You are on page 1of 49

ORAL HEALTH PROMOTION AND INTERVENTION ACTIVITIES CARRIED OUT IN RURAL AREAS OF DAVANGERE DISTRICT.

A GOI – WHO COLLABORATIVE PROGRAMME 2006 - 2007

BAPUJI DENTAL COLLEGE AND HOSPITAL DAVANGERE-577004

PROJECT TITLE: ORAL HEALTH PROMOTION AND INTERVENTION ACTIVITIES CARRIED OUT IN RURAL AREAS OF DAVANGERE DISTRICT. Principal Investigator : Dr. RAJU H G Department of Community Dentistry Bapuji Dental College and Hospital Davangere. Co-Investigators : Dr. NAGESH L Department of Community Dentistry Bapuji Dental College and Hospital Davangere. Dr. DEEPA D Department of Periodontology and Implantology Bapuji Dental College and Hospital Davangere. Contributors: Dr. Cherian Varghese Cluster Focal Point (Non Communicable Diseases and Mental Health) WHO – India Control Office NEW DELHI. Dr. K. Sadashiva Shetty, Principal, Bapuji Dental College and Hospital, Davangere. Dr. Kumar Rajan National Consultant WHO – India and Directorate General of Health Services Government of India. Post Graduate Students of Department Of Community Dentistry. • Dr. Umesh. K, • Dr. Mohammed Imranullah, • Dr. Siddana Goud. R, • Dr. Parappa Sajjan • Dr. Shilpa Gunjal, • Dr. Muthu Karuppaiah, Clinical Assistants of Department Of Community Dentistry • Dr Deepa Reddy • Dr Sneha Bhat • Dr Shweta R S • Dr Rukmini i

PREFACE Oral health is an integral component of general health. Research in the past few years has revealed the causal link between oral diseases and systemic diseases. Oral health has also been found to profoundly influence the quality of life. Dental caries and periodontal disease are the highly prevalent diseases in many populations. They are highly irreversible once they occur and also have complex etiology. Although primary preventive techniques exist, they do not confer total protection. Dental caries continues to be a major problem in many countries, especially in developing countries like India, where it is consistently reflecting increasing trend in last couple of decades. The point prevalence surveys conducted by the post graduate students in and around Davangere have shown persistence of “untreated carious lesions” among children in rural areas. It reflects either non-availability of oral health care services or poor oral health seeking behavior of rural people. Awareness related to oral health among them is also found to be poor. The prevailing poor status of oral health prompted us to plan and execute an integrated programme in the form of assessing oral health awareness, providing oral health education and treating untreated carious lesions by ART technique for school children in villages of Mayakonda Hobli. In addition, the oral health awareness was also provided to selected school teachers and school children. At this juncture we sincerely acknowledge the logistic support, expertise, financial assistance and moral support extended by WHO in this endeavour.

ii

CONTENTS INDEX 1. Executive summary 2. Introduction 3. Aims & Objectives 4. Materials and Methods 5. Results a. Descriptive data b. Statistical analysis c. Results 6. Discussion 7. Recommendations 8. References 9. Acknowledgements 10. Annexure a. Photos. b. Questionnaire on Oral Health for Adults/Children. c. IEC Material. 21 23 24 25 26 Page No. 01 02 04 05 12

iii

1 . A total of 3937 school children aged 9-15yrs were screened and 1002 children having caries were provided ART.EXECUTIVE SUMMARY The present study was conducted in a rural area of Davangere district. The knowledge.95. A majority of the decayed teeth were unfilled typically representing lack of treatment.3 and the mean ‘D’ was 0. attitude and practices of school children and school teachers towards oral health in the selected area followed by re-evaluation after imparting oral health education. It aimed at assessing knowledge. The school children were assessed for dental caries experience and treatment needs applying Dentition status Treatment need index followed by provision of ART at the site for indicated carious lesions. attitudes and practices of school teachers showed appreciable improvement after providing oral health education. The mean “DMF-T” was 1.

