Review of literature



PROFORMA FOR REGISTRATION OF SUBJECTS

FOR DISSERTAION

| 1. |NAME OF THE CANDIATE AND |Mr.Rajashekhar.Kumbar. |

| |ADDRESS |s/o C.C.kumbar,Nr.Durga Devi Temple, Jorapur Peth,Bijapur.586101 |

| 2. |NAME OF THE INSTITUTION | |

| | |Smt.M.C.Vasantha College Of Nursing.Bidar |

| 3. |COURSE OF STUDY AND SUBJECT |1st Year M.Sc. Nursing |

| | |Pediatric Nursing |

| 4. |DATE AND ADMISSION TO COURSE | |

| | |2-11-2009 |

| | |A study to assess the effectiveness of structure teaching programme regarding |

|5. |TITLE OF THE TOPIC |prevention of dental caries among primary school teachers in selected school |

| | |at Bidar. |

|6 |BRIEF RESUME OF THE INTENDED WORK |

| | |

| | |

|6.1 |NEED FOR THE STUDY |

| | |

| |Oral Health is an integral component of general health. It has also become clear that causative and risk factors in oral diseases are |

| |often the same as those implicated in the major general diseases. The overall health, well being, education and development of children,|

| |families and communities can be affected by oral health. Though there has been considerable improvement in the oral health of children |

| |in the last few decades, dental caries (tooth decay) still remains one of the most commonly occurring oral health problems in the |

| |children all over the globe. A considerable population of children in the developing nations is being affected by tooth decay and most |

| |of the time their proper treatment is given the last priority owing to limited access to oral health services. The lack of availability |

| |and affordability of oral health services not only results in aggravation of the disease but also enhances the cost of treatment and |

| |care. There is no single country that claims to have caries free children. Adverse experience during childhood may lead dental phobia, |

| |impacting on attitudes to oral health and self care as well as availing oral health care services for life. Poor oral health in |

| |childhood often continues into adulthood, effecting economic productivity and quality of life. In many countries, a large number of |

| |children and parents have limited knowledge of the causes and prevention of the most common oral diseases. Similarly, the |

| |schoolteacher’s oral health knowledge has also not been satisfactory. It is evident that cultural beliefs and social taboos play an |

| |important role in the perception of the causes of dental decay and gum diseases. In India, a very less percentage of mothers have |

| |received proper advice on oral care of the children from dentists or health care workers. In many countries, the number of children |

| |brushing their teeth is very unsatisfactory including India. A small proportion of children do not clean their teeth at all, some may |

| |not have access to a toothbrush and many are using the traditional cleaning aids like datun, salt and oil, coal ash and locally made |

| |powders etc. This high prevalence of dental caries has also caused increase in the |

| |absenteeism of school hours and loss of working hours and economy for the parents. Apart from this, the treatment of dental caries is |

| |not available to all due to lack of facilities in their areas. This has further caused an increase in tooth loss before time, resulting |

| |in malocclusion and other problems.The availability, affordability and quality of Fluoride tooth paste remains a major problem in many |

| |developing countries. Only a small proportion of population is using fluoridated toothpaste and moreover because of high concentration |

| |of fluoride in drinking water in certain parts of India, also has a prohibiting effect as use of fluoride toothpaste. The high |

| |prevalence of Dental Caries has been brought under control in many developed countries during the last three decades. This was possible |

| |only through community or school based organized primary preventive programmes essentially composed of generation of oral health |

| |awareness through education of the public and school children at large. Presently India is also passing through the same phase where |

| |Sweden, Norway Denmark, USA and UK were in 1970’s. Parkash et al (1993) did a study in 10-15 year old School children using WHO (1987) |

| |criteria and reported an average DMFT of 2.61 for the effected children. |

| |School is a place of learning for the children and is in fact microcosms of the larger community. Schools are the ideal setting for |

| |integrating oral health instructions in the curriculum. At the school age, children are receptive to guidance and familiar with the |

| |learning environment and culture. School teachers can effectively influence student’s knowledge, attitude and practices regarding oral |

| |health and can bring change in behavior. It is very important to target oral health education to the children since the lifestyle and |

| |hygiene practices once established at an early age can go a long way in spending rest of the life in a healthy way. They should be |

| |empowered to take control of their own health early in their lives and encouraged to develop positive attitude towards preventive |

| |measures. |

| |Oral health educational programmes implemented through schools have the additional advantage of imparting primordial and primary |

| |preventive instructions to all the children of all socio-economic status. Based on this background, an attempt has been made to develop |

| |an accessible and sustainable module for prevention of dental caries among school children using existing educational infrastructure and|

| |to find out the feasibility of such a primary preventive module for prevention of dental |

| |caries in school children of Delhi. |

| |Therefore the investigator have been worked in community & rural area had seen that the primary school teachers come in contact with the|

