SUBMITTED BY
MS.BILGY BABU
Child Health Nursing,
2012-2014 Batch.
Oriental college of nursing
Bangalore – 10.
RANJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
SYNOPSIS PERFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1 / NAME OF THE CANDIDATE AND ADDRESS / Ms. Bilgy BabuORIENTAL COLLEGE OF NURSING
#43/52, 2nd MAIN, INDUSTRIAL TOWN
WEST OF CHORD ROAD
RAJAJINAGAR
BANGALORE-10
2 / NAME OF THE INSTITUTE / ORIENTAL COLLEGE OF NURSING
#43/52, 2nd MAIN, INDUSTRIAL TOWN
WEST OF CHORD ROAD
RAJAJINAGAR
BANGALORE-10
3 / COURSE OF THE STUDY AND SUBJECT / M.Sc NURSING I YEAR
PAEDIATRIC NURSING
4 / DATE OF ADMISSION / 20TH JUNE 2012
5 / TITLE OF STUDY / A study to assess the effectiveness of structured teaching program regarding dental care in increasing the knowledge& practice among children in selected schools at Bangalore
6 / BRIEF RESUME OF INTENDED WORK
6.0 INTRODUCTION
6.1 NEED FOR THE STUDY
6.1.1. STATEMENT OF THE PROBLEM
6.2. REVIEW OF LITERATURE
6.3 OBJECTIVES OF THE STUDY
6.3.1. OPERATIONAL DEFINITIONS
6.3.2. ASSUMPTION
6.3.3.HYPOTHESIS
6.3.4. SAMPLING CRITERIA
(INCLUSION &EXCLUSION CRITERIA)
6.3.5. DELIMITATION / ENCLOSED
ENCLOSED
ENCLOSED
ENCLOSED
ENCLOSED
ENCLOSED
ENCLOSED
ENCLOSED
ENCLOSED
ENCLOSED
7 / MATERIALS AND METHODS
7.1. SOURCES OF DATA: The data will be collected from the boys and girls who are in the age group of 6-12yrs,studying in selected schools at Bangalore.
7.2. METHOD OF DATA COLLECTION: Self-administered questionnaire.
7.3. Does the study require any investigations or interventions to be conducted on the patients or other humans or animals? NO
7.4. Has ethical clearance been obtained from your institution?
Yes, ethical clearance report is here enclosed.
8. / LIST OF REFERENCES / ENCLOSED
RANJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
SYNOPSIS PERFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION
1 / NAME OF THE CANDIDATE AND ADDRESS / Ms. Bilgy BabuORIENTAL COLLEGE OF NURSING
#43/52, 2nd MAIN, INDUSTRIAL TOWN
WEST OF CHORD ROAD
RAJAJINAGAR
BANGALORE-10
2 / NAME OF THE INSTITUTE / ORIENTAL COLLEGE OF NURSING
#43/52, 2nd MAIN, INDUSTRIAL TOWN
WEST OF CHORD ROAD
RAJAJINAGAR
BANGALORE-10
3 / COURSE OF THE STUDY AND SUBJECT / M.Sc NURSING I YEAR
PAEDIATRIC NURSING
4 / DATE OF ADMISSION / 20TH JUNE 2012
5 / TITLE OF STUDY
A study to assess the effectiveness of structured teaching program regarding dental care in increasing the knowledge & practice among children in selected schools at Bangalore
6. BRIEF RESUME OF THE INTENDED WORK
6.0. INTRODUCTION
“YOUR MOUTH IS THE MIRROR THAT CAN REFLECT THE OVERALL HEALTH OF YOUR BODY”
Oral health is essential for general health and well being throughout the lifespan and is a mark of overall health status Oral health means being freeof chronic mouth &facial pain. oral health is fundamental to general health & well-being. Itis the practice of keeping the mouth& the teeth clean in order to prevent dental problems. Oral health is a determinant of general health &quality of life. A combination of measures that includes water fluoridation, brushing, flossing, sealants, good nutrition ®ular visits to the dentists can prevent 80-90%of dental problem. Tooth are small ,calcified, whitish structures found in the jaws of many vertebrates that are used to break down .The roots of teeth are covered by gums. Teeth are not made of bone but rather of multiple tissues of varying density& hardness2
A regular dental checkup &proper cleaning of mouth can use better ways to maintaining better oral health than using expensive tooth paste. It is a chain, improper cleaning leads to logging of food particles and that further leads to cavity and tooth decay and the general trend is that ‘people doubt see a dentist unless they experience pain or any other hurdle in their routine ‘ Tamhans points out .He also says that a tooth paste-less cleaning of teeth after every meal will keep the problems at bay When you brush your teeth properly at least twice a day ,you are removing the plaque that causes cavities. plaque is the soft & sticky substance that accumulates on the teeth from food debris &bacteria. Flossing daily will remove the plaque from in between the teeth that the tooth brush cannot reach. Removing plaque from your teeth helps to prevent gum diseases.4
Research and other advances in oral health have led to safe and effective means of maintaining oral health and preventing dental caries and periodontal disease. Dental caries, the most common chronic childhood disease, has shifted from beinga universal health problem to one primarily afflicting low-income children Safe and effective strategies for obtaining and maintaining optimal oral health exist, and states, communities, health care providers, and all individuals can contribute for achieving this goal.5
Dental caries can be prevented by a combination of community, professional, and individual measures including water fluoridation, professionally applied topical fluorides and dental sealants, and use of fluoride toothpastes. Yet, tooth decay is the most common chronic disease of childhood. Dental care is the most prevalent unmet health need in US children with wide disparities existing in oral health and access to care. Only 1 in 5 children covered by Medicaid received preventive oral care for which they are eligible. Children from low income and minority families have poorer oral health outcomes, fewer dental visits, and fewer protective sealants. Water fluoridation is the most effective measure in preventing caries, but only 62% of water supplies are fluoridated, and lack of fluoridation may disproportionately affect poor and minority children.4
