Evaluation of knowledge and awareness of pediatric oral health among school teachers of Hazaribag before and after oral health education: Study Protocol for Interventional study

Children’s growth and development is directly linked to their oral health. As they spend a

lot of time in schools, oral education can bring an inevitable change in dental

attitude and behaviour of these children, if taught with other subjects in

schools. There is a paucity of studies reported in the past which prove that

the school teachers had poor knowledge of oral health in varied aspects especially dentistry for children. Pediatric dentistry is an invincible segment of dentistry covering all aspects of dentistry in children from birth to adolescence. Hence, adequate knowledge should be given right from infancy to parents, school teachers and child^1-6.1-6

Studies conducted on knowledge, attitude and practices in school teachers in relation to oral health had clearly demonstrated the inaccurate and lack of information to the people of this profession.

To assess and evaluate the knowledge and awareness of school teachers in

Hazaribag town of Jharkhand regarding pediatric oral health

To determine if an online webinar series of lectures could ameliorate the

knowledge and awareness level in school teachers

To compare these parameters at pre- and post-webinar levels.

Study design

An interventional study will be conducted among primary, elementary and high school

teachers of private schools in the Hazaribag town of Jharkhand State in East

India to evaluate the knowledge of participants on pediatric oral health. A

total of 156 school teachers will be selected using a random sampling method.

Inclusion Criteria

1. Primary, Elementary and

High school teachers of private schools in the Hazaribag town of Jharkhand

2. School teachers who are ready to receive web based online education training.

3. School teachers who acquire basic computer knowledge

4. School teachers who gave their consent for the study

Exclusion Criteria

1. Primary, Elementary and High school teachers of government schools in the Hazaribag town of Jharkhand

2. School teachers who were not interested in web based online dental education training.

All the nominated teachers will take part in the training as an indispensable

segment of a one-week teachers training program to be organized by the

Department of Pediatric and Preventive Dentistry, Hazaribag College of Dental

Sciences and Hospital, Hazaribagh.

Study questionnaire

A self‑administered, 30‑item questionnaire is formulated as Google forms in English

language; the design and inclusiveness of the questionnaire is finalized with

the support of a team of experts from the Department of Pediatric and

Preventive Dentistry, Periodontics and Public Health Dentistry before the

study. The questionnaire includes two sections: the first section is about

demographic details such as gender, marital status, school location; the second

section is about 30 questions on pediatric oral health with three divided

subsections: Subsection A (including 7 questions): Questionnaire on general

pediatric oral health, B (including 9 questions): Questionnaire on preventive

pediatric oral health and C (including 14 questions): Questionnaire on clinical

pediatric oral health will evaluate the knowledge of teachers toward oral

health in children. All the questions were in a digital format, uploaded on

Google Forms. A pilot study will be done prior to our study among primary and

elementary school teachers and the participants will not be counted in the

training program. Any problems and technical hitches, if incur during the

filling of the pilot form will be corrected. Pre and Post training

questionnaire will be compared and statistically analysed.

Study procedure

Four stages of training program:

Stage 1: Pre-training module of knowledge and awareness assessment: A 30-Item questionnaire

will be send to all the participating school teachers with a title of pre-test

questionnaire. The questionnaire will be in the form of an online self‑administered

questionnaire (English) and will be formatted as google forms. 

Stage 2: Webinar-based oral health education module: This module comprises of oral

health education program to be attended by all participants using a web-based

online education training protocol on the Zoom platform. The training is

specially designed for school teachers and is segregated into four sessions:

Ist session: Introduction to pediatric dentistry and morphology of tooth h- this session

includes lecture of 30 minutes and where school teachers are introduced with

children dentistry and importance of primary teeth with their clinical

applications. The morphological differences between primary and permanent teeth

will be highlighted with reference to dental caries and its prevention.

IInd session: Oral health care and brushing techniques in children n- this session includes

lecture of 45 minutes and where school teachers will be educated in oral care

and hygiene maintenance of children oral cavity. The knowledge will be shared

on plaque and gingiva, gingival problems in growing children and also tooth

brushing techniques in children are taught with special mention to Fones

techniques; after that demonstration of brushing techniques will be given to

comprehend the brushing skills practically.

IIIrd session: Early Childhood Caries s- this session includes lecture of 45 minutes and

the pandemic incurrence of early childhood caries in children, etiological

factors like bottle feeding, sugary syrups, prevention and treatment aspects

including restorations and pulp therapies will be shared with school teachers.

IVth session: Clinical myths and facts of children dentistry y - this session includes lecture of

45 minutes and it is a tailored made discussion on clinical myths and facts of

children dentistry in Indian population with special mention to pulp therapy,

dental caries, malocclusion, oral cancer, dental trauma, and dental fluorosis,

home and professional dental practices, prevention of oral diseases. A plethora

of myths and their corresponding facts will be discussed and the section of

training will be concluded.

Stage 3: A panel discussion followed by a dental quiz: After completing each session,

a panel discussion will be done for 30-45 minutes with the aim of clarifying

individual teacher queries and discussing frequently asked questions regarding

pediatric oral health with panellists comprising of professors from varied departments

of Pediatric and Preventive Dentistry, Periodontics and Implantology, Public

Health Dentistry and Oral Pathology in Hazaribag College of Dental Sciences and

Hospital, Hazaribag. After that, a dental quiz will be organized to assess the

dental knowledge gained through the webinar session.

Stage 4: Post-training module of knowledge and awareness assessment: A 30-Item questionnaire

which will be same as pre-test questionnaire will send to all the participating

school teachers with a title of post-test questionnaire and the scores will be

recorded and compared to Pre-test scores. The feedback will also be recorded

form the participants regarding the program.

Ethical considerations

Ethical

approval is obtained from the Institutional Review Board of Hazaribag College

of Dental Sciences and Hospital, Hazaribag, Jharkhand, India (with no.

HCDSH/ADM/BNF/2020/214 and dated 25.01.2020). The written informed consent will

be obtained from all the participants before the start of the study.

Scoring

The

data collection, scoring and data analysis will be done by single trained

investigator (Dr Annapurna Ahuja) to avoid inter-examiner variability by

analysing the pre-questionnaire before online education and post-questionnaire

after online education. The scoring will be done as ‘1’ for Option A, ‘2’ for option B, ‘3’ for option C.  The test-retest reliability of the Questionnaire will be estimated by providing the same questionnaire to same participants of pilot study at different times and after a satisfactory correlation coefficient is established, study will be proceed further.

The collected data will be entered into Microsoft Excel 2007 and subjected to statistical analysis using SPSS version 22.0 (IBM Statistics Inc., Chicago, Illinois, USA). The statistical test used will be Chi-Square test to assess the categorical difference in scores before and after oral

health education. P ≤ 0.05 will be considered for statistical significance.