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Bangladesh Journal of Medical Science Vol. 13 No. 04 October’14

421

Original article

An educational intervention program on knowledge about oral hygiene measures

Karim F1, Begum J2

Introduction:

Oral health knowledge is considered to be an essen-

tial prerequisite for health-related practices1, there is
an association between increased knowledge and

better oral health2,3. Those who have assimilated
the knowledge and feel a sense of personal control
over their oral health are more likely to adopt self-

care practices4.
Now-a-days oral disease can be considered as a pub-
lic health problem due to its high prevalence and sig-
nificant social impact. Chronic oral disease typically
leads to tooth loss, and in some cases have physical,

emotional and economical impacts5. Physical
appearance and diet are often worsened and the pat-

tern of daily life and social relations are also often
negatively affected. These impacts lead in turn to
reduce welfare and quality of life. To minimize these
negative impacts of chronic oral diseases, there is a
clear need to reduce harmful oral health habits. Such
a reduction can be achieved through appropriate

health education program5,6 .
Bangladesh is a developing country with a vast pop-
ulation. Many people of this country live below
poverty line. They possess a harmful life style for
health, especially oral health. Dental problem is still
a significant public health problem in both devel-
oped and developing countries. Good oral health is a
key for ensuring overall well being. Our teeth play

Corresponds to: Dr. Farzana Karim, Assistant Professor, Department of Paediatric Dentistry, Marks Dental
College, Mirpur-14, Dhaka, Bangladesh. E-mail: bluebird4445@yahoo.com

Abstract:

Background: Health education is a process of transmission of knowledge and skills necessary 
for improvement in quality of life. Objectives: The purpose of this quasi-experimental study 
was to evaluate the oral hygiene related knowledge among the population in a selected 
community before and after health education. Materials and Methods: A total of 106 
respondents were taken purposively at South Pirerbag of Dhaka city. Baseline data were 
collected by pre-tested structured questionnaire. An educational intervention program was 
conducted by dividing the respondents into seven groups, 15 in each group; method was 
group discussion and lecture; poster, model of teeth and brush were the aids. Post intervention 
data were collected by the same questionnaire. Results: Among the respondents, 61.32% were 
male and 38.68% were female, mean age was 46.25 years, 35.85% had primary level 
education, monthly family income was Tk 5000-10000 in 66.98%. Before intervention 
64.15% told that teeth should be cleaned twice daily, 62.26% told teeth should be cleaned by 
brush and paste and 2.83% told teeth should be cleaned after breakfast and night; whereas 
after intervention the result was 91.51%, 85.85% and 67.93% respectively. Before 
intervention 66.98% stated that tobacco is hazardous to health but 32.4% have no idea about 
the type of diseases that occur due to tobacco; whereas after intervention 89.62% told that 
tobacco is hazardous to health and most of them had idea about harmful effect of tobacco. 
Conclusion: Educational intervention program is effective to improve the knowledge of the 
respondents about oral hygiene.
Keywords: knowledge; oral hygiene; health education

1. Dr. Farzana Karim, Assistant Professor, Department of Paediatric Dentistry, Marks Dental College,
Mirpur, Dhaka, Bangladesh.

2. Dr. Jahanara Begum, Assistant Professor and Head, Department of Health Promotion and Health
Education, National Institute of Preventive & Social Medicine, Mohakhali, Dhaka, Bangladesh.

DOI: http://dx.doi.org/10.3329/bjms.v13i4.20589
Bangladesh Journal of Medical Science Vol. 13 No. 04 October '14. Page: 421-426



an important role in our daily lives. It increases the
beauty of the face, helps in digestion of food by
chewing and grinding and enables to articulate and
pronounce words correctly while talking. 
In order to establish oral hygiene as an important
prophylactic measure influencing successful protec-
tion of oral health of the whole population, it is nec-
essary to inform as many people as possible about
oral hygiene effectiveness and its necessity in pre-
venting oral and dental diseases; to develop the
habits of regular oral hygiene maintenance in the
people. Regarding high prevalence of dental prob-
lem in population, the issue of prophylaxis is of
great significance. In that respect, health education
should point out to the significance of proper and
regular oral hygiene, all aimed at preventing dental
diseases. 
The purpose of the study is to assess the knowledge
about oral hygiene among the population in a select-
ed community before and after health education. The
information from this study will help policy makers
to identify the information gaps and formulate
guidelines and act as a baseline for further study.
Methodology:

Study Design:

