|Year : 2018 | Volume
| Issue : 1 | Page : 31-35
Evaluation of oral health awareness of secondary school teachers
Edomwonyi I Augustine1, Oyapero Afolabi2
1 Department of Preventive Dentistry, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
2 Department of Preventive Dentistry, Lagos State University College of Medicine, Ikeja, Lagos State, Nigeria
|Date of Web Publication||5-Jan-2018|
Edomwonyi I Augustine
Department of Preventive Dentistry, Lagos State University Teaching Hospital, Ikeja, Lagos State
Source of Support: None, Conflict of Interest: None
Background: Teachers play key roles in the educational system, and if well trained and motivated on oral health, they may be able to impart this knowledge to their pupils. The aim of this study was to evaluate the oral health awareness of secondary school teachers. Materials and Methods: This was a cross-sectional study conducted amongst 120 teachers in eight secondary schools in Lagos State using a self-administered questionnaire. Information obtained included sociodemographic data and oral health knowledge, attitude and practices of the respondents. Data entry and analysis were done using the SPSS version 20. Confidence interval for statistical tests was set at 95% at P < 0.05. Results: Response rate was 100%. The majority of the teachers in the eight schools obtained an oral health knowledge score of 58.33%, which was fair. Only 27.5% of teachers in the sampled schools had a positive attitude towards oral health while 72.5% had a negative attitude. The oral health practices of 26% of the teachers was poor, 63.5% had fair oral health practices while 26.0% of the teachers had good oral health practices. Conclusion: Overall, the oral health knowledge and practice was fair among the school teachers and majority had a negative attitude towards oral health. With further education, they should be able to serve as agents of oral health education in schools.
Keywords: Attitude, knowledge, practice, schools, teachers
|How to cite this article:|
Augustine EI, Afolabi O. Evaluation of oral health awareness of secondary school teachers. Adv Hum Biol 2018;8:31-5
| Introduction|| |
Oral health is fundamental to the general health and well-being of people because of its significant impact on the quality of life.,, Poor oral health among children has been related to the loss of considerable hours in school each year, reduced learning, decreased school performance and less success later in life., Studies have shown that there is a low awareness and poor attitude to oral health in Nigeria irrespective of the educational status of the respondents. The oral healthcare-seeking behaviour of Nigerians has been symptoms based rather than preventive based while the delivery of oral healthcare has traditionally been treatment oriented,, hence there is a need for health campaigns to focus efforts at creating demand for oral healthcare services, for both preventive and curative purposes.
The oral health challenges affecting the Nigerian nation as highlighted above are reflected in Lagos State because of its multiethnic nature.,, Lagos is a densely populated cosmopolitan state located in the South-West geopolitical zone of Nigeria. It was estimated to have a population of about 9,113,605 million people in 2006. There are 821 practicing dental surgeons in Lagos; this gives a ratio of 1:24,360. There is a skewed distribution of dental clinics and facilities in the State as majority of the dentists are based in the urban areas and some rural communities have no dentist or dental facility, this may explain why some individuals are unable to access oral healthcare in the state.,, The oral health situation in the state demands that community-based oral health preventive programmes should be implemented statewide if oral diseases are to be curtailed from growing to an epidemic level.
Health education is an accepted approach in the prevention of oral diseases. It is a process of transmission of knowledge and skills necessary for improvement in the quality of life. Planned health education programmes not only bring about new behaviours, but also reinforce and maintain healthy behaviours that will promote and improve the health of individuals, in the community. To achieve the goals of a health education programme, schools are thought to be the most suitable environment to provide health information to children. A good and efficiently-run school health programme can be one of the most cost-effective ways of delivering oral health education (OHE).
