Effect of Oral Self-examination on Oral Care Practices among School-going Boys: A Quasi-experimental Study from District in Rural Central India

INTRODUCTION

Almost everyone has experienced poor oral health at some point in their lives, making oral illnesses a persistent global public health concern. Globally, 3.9 billion people suffer from oral health issues. The prevalence of oral disease is rising in developing nations and is notably higher among the underprivileged and impoverished. In India, about four out of five children between the ages of six and nineteen suffer from dental caries.¹

A vital component of overall health is oral health. Dental disease is exacerbated by poor oral hygiene in addition to causing it. Tobacco use has been linked to gingival as well as periodontal inflammatory conditions, diseases that could be cancerous, and oral cancer. In India, there are many cases of oral cancer.²

People don’t return to the dentist for follow-up care and instead seek symptomatic therapy for oral issues, notably pain. The main obstacles for rural women seeking dental care are their dread of the procedure, their anxiety, their lack of time, their propensity for self-medication, and their lack of commitment to their oral health.²

Dental caries, periodontal disease, and oral cancer are examples of common oral conditions that meet the requirements for being classified as public health issues. Periodontal disorders are quite common, especially in socially disadvantaged communities, have an adverse effect on quality of life, and are expensive to treat. Inequity associated with variables including poor income, fewer years of schooling, and black or mixed-race ethnicity characterizes populations that are generally at risk.

Among the population between the ages of 18 and 64, SDH like social security and health insurance, low levels of literacy, the use of dental services, and other behavioral aspects like heavy tobacco use were significant risk factors for periodontal and other oral diseases among groups with comparable socioeconomic status.³

Poor dental hygiene, tobacco use, psychological variables, and related systemic problems are the main risk factors for periodontal diseases. Public health initiatives must address these issues, but they also need to acknowledge and address the underlying distal forces that shape and pattern these global dangers.⁴

The World Health Organization (WHO) recommends oral health promotion in schools to prevent and control dental diseases in schoolchildren as well as to improve oral health-related knowledge, attitude, and behavior. It has been demonstrated that school-based oral health initiatives enhance teenagers’ oral health and behavior linked to oral health.⁵ One of the most important ways to reach kids and teenagers is through schools, which are the perfect setting for educating them about health issues, establishing good habits in them, connecting them with resources, and using the students to connect with parents and the community. Research demonstrates that school health programs have a high cost-benefit ratio and that schools may effectively carry out health initiatives.⁶

Oral self-examination is useful for both raising awareness and identifying oral health issues. It is a simple, inexpensive, and non-intrusive procedure. Students’ oral hygiene will improve as a result of oral health education in school health programs, and they will be better equipped to detect oral lesions early on. Disease prevention is aided by early diagnosis.⁷ The objective of the study measure the effect of oral self-examination on oral care practices among school-going boys in central rural India.

MATERIALS AND METHODS

A school-based quasi-experimental study with a non-equivalent group design was conducted among adolescents in class V (their fifth year of school) to class X (their tenth year of school) between January and June 2022. In the Wardha district of Maharashtra state, India, our medical institute runs a school health education program at several secondary schools. The study was carried out in eight different Wardha schools while considering implementation feasibility. The study also included boys.

The sample size was calculated using OpenEpi software. Assuming a reduction of 10% from baseline prevalence of 15% chewing smokeless tobacco,⁸ power of 90% and confidence interval of 95%, and a 10% data loss due to nonresponse/non-attrition, the estimated sample size was around 460. Hence 230 students will be included in each group. The school had a total strength of around 100 from class V to class X in each school. An enumeration List of all students from class V to class X was prepared based on their attendance register from the school which served as the sampling frame. 60 students were selected randomly from the attendance register from each school. All those who consented to participate were included in the study. All those who were suffering from any chronic illness were excluded from the study. The identity of study participants was kept confidential by assigning them a unique identification number. Socio-demographic data were collected individually by interviewing each participant maintaining confidentiality and privacy.

The questionnaire was available in Marathi, and the participants were self-administered the Marathi questionnaire for filling.⁹ The team was on hand to aid participants with any issues they were unclear about and to explain the meaning of the questions. Students were seated on chairs during the day to conduct oral examinations of the children. Before computing the oral hygiene index simplified (OHI-S) score, the principal investigator received training from a dentist to examine mouth health. Calculus index (CI) and debris index (DI) scores were computed. Individual tooth scores were added together for both indices. The debris index and calculus index were obtained by dividing this amount by the number of teeth analyzed. The OHI-S was calculated by adding the DI and CI. The OHI-S range is 0–6.¹⁰

RESULTS

DISCUSSION

This present study was conducted in eight schools of districts in rural Central India. We assessed the effect of oral self-examination on oral care practices of school-going boys. There were four schools each in the control block and intervention block, respectively. Routine health education was conducted in the control school by teachers and peer groups and information regarding oral self-examination was given to children in intervention school by their peer groups once in week and their teacher gave information once in month. Peer groups and teachers were trained about the steps of oral self-examination before giving intervention.

A study conducted by Sanadhya et al.¹¹ on school children found a significant reduction in mean OHI-S Score from 1.92 ± 0.85 to 1.21 ± 0.82. The study demonstrated that a school-based method may be used to simply deploy an effective intervention plan. Adolescence and juvenile smoke cessation programs were best implemented in schools. The study’s strength was the students’ enthusiasm in taking oral self-examination in class when they interacted with their peers. According to the study, oral self-assessment could be used to teach pupils in school skills.

CONCLUSION

With growth in emerging nations, the burden of oral disease is disproportionately high among poor and disadvantaged people. Almost everyone has poor oral health at some point in their lifetime, making oral illnesses a persistent public health issue around the world. Since schools offer a great environment for teaching about health issues, modeling healthy behaviors in them, connecting them with services, and interacting with parents and the community through the students, education is one of the most efficient ways to reach children and adolescents. School‑based cessation programs facilitate the prevention of tobacco use initiation and help the users overcome difficulties that may crop up when they are attempting to quit tobacco.¹² The oral hygiene index and oral hygiene practices of school-going boys in the intervention school improved.

ORCID

Mohnish Y Giri https://orcid.org/0009-0003-4779-3941

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