This was a quasi-experimental type of study. In this
study the outcome of educational intervention is
obtained by comparing pre and post intervention on
knowledge of the same group of people. The study
was carried out at South Pirerbag, Dhaka. The study
population was selected randomly irrespective of
age, sex and religion. Participation was voluntary.
The sample size was 106. The sample was collected
by non probability purposive sampling.
Data Collection Procedure:

A structured questionnaire was developed based on
the objectives and variables of the study. It was final-
ized after modification and correction based on the
findings of questionnaire pretesting. Before collec-
tion of data permission was taken from the respon-
dents. The purpose of the study was explained to the
respondents prior to administering the interview.
With the consent of the respondents data was collect-
ed by face to face interview by using Bengali version
questionnaire. The study population was interviewed
twice with the same sets of structured questionnaire.
At first baseline data were collected. After collection
of baseline data, health education program was con-
ducted by preparing a lesson plan according to the
objectives. Second phase of data was collected after
intervention. The privacy of the respondents was
maintained strictly. This study was not involved any

physical, mental and social risk of the respondents.
Data Processing And Analysis:

After collection of information through question-
naire, the data were coded, entered and analyzed in a
computer. The findings of the study were presented
by frequency, percentage and table and data analysis
was done using statistical package for social sci-
ences or SPSS version 14 (Chicago, IL, USA).
Educational Intervention Program

According to the baseline information an education-
al curriculum was prepared with necessary educa-
tional materials for health education intervention
program. A total 106 respondents were selected pur-
posively. They were divided into seven groups, each
groups consist of 15 respondents. The allocated time
was thirty minutes for each group. The respondents
were informed previously according to scheduled
date and time. Health education intervention session
was conducted using various methods (lecture,
group discussion) and media (poster, model of teeth,
tooth brush) for dissemination of knowledge. The
program was evaluated on the basis of change in
knowledge about oral hygiene before and after inter-
vention by applying structured questionnaire.Post
intervention data collection was started after 15 days
of educational intervention program. 
Results:

In this study 106 respondents were participated with
mean age 46.25 ± 11.27 years. Majority of them had
only school level education and others were illiter-
ate. Mean monthly family income was 7520.94 ±
320.40 Taka. Among the respondents 61.32% were
male and 38.68% were female.
Among 106 respondents, before intervention
64.15% respondents told that teeth should be
cleaned twice daily and 25.47% respondents told
once daily; whereas after intervention it was
changed into 91.51% and 4.72% respectively.
(Table-1).

knowledge about oral hygiene measures

422

Frequency of

tooth 
cleaning

 

 
 

Before intervention  After intervention 

frequency percent frequency percent 

Once daily 27 25.47 5 4.72 

Twice daily 68 64.15 97 91.51 

Thrice daily 11 10.38 4 3.77 

Total 106 100.00 106 100.00 

Table - 1: Distribution of the respondents by 
knowledge on frequency of tooth cleaning before 
and after intervention (n=106)



Before intervention 62.26% respondents told that
teeth should be cleaned by tooth brush and tooth
paste, 20.76% respondents told tooth powder, rest of
them told coal, Miswak and ash were ideal tooth
cleaning materials; whereas after intervention
85.85% respondents told that teeth should be
cleaned by tooth brush and tooth paste, 10.38%
respondents told tooth powder (Table-2).

Before intervention 72.64% respondents told that
people should visit to dentist when dental problem
occur and 10.38% respondents told taking drug from
pharmacy; whereas after intervention percentage
towards dental visit was increased into 95.28%.
(Table-3)

Table -4 shows the distribution of the respondents by
knowledge on time of   tooth cleaning before and
after intervention. Among 106 respondents 26
(24.53%) told teeth should be cleaned before break-
fast, 2 (1.89%) told after breakfast, 9( 8.49%) told
every after meal, 66 (62.26%) told before breakfast
and before going to bed, 3 (2.83%) told after break-
fast and before going to bed ; where after interven-
tion 10 (9.43%) told teeth should be cleaned before
breakfast, 1 (0.94%) told after breakfast, 6 (5.66%)
told every after meal, 17 (16.04%) told before break-
fast and before going to bed, 72 (67.93%) told after
breakfast and before going to bed.

