KNOWLEDGE, ATTITUDE AND PRACTICE OF DENTAL HEALTH CARE AMONG PRIMARY SCHOOL PUPILS IN ZARIA
The purpose of the study was to assess,“The knowledge, attitude and practice of dental health care among primary school pupils in Zaria”. The expo-facto research design was usedfor the study because the information needed was within the respondentsand was elicited by the research instrument. Stratified random sampling technique was employed for the study of a population of eighty six thousand and one pupils (86,0001). The 173 public primary schools were stratified into Zaria and SabonGariLocal Government Areas of Kaduna state. A sample size of 382 was drawn for the study. A self constructed questionnaire was used for the collection of data and the statistical package of social sciences (SPSS) was used for the analysis. The major hypothesis for the study states that “There is no significant relationship between knowledge, attitude and practice of dental health care among primary school pupils in Zaria”. Descriptive statistics of frequency and percentageswere used to analyse the main variables. Means and standard deviation were used to answer the research questions. The major and sub-hypotheses were tested with PPMCC and paired sample t-test respectively. The result of the major hypothesis showed that there was nosignificant relationship betweenKnowledge, Attitude and Practice of dental health care among primary school pupils in Zaria and the hypothesis was therefore retained. Generally, the result of the study revealed that the Knowledge and Attitude of dental health care among Primary school pupils in Zaria was still below satisfactory level. It also revealed that the practice of oral hygiene among the pupils was majorly the use of finger/water and salt/ash.Only a small proportion used tooth pasteand brush. The researcher recommended that there is need for their Knowledge, Attitude and Practice of dental health care to be improved upon through regular oral health education promotion programme, school teachers and parents should intensify on their effort in educating children on the importance of oral hygiene both at home and at school.
TABLE OF CONTENTS
Title Page i
Table of Contents viii
Definition of Terms xii
1.0 Introduction 1
1.1 Background of the Study 1
1.2 Statement of the Problem 3
1.3 Research Questions 5
1.4 Purpose of the Study 5
1.5 Basic Assumption 6
1.6 Hypotheses 6
1.7 Significance of the Study 6
1.8 Delimitation of the Study 7
1.9 Limitation of the Study 7
2.0 Review of Related Literature
2.1 Introduction 8
2.2 Concept of Dental Healthcare 8
2.3 Knowledge of Dental Health Care 10
2.4 Attitude of Dental Health Care 14
2.5 Practice of Dental Health Care 16
2.6 Dental Irregularities 21
2.6.1 Factors responsible for Dental Irregularities 21
2.6.2 Examples of Dental Irregularity 22
2.6.3 Effect of Dental Irregularity on Facial looks (Age). 22
2.7 Nutrition and Healthy Teeth 23
2.8Teenagers Dental Health 25
2.9 Dental Problems 26
2.9.1 Dental Caries 27
2.9.2 Dental Plaque 28
2.9.3 Dental Calculus 29
2.9.4 Materia Alba 29
2.9.5 Dental Stains 30
2.9.6 Bad Breath (Halitosis) 31
2.9.7 Gum disease 32
2.9.8 Baby bottle decay 39
2.9.9 Medication and Oral Health 39
2.10 Summary 41
3.0Research Methodology 43
3.1 Introduction 43
3.2 Research design. 43
3.3 Population of the Study 43
3.4 Sample and Sampling Techniques 44
3.5 Instrument for Data Collection 46
3.6 Validation of the instrument 47
3.7 Administration of the questionnaire 47
3.8 Statistical Techniques 47
4.0Results and Discussion 49
4.1 Introduction 49
4.2 Results 49
4.3 Discussion 58
5.0Summary, Conclusion, and Recommendation
5.1 Summary 63
5.2 Conclusion 63
5.3 Recommendation 64
Recommendation for further study 65
AppendixA: Questionnaire 73
Appendix B: Introduction Letter 77
Appendix C: Table of Sampled Schools 78
Operational Definition of Terms
Knowledge:-Information acquired about dental health care.
Attitude:-The behavior of the primary school pupils about dental health care.
