Parents knowledge and oral hygiene level of kindergarten students

Vania Arista Muljadi*, Henry Mandalas**, Grace Monica*

*
Department of Public Health Faculty of Dentistry Maranatha Christian University

**
Department of Periodontics Faculty of Dentistry Maranatha Christian University

ABSTRACT

Introduction: Parents knowledge related to oral health affects toothbrushing behavior in children. The
habit of toothbrushing introduced to the children by their parents, and usually becomes child's habit that
affects the application of toothbrushing and how to maintain good oral hygiene in the future. The purpose
of this study was to know the description of parents knowledge about toothbrushing and the kindergarten
students oral hygiene level. Methods: This study was conducted towards 25 students of Gymboree and
Kidsville which consisted of 14 boys (56%) and 11 girls (44%). The study design was cross sectional
research. The data collection was done by giving questionnaires to parents and examination of student’s
oral hygiene level by using PHP index. Results: Generally parents already have the good knowledge that
supports the children oral hygiene level of children, but there were still 52% of parents who does not use
the techniques recommended to brush the outer surface of the teeth and 64% of parents who does not
use the techniques recommended to brush the tooth surface that close to the cheek. The oral hygiene
level of Gymboree and Kidsville students were very good 0% (0), 32% good (0.1 -1.7), 60% medium (1.8 -
3.4), and 8% bad (3.5-5.0). Conclusion: Awareness of parents about toothbrushing and oral hygiene level
of children were generally adequate, but were not fulfilling the standards of oral health recommended
by dentist.

Keywords: Parents knowledge, How to brush your teeth, Oral hygiene levels

Introduction

Oral health is an important aspect of public health that can be defined as "a

standard of oral tissue health that allows an individual to eat, talk, and socialize

without getting sickness, discomfort or shame and who contribute to the general

welfare."1 Knowledge of oral health is regarded as an important prerequisite in the

practice of health-related, and there is a relationship between increased knowledge

and better oral health.1 Oral health in children affect oral health as children grow into

adults. Parents play an important role in creating oral hygiene and prevention of dental

and mouth disease in children.3 child's oral health can be affected by parental
knowledge, attitudes and cultural beliefs can also be related to lifestyle and behavior

of parents in maintaining oral health.4

Parents' knowledge of oral and dental health affects the health of their child's

teeth and mouth. Parental knowledge related to dental and oral health, beliefs and

attitudes proved to affect the toothbrushing behavior of their child. 3 The initial concept

in maintaining oral hygiene is to clean debris by removing plaque and infectious agents

that can cause gum disease.3

Plaque may be defined as a soft deposit formed from the attachment of biofilms

on tooth surfaces or hard surfaces in the oral cavity. Plaque is the leading cause of

disease in the oral cavity such as caries and periodontal disease. 5, 6 Prevention of both

diseases of the oral cavity is by removing plaque, although there are many methods to

remove plaque, but the mechanical method by using a toothbrush is the main method

in maintaining good oral hygiene.7

Toothbrushing is a simple and effective way to remove plaque thus preventing

the occurrence of caries and periodontal disease. The toothbrushing habit introduced

to the child by parents, and this behavior starting from the first year of life will be

embedded and become a child's habit in the future. 4

According to the American Academy of Pediatric Dentistry, parents should

menyikatkan their child's teeth are still at preschool age or until the age of six years

and to assist children in brushing their teeth until the child is eight years old. 9

Maintaining healthy teeth and good oral important in preschool children (3-6 years)

because of the high prevalence of caries.8

Methods

The type of research used is descriptive observasional. Design research is a cross

sectional research. Data collection was done by giving questionnaires about how to
brush your teeth and tooth condition observation.

Results

The population in this study are the parents and children attending kindergarten

Gymboree and Kidsville which numbered 40 people. In this study, 25 subjects who met

the study sample selection criteria and were willing to participate in fill baking caster

and oral examination.

The total number of research subjects were 25 children consisting of 14 male subjects

(56%) and 11 female subjects (44%). The research subjects between the ages of 4 -5

years consisted of 11 subjects aged 4 years (44%) and 14 subjects older than 5 years

(56%).

Table 1 shows the plaque index subject of research by using an index Patient Hygiene

Performance (PHP). The subject of research in general has a plaque index included in

category (1.8 -3.4), as many as 14 people (60%), the rest belongs to the category Good

(0.1 -1.7) as many as 9 people ( 32%), including in the recent category (3.5 -5.0) as

many as 2 people (8%) and no research subjects were included in the category of Very

Good (0).
 Table 1 Overview of Plaque Index of Research Subjects
No Plaque Index Frequency (%)
1 Very Good (0) 0 (0%)

2 Good (0.1 -1.7) 8 (32%)

3 Medium (1.8 -3.4) 15 (60%)

4 Bad (3.5-5.0) 2 (8%)

Total 25. (100%)

Table 2 shows the distribution of plaque on each study subject. From the average

plaque distribution in the study subjects, most plaques were found mostly on the 54th

and 64th teeth, with the average number of plaques on tooth surfaces of 3, whereas in

teeth 51, 74, 71 and 84 had an average number of plaques on tooth surface of 2.

