79 International Journal of Human and Health Sciences Vol. 01 No. 02 July’17 Original article: Oral Hygiene Awarness Among The Primary School Childrenin A Rural Areaof Bangladesh Karim F Abstract: Background: Now-a-days dental problem is one of the most common diseases in the world.Proper oral hygiene practicingin a regular basis are great ways to prevention of dental disease. Methodology: This cross sectional study was carried out with a view to assess the oral hygiene awareness among the primary school children of a rural area under Dhaka division of Bangladesh. Data about oral hygiene related knowledge and practices were collected by face to face interview of the children. Oral examination was done by disposable dental mirror and probe under sufficient light. Data were analyzed using SPSS version 16. Results: Among the 114 respondents 53.51% are male and rest are female. Age range of the respondents were 6 to 11 years.Oral hygiene related knowledge: Among the respondents 78.07% told that regularteeth cleaning is important,60.52% respondents told that teeth should be cleaned once daily,62.29% told that teeth should be cleaned by tooth brush and tooth paste,70.17% told that teeth should be cleaned before breakfast. Oral hygienerelated practice: Among 114 respondents 64.04% cleaned their teeth everyday,51.75%used tooth paste and toothbrush to clean their teeth, 38.60%respondents cleaned their teeth in their convenient time. Among the tooth brush users, most of them changed their toothbrush when it was damaged or lost. All the respondents used match stick or coconut leaf stick if food was deposited in between their teeth. Oral hygiene status: Among the respondents 68.32 % had caries in their mouth. About 53.42% caries found in the lower jaw. Caries were more prevalent in molar teeth. About 69.34% respondents had plaque or calculus, 46.54% experienced gingival bleeding. Conclusion: Oral hygiene awareness among the respondents were very low. Keywords: oral hygiene, children,caries Correspondence to: Dr. Farzana Karim, Assistant Professor, Department of Pediatric Dentistry Marks Medical College (Dental Unit), Mirpur - 14, Dhaka, Bangladesh. E-mail: farzanakarim25@gmail.com International Journal of Human and Health Sciences Vol. 01 No. 02 July’17. Page : 79-82 Introduction: Oral Health is an essentialpart of general health. It has become clear that causative and risk factors in oral diseases are often the same as those implicated in the major general diseases.1 Without a healthy mouth, it is impossible to eat, speech clearly or smile without difficulties. In the developing country like Bangladesh rural children may be more susceptible to dental diseases due to socio-economic and demographic factors like lack of awareness, inadequate access to expert dental care etc. Children are the future of the nation. School going children spend considerable period of time in the school. It is one of the best platform to gather wide range of basic knowledge in different disciplines. The proper guidance help them to develop proper awareness about oral health behavior. Many research shows thatin many countries, the number of children clean their teeth appropriately is very much disappointing. Many of them do not clean their teeth at all, some of them clean their teeth inadequately and many of them have no experience of using tooth brush and paste. Oral health education of the school children as effective method for prevention of various oro- dental problems.2,3The aim of this study was to investigate the oral hygiene related awareness among the rural primary school children. Methodology: This was across sectional type of descriptive study. The study was carried out in a rural primary school under Dhaka division of Bangladesh.The present study was comprised of 114 respondents. Data were collected from all the students attended on the school on that day of 2015. Face-to-face interview were taken from the children by using structured questionnaire. The oral hygiene status was measured from all the students by clinical examination using disposable mirror and probe International Journal of Human and Health Sciences Vol. 01 No. 02 July’17 80 under sufficient light. Ethical approval for the study was taken from concerned authority.A verbal informed consent was obtained from the respondents beforeclinical examination. All the data were tabulated and statistically analyzed using Statistical Package for Social Sciences (SPSS) version 16. Results: Socio demographic status of the respondents: Most of the respondents came from lower socio economic condition. Table 1: Distribution of the respondents according to their sex Sex Frequency Percentage Male 61 53.51 Female 53 46.49 