ART being a method which advocates utilization of only hand instruments for cavity debridement. lack of qualified dental manpower in rural areas and poor awareness towards oral health has contributed for steady raise in the prevalence of caries in the last few decades. Fear towards dentistry is one important reason which keeps people away from seeking treatment for dental caries. The developing economy. it is well 2 . Poor awareness about oral health. The trauma caused by rotary instruments and the noise generated by them all the more frightens the children. ART is found to be very economical. There is an urgent need for oral health policy which can provide the necessary guidelines for improvement of oral health. The presence of untreated (unfilled) carious lesions is quite common in rural areas among school going children. The annual health budget is 2% of Gross National Product and there is no specific budget allocated or earmarked for oral health exclusively. ART is a novel method and highly practical method for treating dental caries in rural population1. lack of required infrastructure and lack of political will are some possible reasons which have contributed to this picture.INTRODUCTION India is the sixth biggest country by its area but it is the second most populous country. patient friendly and highly acceptable in rural masses. “Oral health promotion in the form of oral heath education + ART” in an integrated module as developed in this project offers both primary and secondary prevention to target population. lack of dental man power.

accepted2. 3 . The use of Glass Ionomer cement which brings in the advantage of secondary caries prevention because of ‘Fluoride ion present in it.” Hence in the present study Oral health promotion through oral health education and provision of ART for indicated carious lesions were utilized in an integrated manner for providing services to a rural population of Davangere district.

4 . 3) To test the efficacy of ART technique among the school children in rural population. 4) Children should be made aware of proper techniques of oral hygiene maintenance measures through their school teachers. Attitude and Practices of rural school children and school teachers towards oral hygiene. oral health and also to assess the dentition status in school children of rural population. 2) To provide ART to needful 1000 school children. thus making it a self-sustainable programme.OBJECTIVES 1) To assess the Knowledge.

Paddy. Cotton. cotton mills and agriculture related industries in and around city. 5 .Mayakonda is a Hobli situated in Davangere taluk at a distance of 35 kms. floriculture and hybrid crops. 02. Groundnut. 1997. Ragi.523 with majority of people residing in Davangere city. Regulated market located in heart of Davangere city hosts platform for both farmer and dealer for business. Harapanahalli and Jagalur. Sunflower. It has a total of 153 villages and 40 gram Panchayats. Sugar cane. Jowar. There are many rice mills. Mango to list few which are priority crops. Davangere was a taluk and it was included under Chitradurga district. Previously. Davangere taluk has an area of 936. It mainly consists of agricultural community. Davangere district has a total of six taluks. Banana. The taluks included under the Davangere district are Davangere.4%. Davangere taluk has a total population of 6. Channagiri. Harihar. The literacy rate in the district was 67. oil extraction mills. The sex ratio in the district was 952 women to 1000 men. Later the district was formed as a result of restructuring of the districts of Karnataka state. Davangere is also having growing community for change in traditional crops to medicine plants. Honnali.MATERIALS AND METHODS Brief profile of the area and population included Davangere district lies in the central Karnataka.1 kms with a population density of 644person/sq km. The district was newly formed on August 15th.

3 8 7 1 6 5 4 2 6 .

3) SCHEDULE OF THE PROJECT: The project was systematically scheduled to spread over a period of one year starting from the month of May 2006. examined and 7 .MATERIALS AND INSTRUMENTS USED: The essential Instruments for ART are: Mouth mirror. On an average. METHODS ORGANIZATION AND ADMINSTRATION WORKOUT 1) APPROVAL FROM AUTHORITIES: Permission to implement the project was obtained from the concerned authorities. Petroleum jelly. school teachers and parents of school children. Sufficient numbers of instruments and required amount of material were made available to have smooth uninterrupted examination and treatment. GIC Fuji ix. medium and large). plastic strips and articulation paper. hatchet. The essential materials are: Gloves. 2) REQUIRED INFORMATION ABOUT STUDY AREAS: All required and relevant information regarding the Mayakonda Hobli including Davangere taluk map was obtained from the census office. In the field. the used instruments were disinfected using Korsolex. A detailed weekly and monthly schedule was prepared well in advance by informing and obtaining consent from authorities of respective rural areas. straight probe. School Head masters. cotton roll and pellets. 50 subjects were interviewed. DDPI and Gram Panchayats of Mayakonda Hobli. plastic filling instrument and WHO CPI probe. spoon excavators (small. explorer and pair of tweezers.