Traditionally, OHE has largely been given in schools by the dentist or the dental hygienist, and the cost-effectiveness, efficiency, widespread effect and sustainability of this method are doubtful since there is an acute shortage of dental personnel. School teachers influence a large number of children because they spend most of their time in school with them and can therefore play a major role in planning and implementation of preventive oral health programmes. They can provide the necessary skills about oral healthcare to children and also help in the early detection of oral diseases.,
Studies have shown that the utilisation of teachers for delivering and reinforcing OHE is effective., However, teachers often lack adequate knowledge of oral health and hence are not able to adequately inform the children, resulting in deficient OHE sessions in schools.,, For a school oral health care programme to be successful, there should be full participation of teachers who have up-to-date oral health information and must be able to impact positively on the life of the pupils. With appropriate training workshops and seminars, teachers may gain proficiency in teaching oral health topics. This study aims to evaluate the oral health awareness of secondary school teachers in Nigeria.
| Materials and Methods|| |
Lagos is a metropolitan city of diverse population of Nigerians located in the southwestern part of Nigeria. It has a population of about 9,113,605 million people as at 2006 and the city is about 3345 km2, bounded by Ogun state to the north and east, the Bight of Benin to the south and the Republic of Benin to the west. The study was conducted in eight secondary schools in Lagos State, whose inhabitants are majorly of the Yoruba tribe. Four schools were selected in the urban area and the remaining four schools were chosen from the rural areas of the state.
This is a descriptive cross-sectional study.
The study population was made up of secondary school teachers in the eight selected schools in Lagos State.
The study period was November 2016.
Sample size calculation for teachers participating in this study
The formula for cross-sectional studies was used to calculate the sample size of teachers recruited for the study:
n = the calculated sample size,
P = Prevalence of good knowledge of oral health among teachers = 2.5%
Q = 1– p
d = Precision taken as 0.04.
n = 104.0.
This was rounded up to 110. To take care of attrition and non-response, 10%, which is 11, was added to the number calculated for sample size to give a total number of 121 teachers, which was rounded up to 120 teachers. Approximately 120 teachers in total were recruited for the study i.e., 15 teachers from each of the selected schools.
Sampling technique for the selection of schools
The secondary schools selected for the study were picked through a multistage sampling technique involving two stages. The first stage involved the selection of two local government areas from the list of twenty local government areas in the state, namely Coker Aguda (urban) and Ikorodu (rural) local government areas.
The 2nd stage involved the selection of the participating schools from the list of public secondary schools in the selected local government areas, using the list of public secondary schools in Coker Aguda and Ikorodu local government areas as the sampling frame. Eight secondary schools were selected in the local government area by the simple random sampling technique using the balloting method. The selected secondary schools in Coker Aguda local government areas were Jubilee Junior Secondary School, Jubilee Senior Secondary School, Coker Junior Secondary School and Coker Senior Secondary School. The selected schools in Ikorodu local government area were Majidun Junior Secondary School, Majidun Senior Secondary School, Ipakodo Junior Secondary School and Ipakodo Senior Secondary School.
Sampling technique for the selection of teachers
Consenting teachers were recruited into the study by simple random sampling (balloting method), with the nominal roll serving as the sampling frame. Approximately 120 teachers in total were recruited for the study i.e., 15 teachers from each of the selected schools.
Teachers who gave their consent to participate in the study and had at least a National Certificate of Education (NCE) certificate were enlisted. Those who have had training on oral health and those who have withheld their consent were excluded from the study.
Approval for the study was obtained from the Health Research Ethics Committee of the Lagos State University Teaching Hospital. Written informed consent was obtained from the teachers.
Data collection instruments
A self-administered modified questionnaire was used to evaluate the level of oral health knowledge, attitude and practice of the participating teachers. The questionnaire was adopted from Petersen et al. and Stenberg et al. The first part of the questionnaire obtained the sociodemographic information of the teachers. The second part of the questionnaire consists of questions that assessed oral health knowledge while the third part had questions that assessed attitude and practice.
