|Year : 2017 | Volume
| Issue : 1 | Page : 21-24
Effectiveness of prevention-oriented school oral health program in a private school in Pimpri, Pune
Nitin Gupta, Ladusingh Rajpurohit, Sushil Phansopkar, Deepti Agarwal, Pradnya Kakodkar, Sahana Hegde-Shetiya
Department of Public Health Dentistry, Dr. D. Y. Patil Dental College and Hospital, D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
|Date of Web Publication||3-Jul-2017|
Department of Public Health Dentistry, Dr. D. Y. Patil Dental College and Hospital, D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra
Source of Support: None, Conflict of Interest: None
Introduction: Programs oriented toward prevention have proven to be highly rewarding in reducing the dental disease burden in western populations. Some developing countries have also reported studies of school health programs with varying effectiveness. However, reports regarding improved effectiveness due to mobile dental unit are scarce. Thus, the present study aims at assessment of effectiveness of prevention-oriented school health program in a private school in Pimpri, Pune. Materials and Methods: A longitudinal study was conducted from May 2015 to June 2016 in Dr. D.Y. Patil school among 449 students aged 5 and 10 years using census sampling. Ethical clearance was obtained from Institutional Ethics Committee of Dr. D. Y. Patil Dental College and Hospital and permission was obtained from the school principal. The study was conducted in 3 phases. SPSS version 18 was used for analyzing the data. Results: There was significant reduction in decayed component and a significant increase in filled component in primary and permanent dentition. There was a significant reduction in treatment needs, i.e., one surface, two surface fillings, and pulp care and restoration. Conclusion: It can be concluded that this prevention-oriented 1-year program was helpful in improving the oral health of the children.
Keywords: Dental caries, oral health program, prevention, school children
|How to cite this article:|
Gupta N, Rajpurohit L, Phansopkar S, Agarwal D, Kakodkar P, Hegde-Shetiya S. Effectiveness of prevention-oriented school oral health program in a private school in Pimpri, Pune. J Dent Res Rev 2017;4:21-4
|How to cite this URL:|
Gupta N, Rajpurohit L, Phansopkar S, Agarwal D, Kakodkar P, Hegde-Shetiya S. Effectiveness of prevention-oriented school oral health program in a private school in Pimpri, Pune. J Dent Res Rev [serial online] 2017 [cited 2022 Dec 3];4:21-4. Available from: https://www.jdrr.org/text.asp?2017/4/1/21/209362
| Introduction|| |
Programs oriented toward prevention have proven to be highly rewarding in reducing the dental disease burden in western populations. The western civilization recognized this and adapted its policies toward school health programs as early as the early decades of 20th century. Scandinavian countries have pioneered in introducing the school health programs and by the 1960s, most of these countries had school dental health policies for covering a majority of the school going children.,,,
The impact of these programs on population has been enormous. The first and second international conferences on changing prevalence of dental caries have emphasized that prevention-oriented programs introduced in the schools have been effective in decline of dental caries prevalence. The preventive advice for oral hygiene maintenance in school settings has been proved to improve the oral hygiene, reduce plaque, and gingivitis. The blanket referrals of the schools have improved the dental care, reduced the untreated dental caries, and increased the filled component of decayed, missing, and filled teeth (DMFT). The school health programs have effectively adopted school brushing drills, inclusion of dental health-related topics in school curriculum and participation of parents and community in improvement of oral health.
Some developing countries have also reported studies of school health programs with varying effectiveness. The dental institutions hold a social responsibility for conducting such programs. Although the Dental Council of India prescribes curriculum for conducting school health programs, reports of effectiveness of such programs does exist in the dental literature. However, reports regarding improved effectiveness due to mobile dental unit are scarce.
