STATUS OF ORAL HYGIENE AND PERIODONTAL HEALTH OF PRIMARY SCHOOL CHILDREN IN IBADAN: EFFECT OF INTERVENTION THROUGH HEALTH EDUCATION

Abstract

A study was conducted on the status of oral hygiene and periodontal health of primary school children drawn from two different socio-economic backgrounds in lbadan. The schools were the University Staff School, and the Salvation Army School, Yemetu, representing the elitist and the traditional groups respectively. The study also sought to identify the state of the pupils' Knowledge, Attitude and oral hygienic Practices (KAP). In addition, a two-month health education intervention was conducted among pupils of the Salvation Army School and the effects of such intervention on the oral hygiene as well as on the KAP were assessed. The oral hygiene of pupils was assessed by the Green and Vermillion Oral Hygiene index. Assessment of periodontal health was carried out using the Loe and Silness Gingivitis Index. Structured questionnaires were designed to collect data on the KAP.

The findings reveal that knowledge of tooth cleaning materials, frequency of tooth-brushing and tooth-brushing techniques exhibited by pupils of the two schools differed significantly. Out of the 199 pupils of the University Staff School studied, 124 (63.3%) had no knowledge of traditional cleaning materials, whereas 192 (95.5%) of the 201 pupils of the Salvation Army School showed good knowledge of such materials. With regard to knowledge of modern tooth cleaning materials, 54 (27.1%) of Staff School children were able to mention at least four tooth-paste brand names whilst only 10 (5.0%) of children in Yemetu could display such knowledge. All the pupils in the study expressed the opinion that teeth should be brushed daily. Staff School children reported brushing more frequently than their counterparts at the Salvation Army School, Yemetu. All the 199 pupils of the University Staff School interviewed used toothbrush and toothpaste for regular oral hygiene. ln Salivation Army School, 76 (37.8%) pupils used chewing sticks, 64 (31.8%) used toothbrush and toothpaste, while 25 (12.5%) and another 25 (12.5%) used toothbrush and chewing sticks along with native concoctions respectively. Among pupils of the Staff School, mean debris and calculus scores of 0.989 ± 0.733 and 0.252±0.551 were computed respectively. The mean gingivitis score was 0.829±0.850. Similar readings in Salvation Army pupils were found to be poorer being 1.491 ±0.811, 1.398±0.954 and 1.384±0.864 for mean debris, calculus and gingivitis scores respectively. It was also revealed that mean scores for teeth in the maxillary arch were lower than those for the mandible.

Mean debris scores of 0.988 ± 0. 873 and 1.388 ±0.808 were recorded for maxillary teeth in Staff School and Salvation Army School respectively. In comparison, mean debris scores of 0.99±1.321 and 1.592±1.449 were calculated for teeth in the mandible in the two schools studied. Gingivitis scores were similarly different, being 0.749±0.690 and 0.905 ±0.657 for maxilla and mandible respectively in Staff School and 1.265±0.996 and 1.505±0,807 for Salvation Army School, Yemetu. Mean scores recorded for posterior teeth were higher than those for anterior teeth in both schools, except the mean calculus score on the labial surface of

the lower left incisor which was highest among pupils of both primary schools. A variation in the distribution pattern of mean scores according to side of the mouth was also observed. Mean scores for teeth on the right side were generally Iower for debris, calculus and gingivitis than those on the left side in the two schools studied. Evaluation at the end of the two month's health education intervention revealed a change in the level of knowledge, pupils' altitudes and in the oral hygiene practices. The children had acquired more knowledge and the oral hygiene practices had improved significantly. Mean debris and calculus scores were 0.870 ±0.650 and 1.177± 1.121 respectively Mean gingivitis score was 1.029 ±0.890. This study has therefore shown that the state of oral hygiene, periodontal health and KAP of children in the University Staff School, who belong to the higher socio-economic group is better than those of children in Salvation Army School, Yemetu in the lower socio-economic stratum. This study has also shown that health education is an effective method of improving KAP amongst primary school children in the areas where the oral hygiene is poor as also their oral health.