Evaluation of knowledge, attitude and practice
To assess knowledge, attitude and practice of respondents, correct answers to the questions in the relevant section were awarded a score of 1, while wrong answers, including non-response i.e., ‘I don't know’ answers were scored 0. Attitude was scored either as 1 (positive) or 0 (negative). Right responses to practice questions were similarly given a score of 1, while wrong answers, including non-response i.e., ‘I don't know’ answers were scored 0. The total score was calculated by summing up all the awarded marks, and this was converted to percentages. Using the criteria established in a study conducted in Lagos among nurses by Odusanya et al., respondents who obtained scores of <50% were classified as having ‘Poor’ knowledge, those who obtained scores of 50%–74.9% were classified as having ‘Fair’ knowledge while those whose scores were 75% and above were classified as having ‘Good’ knowledge. Similar measures were used to assess the practice and attitude of respondents.
Data entry and analysis were done using the Statistical Package for the Social Sciences version 20.0 (SPSS Inc., Chicago, IL, United States). Percentages, means and standard deviation of numerical variables were determined and percentages of categorical variables were calculated. Wilcoxon signed-rank test and the McNemar Chi-square test were used to determine the level of association between numerical and categorical variables, respectively. Confidence interval for all statistical tests was set at 95% and P < 0.05 was accepted to be statistically significant. Microsoft Excel was used to draw tables.
| Results|| |
Sociodemographic characteristics of teachers
Majority of the teachers were aged between 41 and 50 years (47.50%), majority were females (58.33%) of the Yoruba tribe (73.34%), married (81.66%) and graduates with BSc (78.34%). The mean teaching years' experience of the teachers was 18.16 ± 9.34. [Table 1] summarises the basic sociodemographic characteristics of the teachers.
Oral health knowledge
Oral health knowledge of majority of the teachers in the eight schools was fair (58.33%), 25% of the teachers had poor oral health knowledge, while only 16.67% had good oral health knowledge. [Table 2] summarises the detailed oral health knowledge scores of the teachers.
Attitude of teachers towards oral health
[Table 3] summarises the detailed attitude of teachers towards oral health. Only 27.5% of teachers in the sampled schools had a positive attitude towards oral health, while majority of the teachers (72.5%) had a negative attitude towards oral health.
Oral health practices of teachers
Majority of the teachers (63.5%) had a fair practice of oral health, 26.0% had poor practice and only 10.0% had a good practice of oral health. [Table 4] summarises the detailed oral health practice scores of the teachers.
| Discussion|| |
In this study, majority (47.5%) of the teachers were aged between 41 and 50 years which was similar to the study conducted by Mesgarzadeh et al. where the majority of teachers (41.8%) were also aged 41–50 years but was in contrast to the findings in the study conducted by Shodan et al. where the school teachers had a mean age of 40.1 years with 69% of them being between the ages of 31 and 40 and between 36 and 40 years in the study done by Sgan-Cohen et al. Majority of teachers in this study being in the age bracket 41–50 years might be as a result of the length of time for teachers to go through training in school and also the fact that many of them are experienced teachers who have been in government employment for a long time.
Majority of teachers in this study were females (58.33%), which was similar to the studies conducted by Abidi, Virtanen et al., Shodan et al. and Sgan-Cohen et al., where most of the school teachers were females. However, Mesgarzadeh et al. in their study found more males as teachers. Having majority of participants in this study being females might be due to more women taking up the teaching profession because it is less stressful, so they can have more time to take care of their children. Most of the teachers (78.34%) in our study were graduates with a BSc degree. This was similar to findings in studies conducted by Shodan et al. and MesGarzadeh et al. which showed that most of the study participants were graduates. This may be due to the phasing out of the NCE and the belief that being a graduate guarantees high salary and a better life.
In this study, the teachers had an average teaching experience of 18.16 years which was close to a study done by Lang et al., who found the teaching experience of the school teachers to be 19 years, in contrast to the study conducted by Mesgarzadeh et al. where the years of experience for most of the study participants (90%) was between 10 and 20 years. This shows that the teachers are very experienced and have been in their various teaching posts for a long period.
Only 16.67% of the teachers in the study population (120 teachers) had good oral health knowledge scores, in contrast to studies done by Shodan et al., Lang et al., Elena and Petr and Petersen and Esheng where majority of the study participants had a good knowledge regarding oral health. Having 16.67% of the teachers in this study population having good oral health knowledge scores may be due to the generally low awareness of oral health in Nigeria irrespective of profession. In the study done by Haloi et al., majority of the school teachers i.e., 182 (56%) had a fair knowledge regarding oral health, this was similar to the findings in this study where the oral health knowledge of majority of the teachers (70 teachers) (58.33%) was fair.