| |mother of under five children’s, the parents of the children’s, the parents of various schools. By educating the primary school. |

| |Teachers it will be possible for them to communicate the message of prevention dental caries to the people. |

|6.2 |REVIEW OF LITERATURE |

| | |

| |A study was conducted in 1979, the Canadian Task Force on the Periodic Health Examination using the evidence then available made |

| |recommendations concerning the prevention of dental caries. Since then, significant reductions in the prevalence of dental caries have |

| |occurred in Canada, and we have new understanding of its epidemiology, diagnosis, risk factors and prevention. In 1989 the U.S. Preventive |

| |Services Task Force published guidelines for the prevention of dental caries and a more recent Canadian publication has provided more |

| |specific preventive guidelines that are similar to those of the U.S. Task Force1. |

| | |

| |A study was conducted to assess the prevalence of dental caries in large group of preschool children, to examine the association between |

| |demographic and socioeconomic factors and the prevalence of caries, and to compare these findings with those from previous studies of |

| |preschool population in the United States.Dental caries exams were performed 5171 children ages 5 months through 4 years,and parent or other|

| |care giver was asked to complete a questionnaire giving information about the child and her or his household.The data show that dental |

| |caries is highly prevalent in this preschool population, with little of the disease being treated. Timing of diagnostic examinations and |

| |prevention strategies for preschool children need to be reconsidered especially for children identified as having a high risk of caries2. |

| |A study was conducted in U.S. The decline in dental caries in US schoolchildren, first observed nationwide in 1979-1980, was confirmed |

| |further by a second national epidemiological survey completed in 1987. Mean DMFS scores in persons aged 5-17 years had decreased about 36% |

| |during the interval, and, in 1987, approximately 50% of children were caries-free in the permanent dentition. Children who had always been |

| |exposed to community water fluoridation had mean DMFS scores about 18% lower than those who had never lived in fluoridated communities3. |

| |An epidemiological study of the oral conditions of 771 schoolchildren aged 6 to 15 years was conducted in 5 departments of South of France. |

| |The DMFT and DMFS indices were slightly higher than the national means. The children had a mean DMFT of 0.66 at 6 years and 7 at 15 years. |

| |The periodontal conditions were relatively good.Caries prevalence data from recent studies in all European countries showed a general trend |

| |towards a further decline for children and adolescents. However, in several countries with already low caries prevalence in primary teeth, |

| |there was no further decrease. Regarding the permanent dentition, further reductions were observed in the 12-year age group, these being |

| |even more evident at the ages of 15-19 years4. |

| | |

| |In order to evaluate suitable strategies for control of dental caries, a longitudinal study of caries progression has been initiated among |

| |12-year-old children in Kaunas, Lithuania. The aim of the present paper was to describe the baseline caries situation in a sample of |

| |12-year-olds, who had been examined using caries diagnostic criteria which differentiate between active and inactive caries lesions at both |

| |the cavitated and non-cavitated levels. The mean fluoride concentration in the drinking waters of Kaunas is 0.16 mg/l. A total of 889 |

| |children in the 6th grade from seven selected schools were examined.A comparison of the caries profile according to the present caries |

| |diagnostic criteria with those recommended by WHO revealed that the WHO criteria yielded much lower DMFS and DMFT values, because this |

| |scoring system does not include non-cavitated caries lesions5. |

| | |

| |The goal of this cluster randomized trial is to test the effectiveness of a counseling approach, Motivational Interviewing, to control |

| |dental caries in young Aboriginal children. Motivational Interviewing, a client-centred, directive counseling style, has not yet been |

| |evaluated as an approach for promotion of behaviour change in indigenous communities in remote settings. Methods/design: Aboriginal women |

| |were hired from the 9 communities to recruit expectant and new mothers to the trial, administer questionnaires and deliver the counseling to|

| |mothers in the test communities. This paper explains the challenges of conducting randomized trials in remote settings, the importance of |

| |thorough community collaboration, and also illustrates the likelihood that some baseline variables that may be clinically important will be |

| |unevenly split in group-randomized trials when the number of groups is small6. |

| |Dental caries in the primary dentition can have significant damaging effects on a childs growth due to impairment of oral functions. Since |

| |the first encounter of a child to a medical environment is often through pediatricians and medical practitioners, it is important that they |

| |be aware of the prevention of oral disease that begins early in life. The aim of this article is to diminish the existing ambiguity among |

| |pediatricians and medical practitioners regarding oral disease and its prevention7. |

| | |

| |A study was conducted among 412 high school students who were voluntary participants of an NCC unit in South India. Knowledge, attitude and |

| |practice scores were calculated, and then were correlated with Simplified Oral Hygiene Index (OHI-S) values. Spearman's correlation test was|