for conducting this study. the principal investigator carried out training of the whole team regarding the criteria for diagnosing the dental caries and also the treatment of dental caries using the ART approach. 5) METHOD OF OBTAINING DATA: The required data.3 7) CALIBRATION AND TRAINING: Before the implementation of the project. A group of subjects were selected 8 . The questionnaire was pilot tested for feasibility and validity. 6) DIAGNOSTIC CRITERIA FOR DENTAL CARIES: Dental caries was recorded according to the criteria of Dentition status and treatment need index as described by WHO-Oral health survey manual (1997). was collected and recorded using printed questionnaire proforma. A few modifications were done and “final proforma” was designed. A structured questionnaire proforma was used which included questions regarding personal data. socio-demographic profile and all the probable common risk factors associated with dental caries. few adjustments and changes had to be made while working it out practically. 4) INFORMED CONSENT: Voluntary informed consent was obtained from the parents of selected school children and the school teachers before administering the questionnaire and providing treatment. This questionnaire in English script was translated into Kannada script (local language) by a recognized translator so that it could be used conveniently during fieldwork.treated on any given day during the survey period excluding the week ends. Even though a detailed schedule plan was prepared well in advance.

Initially. This was another major reason for implementation of the project in rural Davangere. The majority of field activities of Bapuji Dental College & Hospital on improvement of oral health of population are focused on places. 9) SAMPLE SIZE AND SAMPLING PROCEDURE Bapuji Dental College & Hospital is a well-known institution in India and is located in the heart of Davangere city. especially in children. Subjects were reexamined on successive days using same diagnostic criteria. the prevalence of untreated carious lesions is still high.7 and for intra-examiner variability was 0. certain additions and deletions were done before finalizing the questionnaire.8. The reason for including Davangere south was because. The kappa statistics for inter-examiner variability was 0. there are two dental colleges.and examined for dental caries. Few modifications in the questionnaire in terms of rephrasing. 9 . the list of all the schools in Davangere taluk was obtained from the DDPI office and those schools covered under Davangere south were included in the study. 8) PILOT STUDY: A pilot study was conducted on 50 individuals in Mayakonda of Davangere taluk in order to check the feasibility and clarity of the questions in the proforma. serving the population of rural Davangere. Even though. the southern part of Davangere was found to show a higher prevalence of dental diseases when compared to northern part and this was attributed to lack of awareness regarding importance of oral health and lack of affordability for dental treatment. in and around Davangere.

At the end of the day’s clinical examination and treatment. All the schools present in the Mayakonda Hobli were included in the project.Children from the villages belonging to this Hobli.5 dioxyhexane – 8. 10) INFECTION CONTROL: The examiner used disposable mouth masks and gloves during examination. The part one was related to school children and the part two was related to school teachers. Korsolex (Gluteraldehyde – 7. 6-16 years were included and examined. which can be an ideal representation of the complete Hobli. and is the centre place for a majority of surrounding 16 villages. Later. the instruments were sterilized in autoclave. only the age group range of 9-15 years were included in the project because the treatment need was high in the permanent dentition. The village of Mayakonda has a population of 5000.0 gms. study in the schools situated in the head quarters of Hobli. It was convenient to have an access to school children at school premises in the Hobli level.2 gms and polymethyl urea derivative – 11. 1-6 dihydroxy 2. all the school children aged.6 gms) was diluted by adding 1 part to 9 parts of potable water and the instruments were disinfected using this disinfectant and later sterilization was carried out by placing instruments in the pressure cooker. IMPLEMENTATION OF THE PROJECT: The implementation of the project was done in two parts.Mayakonda Hobli was selected for the project implementation. 10 . The sterilization of the instruments was done using both chemical and physical methods. which is situated 35kms away from Davangere city. Initially.