In this study, there was a slight correlation between knowledge and attitude of the teachers. The teachers had limited knowledge of oral health and only 20 (16.67%) replied correctly to all questions assessing knowledge about oral health. Similarly, majority (87, 72.5%) of the teachers had a negative or poor attitude towards oral health. This was similar to findings by Sofola et al. in a cross-sectional, questionnaire-based survey carried out in 100 primary school teachers drawn from ten randomly selected primary schools in Lagos State to assess teachers' knowledge, attitude and practices on oral health and diseases, which revealed that majority of the teachers had poor attitude towards oral health issues.
Similarly, only 13 (10.5%) out of the 120 teachers surveyed had a good oral health practice. This study thus reveals that more work needs to be done by dental healthcare practitioners through school health programmes. The focus should not only be to educate the pupils and screen them for oral diseases but also to educate the teachers. Training programmes can be organised to train teachers to deliver OHE in schools since the number of dental healthcare professionals in Lagos state and the whole of the country is not adequate. Dental professionals should engage in advocacy with the government on the need to add OHE to the teacher training curriculum in colleges of education.
OHE should also be added to the school timetable as this will bring commitment on the part of the teachers to study more about oral health and hence will be able to teach the topic very well. There will be a need for further research in future to see if teachers can deliver OHE like the dental healthcare practitioners if adequately trained and equipped for it.
| Conclusion|| |
The results of this study indicate that there was a direct relationship between knowledge about oral health, attitudes to oral health and oral health practices. Overall, oral health knowledge and practice was fair among the school teachers and majority had negative attitude towards oral health. This study shows that attitude was not fully explained by knowledge, and hence it is not a variable in the relationship between knowledge and practice. With further education, they should be able to serve as agents of OHE in schools.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Low W, Tan S, Schwartz S. The effect of severe caries on the quality of life in young children. Pediatr Dent 1999;21:325-6.
Petersen PE. The world oral health report 2003: Continuous improvement of oral health in the 21st
century – The approach of the WHO global oral health programme. Community Dent Oral Epidemiol 2003;31 Suppl 1:3-23.
Filstrup SL, Briskie D, da Fonseca M, Lawrence L, Wandera A, Inglehart MR, et al.
Early childhood caries and quality of life: Child and parent perspectives. Pediatr Dent 2003;25:431-40.
Åstrøm AN. Stability of oral health-related behaviour in a Norwegian cohort between the ages of 15 and 23 years. Community Dent Oral Epidemiol 2004;32:354-62.
Sofola OO, Agbelusi GA, Jeboda SO. Oral health knowledge, attitude and practices of primary school teachers in Lagos State. Niger J Med 2002;11:73-6.
Adeniyi AA, Ogunbodede EO, Jeboda SO, Sofola OO. Dental caries occurrence and associated oral hygiene practices among rural and urban Nigerian pre-school children. J Dent Oral Hyg 2009;1:64-70.
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]
Folayan MO, Adeniyi AA, Chukwumah NM, Onyejaka N, Esan AO, Sofola OO, et al.
Programme guidelines for promoting good oral health for children in Nigeria: A position paper. BMC Oral Health 2014;14:128.
Ogunbekun I, Ogunbekun A, Orobaton N. Private health care in Nigeria: Walking the tightrope. Health Policy Plan 1999;14:174-81.
Jeboda SO. Manpower training, development and utilisation in primary oral health care. A suggested approach for Nigeria. Odontostomatol Trop 1989;12:130-4.
Ojo K. The crisis in the distribution of health personnel in Nigeria. Health Policy Plan 1990;5:60-6.
Akinosi.OJ. Oral and Dental care in Nigeria: A Legacy from Our Pioneers. Convocation Lecture of the National Postgraduate Medical College of Nigeria; 2011.
