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1. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECTS
FOR DISSERTATION
1. Name of the candidate and address BOSCO JOSE
SHREE DEVI COLLEGE OF NURSING,
BALLALBAGH, MANGALORE.
2. Name of the Institution SHREE DEVI COLLEGE OF NURSING,
MAINA TOWERS
BALLAL BAGH,
MANGALORE – 575 002.
3. Course of study and subject M. Sc. NURSING
COMMUNITY HEALTH NURSING
4. Date of admission to the course 06-09-2009
5. TITLE OF THE STUDY
A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICE
AMONG MOTHERS OF LOWER PRIMARY SCHOOL CHILDREN
REGARDING PREVENTION OF DENTAL CARIES IN SELECTED
AREA OF MANGALORE
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2. 6. BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
Dental caries and periodontal diseases are most common oral diseases showing
striking geographic variations, socio-economic patterns, and severity of distribution all
over the world. Though many studies are conducted in different parts of the world, the
review of literature indicates that there is great deficiency in baseline data concerning the
oral health of Indian school children. There is paucity of information regarding the
frequency and prevalence of dental caries and oral hygiene status in many parts of India.
A descriptive study was conducted in Haryana among 2304 children of 9, 10, 11
and 12 years age (males: females, 1290: 1014). The children were examined in the
classroom with sufficient natural day light on an ordinary chair. The data regarding the
oral health status, oral hygiene status, and general information was filled as per the
proforma provided by W.H.O. for programmes. Oral hygiene status was assessed by using
Oral Hygiene Index-Simplified (OHI-S), Decayed Missing Filled (DMF); caries index
was used to assess the caries status. The result shows that caries experience and
occurrence of untreated lesions in paramount teeth with age and oral hygiene status
worsens as age advanced. Also females experienced more decay as compared to males
though oral hygiene status was poorer in males.1
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3. 6.1 Need for the study
Children suffer from many infectious diseases during the first three years of life
around the time of eruption of deciduous teeth. Parents do not give sufficient attention to
prevent the occurrence of these at early age. The early childhood caries is due to the
combination of child being infected with carcinogenic bacteria and frequent ingestion of
sugar. Despite improvement over several decades, oral disease among children remains a
serious problem.2
A descriptive study was conducted using random sampling method to assess the
pattern of prevalence of dental caries in the primary dentition among five year old
children in urban Pondicherry with a population of 1009 school children of both sexes.
Dental caries was assessed by the Dentition Status and Treatment Need. Statistical
analysis was done using the proportion test. The prevalence of caries was 44.4% among
the study population, being higher in the boys (P < 0.05). It was found that in both the
sexes, primary second molars showed higher caries prevalence.3
A cross-sectional study conducted on the prevalence of dental caries and treatment
needs in the age group of 3-5 years was estimated among 1500 children of Hubli-
Dharwad city in 1999. The attitude of mothers towards their children's oral health and its
relation with caries prevalence was noted among 200 subjects. The prevalence of dental
caries was 54.1%. The attitude of mothers towards children's oral health made a statistical
difference in the mean scores.4
The researcher from experience has observed that many children suffer from
dental caries and associated complications due to lack of adequate knowledge and faulty
practices. Improving the knowledge and practice of mothers of lower primary school
children would help in creating awareness to reduce the prevalence of dental caries
among the children. The present study results may help the mothers to take appropriate
measures in reducing dental caries among their children, thereby improving oral hygiene
and promoting optimal health status.
6.2 Review of literature
A qualitative study was conducted with a convenience sample of Mexican mothers
of young children about their beliefs and knowledge about the causes of caries. All forty-
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4. eight mothers mentioned specific causes. The study shows that mothers recognized the
three major important factors causing caries as: sugar composition, poor oral hygiene, and
bottle use. The study suggested that more comprehensive education is needed, including
that about caries prevention behaviours, which could lead to an increase in the sense of
self-efficacy with respect to their children’s oral health.5
A descriptive study was conducted on the oral health related knowledge, attitudes
and reported behaviours of parents of children aged 12-24 months living in rural areas of
Australia. A robust theoretical model was utilized to identify oral health related
behaviours and their antecedent and reinforcing conditions within the context of this
specific population group. Two hundred and ninety-four parent child dyads were recruited
through their maternal and child health nurses as part of a larger intervention trial.