Provided Atraumatic Restorative Treatment for 1002 school children. charts. Oral examination of each subject was done by seating each subject on a chair in the daylight using required instruments. and audio-visual models at school premises. 3. Provided oral health education on scheduled days using the educational aids like models. manuals.PART ONE: 1. Assessment of knowledge. 2. charts. The investigator applied Dentition status and treatment need index to assess caries experience and the data was recorded in the specially prepared proforma. 4. manuals and audio-visual aids to the school children. Evaluation of knowledge. attitude and practices of selected school children towards oral health was recorded by using the structured questionnaire in local language. 2. 11 . PART TWO This part constituted of:1. 3. attitude and practices towards oral hygiene maintenance and oral health was done after educational intervention using specific questionnaire in selected school children and school teachers. Providing oral health education to all selected school teachers using models. The knowledge. attitude and practices of school teachers towards oral health by using pre-designed questionnaire.

attitude and practices of all the school children belonging to 9-16 years of age towards oral hygiene practices and oral health. Post educational intervention KAP assessment showed improvement in their oral health awareness.95.15and 0. They were later provided oral health education and post-interventional evaluation was done using the same questionnaire to know the effect of oral health education.20 respectively.3. 12 . The prevalence of dental caries was found to 25. The mean DMFT was found to be 1. The school children were also screened for their caries experience using Dentition status and treatment need index. 0. a total of 3937 school children aged 9-15 years were screened and 1002 school children having caries were provided ART. attitude and practices towards oral hygiene and oral health using questionnaire. mean “M” and mean “F” were found to be 0. The mean “D”. to assess the knowledge. The knowledge attitude and practices(KAP) of school children was found to be less than satisfactory when the data of the questionnaire was subjected to qualitative assessment whereas among school teachers it was found to be just satisfactory. 1000 school teachers from Davangere taluk were assessed for their knowledge.RESULTS A project sponsored by WHO was implemented in Mayakonda Hobli.45% in the school children.

Most of the individuals (98%) said oral health played an important role in general health. Avoiding sweets and sticky food b. K-1. Don’t know The above graph shows the distribution of responses to K-1. K . Mouth rinsing after meals d. No c. Yes b. Regularly visiting a dentist e. How can you prevent dental problems? a.2. Brushing regularly c.Teacher’s results The following are the findings of the questionnaire study conducted among teachers. All of the above 13 . Has oral health got any role on general health? a.

K . Most of the individuals (30%) said by avoiding sweets and sticky foods they can prevent dental problems. Yes b. A maximum number of individuals said that they knew a clean mouth prevents dental decay.3. Do you know that clean mouth can prevent tooth decay? a. After health education majority of the teachers appraised the role of all other reasons. 14 . No The above graph shows the distribution of responses to K-3. 26% of the individuals said brushing regularly can prevent dental problems.The above graph shows the distribution of responses to K-2.

16% of the individuals used non-fluoridated tooth paste and the remaining didn’t know whether they used fluoridated tooth paste or not. Yes b.5. No 15 . No c. K . Yes b. Don’t know 56 The above graph shows the responses to K-4. After health education majority of the teachers came to know that tooth paste contains fluoride and the anti-cariogenic property of Fluorides.K . 56% of the individuals used fluoridated tooth paste. Does your tooth paste contain fluoride? a.4. Do you know what Floss is? a.

32% of the total respondents said that regular cleaning of mouth can prevent bleeding from gums. All the above The above graph shows the distribution of responses to K-6. The remaining 45% said that they knew what was meant by floss.This graph shows the distribution of responses to K-5. Loosening of gums c. K . Loss of teeth d. After health education majority of them claim that clean mouth can prevent all of those conditions. Bleeding from gums b. After health education everybody learnt how to use floss.6. Bad smell e. A total of 55% of the individuals did not know what floss is. 16 . Regular cleaning of mouth can prevent a.

More than 50% of the individuals cleaned their teeth once daily (53%).1. How often you change your brush? a. Very few (5%) cleaned their teeth after every meal. How often you clean your teeth? a. After health education they came to know that brushing after every meal is more beneficial. Once in 3 months b. Twice daily c. More than twice daily d. Don’t know exactly 17 . Once daily b. P . Once in 6 months c. After every meal The above graph shows the distribution of responses to P-1.2. Yearly once d.P . When bristles get frayed up e.

