DOI Number: 10.5958/0976-5506.2019.00480.

School Teacher’s Knowledge, Attitude and Practices

Regarding Oral Health in Ballabhgarh Block, Faridabad

Neha Verma1, Meena Jain2, Nisha Rani Yadav3, Souryaa Poudel4, Ankur Sharma5, Vishal Jain6
1
B.D.S., Student, 2Associate Professor, 3Senior Lecturer, 4Intern, 5Lecturer, Department of Public Health Dentistry,
Manav Rachna Dental College; 6PG Student, Institute of Dental Sciences and Technology, Modi Nagar

Abstract
Background: School teachers have an important role in oral health promotion and improvement of oral health
in school children. Positive attitude, knowledge and practices in school teachers are, therefore important.
The present study aims at assessing oral health related knowledge, attitude and practices of school teachers
in Ballabhgarh, India.
Method: A cross sectional survey of school teachers was conducted among school teachers of Ballabhgarh
urban area. A 20-item close-ended questionnaire to assess oral health related knowledge, attitude and
practices were administered to those who consented to participate. The data was assessed in SPSS Version
21 for means, frequency, distribution and descriptive statistics.
Results: The total number of participants was 294 (91.8%) with the mean age of 28 - 45 years. It was found
in the present study that 55.44% of the participants had visited the dentist in the past one year. Majority of
teachers had correct knowledge of oral cleaning aids, however a large number of participants had inadequate
knowledge about causes and prevention of gum disease.
Conclusion: School teachers should be trained in this work and they should further educate the parents as
well as the school going children about the oral health. Their knowledge should be assessed regularly and
further changes in the program should be done in the school oral health program.

