ISSN: 2320-5407 Int. J. Adv. Res.

11(09), 869-875

Journal Homepage: -www.journalijar.com

Article DOI:10.21474/IJAR01/17596
DOI URL: http://dx.doi.org/10.21474/IJAR01/17596

RESEARCH ARTICLE
ASSESSMENT OF KNOWLEDGE, AWARENESS AND ATTITUDE OF SCHOOL TEACHERS OF
KAPADWANJ TALUKA TOWARDS ORAL HEALTH- A QUESTIONNAIRE STUDY

Kruti Bhavsar1, Bela Dave2, Drashti Shah1, Parul Garnayak3, Kinjal Savjani1 and Archana Prajapati1
1. Post Graduate Student, Department of Periodontology, AMC Dental College, Ahmedabad, Gujarat, India.
2. Professor and Head, Department of Periodontology, AMC Dental College, Ahmedabad, Gujarat, India.
3. Undergraduate student, AMC Dental College, Ahmedabad, Gujarat, India.
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Manuscript Info Abstract
……………………. ………………………………………………………………
Manuscript History Objective:Schools and teachers are the vital source of guidance
Received: 25 July 2023 pertaining oral health in students. Oral health education given in early
Final Accepted: 27 August 2023 life has lifelong effect on person. Hence, this study aims to evaluate the
Published: September 2023 knowledge, awareness and attitude of primary and middle school
teachersconcerning oral health of Kapadwanj Taluka.
Key words: -
Oral Health, Oral Hygiene, Knowledge, Materials and Methods: This cross-sectional study was conducted
Teachers, Awareness ongovernment schoolteachers ofKapadwanj taluka, Gujarat. Data of
responses to 11 close ended, self-structured questionnaire assessing
knowledge, awareness and attitude towards oral health was collected
and entered in computer software. The frequency and percentage of
data for all three sections were evaluated.
Results: Total 148 primary and middle school teachers were enrolled in
study without gender preference.98.6% teachers had good
awareness,63.5% of them were with average knowledge while only
46.6% had favorable attitude.Distribution in gender showed almost
equal knowledge and awareness in male and female teachers with
comparatively more favorable attitude in male teachers. Among
primary and middle school teachers, primary teachers showed better
knowledge and awareness.
Conclusion:Most of the teachers showed satisfactory knowledge in
some aspects of oral health, although improvements can be
implemented by regular teacher training, such as oral health seminars
and material activities. These fundamental measures empower and
supports teachers to effectively convey oral health education to students
and scociety.
Copy Right, IJAR, 2023,. All rights reserved.
……………………………………………………………………………………………………....
Introduction:-
Health is a universal human need for all cultural groups. As defined by World Health Organization (WHO), oral
health is state of the mouth, teeth and orofacial structures which enables an individual to eat, speak and socialize
without active disease, discomfort, or embarrassment. It is intricately connected to one’s overall health and has a
profound impact on an individual’s capacity to actively engage in society and achieving their potential.

As peranalysis for Global Burden of Disease 2017, there are estimated to be more than 3.5 billion cases of oral
diseases and other oralconditions, most of which are preventable. 1 For that preventive activities are being executed

Corresponding Author:- Kruti Bhavsar 869

Address:- Post Graduate student, Department of Periodontology, AMC Dental College,
Ahmedabad, Gujarat, India.
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within various divisions of society by dental professionals. School is an important platformfor such activities as each
familycan be made aware by educating the students. As per the saying “reap what you sow”, school‑going age is the
most influential period of life. Children develop skills, beliefs, and attitudes which they practice throughout their
lives during these years.2 Teachers being first one to impart education regarding oral health plays a key role in
students’ life. They have a great potential to integrate general and oral health education into other activities,
seamlessly to ensure the consistent delivery of instructions to community, all while keeping the cost minimal. 4,5

The Ministry of Health and Family Welfare, Government of India hasextended minimum oral health to the entire
Indian population, in national health policy, 1995. 6Later they havelaunched the National Oral Health care Program
(NOHP) which envisaged the implementation of oral health education, preventive and curative services as well. 7
NOHP aims to strengthenpublic health facilities of country for an accessible, affordable, and quality oral health‑care
delivery. One of the key objectives of this program is to train the personnel from various sectors such as health
workers, Anganwadi workers, ASHAs (accredited social health activist), nursing staff, and school teachers for the
promotion of oral health.8

Hence, need of hour is to have aknowledge on role of teachers in oral health care specifically for small cities where
people are more likely to have less access to dental care. Against this background the study was undertaken with
objective of assessing knowledge, awareness and attitude of primary and middle school teachersconcerning oral
healthinKapadwanj talukasituated in Kheda district of Gujarat state, India.

Materials and Methods:-

After approval by the Institutional Review Board, AMC Dental College, Ahmedabad and obtaining permission
fromgovernment primary and middle schools of Kapadwanj Taluka, study was conducted in the form of online surveyin
March and April 2022. Only those teacherswho agreed to give informed consent were included while visiting teachers
were excluded from study. Total 148 teachers from 56 schools were selected by simple random sampling. Online
questionnaire forms weresenttoteachers via social networking platform. Validation of questionnaire and translation was
done beforehand by conducting pilot study in 15 teachers.