Yes b. No The above graph shows the distribution of responses to G-1. 59% of the total individuals changed their brush once in 3 months. G .The above graph shows the distribution of responses to P-2. Only 3% of the individuals changed their brush yearly once. Have you made an attempt to give education related to teeth and mouth to your students? a. A maximum number of individuals (92%) made an attempt to give education related to teeth and mouth to 18 . After health education they appreciated the loss of efficiency due to fraying of the bristles.1.

gum diseases. functions. After health education they were appraised about the profound influence they bear in modifying the children’s attitude towards oral hygiene practices. Education about tooth decay. their causes. b. treatment and prevention. structure and eruption. c. The remaining (8%) did not make an attempt to give education related to teeth and mouth to their students. good dietary habits. to question no G . Education about the teeth types. Unfavorably 19 . More than 50% of the teachers gave education about the teeth types. structure and eruption (56%). Favorably b.their students. irregular teeth. How have your students responded to oral health education? a. If yes.1 then G – 2 . injurious oral habits. Education about brushing.3. G . The above graph shows the distribution of responses to G-2. functions. What kind of oral health education have you given to your school children? a.

93% of the students responded favorably to oral health education. 97% of the respondents said oral health education has benefited their school children. 20 . Do you think oral health education has benefited your school children? a. Yes b.97 The above graph shows the distribution of responses to G-3.4. G . No This graph shows the distribution of responses to G-4.

DISCUSSION Oral health Promotion: Primary school teachers have been utilized as health education agents for school children in many countries. attitude and practices of selected school children and school teachers towards oral hygiene and oral health in selected rural areas of Davangere. The present project aimed at assessing the knowledge. After providing oral health education children were found to have gained better knowledge. attitude and practices towards oral hygiene and oral health among the school teachers reveal they had moderate attitude and behavior towards oral health related issues and these results are similar to study done by Mwangosi IEAT and his associates in Tanzania. attitudes and practices towards oral hygiene and oral health was less than satisfactory. Though they knew sticky sweets are responsible for caries the exact mechanism of caries occurrence was unknown to them. This was in response to the call by the World Health Organization (WHO) for the use of alternative personnel in the primary health care approach in the struggle to fight preventable diseases.5 21 . “Pre-test and post-test within group assessment” of knowledge. In school children the knowledge.4 Teachers wanted more information about oral health and were in favor of including topics related to oral health in the school curriculum. Similar results were obtained in study done by Peterson PE et al. A significant number of school children though were using tooth brush were not aware of its importance and exact method of using them. For attitudes and practices to change it may take more time as it is said that health education has long term impact than immediate effect.

This was probably because the treatment was provided in the familiar setting of their schools. which is frequently neglected by the children and the parents until it reaches terminal stages with painful consequences. unavailability of dental man power and fear towards dental treatment compound this problem. using hand instruments alone followed by restoration of the tooth with an adhesive restorative material.45%. demineralized tooth tissue. it is a treatment procedure that involves removal of soft. The prevalence of dental caries was found to be 25. It was encouraging to find that vast majority of these young children who had no prior dental treatment experience found this treatment approach acceptable. it was both feasible and practical to use the ART approach in rural school children. Atraumatic restorative treatment (ART) is a new approach to the management of dental caries.Intervention programme: Dental caries is a highly prevalent dental disease amongst school children. Multiple untreated carious lesions are frequently observed among rural children because of low priority attached to dental care by the rural masses. The present intervention programme consisted of assessing the dentition status and treatment needs of the children aged 9-15 yrs and providing atraumatic restorative treatment to the selected sample of school children. Lack of awareness. In this project out of 3932 school children 1002 school children were selected to receive Atraumatic Restorative Treatment. In this project.6 22 . such as Glass Ionomer cement in the present programme Fuji IX Glass Ionomer Cement was used for restoration. A total of 1416 teeth were restored by this technique among 1002 selected school children. Similar findings were reported by Lo ECM AND Holmagren J.

