
21.7 |
|
Every
6 months |
14 |
23.2 |
|
A
year |
1 |
1.7 |
|
Total
|
60 |
100 |
Data were
gathered on how often respondents change their brush and the result is
presented in Table 6. It was revealed that about 17 respondents change their
tooth brush monthly, followed by 15 respondents who change their tooth brush
every 2 months while only a respondent change his/her brush yearly. This
implies that majority of the respondents often change their tooth brush at
least for every quarter. This is a good practice to ensure proper oral hygiene
since most of the children mishandled their tooth brush and therefore,
replacing them quarterly will help a lot.
Table
7. Some
practice of students on oral hygiene
|
STATEMENTS |
Yes |
No |
Don’t know |
|
Do
you rinse your mouth after meal/sweets/fizzy drinks |
33(55) |
27(45) |
0 |
|
Do
you clean your tongue regularly |
55(91.7) |
5(8.3) |
0 |
|
Do
you parents follow up on you when brushing your teeth |
13(21.7) |
47(78.3) |
0 |
|
Have
you visit a dentist before |
40(66.7) |
20(33.3) |
0 |
According
to Table 7, a little about half (55%) of the respondents agreed that they rinse
their mouth after meal/sweets/fizzy drinks while small proportion (25%) of the
respondents do not. This shows that about half of respondents do not rinse
their mouth after meals.
Also, majority
of respondents (91.7%) clean their tongue regularly while only few (8.3%) of
the respondents do not. Moreover, 13 (21.7%) of the respondents’ parents follow
up on them when brushing their tenth while 78 percent of the respondents’
parents do not. Thus, majority of respondents brush their teeth without any
supervision from their parents.
On visit to the
dentist, about two-thirds of respondents have visited before while about
one-third of the respondents have not. It deduced that most of the respondents
have visited the dentist before.
Table
8. Time used
by respondents to brush their teeth
|
Time needed to clean your
teeth |
Frequency |
Percent |
|
Less
than a minute |
2 |
3.3 |
|
A
minute |
3 |
5 |
|
Two
minutes |
22 |
36.7 |
|
More
than two minutes |
18 |
30 |
|
Don’t
know |
16 |
25 |
|
Total
|
60 |
100 |
According
to Table 8, 22 respondents used two minutes to brush their teeth, followed by
18 respondents who used more than two minutes. In addition, only 5 respondents
used less than two minutes to brush while 16 respondents do not know the exact
time they take to brush their teeth. This means that only small number of
respondents spend more time to brush their teeth.
Table
9. How
often students eat sweet in a week
|
Often |
Frequency |
Percent |
|
Daily
|
12 |
20 |
|
Once
a week |
36 |
60 |
|
Twice
a week |
3 |
5 |
|
No
sweet |
9 |
15 |
|
Total
|
60 |
100 |
Table 9 shows
that about two-thirds of the respondents eat sweet once a week, followed by 12
respondents who eat sweet daily and 3 respondents eat sweet twice a week.
However, only 9 respondents do not eat any sweet.
Table
10. Number
of decayed teeth
|
|
Frequency |
Percent |
|
One
|
18 |
30 |
|
Two
|
2 |
3.3 |
|
None
|
40 |
66.7 |
|
Total
|
60 |
100 |
Table 10 shows
that about 30 percent of the respondents have one decayed teeth, followed by 2
respondents who have 2 teeth decayed while 40 respondents do not have any
decayed tooth. Thus, about two-thirds of the respondents do not have any
decayed tooth.
Table
11. When do
you clean your teeth
|
|
Frequency |
Percent |
|
Before
eating |
42 |
42 |
|
After
eating |
2 |
2 |
|
Before
going to bed |
33 |
33 |
|
At
any time |
3 |
3 |
|
Before
eating and before going to bed |
20 |
20 |
|
Don’t
remember |
0 |
0 |
|
Total
|
100 |
100 |
Time for
brushing teeth is crucial when it comes to oral hygiene. Therefore, data were
gathered from the respondents to indicate the time they used to brush their
teeth and the result is presented in Table 11. It shows that 42 percent of the
respondents brush before eating, followed by 33 percent who claimed that they
brush before going to bed and 3 respondents brush their teeth any time.
However, 20 of the respondents brush their teeth before eating and before going
to bed daily. Thus, small number of respondents brush their teeth twice in the
day, thus, before eating and before going to bed. This is the recommended
standard for proper oral hygiene.