Thus, the present study aims at assessment of effectiveness of prevention-oriented school health program in a private school in Pimpri, Pune. The objectives were to assess the caries experience and treatment needs of school children at baseline and after 1 year and effectiveness of blanket referrals on reported utilization of dental services.
| Materials and Methods|| |
Study design and population
A longitudinal study was conducted from May 2015 to June 2016 in Dr. D. Y. Patil school among 449 students aged 5 and 10 years using census sampling. Ethical clearance was obtained from the Institutional Ethics Committee of Dr. D. Y. Patil Dental College and Hospital and permission were obtained from the School Principal.
The study was conducted in the following phases:
Phase I: Oral health screening
All included children underwent screening for dental caries in the month of May and June 2015. Calibrated dentists of Public Health Dentistry Department carried out the survey. Each child's caries status and treatment needs were recorded using modified WHO pro forma 1997 at baseline. Referral card was given and all the children needing further care were free to visit any dentist of their choice including the dental college and hospital.
Phase II: Health education program
Group health education was provided through audio-visual aids to each class in the school by the Department of Public Health Dentistry. The parents were also provided health education on the day of parents-teachers meeting in the month of December 2015. The health education given to children consisted of one lecture of 30 min duration through powerpoint presentation. A booklet of instructions including diet, self-care, and related activities such as brushing and flossing techniques was handed over to the class teacher and was put up on the notice board for students to refer.
Phase III: Screening for caries experience
The children were screened after 1 year in May and June 2016.
SPSS version 18 (IBM Corporation) was used for analyzing the data. Mean and standard deviation of the scores were calculated. The intragroup comparison was done with Wilcoxon signed-rank test.
| Results|| |
The present study was conducted among 449 school children of Dr. D. Y. Patil School Pimpri. The demographic data are presented in [Table 1].
The results are as follows:
The decayed (D), filled (F), d, and f scores improved from baseline after the health education [Table 2] and [Table 3]. Treatment need as interpreted by one surface filling, two surface filling, pulp care, and extractions reduced after the intervention [Table 4] and [Table 5].
|Table 3: Comparison of treatment needs (teeth) before and after intervention|
Click here to view
|Table 4: Comparison of teeth status between baseline and after health education|
Click here to view
|Table 5: Comparison of treatment needs between baseline and after health education|
Click here to view
There was significant reduction in decayed component and a significant increase in filled component in primary and permanent dentition.
There was significant reduction in treatment needs, i.e., one surface, two surface fillings, and pulp care and restoration.
| Discussion|| |
It has been reported that in the present study, the majority of students with dental caries were in the 5–10 years age group with a mean age group of 7 years [Table 1].
The entire sample of 449 had an almost equal distribution of males, 45% and females, 55% [Table 1]. The baseline data showed higher D-component when compared to M and F component in the DMFT index; however, after health education intervention, the D-component drastically shifted to the F-component (i.e., 62%) which indicates that awareness helped seek dental care [Table 2]. Similar result was found in the 3-year follow-up study conducted by Petersen et al. and Chachra et al. conducted among children aged 5–16 years. Highly significant reduction in DMFT scores was observed. However, no difference in pre- and post-health education DMFT score was found between the study participants aged 12–15 years in the study conducted by Ajithkrishnan et al. and Bhardwaj et al. The reasons could be that they were educated and motivated to take dental care at the earliest keeping in mind all the possible outcomes of having decayed tooth taught to them during the dental health education program. The teachers and some parents who were imparted health education could have played a role in reinforcement.
The deciduous dentition also showed an improvement in the dft score by 55.5% by shifting the d-component to f-component at the mean age of 7 years [Table 2], and this, results were found in accordance to the study conducted by Petersen et al.
The improvement was seen more sensitive when the comparison of treatment needs was done after intervention that stated one surface fillings improved by 56.9%, two surface fillings by 59.5%, pulp care restoration by 61.2%, and extractions by 84.7% [Table 3]. The results indicate that health education and reinforcement can prove effective in improving the oral health status in school children.