If allowed to continue would certainly result in complications. 2. Ministry of Health should encourage and endorse “National oral health policy” which can provide clear directions for oral health care delivery at national level.RECOMMENDATIONS In the current study it was observed that the rural school going children although had less than alarming level of caries experience. The knowledge. Specific manpower (A special dental auxiliary). 3. The same rural school dental nurse can be delegated the duty to provide ART for rural masses other than the school children during school vacations. 4. 1. Attitude and Practices of school teachers which may facilitate transfer to school children for a long term. attitude and practices towards oral health although not dismal but was poor among school children and moderate among school teachers. 23 . Evaluation after the educational intervention showed positive changes in the Knowledge. named as ‘RURAL SCHOOL DENTAL NURSE’ can be trained to deliver ART to rural school children. Oral health promotion through well structured oral health education programme (tailor method) can create positive change in awareness and also sensitize them to the respective issues. At primary health centre a special manpower as “oral health educator” can be created by giving training or the existing health educators can be trained by conducting crash courses. 5. ART – was found to be well accepted treatment by rural school children. Encourage oral health promotion activities at primary health care level. a majority of carious lesions were unrestored and active by nature. so that they can take care of oral health education to rural masses.

Intl J Paed dent. 2002: 52(3) : 130-136 5.53(6):363-8. An atraumatic restorative treatment (ART). Phantumvanit P. J Public health dent 1996. 1995 Dec. 2004-05. Petersen PE. Frencken JE. Nyandindi U. and attitudes of children. Danila I. Technique and Development. and schoolteachers in Romania in 1993. Int Dent J.11: 3-10 7. Rationale. ORAL HEALTH SURVEY . Provision of atraumatic restorative treatment (ART) restorations to Chinese pre-school children. Songpaisan Y. 24 . of India.GENEVA. Samoila A. behaviors.a 30-month evaluation. 4TH EDITON (1997).REFERENCES 1. WHO. Manual for ART. 2001. 6. mothers. knowledge. Pilot T. attitude and self assessed status of primary school teachers in Tanzania. Multi centric Oral Health Survey of WHO – Govt. Acta Odontol Scand. Holmgren CJ. 4. Frencken JE. 3. Oral health behavior. Mwangosi I E A T. 56 (3): 135-40.BASIC METHODS. oral health related knowledge. 2. Lo E C M and Holmgren J . Unpublished data.

for his ever encouraging support of academic pursuits. keen surveillance. Davangere. I thank Dr. Reader. For their cooperation and I also thank the school teachers and the school children for their active participation. I would like to thank Dr. for their help in successively completing this project. Professor and Head. for their inestimable aid.G 25 . I would like to thank Dr Nagesh L. Dr. Bio-statistician.. Raju. Kumar Rajan. for he has guided and inspired me throughout the project. K. Cherian Verghese and Dr.Deepa D. I am grateful to Dr. Davangere. My sincere thanks to Mrs. Sadashiva Shetty. valuable guidance and help rendered in completing this project. Rajshree Patil. Department of Community Dentistry with reference.AKNOWLEDGEMENTS It is my immense pleasure to thank the World Health Organization and the Government of India for selecting our institution for the project. It is my deep sense of gratitude. unflinching support. Davangere for her help in carrying out the statistical analysis. S S Institue of Medical Sciences. H. I thank the deputy director of public instructions and the block educational officer. Department of Periodontics and all the post-graduate students of Department of Community Dentistry. Bapuji Dental College and Hospital. Principal.

ANNEXURE Photographs of school children being screened 26 .

Photograph Showing Providing Health Education to the School Children 27 .

Photographs of schoolchildren undergoing ART 28 .

Photograph showing Investigator discussing with National Consultant (WHO) 29 .

Gum Disease c. Mouth rinsing after meals d. Regularly visiting a dentist e. Not regularly visiting a dentist e.. Avoiding sweets and sticky food b. Not rinsing the mouth d. Bad Breath d. Do you know that a dentist can clean and polish your teeth? a. Stains on Teeth e.No K7. K2. KNOWLEDGE: K1. Decay b. Why do we get dental problems? a. K5. Yes b. Does your tooth paste contain fluoride? a.No c. Has oral health got any role on general health? a. Nothing f. Not brushing properly c. Yes b. All of the above. Don’t Know K3. Eating sweets and ice creams b. Yes b. Don’t know 30 . Brushing regularly c. What does irregular tooth brushing cause? a. Don’t know . K4. ATTITUDES AND PRACTICES OF SCHOOL CHILDREN IN RURAL AREAS OF DAVANAGERE DISTRICT TOWARDS ORAL HYGIENE Note: Please tick the appropriate answer ( √ ) A.No K6.Questionnaire for Children WHO PROJECT KNOWLEDGE. Yes b. Any others specify…. Do you know that clean mouth can prevent tooth decay? a. No c. How can you prevent dental problems? a.

