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ORIGINAL ARTICLE
Year : 2020  |  Volume : 13  |  Issue : 3  |  Page : 215-219  

Oral health promoting activities in schools of three different boards in Pune city - A descriptive study


Department of Public Health Dentistry, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India

Date of Submission16-Aug-2019
Date of Decision03-Dec-2019
Date of Acceptance03-Mar-2020
Date of Web Publication3-Jun-2020

Correspondence Address:
Pradnya Kakodkar
Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.mjdrdypu_233_19

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  Abstract 


Aim: The objective was to evaluate and compare the oral health-promoting activities (WHO 5 key points) undertaken in the schools of Pune city belonging to the different boards. Materials and Methods: A descriptive cross-sectional study was conducted from January 2018 to August 2018 among the different board schools in Pune. A total of 50 schools based on quota sampling were selected as follows: Central Board of Secondary Education (CBSE) (n = 17): Indian Certificate of Secondary Examination (ICSE) (n = 5): International Board (n = 1): Cambridge Assessment International Education (n = 1): State Board (n = 26). English medium schools representing the respective board and those willing to give consent for interviews were included in the study. Convenience sampling was used to recruit the required number of schools for data collection. A 5-item checklist was prepared for collecting the information through an interview with the school principals. Approval was obtained from the Scientific and Institutional Ethics committee before starting. Results: Of 50 schools, data were collected from only 44 schools. Among the CBSE schools, 64.7% (n = 11) reported of having oral health policy for the school children, followed by 42.3% (n = 11) of State Board schools. About 100% (n = 17) CBSE and ICSE (n = 1) and 53.84% of State Board schools (n = 15), respectively, were providing the supportive environment to enhance the good oral health. There was no statistically significant difference between CBSE and other boards with regard to school oral health policy (P = 0.19), developing good oral habits (P = 0.52), encouraging children to pass the oral health message to family and community (P = 0.49), and the presence of oral health-care provision (P = 0.19). Conclusion: The school authorities are aware of the dental health problems faced by the children. Some schools are conducting health education programs to educate children about the maintenance of oral hygiene through the involvement of dental colleges and the dentists from the surrounding area. However, they need to emphasize on oral health-promoting concept to incorporate healthy habits to prevent dental diseases at earliest.

Keywords: Children, health education, health promotion, oral health, schools


How to cite this article:
Dagar D, Kakodkar P, Shetiya SH. Oral health promoting activities in schools of three different boards in Pune city - A descriptive study. Med J DY Patil Vidyapeeth 2020;13:215-9

How to cite this URL:
Dagar D, Kakodkar P, Shetiya SH. Oral health promoting activities in schools of three different boards in Pune city - A descriptive study. Med J DY Patil Vidyapeeth [serial online] 2020 [cited 2020 Jul 4];13:215-9. Available from: http://www.mjdrdypv.org/text.asp?2020/13/3/215/285766




  Introduction Top


Oral health promotion aims at preventing oral disease and promoting oral health at early stages, through schools.[1],[2] Oral health promotion can be undertaken by conducting dental camps, oral health education classes for the teachers, and staff nurses/counselors of school and parents regarding dental emergencies and reinforcing dental habits in children.[3]

A systematic review reports that significant improvement in oral hygiene of school children has been observed after imparting dental health education at the school.[4]

Chahar et al. recommend that school should introduce oral health education component in a planned and sequential manner from 1st grade to 12th grade, there should be the provision of regular sessions of health instructions, health checkups, parents/community/staff involvement, and establishment of a health clinic at school premises.[5] Arora et al., in a systematic review, concluded that school screening programs serve a dual process of clinical examination and informing parents of their child's oral health status, which may increase motivation in parents to bring their child to a dentist.[6]

The WHO has proposed a document which is intended to help people use health promotion strategies at school to improve oral health.[7] Through oral health, the overall health, well-being, education and development of children, and families and communities are enhanced. WHO health-promoting school concept advocates five key points: create healthy public policy, develop supportive environments, strengthen community actions, develop personal skills, and reorient health services.[7] The school should implement health-promoting school concept to create an ecosystem conducive to improve oral health.[5]

Pune is referred to as the “Oxford of the East,” the city that has a rich legacy in education. The schools in Pune are affiliated to five different boards, namely Central Board of Secondary Education (CBSE), Indian Certificate of Secondary Examination (ICSE), International Board (IB), Cambridge Assessment International Education (CIE), and State Board. The syllabus, objectives, policy, and examination vary with differing boards. It would be interesting to know if there is any difference with regard to the WHO health-promoting school concept in different board schools. However, there is no literature reporting this information. One study [8] was retrieved, which was conducted in Tamil Nadu, with an objective to evaluate the contents of school textbooks on oral health and to quantitatively analyze the school health camps and guest lectures/demonstrations in three board schools (matriculation board, state board, and central board). It was noted that there was no difference in the conduction of dental camps across the boards.

As against this background, a study has been planned to evaluate and compare the oral health-promoting activities (WHO 5 key points) undertaken in the schools of Pune city belonging to the different boards.