Tooth decay is one of the most common chronic childhood diseases. By the first grade, more than 50 percent of children in India have dental caries (decay) in their primary teeth. Despite the availability of cost-effective preventive measures and improvements in children's oral health in India, many children still lack needed dental care–more, in fact, than lack medical care. There are significant and important disparities in oral health and access to dental care for poor and minority children, and for those with unusual health care needs. In addition, children from low-income families are much less likely to have access to dental care than their peers, and their disease is almost twice as likely to remain untreated. Sadly, the children at greatest risk for problems resulting from tooth decay are also those least likely to receive dental care. In fact, dental care has become the most frequently reported unmet health need of children.2
The prevalence study of dental caries was under taken in 5-13 yearold school children of Mangalore city showed that caries prevalence was highest in 5-7 year age group (94.3%) compared to 8-10 years (82.5%) and 11-13 years age group (82.5%).
A strong correlation was seen between sugar consumption ,with the prevalence increasing with increasing sugar exposure. Higher caries prevalence was also seen in children belonging to low socio-economic status than those of high socio-economic status3. 7
The oral health of children is essential to their overall well-being. Education in schools prepares girls and boys to accept responsibility for their own health and to engage in personal care that will maintain and improve health. The use of precious classroom time to teach personal self-care skills, using the classroom to deliver fluoride products, and using the school setting to screen and refer children for needed dental services can be justified by the impact on children's health and welfare. Dental health problems can profoundly ffect children, impairing their performance as students, lowering self-esteem, and slowing personal development. In addition, failure to prevent dental diseases has a large effect on school attendance8
If your dentist gives you a treatment plan for dental work that you need to have done. You should focus on getting your teeth as only options would be to have a root canal or have the tooth extracted. Oral health affects people physically &psychologically &influences how they grow, enjoy life, look, speak, chew, taste food &socialize as well as their feelings of well-being. Good oral health is essential to improve individual overall health and well-being.6
We urge to take this information and use it for program planning and advocating for the health of children. It is only through working together that we can make excellent oral health It is thus concluded that “EVERY TOOTH IN A MAN’S HEAD IS MORE VALUABLE THAN A DIAMOND”: MIGUEL DE CERVANTES.
6.1 NEED FOR STUDY
Worldwide 60-90% of school children and nearly 100% of adults have dental cavities often leading to pain & discomfort. Severe periodontal diseases, which may intoothloss is found in 15-20% of middle aged adults. Dental cavities and periodontal diseases are major causes of tooth loss. Dental caries is a common dental disease during childhood in India. Over 40% of Indian children are found to be afflicted with dental caries and a large percentage of children reside in rural areas and most of them are in need of dental care. A survey was conducted among 5-6 and 12-13 years old schoolchildren of Puttur municipality, Karnataka State, India, to assess the prevalence of dental caries, malocclusion and dental calculus. Data collection was done using the Basic Oral Health Survey (WHO) form. The deciduous dentition alone was considered for 5-6 year old subjects while the permanent dentition alone was considered for those aged 12-13 years. Overall the prevalence of dental caries was found to be significantly higher among 5-6 year old subjects compared to 12-13 year old .7
A study was conducted to assess knowledge, attitude, and practice (KAP) toward oral health among 11 to 12-year-old school children in a government-aided missionary school of Bangalore city. Data on oral health KAP were collected by means of a self-administered questionnaire. Statistical significance was determined by Chi-square test.Finally the study suggests that oral health KAP of study participants are poor and needs to be improved. Systematic Community-oriented oral health promotion programs are needed to improve oral health KAP of school children.9
Incidence of Children with Dental health problems according to W.H.O(2009)
Table – I
Country / Incidence (Children)India / 1,300,000
USA / 7,960,000
UK / 1,970,000
Canada / 1,330,000
Japan / 1,96,000
Table – 2
State / Incidence (Children)Tamilnadu / 378,000
Maharashtra / 45,600
Andhrapradesh / 9,260
Uttar Pradesh / 1,720
A study was conducted in four primary schools of Mehrauli block of rural Delhi. Four hundred and fifty eight primary school children of both sexes in the age group of 5−14+ were medically examined in daylight using a mouth mirror and probe. The children came from low socioeconomic backgrounds. Presence of clinical caries was recorded by naked eye examination. Teeth cleaning habits of the school children in terms of regularity and associated caries prevalence was also noted. Since childhood is such an impressionable age all students were made aware of the need for proper oral hygiene to minimize the incidence of caries among children.10
A cross sectional study was carried out among primary school children in the age group of 6-12 years from the Varkala municipal area of Kerala. The aim of the study was on the areas like prevalence, severity of dental caries, socio demographic and oral hygiene practices. The prevalence of dental caries for all age groups combined was 68.5%. Association of caries prevalence with study variables like sweet consumption, brushing habits, sociodemographic factors, showed statistically significant1.