Twice daily 31 . Filling d. Do you think that improving and maintaining health of the mouth is not in your Control? a. Once daily b. Tooth Brush and Tooth Paste b. ATTITUDE A1. Finger and Tooth Powder d. a. d. If yes. Do you think maintaining healthy mouth is individual responsibility? a. Tooth Brush and Tooth Powder c. Extraction Any other reason specify A5. Yes b. Yes b. How do you clean your teeth? a. Yes b. Yes b.No K9.No A4.No A2. Neem Sticks e. e. Decay b. b. Do you know what is a floss? a. How often you clean your teeth? a. c. Yes b. PRACTICE P1. Regular cleaning of mouth can prevent Bleeding from gums Loosening of gums Loss of teeth Bad smell Any other specify……. Any other Specify P2.K8.No A3. B. Have you visited a dentist before? a.No C. Pain c. then for what reason? a. Do you think it is required to visit a dentist periodically to maintain the health of Your teeth and mouth? a.

Both in horizontal and vertical directions d. Pea sized amount P6. How do you brush your teeth? a. Once in 3 months b. Tooth Picks d.c. Do you clean your tongue? a. After every meal P3. Tooth brush d. How do you clean your tongue? a. Yes b. Fingers c. P10. Do you press the paste in between the bristles? a. Any others specify …. Use vertical strokes c. How often you change your brush? a. Do you rinse your mouth after meals? a. Mouth Wash b. Yes b. Circular strokes P4. More than twice daily d. Don’t know exactly P5. Yearly once d. Any Other Specify 32 . Yes b. Do you use any other oral hygiene aids? a. Tongue cleaner b. Use horizontal strokes b.. Sometimes P8. Half length of bristles c.No P7. When bristles get frayed up e.No c. Full length of bristles b. What amount of paste you apply on your brush? a. Once in 6 months c.No P9. Dental Floss c.

DENTITION STATUS AND TREATMENT NEEDS 18 17 16 55 15 54 14 53 13 52 12 51 11 61 21 62 22 63 23 64 24 65 25 26 27 28 C R T 85 48 47 46 45 84 44 83 43 82 42 81 41 71 31 72 32 73 33 74 34 75 35 36 37 38 C R T Primary teeth crown A B C D E F G T - Permanent teeth crown / root 0 1 2 3 4 5 6 7 8 T 9 0 1 2 3 7 8 9 Status Sound Decayed Filled & decayed Filled.. no decay Missing as a result of caries Missing any other reason Fissure sealant Bridge abutment special crownor veneer / implant Unerupted tooth (Crown) / unexposed root Trauma (fracture) Not recorded Treatment 0 = None P = Preventive. caries arresting care F = Fissure sealant 1 = One surface filling 2 = Two of more surface fillings 3 = Crown for any reason 4 = Veneer or laminate 5 = Pulp care and restoration 6 = Extraction 7 = Need for other can (specify) ….. 8 = Need for other can (specify …. 9 = Not recorded 33 .

No K7. Nothing f. Not brushing properly e. Eating sweets and ice creams d.. Don’t know K8. No c. Yes b. Any others specify…. Don’t know . Avoiding sweets and sticky food i. How can you prevent dental problems? h. Does your tooth paste contain fluoride? a. Do you know that a dentist can clean and polish your teeth? a. K4.No c. Has oral health got any role on general health? b. Yes b. Any other specify …. Bad Breath d. Regularly visiting a dentist l. Mouth rinsing after meals k. What does irregular tooth brushing cause? a. Brushing regularly j. Decay b. K2.No 34 . Yes b. Don’t Know K3. Do you know that clean mouth can prevent tooth decay? a. Yes b. KNOWLEDGE: K1. Stains on Teeth e.QUESTIONNAIRE FOR SCHOOL TEACHERS KNOWLEDGE. K5. Why do we get dental problems? c. Not rinsing the mouth f. Gum Disease c.. Do you know what is floss? a. Yes b.No K6. Not regularly visiting a dentist g. ATTITUDES AND PRACTICES OF SCHOOL TEACHERS WORKING IN RURAL AREAS OF DAVANAGERE DISTRICT TOWARDS ORAL HYGIENE Note: Please tick the appropriate answer ( √ ) A.