Knowledge of the role early infection was very low, with high levels of behaviours that
may promote early transmission reported. Tooth cleaning was reported by most parents at
least sometimes. However, a large proportion lacked confidence and this was significantly
related to the frequency of the cleaning.6
A survey conducted among 1365 mothers of first grade students and 215
schoolteachers in Yichang, Hubei, using questionnaires to assess the dental knowledge
and behaviours of the teachers and mothers of schoolchildren. The survey showed that the
level of dental knowledge was higher among schoolteachers than among mothers; the
mothers were mostly informed through television/books (62.4%/51.5%), while teachers
received information from various sources, including the dentists (75.3%). Most of the
children (94.0%) didn’t have practical support from their parents in daily tooth cleaning.
Only 18.9% of them visited the dentist at least once a year. This findings suggested that
we should emphasise oral healthy education among mothers and schoolteachers in order
to promote school-based oral health education programme.7
A field study was carried out in rural south-eastern Anatolia, Turkey, where access
to dental care is limited. Twenty seven mother-infant pairs were followed for two years.
The infants were between 2 and 18 months old when the study began. Mothers in the
control group (n=12) received a simple care and advice programme, and those in the test
group (n=15) followed a preventive and operative regimen. The occurrence and the
incremental occurrence of caries in mothers and children in both groups were determined
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5. annually. Using a commercial kit, levels of mutans streptococci and lactobacilli in saliva
and plaque were measured in the children at six month intervals. The microbial data
demonstrated that the children of mothers in the test group had significant reduction in
mutans streptococci and lactobacilli in plaque (P<0.001), whereas no such trend was
observed in control children during the twenty four month monitoring period (P>0.05).
After twelve months, the occurrence of caries (dfs) was significantly lower in the test
group than in the control group (0.13+/-0.35 vs 1.67+/-1.30, respectively; P<0.001). A
similar difference was observed after twenty four months (0.2+/-0.56 vs 3.17+/-1.70,
respectively; P<0.001).8
A cross-sectional study was conducted to describe the prevalence, severity and
distribution of dental caries among 1,782 preschoolers. The caries status was evaluated by
using WHO examination procedures and diagnostic criteria. Results showed that about
40% children (26%, 37%, and 49% for 3-4, 4-5, and 5-6 year-olds, respectively) were
affected by caries. The mean (SD) deft and defs were 1.54 (2.75) and 3.30 (7.49),
respectively. About 90% of the affected teeth were decayed teeth. A significantly skewed
distribution of caries lesions was revealed, indicating that 16% children with high caries
activity (deft≥4) were carrying 78% lesions. Rampant caries, defined as caries affecting
the smooth surfaces of two or more maxillary incisors, was found in 16.5% of children.
About 61% of affected surfaces were smooth surfaces. Higher caries severity and
treatment need were found among Malays and children in the low socio-economic group.
It concluded that caries is a severe oral health problem for preschoolers, especially in the
children with low economic status.9
6.3 Statement of the problem
“A study to assess the knowledge and practice among mothers of lower primary
school children regarding prevention of dental caries in selected area of Mangalore.”
6.4 Objectives of the study
1. To determine the level of knowledge on the prevention of dental caries among the
mothers of lower primary school children as measured by a structured knowledge
questionnaire.
2. To determine the practice of mothers on prevention of dental caries among the
children as measured by a structured practice scale.
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6. 3. To find the correlation between knowledge and practice among mothers of lower
primary school children regarding prevention of dental caries.
4. To find out the association between knowledge score and selected demographic
variables.
5. To find out the association between practice score and selected demographic
variables.
6.5 Operational definitions
1. Knowledge: In this study it refers to the correct responses against the knowledge
questionnaire.
2. Practice: In this study it refers to the measures or activities done by the mothers
to prevent dental caries among their children.
3. Dental caries: It is the destruction of the outer surface (enamel) of the tooth
which results from the action of bacteria that live in plaque, which is a sticky,
whitish film formed by a protein in saliva (mucin) and sugary substances in the
mouth. The plaque bacteria sticking to tooth enamel use the sugar and starch from
food particles in the mouth to produce acid.
6.6 Assumptions
The study assumes that:
1. Mothers will have some knowledge on the prevention of dental caries.
2. Mothers will have some practice on the prevention of dental caries
3. Knowledge and practice can be measured.
6.7 Delimitations
The study is delimited to:
1. Mothers of lower primary school children.
2. Mothers of selected areas in Mangalore.
6.8 Hypothesis
H1: There will be significant correlation between the knowledge and practice among
mothers of lower primary school children at 0.05 level of significance.