A study was carried out to assess the prevalence of tooth ache among school
children aged between 5 and 12 years in various areas of Moodbidri in Udupi district. The
caries prevalence of the total population was found to be 76.9%. The mean DMFT score of
the total population was found to be 0.78 with mean DT, MT and FT being 0.71, 0.04 and
0.03 respectively. The mean deft was found to be 3.48 with mean dt, et and ft being 2.77,
0.69 and 0.02 respectively.16
The survey is based on WHO Oral Health Assessment, which has been modified by including gingival assessment , enamel opacities/ hyperplacia for 5 yrs.Evaluation of the oral health status of children revealed , dental caries is the most prevalent diseases affecting permanent teeth , more than primary teeth and more in corporation than in private schools, there by correlating with the socio economic status12
Punjab is the only state in India which has launched Intensive Dental Health Care Programme Under this Programme one sub-division is selected and the schools are covered block – wise. The aims of this program areto bring down the incidence of oral and dental diseases to less than 40 %., To bring down the Decayed Missed Filled Teeth (D.M.F.T.) in School children of 6 – 12 years less than two,To provide total oral health coverage to all the school going children in the age group of 6 - 12years.andTo provide Dental Health Education Training to all the primary school teachers, medical & paramedical personnel. The Special feature of this Programme is that in addition to the imparting of Dental Health Education training to the School children & detailed Oral Health check up, each child is given a mouth rinses with the freshly prepared 2 % solution of sodium fluoride to arrest the initiation & progress of dental caries and this process is repeated after every six months19.
Health education programs in schools can stress the importance of oral health, increase understanding of the disease process, promote healthful behaviors, and reinforce the value of regular professional care for prevention. Such a role for professional care may not be consistent with the experiences of children who have not received dental care or who only associate it with treatment of toothaches. Instruction of the children and their parents–through educational materials that are taken home–can help alleviate the consequences of some parents' own experiences and dental fears, which may impede their seeking care for their children.
A study was conducted to assess the dental caries status and treatment needs of children belonging to fisher folk communities. The fisher folk communities are mainly the Mogaveera, Thandila, Harkantra, Karwis and Japthis. They reside in the coastal areas of Karnataka in India. Twelve (75%) out of 16 subjects in the 0–4 year-age group had decayed teeth. The percentage of subjects with decayed teeth peaked at 83 (86.45%) out of 96 subjects in the 5–9-year age group. Thereafter, there was a slight decrease in the percentage of decayed teeth ie 125 (80.64%) out of 155 subjects in the 10–14-year age group.In the present study, it was seen that the prevalence of dental caries was high in children.10
The oral health of children is important to their overall well-being. Just as the mouth cannot be separated from the rest of the body, oral health cannot be considered separate from the rest of children's health. Often thought to be only the presence or absence of tooth decay, oral health actually includes all the sensory, digestive, respiratory, structural, and emotional functions of the teeth, the mouth, and associated facial structures.
Like other aspects of children's health, oral health must be considered in the context of social, cultural, and environmental factors. Dental and oral disorders can have a profound impact on children, and the burden of untreated dental health problems is substantial. Untreated dental decay (cavities) can result in pain, infection, tooth loss, difficulty eating or speaking, and poor appearance, all of which present challenges for maintaining self-esteem and attentiveness to learning. Chronic pain can alter a child's ability to sleep and play, and it hinders efforts to show them that their personal actions can make a difference in their own health.11
The magnitude of the dental diseases was high in this child population. Diet, availability of sticky carbohydrate rich food, presence of certain trace elements like selenium, relative humidity might have influenced the occurrence of dental caries in this study population.
India being a developing country, poor dental care is a common problem of rural and urban areas among school children and is all due to low socio-economic background, Poverty ignorance and negligence or poor knowledge of dental care. 3
Hence the investigator felt that by doing this kind of study, will focus on prevailing problems of dental health and findings help to develop effective teaching programme in order to modify the practices and behavior of school children; So that the general health related complications among the future adults may be prevented leading to healthy generations.
The above studies prove that school children do not practice dental hygiene, due to the neglected dental care 60% of children suffering from dental caries and periodontal disease.1
6.2. REVIEW OF LITERATURE
Review of literature is an important step in the development of research project. It involves systematic identification, location, scrutiny, and summary of written materials that contains information on research problems.