Table – 5 shows that before intervention 42 (
39.62%) respondents told that after every meal teeth
should be cleaned by gargling with water, 11
(10.38%) respondents told tooth brushing, 39
(36.79%) respondents told nothing and 14 (13.21%)

Karim F, Begum J

423

Materials 

used for 

tooth

cleaning

 

Before intervention After intervention              

Frequency  Percent Frequency Percent 

Tooth brush
& tooth 
paste

 

66 62.26 91 85.85 

Tooth

powder

 22 20.76 11 10.38 

coal 6 5.66 1 0.94 

Miswak 7 6.60 3 2.83 

Ash 5 4.72 0 0 

Total 106 100.00 106 100.00 

Table -2: Distribution of the respondents by 
knowledge on materials used for tooth cleaning 
before and after intervention (n=106)

Duration of

tooth 
cleaning

 

Before intervention After intervention

Frequency Percent Frequency  Percent 

Less than 1 

minute 

19 17.92 9 8.50 

1-2 minutes 26 24.53 
 

78 73.58 

3-5 minutes 38 35.85 19 17.92 

Don’t know 23 21.70 
 

0 0 

Total 106 100.00 106 100.00 

Table – 3: Distribution of the respondents by 
knowledge on duration of tooth cleaning before 
and after intervention (n=106)

Time of tooth 

cleaning 

Before intervention After intervention

Frequency Percent  Frequency Percent 

Before breakfast          26       24.53         10 9.43 

After breakfast           2       1.89  1 0.94 

Every after meal           9       8.49  6 5.66 

Before breakfast 
and night 

 
        66  

 
    62.26 

 
17 

 
16.04 

After breakfast 

and before going 

to bed 

 

          3  

 

     2.83  

 

72 

 

67.93 

Total       106  

 

   100.00 106 100.00 

Table -4: Distribution of the respondents by 
knowledge on time of   tooth cleaning before and 
after intervention (n=106)

Cleaning teeth 

after every meal 

Before intervention After intervention

Frequency Percent 

 

Frequency Percent 

Gargling with 

water 

42 39.62 98 92.45 

Tooth brushing 11 

 

10.38 5 4.72 

Nothing 39 

 

36.79 3 2.83 

Don’t know 14 

 

13.21 0 0 

Total 106 

 

100.00 106 100.00 

Table -5: Distribution of the respondents by 
knowledge on cleaning teeth after every meal 
before and after intervention (n=106)



respondents did not know the answer where after
intervention 98 (92.45%) respondents told that after
every meal teeth should be cleaned by gargling with
water, 5 (4.72%) respondents told tooth brushing.
Table – 6 shows that before intervention 77
(72.64%) respondents told that measures taken dur-
ing dental problem should be go to dentist, 18
(16.98%) respondents told gargling with warm salt
water and 11 (10.38%) respondents told taking drug
from pharmacy; where after intervention 101
(95.28%) respondents told that go to dentist in a den-
tal problem is correct decision, 5 (4.72%) told gar-
gling with warm salt water and  no respondent was
positive for taking drug from pharmacy in a dental
problem.

Table – 7 shows that before intervention 71 (
66.98%) respondents told that tobacco is hazardous
to health, 35 (33.02%) respondents told tobacco is
not hazardous to health; where after intervention 95
(89.62%) respondents told that tobacco is hazardous
to health and 11 (10.38%) respondents told that
tobacco is non hazardous to health.

Table – 8 shows that before intervention 23
(32.40%) respondents did not know what kind of
disease occur due to smokeless tobacco consump-
tion. 12 (16.90%) respondents told that smokeless
tobacco cause both bad breath and stain in tooth, 7
(9.86%) told cancer, 9 (12.68%) told bad breath

only; where after intervention 63 ( 66.32%) respon-
dents told that smokeless tobacco cause ulcer, stain,
bad breath, loss of taste and cancer all, 9 (9.47%)
told both bad breath and stain of tooth and 6 (
6.32%) told cancer only.  

Discussion:

This educational intervention study was carried out
among the general population in a selected commu-
nity with a view to assess the effect of health educa-
tion about oral hygiene measures. A total 106
respondents were interviewed with structured ques-
tionnaire and an educational intervention program
was conducted which was evaluated after interven-
tion.
Among 106 respondents maximum 35 (33.02%)
belongs to 41- 50 years age groups, 28(26.42%)
belonged to 31-40 years, 22 (20.75%) were 51-60
years, 14(13.21%) were 61-70 years and 7 (6.60%)
belonged to 21-30 years. The mean age was 46.25±
11.27 years. About 38 (35.85%) of respondents were
primary level education, 28 (26.41%) were second-
ary level, 27 (25.47%) were illiterate, 11 (10.38%)
were S.S.C. passed and 2 (1.89%) were H.S.C.
passed. Among the respondents 37 (34.90%) were
Day laborer, 19 (17.92%) were Service holder, 17
(16.04%) were Housewives, 11 (10.38%) were
Rickshaw puller, 9 (8.49%) were Driver, 8(7.55%)
were Businessman and 5 (4.72%) were self
employed.
Majority 71 (66.98%) of the respondents monthly
family income within taka 5000 – 10000, 25