| |used to measure the correlation. Most of the cadets did not have knowledge about the causes and the prevention of dental diseases. A |

| |significant number of participants sought further information, hence it can be said that the cadets had a positive attitude towards oral |

| |health. There was no correlation seen between knowledge and attitude scores with that of OHI-S measured, but a significant correlation was |

| |noted between practice and OHI-S scores8. |

| | |

| |Early Childhood Caries (ECC) is a lifestyle disease that begins when the child's teeth erupt in the oral cavity. The distinctive pattern of |

| |decay rapidly spreads from one tooth to another and involves the surfaces of teeth that are usually not at risk. Detection of disease is |

| |crucial to control the oral condition using preventive and therapeutic regimes. The aim of this study was to determine the prevalence of |

| |caries in children of age 3-6 years in Ludhiana and to examine the relationship between age and caries experience. A total of 609 children |

| |in the age group of 3-6 years were examined using def index. To determine dental care seeking attitude, 105 caregivers were interviewed.The |

| |results of the present study can be used mainly for screening child populations in need of treatment, helping public workers and planners to|

| |develop dental health programs to aid early intervention and prevention9. |

| | |

| |A total of 2000 children (1-14 year age group) attending pediatric OPD, school clinic & well body clinic of Dr. R.N. Cooper Municipal |

| |Hospital & K.E.M Hospital, Mumbai were examined for caries prevalence and 35.6% had dental caries. Parental literacy, particularly maternal |

| |literacy was shown to influence caries prevalence in children. The prevalence was low in well-nourished children and in those taking |

| |vegetarian type of diet. Frequency of sweet consumption was shown to be associated with prevalence of dental caries. In 1-4 year age group |

| |it was noted that bottle fed children were more affected by dental caries. Tooth brush with paste was the commonest method used for cleaning|

| |their teeth in all age groups in our study. Caries prevalence was low in those children using tooth brush than in those using tooth |

| |powder10. |

| | |

|6.3 |STATEMENT OF PROBLEM. |

| | |

| |A study to assess the effectiveness of structure teaching programme regarding prevention of dental caries among primary school teachers |

| |in selected school at Bidar. |

|6.4 |OBJECTIVE OF THE STUDY. |

| | |

| |To assess the pre-test knowledge among the primary school teachers regarding the prevention of Dental Caries. |

| |To administer structured teaching programme to primary school teachers regarding the prevention of Dental Caries. |

| |To assess the post-test knowledge of primary school teachers regarding the prevention of Dental Caries. |

| |To determine the effectiveness of structured teaching programme in terms of knowledge course. |

| |To know the association between pre-test & post-test knowledge course with selected demographical variables. |

| | |

|6.5 |OPERATIONAL DEFINATIONS |

| | |

| |Assess:- It referece to be ability to interpet guess the effectiveness of planed teaching programme. |

| | |

| |Effectiveness :- It refers to the significant gain in knowledge of determined by deference in pre-test & post-test course. |

| |Structured teaching programme:- |

| |It is action of building or constructing – arranging things in a definite pattern of organization. |

| |Dental Caries:- |

| |A destructive process causing decalcificatiol of the tooth |

| |enamel and leading to continued destruction of enamel and dentin and cavitaion |

| |of the tooth. |

| | |

| |Primary School teachers:- |

| |Primary school teachers develop schemes of work and lesson plan in line with curriculum objectives. They parlitaste teaching by |

| |establishing a relationship with pupils & by their organization of learning resources and the class room learning environment. |

|6.6 |HYPOTHESIS |

| | |

| |H1 There is no significant difference in the mean pre test scores & mean post test scores on subject exposed to structure teaching |

| |programme |

| | |

| |H2 There is no significant association between pre test & post test knowledge score with demographic variable. |

| | |

|6.7 |ASSUMPTION OF THE STUDY |

| |The primary school teachers have knowledge on prevention of dental caries. |

| |Structured teaching programme will enhance the knowledge of primary school teachers on prevention of dental caries. |

| |Structured teaching programme is an excepted teaching strategies. |

|6.8 |DELIMITATIONS |

| | |

| |Study is delimitations to the primary school teachers working in selected school. |

| | |

| |Period of study is limited to 6 weeks |

|6.9 |PROJECTED OUTCOME |

| |The study will enhance the knowledge of primary school teachers which helps in prevention of dental caries among the primary school |

| |children. |

| | |

|7 |MATERIALS AND METHODS |

|7.1 |SOURSE OF DATA |A primary school teacher working in selected school |

|7.2.1 |INCLUSION CRITERIA |Primary school teachers who are regular to the selected schools. |