  Materials and Methods Top


A descriptive cross-sectional study was conducted from January 2018 to August 2018 among the different schools in Pune. The scientific committee and ethics committee approval were obtained before start of the study (DPU/R&R (D)/971 (37)/16). List of all the schools representing the five boards: CBSE, ICSE, IB, CIE, and State Board in Pune, India, were obtained from the enrollment desk website.[9] There were a total of 262 schools (CBSE {87}, ICSE {26}, IB [6], CIE [6], and State Board {137}). The sample size was calculated by quota sampling, and hence, the quota obtained was as follows: CBSE (n = 17), ICSE (n = 5), IB (n = 1), CIE (n = 1), and State Board (n = 26). The final sample of 50 schools was selected using the convenience sampling method. A 5-item checklist was prepared for collecting the information through an interview with the school principals [Table 1] using the WHO 5 key points.[7] A pilot study was conducted in one school to check the feasibility of the interview checklist. The aim and objectives of the study were explained, and permission was obtained from the school principals before taking the interview. The ICSE (except for one), IB, and CIE board schools refused to give the interview. The author noted down all the answers as given by the school principals.
Table 1: Questions for interview

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Statistical analysis

Descriptive data as number and percentages were calculated. Inferential statistics were used for comparisons between CBSE and other board schools (state and ICSE). Chi-square test for Q1, Q3, Q4, and Q5 and Fischer's exact test for Q2 were used. P < 0.05 was considered as statistically significant. To conduct the analysis, Primer of Biostatistics software was used.


  Results Top


Of the 50 schools, data collection was completed in only 44 (88%) schools [CBSE 100% (n = 17), ICSE 20% (n = 1), IB 0% (n = 0), CIE 0% (n = 0), and State Board 100% (n = 26)].

The WHO key findings for different board schools are depicted in [Table 2]. It was observed that 64.7% of CBSE schools reported of having oral health policy for the school children followed by 42.3% of State Board schools and no such policy in ICSE school (Q1). It was observed that 100% CBSE and ICSE and 53.84% of State Board schools, respectively, were providing a supportive environment to enhance good oral health (Q2). Further, it was observed that emphasis made on developing good oral habit was present in 100% of ICSE schools, 82.35% of CBSE schools, and 73.07% of State Board schools (Q3). It was observed that the children were encouraged to pass on the health message to the family and community in 100% of ICSE schools, 76.47% of CBSE schools, and 65.38% of State Board schools (Q4). Finally, it was observed that 100% of ICSE schools, 52.9% of CBSE schools, and 30.7% of the State Board schools had the provision of oral health-care services (Q5).
Table 2: Responses of different schools (n=44)

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[Table 3] shows the comparison for the WHO key parameters between CBSE and other schools. Overall, there was no statistically significant difference between CBSE and other boards, except for the second parameter (Q2) about providing a supportive environment, where a statistically significant difference was observed (P = 0.001).
Table 3: Comparison between Central Board of Secondary Education schools (n=17) and others (n=27) with regards the WHO key parameters

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[Table 4] summarizes the qualitative content of the WHO key parameters, as explained by the different board schools. Overall, yearly once provision for oral health checkup was done by all the boards. It can be noted that CBSE schools reported more activities than the other boards.
Table 4: Qualitative description of the oral health activities undertaken by the different board schools

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  Discussion Top


The health of schoolchildren is one of the responsibilities of the teachers, leaders, and health-care providers.[10]

In the present study, it has been observed that the concept of school oral health policy is existing in few CBSE and State Board schools only. However, in India, there are no organized school oral health programs at the regional/national level.[5] What exists are sporadic programs in schools because the school management has taken interest, the dental institutions have conducted the program and/or the local government has arranged them.[8]

Oral health-promoting activities include the health camps, workshops conducted by school or nearby colleges/hospitals, and any other health-promoting programs.[5] In the present study, it was found that the CBSE schools were providing a variety of options as a supportive environment to the school children, which was followed by the State Board and then ICSE. However, there was a statistically significant difference between CBSE schools and the state and ICSE boards. These results are not in consensus with the outcome of the study by Geetha Priya et al. who reported that there was no difference seen in the dental camps conducted in school by CBSE or the state and matriculation board.[8]

A cross-sectional survey was conducted among randomly selected 61 schools of Bengaluru. Data were collected through structured interviews with the head of the schools. It was observed that oral health education was not integrated into the curriculum in 39.3% of schools.[11]

All three board schools were laying emphasis on school children to develop good oral habits. Promoting health through schools is a “life-course” approach to promote healthy behavior among children.[12]

Similarly, all three board schools encouraged the child to pass the oral health message taught at school to the family and community. Schools, therefore, play an important role in learning, promoting the health and development of students, their families and community.[13]

About 52.94% of (n = 9) CBSE schools, 30.7% (n = 8) State Board schools, and 100% (n = 1) ICSE schools had provision for oral health-care services.