Total 114 100.00 Table 1 shows that among the respondents 53.51% are male and 46.49% are female. Table 2: Distribution of the respondents according to their age Age ( in years) Frequency Percentage 6 15 13.15 7 18 15.80 8 24 21.05 9 17 14.91 10 19 16.67 11 21 18.42 Total 114 100.00 Table 2 shows that the age range of the respondents were 6 to 11 years. Oral hygiene related knowledge of the respondents: Table -3: Distribution of the respondents by knowledge on importance of regular teeth cleaning Regular teeth cleaning is important Frequency Percentage Yes 89 78.07 No 25 21.93 Total 114 100.00 Table 3 shows that among the respondents 78.07% respondents told that teeth cleaning in regular basis is important whereas others said not. Table- 4: Distribution of the respondents by knowledge on frequency of tooth cleaning Frequency of teeth cleaning Frequency Percent Once daily 69 60.52 Twice daily 10 08.78 Do not know 35 30.70 Total 114 100.00 Table 4 shows that60.52% respondents told that teeth should be cleaned once daily whereas 08.78% told twice daily and 30.70% told that they did not know the answer. Table 5: Distribution of the respondents by knowledge on materials used for tooth cleaning Materials used for teeth cleaning Frequency Percentage Tooth brush & tooth paste 71 62.29 Ash 14 12.28 Coal 29 25.43 Do not know 00 00.00 Total 114 100.00 Table 5 shows that among the respondents 62.29% told that teeth should be cleaned by tooth brush & tooth paste whereas 25.43% told coal and 12.28% told ash. Table -6: Distribution of the respondents by knowledge on time of tooth cleaning Time of teeth cleaning Frequency Percentage Before breakfast 80 70.17 After breakfast 08 07.02 After breakfast & before going to bed 05 4.39 Do not know 21 18.42 Total 114 100.00 Table 6 shows that among the respondents about 70.17% told that teeth should be cleaned before breakfast, 7.02% told after breakfast, 4.39% told after breakfast and before going to bed and 18.42% did not know the answer. Oral hygiene related practice among the respondents: Table 7: Distribution of the respondents by cleaning of teeth everyday Clean teeth everyday Frequency Percentage Yes 73 64.04 No 41 35.96 Total 114 100.00 Table 7 shows that among the 114 respondents 64.04% cleaned their teeth everyday whereas others did not clean their teeth everyday. Table 8:Distribution of the respondents by frequency of tooth cleaning Frequency of teeth cleaning Frequency Percentage Once daily 64 87.67 Twice daily 07 9.59 Thrice daily 02 2.74 Total 73 100.00 Table 8 shows that among 73 respondents 87.67% 81 International Journal of Human and Health Sciences Vol. 01 No. 02 July’17 cleaned their teeth once daily, 9.59% cleaned twice daily and 2.74% cleaned thrice daily. Table 9: Distribution of the respondents by materials usedfor tooth cleaning Materials used for teeth cleaning Frequency Percentage Tooth brush & tooth paste 59 51.75 Ash 23 20.18 Coal 32 28.07 Total 114 100.00 Table 9 shows that among the respondents 51.75% used tooth brush & tooth paste for teeth cleaning whereas 20.18% used ash and 28.07% used coal. Among 59 respondents 89.23% respondents changed their toothbrush when it damaged or lost whereas others changed their tooth brush after every six months to one year. Among the respondents all of themused match stick or coconut leaf stick if food was deposited in between their teeth. Table -10: Distribution of the respondents by knowledge on time of tooth cleaning Time of teeth cleaning Frequency Percentage Before breakfast 62 54.39 After breakfast 03 2.63 After breakfast & before going to bed 05 4.38 No specific time 44 38.60 Total 114 100.00 Table 10 shows that among the respondents about 54.39% cleaned their teeth before breakfast, 2.63% after breakfast, 4.38% after breakfast and before going to bed and 38.60% told that they cleaned their teeth according to their convenient time. Oral hygiene status:Among the respondents 68.32 % had caries in their mouth. About 46.58% caries found in the upper jaw whereas 53.42% caries present in the lower jaw. Caries were more prevalent in molar teeth. Among the respondents about 69.34% respondents had plaque or calculus, 46.54% experienced gingival bleeding. Discussion: The cross sectional study was carried out with a view to assess the oral hygiene awareness among the primary school children in a rural area under Dhaka division of Bangladesh. The present study was comprised of 114 respondents.Among the respondents 53.51% are male and 46.49% are female.Age range of the respondents were 6 to 11 years. Oral hygiene related knowledge: Among the respondents 78.07% respondents told that teeth cleaning in regular basis is important whereas others said not. About that 