Table 2 Distribution of Plaque On Research Subjects

Research Plaque Distribution
subject 54 51 64 74 71 84
1 2 3 3 3 2 3
2 1 3 2 1 2 1
3 1 2 1 4 2 4
4 3 3 3 1 1 1
5 1 3 2 1 2 1
6 2 1 1 3 1 2
7 2 1 1 2 2 2
8 3 5 4 3 3 3
9 4 2 2 1 1 3
10 4 2 3 2 2 3
11 4 2 2 2 2 3
12 4 2 3 3 2 4
13 3 2 3 4 2 5
14 1 3 2 5 1 1
15 1 1 3 2 1 2
16 1 3 2 2 2 2
 17 1 4 1 1 2 1
18 2 1 2 2 1 2
19 2 2 2 2 2 3
20 1 2 2 1 2 1
21 5 1 5 3 1 2
22 3 1 5 3 1 2
23 5 5 5 1 2 1
24 3 5 3 3 1 3
25 5 2 5 4 3 3
Average 3 2 3 2 2 2

Table 3 shows the distribution of parents 'answers to fill out the questionnaires about

parents' knowledge about how to brush their teeth. There are 25 respondents (parents)

who fill in the questionnaire given.

Table 3 Overview of Parents' Knowledge of How To Brush Teeth

Knowledge of Parents Frequency (%)
Help parents give to children to brush their teeth
17 (68%)

Always
8 (32%)

Sometimes
0 (0%)

Never
25 (100%)

Use of a child's toothbrush in cleaning teeth

0 (0%)

Yes
24 (96%)

No
1 (4%)

Use of child toothpaste in cleaning teeth

15 (60%)

Yes
10 (40%)

No
25 (100%)

Use of toothpaste the size of a pea

0 (0%)

Yes
17 (68%)

No
8 (32%)

The bristles position is affixed perpendicular to the surface of

22 (88%)
the tooth while brushing
 Yes 3 (12%)

No 23 (92%)

The state of the tooth is held in the position of biting (jaw in 2 (8%)
the closing state) when brushing teeth
22 (88%)
Yes
3 (12%)
No
25 (100%)
Brushing the outer surface of the tooth
0 (0%)
Yes
18 (72%)
No
7 (28%)
Brushing surfaces in teeth
25 (100%)
Yes
0 (0%)
No
15 (60%)
Brushing the back surface of the front teeth
10 (40%)
Yes
12 (48%)
No
13 (52%)
Brushing the tooth surface close to the cheek
21 (84%)
Yes
4 (16%)
No
9 (36%)
Brushing the tooth surface close to the tongue
16 (64%)
Yes
24 (96%)
No
1 (4%)
Brushing the surface of the tooth dental plateau
19 (76%)
Yes
6 (24%)
No
19 (76%)
Brushing tongue
 Yes 6 (24%)

No 23 (92%)

The best technique to brush the outer surfaces of teeth 2 (8%)

Coiled 25 (100%)

Horizontal 0 (0%)

The best technique to brush the back surface of the front 15 (60%)
teeth
10 (40%)
Ups and down
23 (92%)
Horizontal
2 (8%)
The best technique to brush the tooth surface is close to the
cheek 25 (100%)

Coiled 0 (0%)

Horizontal

The most excellent technique for brushing the surface of the

dental plate is to mastication

Back and forth

Horizontal

The best technique to brush the tongue

One way

Two-way direction

Need to brush the same surface on each tooth continuously

for at least 5 seconds

Yes

No

Time to brush your teeth for 2-3 minutes is enough

Yes

No
 Need to rinse after brushing

Yes

No

Need to rinse many times after brushing your teeth

No

Yes

Need to clean the bristles with running water after use

Yes

No

Need to replace toothbrush in a certain period of time

Yes

No

Discussion

The results showed the knowledge of parents about how to brush teeth and the level

of oral hygiene children attending kindergarten Gymboree and Kidsville can be seen

that the knowledge of the parents are both supported by the results in Table 1 of the

Plaque Index Research Subjects are the criteria good (32%) and moderate (60%) use

indexes Patient hygiene Performance (PHP) so that the formation of the level of health

and children's oral hygiene is good enough.

The results also showed that parents' knowledge of techniques for brushing outer

surfaces (52%) and tooth surfaces close to the cheeks (64%) were not good can be seen

in the results of the study on Plaque Distributions showing plaque buildup in teeth 54

and 64 with scale 3.

 The level of oral hygiene children attending kindergarten Gymboree and Kidsville be

enhanced by the dissemination and promotion of health and dental hygiene more fully

with the guide in the form of a demo video and posters poster showing the phases of

the correct way of brushing teeth.

Conclusion

Parents' knowledge of how to brush their teeth and the level of oral hygiene of children

was generally adequate, but not in accordance with recommended dental and oral

health standards.

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