Practice:- The way and manner the primary school pupils observe their oral hygiene.
Pupils :- Children between 8-13 years in primary school in Zaria.
1:1 Background of the Study
Dental health care and education have a direct relationship with the whole child‟s health and well being. Studies have shown that appropriate oral health education can help to cultivate oral health practice (Ab-murat& Watt 2006). The change to healthy attitude can beinfluenced by giving adequate information, motivation and practice of the measures to the children (Smyth, Caamano&Femandez-Reveiro 2007). Dental health education is an accepted procedure in schools based on the assumption that the knowledge needed for good dental health practice can result inbehavioural change (Betsey, 1980).Schools therefore, havetheresponsibility to help protect, maintain and improve the health of their students through the school health programmes. This is why the total school health programme is composed of school health services, health education/instruction, nutrition services and healthful school living.
The aspect of school health programme that introduces dental health education is the School health instruction – a planned, sequential curriculum that addresses the physical, mental, emotional and social dimensions of health of school children. It is designed to motivate and assist students to maintain and improve their health, prevent diseases and reduce health related risk behaviour. (Maryland School Health Services, 2006).It allows student to develop and demonstrate health related knowledge, attitude, skills and practices. The comprehensive health instructioncurriculum includes a variety of topics including dental health education where pupils are taught about oral hygiene principles and disease associated with poor dental health care. Therefore, dental health education depends largely upon the acquisition of accurate and useful knowledge concerning good dental health on the part of the students. This becomes successful when the knowledge is put into daily practice resulting in behavioural change.
In dental health as in other instructions, the compilation of facts by the learner is not enough and knowing what to do does not guarantee that it will be done (Ajala, 2005&Cooper, 2002). For example, to know that it is necessary to brush your teeth once or twice daily and actually doing it are two different things completely. In other words people may be aware of the dental ills that are associated with bad oral hygiene and yet fail to maintain it. For dental instruction to be truly successful, a change must result in attitude, habit or skill. This can be achieved by selecting learning experiences that allow the learner to perform the desired behavioural outcomes and a means to evaluate the retention of content covered and changes in behaviour of the learner.
Dental health care measures still include brushing the mouth once or twice daily.This ensures that bacteria and microbes present in the mouth are killed and removed from time to time. The use of chewing stick also helps in cleaning the teeth but not as effective because the oral cavity has a number of space that are very small and narrow where even the bristles of the brush cannot reach, hence flossing becomes an effective mechanism to ensure good dental hygiene and health as it helps to remove food particles and debris between the teeth. (Check dent, 2011). Regular visit to the dentist will also help to detect the onset of dental disease.
The aim of intervention among primary school pupils is to create awareness and increase knowledge onthe importance of oral hygiene among pupils within the ages 8-12 years to promote positive behavioural change (Nguyen 2008). .
1:2 Statement of the Problem
Surveys have shown that dental disease is on the increase globally (Bagramian 2009 & WHO, 1997). This has been attributed to many factors among children in developing nations of the world including Nigeria. One important factor is lack of knowledge of dental health care. Evidence has shown that strong knowledge of oral health demonstrates better oral care practices (Smyth, et al; 2007). It has been observed that most primary school teachers do not give dental health instruction to pupils adequately hence they are not aware of various dental health problemsassociated with poor oral hygiene. Generally, children are faced with health problems that can either predispose them to dental disease or complicate dental care. Nutritional disorder (vitamin C deficiency) and diabetes have also beenidentified as contributing factors to periodontal disease. For children with diabetes, good oral hygiene should begin at a young age (Lamster, Lalla, Borgnakke& Taylor, 2008). A lack of understanding of conditions linked with dental disease has often times hindered the process of preventing the occurrence of various dental problems among Nigerian children. Dental investigators have explained that plaque plays a definite role in the initiation and progression of dental disease. Plague is a mass of soft accumulated material, covering areas of the mouth that are not cleansed.
A lack of awareness about the link between nutrition and dental disease has also caused a lot of dental health problems like scurvy and dental caries etc. Periodontal pockets have been observed among children from as early as 10 years of age and this has been attributed to general nutritional deficiency and poor oral hygiene (Barenes 2001).