60.52% respondents told that teeth should be cleaned once daily whereas 08.78% told twice daily and 30.70% told that they did not know the answer. Among the respondents 62.29% told that teeth should be cleaned by tooth brush & tooth paste whereas 25.43% told coal and 12.28% told ash. About 70.17% told that teeth should be cleaned before breakfast, 7.02% told after breakfast, 4.39% told after breakfast and before going to bed and 18.42% did not know the answer. Oral hygiene practice: Among the 114 respondents 64.04% cleaned their teeth everyday whereas others did not clean their teeth everyday which is near about similar to a study done by Humagain.4 Among the respondents 51.75% used tooth brush & tooth paste for teeth cleaning which is lower than a study done by Ahmedet al 5 and others used ash, coal. This differences may be due to socio-economic condition or wrong conception or traditional belief of the respondents. Among 59 respondents 89.23% respondents changed their toothbrush when it damaged or lost whereas others changed their tooth brush after every six months to one year. This may be due to lack of proper dental health education. Socio economic condition may also attribute the factor. Among the respondents all of them used match stick or coconut leaf stick if food was deposited in between their teeth. Dental floss or other inter dental cleaning device is costly compare to match stick. Coconut leaf stick is easily available in the Bangladeshi rural area.That’s why rural people use this kind of stick for inter dental cleaning. Among the respondents about 54.39% cleaned their teeth before breakfast, 2.63% after breakfast, 4.38% after breakfast and before going to bed and 38.60% told that they cleaned their teeth according to their convenient time. Oral hygiene status: Among the respondents 68.32 % had caries in their mouth. This is similar to a study done by Sarwar et al6 and more than twice than the study done by Edward et al7. About 46.58% caries found in the upper jaw whereas 53.42% caries present in the lower jaw. Caries were more prevalent in molar teeth. Which is similar to International Journal of Human and Health Sciences Vol. 01 No. 02 July’17 82 a study done by Zhu et al8. Among the respondents about 69.34% respondents had plaque or calculus, 46.54% experienced gingival bleeding which is lower than a study done by Sarwaret al.6 Knowledge vs practice: Among the respondents 78.07% told that regular tooth cleaning is important but only 64.04% cleaned their teeth everyday. Among the respondents 62.29% told that teeth should be cleaned by tooth brush and tooth paste but 51.75% used tooth brush and paste to clean their teeth. These show that there is no association between their knowledge and practice. Similar findings were found in the study done by Krawczyk.9 Conclusion: Oral hygiene awareness among the rural primary school children was very little associated with poor oral hygiene.Dental caries is a common public health problem among the school children. It is still probably important to promote good oral hygiene practices among young children to reduce the risk of caries and other dental problem. Recommendation: Health educational program on oral hygiene and periodic free dental checkup should be arranged on school. References: 1. World Health Organization. World Oral Health Report 2003.Geneva. 2. Petersen PE, Zhou E. Dental caries and oral health behavior situation of children, mothers and schoolteachers in Wuhan,Peoples Republic of China. Int J Dent J 1998; 48: 210-16. 3. Petersen PE, Kaka M. Oral health status of children and adults in the Republic of Niger, Africa. Int Dent J 1999; 49:159-64. 4. Humagain M. Evaluation of Knowledge, Attitude and Practice (KAP) About Oral Health Among Secondary Level Students of Rural Nepal - A Questionnaire Study. Webmed central Dentistry,2011;2(3):WMC001805 5. Ahmed NAM, Astrom AN, Bergen NS,Petersen PE.Dental caries prevalence andrisk factors among 12-year old schoolchildren from Baghdad,Iraq: a post-war survey.International dental journal 2007;57:36-44 6. SarwarAFMa, KabirMHb, Rahman AFMMe, HaqueAaKasemMAa, Ahmad Sac et al.Oral hygiene practice among the primary school children in selected rural areas of Bangladesh.J. Dhaka National Med. Coll. Hos. 2011; 18 (01):43-8 7. Edward CML, Loo EKY, Lee CK. Dental health status of Hong Kong preschool Children.Hong Kong Dent J 2009;6:6-12 8. Zhu L, Petersen PE, Wang HY, Bian JY,Zhang BX. Oral health knowledge, attitudes and behaviour of adults in China. International Dental Journal 2005;55:231–41 9. Krawczyk D, Pels E, Prucia G, Kosek K, Hoehne D. Students’ knowledge of oral hygiene vs its use in practice. Advances in Medical Sciences. 2006;51:122-5.