Discussions
Knowledge
of Students on Oral Hygiene
The study
found that all the respondents (100%) know that their teeth is an important
part of their body and therefore, bushing their teeth regularly will prevent
oral problems. About 98 percent of the respondents agreed that oral health has
an impact on their general health and therefore believed that they should brush
twice a day. Also, majority of the respondents (86.7%) believed that fizzy
drinks negatively affect teeth, 93 percent said that teeth cleaning prevents
dental caries and use of fluoride is essential for teeth, and about 86 percent
of the respondents believed that improper cleaning of tongue results in bad
breath. However, only about 26 percent of the respondents were aware that sweet
negatively affect their teeth. Moreover, all the respondents agreed that
maintaining a good oral hygiene prevents tooth decay and see a dentist as a
professional who examine the patients and inform about dental problems.
Furthermore, about 95 percent of the respondents agreed that regular visit to
dentist are essential.
Oral
health knowledge is necessary for establishing healthy behaviors, and studies
have demonstrated a link between improved knowledge and better oral health (Gupta et al., 2012; Haque et al., 2016).
This finding is similar to the view of
Yusuf et al. (2007) that pupils are knowledge able about their oral
health and pupils often referred to
as the intellectual
period or the period of school
compatibility.
Attitude
of Students on Oral Hygiene
It was revealed
that all the respondents (100%) agreed that brushing their teeth regularly will
help prevent oral problems and therefore, maintaining good healthy teeth is an
individual responsibility. Also, about 98 percent of the respondents believed
that school has a role when it comes to oral hygiene, 93 percent of the
respondents thought that regular visit to dentist is necessary; and dentist
helps to maintain oral health. Moreover, about 41 per cent of the respondents
thought that oral problems force children to miss school and about 15 percent
of the respondents thought that children visit dentist only due to pain or
discomfort. Ab-Murat and Watt (2006) reported
that appropriate oral health education can help to implant good oral health
practice. Therefore, with adequate knowledge and attitude, pupils were expected
to put it into a good practice.
Practices
of Students on Oral Hygiene
It was
found that a little beyond half of the respondents brush twice daily. This is a
good practice and therefore, more children should be encouraged to do same for
proper oral hygiene. About 45 respondents used tooth paste and tooth brush in
brushing their teeth often, followed by 14 respondents who used mouth wash
sometimes. However, only a respondent used tooth powder to brush his/her teeth.
It can be deduced that majority of the respondents used the right materials or
things to brush their teeth. However, just mouth wash is not advisable,
especially, when it is used daily in the morning without proper brushing.
Most of
the respondents brush their teeth without any supervision form their parents
while small proportion always need supervision and guidance in brushing their
teeth. Majority of the respondents often change their tooth brush at least for
every quarter. A little about half (55%) of the respondents agreed that they
rinse their mouth after meal/sweets/fizzy drinks while small proportion (25%)
of the respondents do not. Also,
majority of respondents (91.7%) clean their tongue regularly while only few
(8.3%) of the respondents do not. Majority (78%) of respondents brush their
teeth without any supervision from their parents. On visit to the dentist,
about two-thirds of respondents have visited before while about one-third of
the respondents have not. It deduced that most of the respondents have visited
the dentist before.
Only small
number of respondents spend more time to brush their teeth. Two-thirds of the
respondents eat sweet once a week, followed by 12 respondents who eat sweet
daily and 3 respondents eat sweet twice a week. However, only 9 respondents do
not eat any sweet. About 30 percent of the respondents have one decayed teeth,
followed by 2 respondents who have 2 teeth decayed while 40 respondents do not
have any decayed tooth. Thus, about two-thirds of the respondents do not have
any decayed tooth. About 42 percent of the respondents brush before eating,
followed by 33 percent who claimed that they brush before going to bed and 3
respondents brush their teeth any time. However, 20 of the respondents brush
their teeth before eating and before going to bed daily. Thus, small number of
respondents brush their teeth twice in the day, thus, before eating and before
going to bed. This was in support of
Ab-Murat and Watt (2006) who
found that tooth brushing and dental flossing are important self-care practices
for prevention of dental caries and periodontal diseases. According to research
on young Saudi people' perceptions of their own oral health habits undertaken
by Al-Ansari et al. (2020), those with a
poor grasp of oral health and an addiction to the Internet consumed less sugar
than those with an average or high Internet consumption. Oral health education
in elementary or secondary school may lead to better oral health practices, as
suggested by research by Taniguchi-Tabata et al. (2017) on links between
dental knowledge and oral behavior in Japan.
CONCLUSION
Students have good attitude towards oral
hygiene. They thought that brushing their teeth regularly will help prevent
oral problems; regular visit to dentist is relevant; and think that maintaining
good healthy teeth is an individual responsibility.
Students have good practice regarding oral
hygiene. Thus, they brush regularly with appropriate resources or materials
such as tooth brush and tooth paste while few brush twice a day. Respondents
spend small time in brushing their teeth while small respondents brush under
the supervision of their parents.
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Oscar Agyemang Opoku, Erica
Yeboah, Okudzeto Henry, Nancy Plange, Juliana Nyarko (2023)
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