Keywords: Oral health, Knowledge, attitude, school teachers

Introduction to infants and pre-school children had been recognized

Globally it has been seen that the burden of oral
diseases is considerable. Oral disease can lead to pain
and tooth loss, a condition that affects the appearance,
quality of life, nutritional intake and, consequently,
the growth and development of children. Tooth decay
and gum disease are among the most widespread
conditions in human populations, affecting over 80% of
schoolchildren in some countries1, 2, 3.In order to reduce
the oral diseases in school children, it is required to
provide the oral health knowledge at infant and preschool
level. The importance of imparting lessons on hygiene
Corresponding Author:
Dr Nisha Rani Yadav
Senior Lecturer, Department of Public Health Dentistry,
Manav Rachna Dental College
Phone: 9911227035
as early as 18784, 5. Children spend considerable time in
school especially during the age when their habits are
being formed6.
School is also considered as the ideal sites for
imparting oral health education, and conducting
preventive programs to reduce burden of these diseases as
services can be made available to all children, including
those who, for a variety of reasons, may not be receiving
professional care7.The need for the promotion of oral
health in schools is evident and it can easily be integrated
into general health promotion, school curriculum and
activities. Healthy behaviors and lifestyles developed
at a young age are more sustainable. Messages can be
reinforced throughout the school years 8, 9.
Shaping ways of life and personality development of
school children during elementary education is the key
responsibility of school teachers and parents10. School
teachers are role models for their student and the role
 168 Indian Journal of Public Health Research & Development, March 2019, Vol.10, No. 3
of teachers during these development stages of the child
critical6 as they can educate the children about how to
prevent oral diseases and promote oral health. They shape
the future of the students and they are the one, who are
entrusted with the role of carrying out various preventive
services and delivering education on oral health in the
long run11, 12. It has been seen that teachers are more skilled
in educational psychology than dentist13. Schoolteachers
are often asked to conduct oral health education and to
administer preventive services also 7.
Hence, given the continuing, important role of
teachers in school oral health programs and in the habits
and lifestyle behavior of school children, the objectives
of this study were: to assess the oral health knowledge,
attitudes, and practices of school teachers
Material and Method
A cross sectional study was conducted in schools
from urban area of Ballabhgarh block, Faridabad district
from August-September 2018. Ethical clearance was
obtained from the institutional committee for conducting
the study. Permission for conducting the study was
obtained from the concerned school authorities. A close
ended questionnaire was administered to find the level
of knowledge of oral health and their determinants like
educational qualification and years of experience. The
questionnaire included 20 questions and was adopted
from the previous studies6, 10.
Ballabhgarh block of Faridabad district has 14 schools
in urban area14. All the school teachers working in these
schools and present on the days of data collection were
included in the study. 4 schools did not give the permission
for the data collection. A total of 320 school teachers
were working in the remaining schools. Participation was
voluntarily. The overall complete questionnaires collected
at the end of the study were 294. The response rate found
in the present study was 91.8%. Two dental professionals
evaluated the prepared questionnaire to maintain its face
and content validity. This questionnaire was then pretested
Table 1: Attitude of school teachers regarding oral health
School teachers should inspect lunch boxes
Fluoride protection against decay is required
Regular checkup by dentist is necessary
Parents should restrict consumption of sweet and sticky snacks
Children less than 10 years need help while brushing
on 20 school teachers and required changes were made in
the questionnaire.
The questionnaire measured demographic details,
knowledge, attitude and practices of school teachers
regarding oral health and dental treatment The knowledge
questions assessed tooth cleaning medium, tooth
cleaning materials, causes of decay and its prevention,
any accessory tooth cleaning aid, frequency of tooth
brushing, causes and prevention of gum diseases.
Attitude was assessed using questions regarding
visiting dentist, parent’s restriction on snacks, fluoride
protection and inspection of lunch boxes by teachers.
Further, the practices were assessed using questions
on brushing activity (frequency of brushing, brush
changing frequency) and visiting dentist. After consent,
participants were explained regarding purpose of the
survey. The questionnaire was self-administered and
one of the authors stood by the participant to answer
any query. On an average, it took 10 - 12 minutes to
the participant to complete the questionnaire. Data was
compiled and analyzed using SPSS version 21 (IBM
Chicago). Descriptive statistics were obtained and
means and frequency distribution were calculated
Results
The total number of participants in the present
study was 294 with the mean age of 28 - 45 years.
Male subjects were 60 (20.41%) and female were 234
(79.59%). Majority of the participants were graduates
i.e. 62.58% and 71.42% were married. It was found in the
present study that 55.44% of the participants had visited
the dentist in the past one year and the most frequent
reason for visiting the dentist was routine dental checkup
(40.47%). Further it was also observed that majority of
school teachers were brushing twice daily (56.80%) and
few were brushing even thrice and more (16.32%). Most
of the study participants were changing the tooth brush
in every three months i.e. 41.49%. Table 1 is showing
attitude of the study participants regarding oral health.
Yes No
206 (70.06%) 88 (29.93%)
193 (68.64%) 101 (34.35%)
201 (68.3%) 93 (31.63%)
185 (62.92%) 109 (37.07)
223 (75.85%) 71(24.14%)
 Indian Journal of Public Health Research & Development, March 2019, Vol.10, No. 3
Discussion
Assessing the knowledge, attitude and practices for
oral health among school teacher is important as they
have the most critical role to `play in the behavioral
practices of school students. Majority of the participants
in the present study were females. This is similar to
the study done by Sekhar V et al. in Pondicherry and
Glasrug P S et al in University of Minnesota, where
most of the study subjects were female i.e. 79% and 84%
respectively10, 15.
It was seen in the study done by Almas et al that
majority (62%) of the participants brushed their teeth
with Miswak daily due to Sunnah16. However, it was
found in the study done by Mwangosi et al that 98.7 of
the school teachers were brushing only once a day22. It
was observed in the present study that around 56.80% of
the participants were brushing twice daily. This reflects
the social and religious norm of the society in the study
done by Almas et al. But when asked for knowledge in
the present study regarding brushing frequency then
it was found that around 68% knew that one should
brush twice daily16. Similar results have been reported
in the study done by Mota A et al where majority of
the teachers (88.7%) believed that a child should brush
at least twice a day and expected exceptional oral
hygiene practices from children6. However, the teachers
themselves exhibited moderate oral hygiene practices.
So, this shows that the school teachers are practicing the
twice brushing habit less frequently even if they have the
correct information.
It was seen in the present study, that majority of the
study participants (45.23%) had knowledge regarding
causes of dental decay i.e. bacteria and sugar. Similar
results had been reported in other studies done by Sekhar
V eta al, Nyandindi et al., and Khan et al10, 17, 18. However,
it is in contrast to study done by Lang P of China19. When
school teachers in the present study were asked about
their knowledge for tooth cleaning medium and material
then it was seen that toothbrush and toothpaste was most
frequent answer given by the participants.
As to prevention of dental caries, regular brushing
was suggested by 29.95%, regular brushing and
avoidance of sweets by 21.76% and regular dental visits
by 30.27%. However, in the study done by Altamimi et
al it was found that 76 per cent considered toothbrushing,
73 per cent of the teachers suggested the use of Miswak,
169
and regular dental visits were recommended by 76
per cent20. The reason for this difference is that the
preventive techniques were differently classified in the
questionnaire of the other study.
In the present study, it was observed that 55.44%
of the participants had visited the dentist in the past one
year and the most frequent reason for visiting the dentist
was found to be routine dental checkup (40.47%).Similar
results have been found in the study done by Ehezele et
al, where 42.4% of the respondents have ever been to the
dentist for routine dental checkup21.
Around 38% of the study participants from the
present study believed that irregular brushing is the main
reason behind gum diseases. However in the study done
by Sekhar V et al it was seen that majority of the school
teachers believed that plaque and calculus is the main
causative factor for gum diseases10.
The school teachers were asked about the role of
fluoride in dental caries prevention. It was observed
that 68.64% of the study subjects were aware about the
role of fluoride and hence said that fluoride protection
is required for caries prevention. In the study done by
Sekhar V et al it was found that around 74.5% teachers
know that fluoride protects against tooth decay10.
Dental floss and other interdental cleaning aids
are known as important dental hygiene aids and are
essential for removing debris, food particles and plaque
from interdental areas of tooth21, 23, 24. The percentage
of teachers knowledge regarding use of dental floss
as accessory dental aid in the present study is very
low (7.14%). Interestingly, many of the teachers have
knowledge about mouth wash as an accessory tooth
cleaning aid (31.29%). Whilst the reason behind this
difference could not be ascertained, one probable
explanation could be the more promotion of mouth
washes in visual media and newspapers.
The present study gives an insight into the
knowledge as well as attitude of school teachers
regarding oral health. National oral health policy
gave special emphasis to preschool children primary
and secondary school children, expected and nursing
mothers25. It has also emphasized on training of trainers.
So teachers should be trained for providing oral health
educations to the students. No comparison was done
among different demographic variables for knowledge
 170 Indian Journal of Public Health Research & Development, March 2019, Vol.10, No. 3
and attitude questions in the present study. The study
was done only on urban school teachers of Ballabhgarh
block. So, further studies can be done on other rural as
well as in other blocks of Faridabad district to know
about the level of perception among school teachers for
oral health.
Conclusion
The school teachers in the present study had fair
level of knowledge. School teachers should be trained
in imparting oral health education to the parents as well
as the school going children about the oral health. Their
knowledge should be assessed regularly and further
changes in the program should be done in the school oral
health program.
Conflict of Interest: None
Source of Funding: None
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