Neem Sticks e. Yes b.No A4. Pain c. Do you think that improving and maintaining health of the mouth is not in your Control? a. PRACTICE P1.No C.No A2. Regular cleaning of mouth can prevent a. Tooth Brush and Tooth Paste b. Extraction Any other reason specify A5. B. Decay b. Loss of teeth d. Do you think it is required to visit a dentist periodically to maintain the health of Your teeth and mouth? a. Bleeding from gums b. then for what reason? a. How do you clean your teeth? a.K9. Do you think maintaining healthy mouth is individual responsibility? a.No A3. Bad smell e. Tooth Brush and Tooth Powder c. Yes b. Have you visited a dentist before? a. Loosening of gums c. Any other specify……. Finger and Tooth Powder d. ATTITUDE A1. Yes b. Yes b. If yes. Filling d. Any other Specify 35 .

Sometimes P8. When bristles get frayed up e. Don’t know exactly P5. Fingers c. Tooth Picks d. Use horizontal strokes b. Circular strokes P4. How do you clean your tongue? a. Do you use any other oral hygiene aids? a. Twice daily c. Yearly once d. Do you clean your tongue? a. Tooth brush d. Any Other Specify……… 36 . Full length of bristles b. After every meal P3.No P7.No P9. Once daily b. Do you rinse your mouth after meals? a. What amount of paste you apply on your brush? a. More than twice daily d. Yes b. Yes b. Use vertical strokes c. Both in horizontal and vertical directions d. P10.P2. Tongue cleaner b. Yes b. How do you brush your teeth? a. Do you press the paste in between the bristles? a. How often you change your brush? a. Any others specify ….No c.. Pea sized amount P6. Once in 6 months c. Dental Floss c. Mouth Wash b. How often you clean your teeth? a. Once in 3 months b. Half length of bristles c.

D. Do you think oral health education has benefited your school children? a. Have you been trained to give education on topics related to teeth and mouth to School children? a. functions.No G2. Yes b. Education about tooth decay. No 37 . Charts and Posters c. How have your students responded to oral health education? a. Yes b. their causes. Education about the teeth types. Models. gum diseases. b.No If yes. irregular teeth. Unfavorably G7. good dietary habits. treatment and prevention. Any others G6. structure and eruption. What kind of oral health education have you given to your school children? a. c. What methods are you employing to give oral health education to school children? a. Have you made an attempt to give education related to teeth and mouth to your Students? a. G5. Oral Health Talks b. Education about brushing. Yes b. to question no G3 then G4. injurious oral habits. Yes b. Are there topics related to teeth and mouth in the present school curriculum? a. GENERAL G1. Favorably b.No G3.

Bada Government higher primary school. Bada Sri Anaberu kenchappa high school. Avaragolla. Government higher primary school Angodu Government high school. Avaragolla. Bada Government higher primary girls school. belavanuru Government high school. Mayakonda S T G school. Mayakonda S A K higher primary school. Huvinamadu Government higher primary school. Gopnal Government higher primary school. Huvinamadu Sri maganur basappa high school. Mayakonda Government higher primary school. Mayakonda Government higher primary school. Ramagondanahalli P. Anaberu Government pre university college. High school. Attigere Sri maralu siddeshwara high school. Davangere Sri maruti junior college. Anaberu Government higher primary school. Mayakonda Government higher primary boys school. Gopnal Government junior college. Bada S G V boys school. Government higher primary school.N.H. Hadadi Government higher primary school. Taralabalunagara.LIST OF SCHOOLS Sl no 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 School Government high school. Taralabalunagara Government higher primary school. Mayakonda Government pre university college. Mayakonda Girls residential high school.G.K. Hadadi Sri matruti high school. Mayakonda 38 . Gopnal Government Urdu primary school.

IEC Materials: ( Teacher’s manual) 39 .

40 .

41 .

42 .

43 .

44 .

45 .