An exploratory study [13] was carried out to assess the availability of school-based health promotion facilities under the health-promoting schools initiative of WHO in selected schools of Chandigarh in the year 2012–2013. The most promising facility in school observed was student's health checkups in schools and the maintenance of their health cards. Furthermore, there was availability of sick room in 6 (46.2%) government and 7 (58.3%) private schools, examination table and chair were available in 5 (38.01%) government and 6 (50%) private schools, first aid kits were available in 3 (23%) government and 5 (41.7%) private schools, and regular physician/school nurse was there only in 6 (50%) private schools.

Chandrashekar et al.[14] conducted a 6-month interventional study to find the effect of dental health education through different methods. Postintervention, the results revealed that maximum benefit was reaped by the group who were provided health education by trained teachers every fortnightly along with oral hygiene aids as compared to the dentist who provided health education once in 3 months. The study also found that the teachers can undertake the task of screening children for gross deposits of debris and calculus on a periodic basis with short-term training.

This study has a few limitations. Majorly, “Nonresponse” from the IB, CIE, and ICSE board schools, which may have resulted in the bias of the measures of the outcome. Interviews also result in the outcome bias due to the “Social Desirability” factor.


  Conclusion Top


Within the limitation of the study, it can be revealed that the school authorities are aware of the dental health problems faced by the school children. Some schools are also conducting health education programs to educate children about the maintenance of oral hygiene through the involvement of dental colleges and the dentists from the surrounding area. Since school is the best platform to incorporate healthy habits which will stay for life, as per the WHO key points for oral health-promoting schools, it is recommended that as follows:

  1. Every School should have a “School Oral Health policy”
  2. Every school should provide a supportive environment for providing oral health services in the school and provision for emergency oral health services
  3. Every school should initiate efforts to inform, motivate, and create awareness about oral health and disease condition among the children
  4. Awareness program can be conducted for the parents as well
  5. Teachers should be actively involved in the health education program
  6. Some dental topics should be included in the curriculum through the textbooks for learning among students
  7. Toothbrushing day once every year should be nationally observed
  8. Yearly once, oral health checkups should be conducted in the school.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Nalli S, Bindiganavale SR, Chowdary BU. A study of oral health promotion activities in India. Int J Community Med Public Health 2016;3:2270-4.  Back to cited text no. 1
    
2.
Parmar P, Radha G, Rekha R, Pallavi SK, Nagashree SR. Promoting oral hygiene and health through school. Int J Oral Health Sci 2016;6:70-7.  Back to cited text no. 2
  [Full text]  
3.
Macnab AJ. Children's oral health: The opportunity for improvement using the WHO Health promoting school model. Adv Public Health 2015;1-6. [Doi: 10.1155/2015/651836]. Available from: https://www.hindawi.com/journals/aph/2015/651836/ accessed on 12-3-2020. [Last accessed on 2020 Mar 12].  Back to cited text no. 3
    
4.
Gambhir RS, Sohi RK, Nanda T, Sawhney GS, Setia S. Impact of school based oral health education programmes in India: A systematic review. J Clin Diagn Res 2013;7:3107-10.  Back to cited text no. 4
    
5.
Chahar P, Jain M, Sharma A, Yadav N, Mutneja P, Jain V. Schools as opportunity for oral health promotion: Existing status in India. Indian J Child Health 2018;5:513-17.  Back to cited text no. 5
    
6.
Arora A, Khattri S, Ismail NM, Kumbargere Nagraj S, Eachempati P. School dental screening programmes for oral health. Cochrane Database Syst Rev 2019;8:CD012595.  Back to cited text no. 6
    
7.
World Health Organization. Oral Health Promotion through Schools. World Health Organization; 2003. Available from: https://www.who.int/oral_health/publications/doc11/en/. [Last accessed on 2020 Mar 12].  Back to cited text no. 7
    
8.
Geetha Priya PR, Asokan S, Kandaswamy D, Malliga S, Arthi G. Health camps in schools and content analysis of the school textbooks: A cross-sectional study in Tamil Nadu. J Indian Soc Pedod Prev Dent 2016;34:223-6.  Back to cited text no. 8
    
9.
Enrollment Desk; 2018. Available from: https://www.enrolmentdesk.com/pune/schools. [Last accessed on 2020 Mar 12].  Back to cited text no. 9
    
10.
Karkada S, Pai MS. Concept of health promoting schools. Manipal J Nurs Health Sci 2016;2:65-8.  Back to cited text no. 10
    
11.
Periyasamy S, Krishnappa P, Renuka P. Adherence to components of health promoting schools in schools of Bengaluru, India. Health Promot Int 2019;34:1167-78.  Back to cited text no. 11
    
12.
Lee A. Health-promoting schools: Evidence for a holistic approach to promoting health and improving health literacy. Appl Health Econ Health Policy 2009;7:11-7.  Back to cited text no. 12
    
13.
Kaur J, Saini SK, Bharti B, Kapoor S. Health promotion facilities in schools: WHO Health promoting schools initiative. Nurs Midwifery Res J 2015;11:103-11.  Back to cited text no. 13
    
14.
Chandrashekar BR, Suma S, Sukhabogi JR, Manjunath BC, Kallury A. Oral health promotion among rural school children through teachers: An interventional study. Indian J Public Health 2014;58:235-40.  Back to cited text no. 14
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