Hebbal M1, Ankola AV, Vadavi D, Patel K. Evaluation of knowledge and plaque scores in school children before and after health education. Dent Res J (Isfahan) 2011;8:189-96.
Haleem A, Siddiqui MI, Khan AA. School-based strategies for oral health education of adolescents – A cluster randomized controlled trial. BMC Oral Health 2012;12:54.
Hanganu C, Dãnilã I, Bârlean L, Murariu A, Mihailovici L, Săveanu I. School based dental health considerations for program development. Oral Health Dent Manag Black Sea Ctries 2004;3:4-10.
Dedeke AA, Osuh ME, Lawal FB, Ibiyemi O, Bankole OO, Taiwo JO, et al.
Effectiveness of an oral health care training workshop for school teachers: A pilot study. Ann Ib Postgrad Med 2013;11:18-21.
Craft M, Croucher R, Dickinson J, James M, Clements M, Rodgers AI, et al.
Natural nashers: A programme of dental health education for adolescents in schools. Int Dent J 1984;34:204-13.
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.
Astrøm AN, Jackson W, Mwangosi IE. Knowledge, beliefs and behavior related to oral health among Tanzanian and Ugandan teacher trainees. Acta Odontol Scand 2000;58:11-8.
Ehizele A, Chiwuzie J, Ofili A. Oral health knowledge, attitude and practices among Nigerian primary school teachers. Int J Dent Hyg 2011;9:254-60.
Oredugba FA. Use of oral health care services and oral findings in children with special needs in Lagos, Nigeria. Spec Care Dentist 2006;26:59-65.
William GC. Sampling Techniques. 4th
ed. New York: John Wiley and Sons; 2007.
Petersen PE, Aleksejuniene J, Christensen LB, Eriksen HM, Kalo I. Oral health behavior and attitudes of adults in Lithuania. Acta Odontol Scand 2000;58:243-8.
Stenberg P, Håkansson J, Akerman S. Attitudes to dental health and care among 20 to 25-year-old Swedes: Results from a questionnaire. Acta Odontol Scand 2000;58:102-6.
Odusanya OO, Tayo OO. Breast cancer knowledge, attitudes and practice among nurses in Lagos, Nigeria. Acta Oncol 2001;40:844-8.
Mesgarzadeh AH, Shahamfar M, Hefzollesan A. Evaluating knowledge and attitudes of elementary school teachers on emergency management of traumatic dental injuries: A study in an Iranian urban area. Oral Health Prev Dent 2009;7:297-308.
Shodan MR, Prasad KV, Javali SB. Factors affecting the knowledge on prevention of oral diseases among school teachers of Dharwad City - A survey from India. Webmedcentral Dent 2011;2:4-13.
Sgan-Cohen HD, Saadi S, Weissman A. Dental knowledge and attitudes among Arab schoolteachers in Northern Israel. Int Dent J 1999;49:269-74.
Abidi SY. Knowledge about the management of avulsed tooth among Karachi school teachers. Pak Oral Dent J 2010;30:515-20.
Virtanen M, Kivimäki M, Elovainio M, Linna A, Pentti J, Vahtera J, et al.
Neighbourhood socioeconomic status, health and working conditions of school teachers. J Epidemiol Community Health 2007;61:326-30.
Lang P, Woolfolk MW, Faja BW. Oral health knowledge and attitudes of elementary schoolteachers in Michigan. J Public Health Dent 1989;49:44-50.
Elena B, Petr L. Oral health and children attitudes among mothers and schoolteachers in Belarus. Balt Dent Maxillofac J 2004;6:40-3.
Petersen PE, Esheng Z. Dental caries and oral health behaviour situation of children, mothers and schoolteachers in Wuhan, People's Republic of China. Int Dent J 1998;48:210-6.
Haloi R, Anand Ingle N, Kaur N, Gupta R. Comparing the oral health promoting role and knowledge of government and private primary school teachers in Mathura city. Int J Sci Study 2014;1:9-14.
[Table 1], [Table 2], [Table 3], [Table 4]