Questionnaire Design:
11 closed-ended questionnaires wereprepared in English and Guajarati languages. Apart from demographics, questions
regarding general as well as systemic factorsimpacting oral health, oral cancer, oral health care routine andoral health
promotion in community were divided into three categories- knowledge, awareness and attitude towards oral health.Along
with the informed consent, participant information sheet was prepared mentioning purpose of study.

Collected data were entered in computer software for analysis. Independent percentages were calculated for each section
to determine the frequency of the responses.Results were calculated and compared for each section and category.

Results:-
All the 148 responses were received in Gujarati language. Average age of teachers was 43.26 ±7.54 years ranging from 27
to 58 years. Demographic data showed that majority of participants were male (64.9%) compared to female teachers
(35.1%). 68(45.9%) were primary school teachers teaching in class 1-5 whereas 80(54.1%) were middle school teachers
teaching in Classes 6-8. Majority of teachers were well aware and acquainted with fair knowledge regarding oral health.
Table 1 summarizes the responds of teachers for each question about knowledge, awareness and attitude towards oral
health.

Table 1:- Knowledge, awareness and attitude of teachers towards oral health.
Questions Frequency Percentage
Knowledge about causes of tooth decay
Dental plaque 114 77
Sugar consumption 57 38.5
Bacteria 39 26.4
Other 1 0.7
Knowledge about causes of gum disease
Plaque and tartar build up 70 47.3
Lack of nutritious food 60 40.5

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Bacterial infection 67 45.3

Knowledge about oral cancer and tabaco 131 88.5
Improper dental care leads to
Tooth decay 27 18.2
Gum disease 15 10.1
Both 106 70.6
Does health of tooth and mouth affect systemic health? 93 62.8
Awareness about diabetes and gum diseases 44 29.7
Awareness about brushing technique 52 35.5
How they maintain oral hygiene at home.
By brushing tooth only 65 43.9
Brushing and tongue cleaning 78 52.7
Brushing and using mouthwash 5 3.37
When they visit the dentist
On having toothache or pain in mouth 105 70.5
Every 6 months 16 10.8
Every 3 months 8 5.4
Never 19 12.8
When they change tooth brush
On noticing worn bristles 14 9.5
Every month 47 31.8
Every 3 months 59 39.9
Every 6 months 28 18.9
Guide children and their family about oral health at school level 119 80.4

For assessment of knowledge 3 questions were asked related to causes of oraldiseases.Those having correct and incorrect
knowledge were given a score of 1 and 0 respectively. All respondents with total score 3 considered having good
knowledge, 2average and 1 poor knowledge.Figure 1 shows that 35.8% teachers had good knowledge compared to 63.5%
had average and 0.7% were having poor knowledge.Table 2presents responds regarding knowledge of teachers
distributedaccording to gender and grade level they teach in. Fairly equal percentage of female (38.5%: 19) and male
(34.4%: 33) school teachers had good knowledge with equal distribution in primary and middle school teachers (64.7%
and 62.5% respectively).

Figure 1:-Oral health knowledge of school teachers.

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Table 2:- Distributionof school teachers based on knowledge according to gender and grade level taught.
Category Knowledge Frequency Percent
Male Poor 1 1.0
Average 62 64.6
Good 33 34.4
Total 96 100
Female Average 32 61.5
Good 20 38.5
Total 52 100
Primary school teachers Average 44 64.7
Good 24 35.3
Total 68 100
Middle school teachers Poor 1 1.3
Average 50 62.5
Good 29 36.3

Four questions were asked to assess awareness. Out of 4up to 3 score were given tolow awareness and score >3
considered good awareness.98.6% teachers had good awareness whereas only 1.4% teachers were having low awareness.
(Figure 2).Table 3presents distribution of awareness in teachers gender wise and according to grade level they teach in.
All female and all primary school teachers had a good awareness while 2 male (2.1%) school teachers had a low
awareness.

Figure 2:- Oral health awareness of school teachers.

Table3:- Distribution of school teachers based on awareness according to gender and grade level taught.
Category Awareness Frequency Percent
Male Low 2 2.1
Good 94 97.9
Total 96 100
Female Good 52 100
Primary school teachers Good 68 100
Middle school teachers Low 2 2.5
Good 78 97.5
Total 80 100

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Regarding attitude of teachers towards oral health care 4 questions were asked.53.4% teachers had unfavorable attitude
and 46.6% hada favorable attitude as scores up to 2 were scaled as unfavorable and scores >2 considered favorable
attitude. (Figure 3)Table 4depicts the distribution of teachers based on attitude according to gender and grade level they
teach in. More male (59.4%: 57) teacher had favorable attitude compared to 42.3% (33) female teachers having favorable
attitude. Distribution of teachers based on attitude and grade they teach in was almost equal for both arms.