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7. H2: There will be significant association between knowledge of score of mothers on
prevention of dental caries and selected demographic variables at 0.05 level of
significance.
H3: There will be significant association between the practice score of mothers on
prevention of dental caries and selected demographic variables at 0.05 level of
significance.
7. Material and methods
7.1 Sources of data
The data is collected from mothers of lower primary school children from the
selected area at Mangalore.
7.1.1 Research design
A descriptive survey design is selected for the study.
7.1.2 Setting
This study will be conducted in the selected area of Mangalore.
7.1.3 Population
Mothers of lower primary school children from the selected area at Mangalore.
7.2 Method of data collection
7.2.1 Sampling procedure
The sample for the present study would be selected by purposive sampling
technique.
7.2.2 Sample size
The sample for the present study would comprise 60 mothers of lower primary
school children.
7.2.3 Inclusion criteria
1. Mothers of lower primary school children.
2. Those who know to read and write Kannada.
7.2.4 Exclusion criteria
1. Not available at the time of data collection
2. Not willing to participate.
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8. 7.2.5 Instruments intended to be used
Instruments intended to be used in this study are:
• Structured knowledge questionnaire.
• Structured practice questionnaire.
7.2.6 Data collection methods
1. Prior to the data collection permission will be obtained from the authority
concerned.
2. The investigator will introduce himself to the mothers and explain about the study.
The investigator will assure the subjects that all the responses will be kept
confidential.
3. Structured knowledge and practice questionnaire will be administered to mothers.
7.2.7 Data analysis plan
Data would be analysed using the descriptive and inferential statistics on the basis
of objectives and hypothesis of the study.
− Knowledge and practice scores will be analyzed by using percentage, mean,
median and SD.
− Karl Pearson correlation coefficient formula will be used to find the correlation
between the knowledge and practice.
− Chi square test will be used to find the association between the knowledge score
of mothers on the prevention of dental caries and selected demographic variables.
− Chi square test will be used to find the association between the practice score of
mothers on the prevention of dental caries and selected demographic variables.
7.3 Does the study require any investigation or intervention to be conducted on patients
or other humans or animals?
No, the study doesn’t require any investigation or intervention to be conducted on
patients or other humans or animals.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
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9. Yes. Ethical clearance will be obtained from concerned authority.
Bibliography
1. Rai B, Jain R, Kharb S, Anand S. Dental caries and oral hygiene status of 8 to 12
year school children of Rohtak, A brief report. The Internet Journal of Dental
Science 2007;5(1).
2. Edgard CA, Hall PL. Parents attention on children dental caries disease. Medline
plus. 2001;[1screen] Available from: URL:http://medlineplus/dental caries
disease.
3. Saravanan S, Madivanan I, Subashini B, Felix JW. Prevalence pattern of dental
caries in the primary dentition among school children. The Indian Journal of
Dental Research 2005;16(4):140-6.
4. Menon A, Indushekar KR. Prevalence of dental caries and co-relation with
fluorosis in low and high fluoride area. J Indian Soc Pedod Prev Dent 1999
Mar;17(1):15-20.
5. Hoeft KS, Barker JC, Masterson TT. Urban Mexican American mothers’ belief
about caries aetiology in children. Community Dent Oral Epidemiol 2010 Feb 10.
6. Riordan PJ, Dalton-Ecker L, Edwardz TS. Dental status of 12-year-olds treated in
private practice and a school dental service. Community Dent Oral Epidemiol
1993 Aug;21(4):198-202.
7. Jiang H, Tai B, Du M. A survey on dental knowledge and behaviour of mothers
and teachers of school children. Hua Xi Kou Qiang Yi Xue Za Zhi 2002
Jun;20(3):219-20,22.
8. Efe E, Sarvan S, Kukulu K. Self-reported knowledge & behaviours related to oral
& dental health in Turkish children. Issues Compr Paediatr Nurs 2007 Oct-
Dec;30(4):133-46.
9. Al-Malik MT, Rehbini YA. Prevalence, severity and distribution of 3 to 6 years of
children. J Contemp Dent Pract 2006 May 1;7(2) 46-54.
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10. 9. Signature of the candidate
10. Remarks of the guide
11. Name and designation of (in block letters)
11.1 Guide
11.2 Signature
11.3 Co-guide
11.4 Signature
11.5 Head of the department
11.6 Signature
12.1 Remarks of Chairman and principal
12.2 Signature
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