| | |Primary school teacher who give consent to the study. |

| | |Primary school teachers who can read and understand Kannada & English. |

| |EXCLUSION CRITERIA |Primary school teachers are on leave |

| | |Primary school teachers who are not willing to participate in the study |

|7.2.2 |RESEARCH DESIGN |QUASI experimental one group pre-test and post-test |

|7.2.3 |SETTING OF THE STUDY |The study will be conducted in selected schools at Bidar. |

|7.2.4 |SAMPLING TECHNIQUE |Non probability convenient sampling techniques |

|7.2.5 |SAMPLE SIZE |It consist of 60 primary school teachers. |

|7.2.6 |TOOL OF RESEARCH |The tool for data collection is Self -Administered knowledge questionnaire it consist|

| | |of following sectors |

| | | |

| | |Section A : To assess the demographic data . |

| | |Section B : To assess the knowledge with structured knowledge questionnaire. |

|7.2.7 |DATA COLLECTION |The investigator will administer the structured knowledge questionnaire to assess the|

| | |knowledge and structured teaching programme is administered and the post-test will |

| | |be conducted after one week. |

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|7.2.8 |METHODS OF DATA ANALYSIS AND PRESENTATION |The investigator will analyse data obtained by means of descriptive and inferential |

| | |statistics. The plan of data analyses will be as follow : |

| | | |

| | |Organizing the data in master sheet. |

| | |Frequency and percentage of data will be calculated to describe the demographic |

| | |variable. |

| | |Mean slandered detection and paired “T” test to determine the significance. |

| | |Chi-Square test to measure the association. |

|7.3 |DOES THE STUDY REQUIRE ANY INVESTIGATIONS OF INTERVENTION TO BE CONDUCTED ON PATIENT OR OTHER HUMAN OR ANIMALS IF SO PLEASE DISCRIBE |

| |BRIEFLY. |

| | |

| |Yes the study will be conducted any on primary school teachers in selected primary schools at Bidar. |

|7.4 |HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3? |

| | |

| |Yes informed consent to be obtained from the institution authorities and subjects privacy, confidentiality and anonymity of subjects |

| |will be guarded, scientific objectivity of the study will be maintained with honesty and impartiality |

| | |

| | |

|8 |LIST OF REFERANCE |

| | |

| |Donald W. Lewis, DDS, Amid I, et al prevence of dental caries.Public Health Reports, July 1st aug 1997. Volume 112. |

| | |

| |Julie M.W. Tang, Donald S. Altman, Don.C.Robertson.Dental Caries Prevelance & treatment levels in Arizona preschool children. Public Health |

| |Reports, July 1st aug 1997. Volume 112. |

| | |

| |J.A. Brunelle, J.P Carlos, Recent Trends in Dental caries in U.S.Children & the effect of water fluoridation, Journal of Dental Research. |

| |February 1990 ( Volume 69, Special issue, Pages 723-727) |

| | |

| |Bonnarde v Bouziz N, Coulumb E.The Dental Caries in Provence in 6-15-year- old children. J Biol Buccale.1988, Dec:16(41):225-30. |

| | |

| |Machiolskiene V, Nyvad B, Baelom v. Prevalence & Severity of dental caries in 12-year old Children in Kaunas, Lithuania 1995. Caries |

| |Res.1998;32(3):175-85. |

| | |

| |Harrison R, Veronneau J, Levoux B. Design & implemention of a dental caries prevention trial in remote Canadian Aboriginal Communities. Trial,|

| |2010 May 13;11(1):54. |

| | |

| |Chandna P, Ad lakha VK. Oral health in children guidelines for pediatricians. Indian Pediatr.2010 Apr 7;47(9);323-7. |

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| |Singh A. Oral health Knowledge, attitude & Practice among NNC Navy Cadets & their Corration with oral hygiene in South India. Oral Prev |

| |Dent.2009;7(4);363-7. |

| | |

| |Simratvis M, Maghe GA, Thomas AM, et al. Evaluation of Caries experience in 3-6 year old Children, and dental attitudes amongst the Caregivers|

| |in the Ludhiana city J Indian Soc Pedal Prev dent.2009 Jul-Sept:27(3);164-9. |

| | |

| |Venugopal T, Kulkarni VS, Nerurkas RA, et al. Epidemiological Study of dental caries. Indian J Pedatr.1998 Nov-Dec;65(6):883-9. |

|9 |SIGNATURE OF THE CANDIDATE | |

| |REMARKS OF THE GUIDE | |

|10 | | |

|11.1 |NAME AND DESIGNATION OF THE GUIDE | |

|11.2 |SIGNATURE | |

|11.3 |CO-GUIDE | |

|11.4 |SIGNATURE | |

|11.5 |HEAD OF THE DEPARTMENT | |

|11.6 |SIGNATURE | |

|12 |REMARKS OF THE CHAIRMAN/PRINCIPAL | |

|13 |SIGNATURE | |

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