Pearson correlationcoefficientbetween knowledge and awareness was -0.035 and, between knowledge and attitude is -
0.087. It implies that no significant linear relationship found between knowledge and awareness or knowledge and
attitude.(Table 5)

Figure 3:- Attitude of school teachers towardsoral health.

Table4:- Distribution of school teachers based on attitude according to gender and grade level taught.
Category Attitude Frequency Percent
Male Favorable 57 59.4
Unfavorable 39 40.6
Total 96 100
Female Favorable 22 42.3
Unfavorable 30 57.7
Total 52 100
Primary school teachers Favorable 37 54.4
Unfavorable 31 45.6
Total 68 100
Middle school teachers Favorable 42 52.5
Unfavorable 38 47.5
Total 80 100

Table5:- Correlation between oral health knowledge, awareness and attitude.

Correlations
Knowledge Awareness Attitude
Knowledge Pearson Correlation 1 -.035 -.087
Sig. (2- tailed) .669 .294

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Discussion:-
This study provided detailed view of the primary and middle school teachers’ knowledge,awareness and attitudeabout
oral health. To the best of our knowledge present study was the first of its kind inKapadwanj.
Mean age of teachers instudy was 43 years which suggest teachers in this study have an experience of around 10-15
years.This is in unison with a study byVidya Sekhar et al. 9

More school teachers knew about dental caries and oral cancer in comparison to periodontal disease.This finding was
contradictory to the study done by Singh H et al in which more teachers had a good knowledge about periodontal
disease.2 77% of respondentsagreed that lack of oral hygiene is principal cause for dental caries, 38.5% of all
respondentsbelieves more sugar consumption causes dental caries. This finding indicatesbetter knowledge of teachers
for dental plaque and oral hygiene in our study. Out of total number of respondents 48 (32.4%) teachers had
knowledge of effect of tabaco on gums although 88.5% of them knew about tabaco causing oral cancer.62.8% teachers
were aware about effect of oral and dental health on overall health and 29.7 % were aware about association of
diabetes with periodontal disease.

Regarding oral hygiene routine, 35.5% teachers were aware about proper brushing technique. More than half of
teachers considers tongue cleaning necessary along with tooth brushing. 31.8% teachers change their tooth brush every
month, 39.9 % every three months, 18.5% every six months and only 9.5 % changes tooth brush when they notice
worn bristles. This is similar to study by Prabhadevi C Maganur et al. 10

At 70.9 % of the time, teachers visit the dentist when they are in pain or have a toothache while only 16.2% see their
dentist on regular bases. In developing countries like India, pain is traditionally the primary motivator for visiting a
dentist or doctor rather than being concerned aboutpreventive care. In a survey conducted by Ehzille et al. in Nigeria 12,
48% of school teachers said there is no specific reason for not seeing the dentist, followed by high expense, fear, and
lack of time.

Results as per the distribution in gender showed almost equal knowledge and awareness in male and femaleteachers
with comparatively more favorable attitude in maleteachers.Among primary and middle school teachers, primary
teachers showed better knowledge and awareness.There is a requirement of further study to evaluate possible factors
which can help to improve teacher training program specific to this group of teachers.

Overall, 98.6% and 35.8% teachers had a good awareness and knowledge respectively but more than half of teachers
had unfavorable attitude for oral health. As per Pearson correlation coefficient significant there is no significant linear
association between Knowledge and awareness or between knowledge and attitude.

Multiplestudies have been conducted worldwide, highlighting the attitudes, knowledge, practices, and willingness of
schoolteachers to promote oral health within school settings. Studies from Romania, China,Saudi Arabia, and United
States of America have reportedpositive attitudes and knowledge on oral health amongteachers, and that they
showed willingness to participatein oral health promotion. 11,12Results of our study were in par with study conducted
by KA Kamala et. Al. in 2019,13inferred that overall oral health knowledgeand attitude was good with 88.67 %
teachers having regular dental visits.Charu Khurana et. Al. carried out a study in the year, 14 in which teachers’
training program was conducted after initial questioner survey among 50 primary school teachers across the country.
A significant increase in mean knowledge scores of school teachers was seen after a 1-day training program.

There is a possibility for bias, since it is a survey in which respondents are aware that it is conducted by dental
professional and tend to provide responses more favorable or aligned with expectations of person conducting this
survey.Though most of the teachers show satisfactory knowledge in some aspects of oral health, improvements can
be implemented by regular teacher training, such as oral health seminars, materials, and other similar ways. These
fundamental measuresempower and supportsteachers to effectively convey oral health education to young students.

Conclusion:-
Study infers that majority of teachers are well aware and acquainted with fair knowledge regarding oral health
although have an attitude similar to the general public, with most of them tending to go to the dentist only whenin
pain and not paying attention to any other oral cavity problems other than toothache. Hence,further workshops on
implication of oral health knowledge in daily life are essential toincrease oral health knowledge and attitudes among

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school teachers. Conducting training program for Anganwadi workers, ASHAs, nursing staff, andteachers is also a
proposal by National Oral Health Program launched by Indian government.With this background of teachers,
training program on oral health can be conducted efficiently and made much more effective.

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