Lack of oral hygiene practices has been identified as a possible predisposing factor for occurrence of dental caries. Children generally engage in unhealthy habits that can cause dental problems like failing to brush, nibbling of sweets and consumption of sugary snacks. All these can cause acid formation which eats away the tooth enamel. The general health of children who suffer dental disease is put further at risk and because of this risk to health, their dental care is of vital importance. It is therefore paramount to instill proper oral hygiene habit early in school children in order to prevent dental ills and promote healthy teeth growth.
The researcher has personally observed tooth discoloration, dental caries and gingivitis among school children in Zaria and Sabon-Gari local government areas and was therefore prompted to investigate the knowledge, attitude and practice of dental health care among the primary school pupils.
1:3 Research Questions
The study sought to answer the following questions.
- Do primary school children in Zaria have the knowledge of dental health problems?
- What is the attitude of the school children towards dental health care?
- Do primary school children in Zaria practice dental health care?
1:4 Purpose of the Study
The purpose of the study was to investigate the knowledge, attitude and practice of dental health care among primary school pupils in Zaria and SabonGariLocalGovernment Areas of Kaduna state. Specifically,the study will find out;
- Knowledge of dental health care among primary school children in Zaria.
- Attitude of primary school pupils towards dental health care.
- Practice of dental health care among primary school pupils in Zaria.
- Basic knowledge about dental health care will improve pupil‟sattitude towards oral hygiene in Zaria.
- An awareness of the link between diet and oral health will help discourage frequent consumption of sugary snacks especially between meals.
- The practice of dental health care is influenced by classroom instruction.
For the purpose of this study, the following major and sub-hypotheses were raised.
1:6:1 Major Hypothesis
There is no significant relationship between knowledge, attitude and practice of dental health care among primary school pupils in Zaria.
- There is no significant difference between Knowledge and Attitude of dental health care among primary school pupils in Zaria.
- There is no significant difference between Knowledge and Practice ofdental health care among primary school pupils in Zaria.
- There is no significant difference between Attitude and Practice of dental health care among primary schoolpupils in Zaria.
1:7 Significance of the Study
The study which assessedthe knowledge, attitude and practice of dental health care among primary school children in Zaria is significant in the following ways.
- The result of this study will elicit information that would educate public primary school pupils within Zaria on the importance of dental health care and will also help them to cultivate healthy oral health practice thus reducing the cases of dental diseases among primary school pupils in Zaria.
- The result of this study will provide data on the level of dental health care practiceamong primary school pupils in Zaria and will show the behaviour of pupils regarding dental health care.
- The result of this study will help primary school teachers to improve on their effort in the teaching of dental health education in schools.
1:8 Delimitation of the Study
The study was delimited to; The Knowledge, Attitude and Practice of dental health care among public primary schools in Zaria. Only pupils in classes 3-6 were used for the study. These age groups are considered to have acquired health education knowledge capable of influencing behaviour in various ways. Both male and female primary school children were used for this study.
1:9 Limitation of the Study
The limitation of this study was the inability of some pupils in the lower classes to read and comprehend what was contained in the questionnaire. However, the researcher and the school teachers (research assistants) helped in overcoming this challenge by explaining and interpreting the content of the questionnaire in the language they could understand best.
2:0 REVIEW OF RELATED LITERATURE
The purpose of this study is to investigate the knowledge attitude and practice of dental health care among primary school pupils in Zaria. Thus, this chapter undertakes a review of literature related to the study and it is therefore discussed under the following subheadings.
2.2.Concept of DentalHealth Care
2.3 Knowledge of Dental Health Care
2.4Attitudeof Dental Health Care
2.5Practiceof Dental Health Care
2.6 Dental Irregularities
2.7 Nutrition and Healthy Teeth
2.8 DentalHealth of Teenagers and Children
KNOWLEDGE, ATTITUDE AND PRACTICE OF DENTAL HEALTH CARE AMONG PRIMARY SCHOOL PUPILS IN ZARIA