knowledge about oral hygiene measures

424

Measures taken 

during dental 
problem 

Before intervention After intervention          

Frequency Percent Frequency Percent 

Taking drug from 

pharmacy 

11 10.38 0 0 

Go to dentist 77 
 

72.64 101 95.28 

Gargling with warm 

salt water 

18 16.98 5 4.72 

Tables - 6:  Distribution of the respondents according 
to knowledge on measures taken during dental 
problem before and after intervention (n=106)

Tobacco is 

hazardous to

oral health 

Before intervention After intervention     

Frequency Percent Frequency Percent 

Yes 

 

71 66.98 95 89.62 

No 
 

35 33.02 11 10.38 

Total 

 

106 100.00 106 100.00 

Table -7: Distribution of respondents by opinion 
on effect of tobacco on oral health before and after 
intervention (n=106)

Type of disease Before intervention After intervention 

Frequency Percent Frequency Percent 

Cancer 7 9.86 6 6.32 

Bad breath 9 12.68 3 3.16 

Stain in tooth 6 8.45 5 5.26 

Loss of taste, 

ulcer in the 
mouth 

5 7.04 4 4.21 

Bad breath, 

cancer 

5 7.04 5 5.26 

Bad breath, stain 
in tooth 

12 16.90 9 9.47 

Ulcer, stain, bad 

breath, cancer, 

loss of taste 

4 5.63 63 66.32 

Don’t know 23 32.40 0 0 

Total 71 100.00 95 100.00 

Table – 8: Distribution of the respondents by 
knowledge on type of disease occur in the mouth 
due to smokeless tobacco use before and after 
intervention                                                                                                 



(23.59%) respondents family income below 5000, 7
(6.60%) respondents family income between 11000-
15000 and 3 (2.83%) respondents family income
more than taka 15000. 
Oral health includes preservation of dentition and
maintenance of good oral hygiene. Dental dis-
eases—such as dental caries (tooth decay) and peri-
odontal disease (gum diseases)—cause pain, dis-
comfort on chewing, hypersensitivity, and bad
breath. Tooth loss may restrict choices of food, and
be associated with loss of pleasure in eating,4

decline in self-confidence7, poor articulation and
malnutrition. Chewing difficulties are associated
with a personal perception of poor health and

depression8. Oral health affects the quality of life.
Thus, good oral hygiene benefits both oral and gen-
eral health. 
This educational intervention study showed that the
knowledge of the respondents regarding oral
hygiene measures was improved after health educa-
tional intervention. This was similar to a study done

by Hebbal et al. in Belgaum, India9. Similar result
was found in the study done by Shenoy in India,

Thomas in Kerala and Tewari in Ambala10-12.
Though after intervention the percentage of the
respondents on oral hygiene knowledge slightly
improved, but the increase percentage is not satisfac-
tory. The concerned authority can play a vital role to
improve the knowledge on everyday science and per-

sonal hygiene including oral hygiene among the mass
population in Bangladesh. Hence we may get a gen-
eration free of oral diseases and a good oral health.
Conclusion:

The change to healthy attitude and knowledge can be
occurred by giving adequate information and moti-
vation to the respondents. Therefore dental health
education is needed focusing on the special needs of
the population to improve their quality of life. 
Recommendation:

On the basis of the findings of the present study fol-
lowing recommendations were drawn:
Community oriented intervention program for com-
munity people should be arranged. 
Provide effective and appropriate messages on oral
health through mass media such as radio, television,
newspaper, folk song, billboard etc.           
Educational Intervention program should be
arranged at school, work place and hospital.
Include a chapter on oral hygiene and practices in
the health education curriculum at school so that the
school going children improve their knowledge and
practice and dissemination of information among
their family members.
Regular training among the community health work-
ers to educate the community people about oral
health.           
Train up the community leaders about proper oral
hygiene so that they can build awareness to the com-
munity people through disseminating information.

Karim F, Begum J 

425



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