Overall reduction in treatment needs between baseline and after health education was seen among the study participants and was found to be statistically significant and the results were in accordance with the study conducted by Anupriya Sharma et al. among 5–8 years children, dissimilar results were seen in children aged 9–12 years in the same study. This could be attributed to the effect of oral health education and intervention, which lead to an increase in the awareness regarding oral health, and moreover, increased visits to the dentist resulted in a decrease in the caries experience. School age is an influential stage in people's lives, a time when lifelong sustainable oral health-related behaviors as well as beliefs and attitudes are developed. Children are particularly receptive to health messages during this period and the earlier the good habits are established, the longer the impact of these habits will last. Moreover, the messages can be reinforced regularly throughout the school years.
The schools have a rigid curriculum and do not readily oblige to dedicate time for dental programs. The parents were approached for providing health education during the parents-teachers meeting, but only a few complied. Prevention by reinforcement every 3 months is required. The present program had an interaction only once during the 1-year study period. The study participants' age ranged from 5 to 10 years.
| Conclusion|| |
It can be concluded that this prevention-oriented 1-year program was helpful in improving the oral health of the children. However, prevention is not a one-time activity, but lifelong. Hence, to sustain this improvement, the program needs to be continued, and further long-term effects of this program need to be evaluated.
This study is a part of the Staff research project wherein Dr. D. Y. Patil Vidyepeeth, Pune, has granted Rs. 1,539874 to procure a new mobile dental clinic.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
O'Mullane D, Whelton H. Caries prevalence in the Republic of Ireland. Int Dent J 1994;44 4 Suppl 1:387-91.
Truin GJ, König KG, Bronkhorst EM. Caries prevalence in Belgium and The Netherlands. Int Dent J 1994;44 4 Suppl 1:379-85.
von der Fehr FR. Caries prevalence in the Nordic countries. Int Dent J 1994;44 4 Suppl 1:371-8.
Downer MC. Caries prevalence in the United Kingdom. Int Dent J 1994;44 4 Suppl 1:365-70.
Downer MC. Changing pattern of dental disease in the western world. Cariology Today. Basel: Karger; 1984. p. 1-12.
Kressin NR, De Souza MB. Oral health education and health promotion. In: Gluck GM, Morganstein WM, editors. Community Dental Health. 5th
ed. New York: Mosby Publishers; 2003. p. 277-377.
Petersen PE, Peng B, Tai B, Bian Z, Fan M. Effect of a school-based oral health education programme in Wuhan City, Peoples Republic of China. Int Dent J 2004;54:33-41.
Chachra S, Dhawan P, Kaur T, Sharma AK. The most effective and essential way of improving the oral health status education. J Indian Soc Pedod Prev Dent 2011;29:216-21.
] [Full text]
Ajithkrishnan CG, Thanveer K, Sudheer H, Abhishek S. Impact of oral health education on oral health of 12 and 15 year old schoolchildren of Vadodara city, Gujarat state. J Int Oral Health 2010;2:15-20.
Bhardwaj VK, Sharma KR, Luthra RP, Jhingta P, Sharma D, Justa A. Impact of school-based oral health education program on oral health of 12 and 15 years old school children. J Educ Health Promot 2013;2:33.
Sharma A, Bansal P, Kaur G, Sharma A, Sharma N, Sharma P. The effect of oral health education and treatment on dental caries prevalence among primary schoolchildren in Nagrota Bagwan Block of Kangra, Himachal Pradesh, India: A school-based cross-sectional study. J Indian Acad Spec Res 2015;2:59-63.
World Health Organization. The Status of School Health. Report of the School health Working Group and the WHO Expert Committee on Comprehensive School Health Education and Promotion. Geneva: WHO; 1996.
Petersen PE, Torres AM. Preventive oral health care and health promotion provided for children and adolescents by the Municipal Dental Health Service in Denmark. Int J Paediatr Dent 1999;9:81-91.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]