Abstract
Objective: To evaluate the oral health knowledge among caretakers working in baby day care centres. Methodology: The present study is a descriptive cross sectional study conducted to evaluate the oral health knowledge among caretakers in baby day care centres of Greater Hyderabad over a period of one month from December2012 – January 2013.SPSS version 14.0 was used to evaluate the collected data. Results: Likert scale was used for recording the responses of the study subjects. 69% agreed that caries can effect infants below 2 yrs of age and 31.3% of the care takers did not have the knowledge about this. 52.7% strongly agree that the child should rinse the mouth after every meal and 47.3 did not know this. 60.7% of the care takers do not give any oral hygiene instructions to the kids and only 39.3% of the care takers give oral hygiene instructions. 74.7% did not know when the child should be taken to a dentist and 0.7% of the care takers had the knowledge about this. 56% of the care takers did not have the knowledge whether sugar added fruit juice should be given to the child before naptime and 40.7% disagreed to this. Conclusion: Care givers knowledge towards oral health plays an important role in maintaining the oral hygiene and oral health of the child. Dental care needs should be improved. The study gives us an insight to so far an unknown domain.
Introduction
Oral health is an important aspect of general health in infants and children and impacts the quality of life and health outcomes. As we know children are the future of any nation more attention and care is required. Among the dental problems dental caries is the most existing and prevailing problem which effects the children of low and high economic communities without any discrimination1. Now, as children spend most of their time in a day outside home it is time to watch out what are the factors which lead to the disease. The nuclear system of families have emerged and this is also one reason where the children are send to day care centres to look after. Here the caretakers come into focus. The knowledge of the caretaker is very important in imbibing the good oral health behaviour to the children. The children come from different communities where their standard of living differ from one another. So, the care taker should be patient enough to inculcate good oral health behaviour in them. The caretaker knowledge is also very important. Mothers are undoubtedly the primary source of early education in children with regard to a good oral health. But in 21st century as most of the mothers tend to work and they work most of the time in a day outside their homes in order to increase their quality of life2. As it was conceived long ago, children are an important for oral health education and thus agreed among dental health educators. So, dental health education given to mothers and aimed at children is more concerned with forming habits, rather than trying to manage established routines. Behaviour learnt during the child’s first year becomes deeply ingrained and resistant to change1. Children at this tender age inherit health practices from their parents, but in this workaholic era children often find themselves under the care of caretakers in places such as day care centres. Day care is a care of child during the day by a person other than the child’s parents or legal guardians3. Now the role of care taker comes into existence. Here the role of the care taker is similar to that of a school teacher and may be even more important as they are involved with children’s daily diet, general hygiene and oral health care4. Many studies have focused on parents, school teachers and school children oral health knowledge, attitudes and practices, there are not many studies which focused on the role of care takers in promoting oral health of the children under their care in day care centre. The aim of the present study was done to evaluate the oral health knowledge among care takers in baby day care centres of Greater Hyderabad as the children spend most of their time in a day care centre and the role of care taker is important in maintaining the oral health of the children under their care.
Methodology
The present study is a descriptive, cross-sectional, epidemiological survey conducted on care takers working in baby day care centres to evaluate their oral health knowledge regarding oral health and diet. The study population comprised of care takers working in baby day care centres of Hyderabad city. 40 day care centres, which are scattered throughout Hyderabad city and are divided geographically into five zones were randomly selected by the investigators. In 40 centres employing 160 caretakers 150 provided consent for participation after the study purpose was explained to them. Day care centres whose permission was obtained from the higher authorities and care takers present at the time of the study and who were willing to participate and agreed to give informed consent (verbal consent) were included. A Pilot study was carried out on a sample of 30 subjects to check the feasibility of conducting the survey and understanding the questionnaire. This pilot study also helped in exacting the pre-designed proforma (which included questions on socio demographic factors like age, sex, name of the centres, questions regarding their knowledge on oral health and diet) and in making modifications wherever necessary to design the final proforma. The study was systematically scheduled for a period of about two months from December 2012- January 2013. For the collection of data, a specially designed, pre tested questionnaire was used to test the knowledge. The questionnaire consisted of demographic data and questions regarding knowledge of oral health and diet. The purpose of the study was explained to the care takers and only those who were willing to participate were asked to answer the questions.
For statistical analysis data was done using SPSS version 14. A p-value of < 0.05 was considered statistically significant. Descriptive statistical analysis was done for all the results.
Results
The present study is a descriptive, cross-sectional, epidemiological survey conducted on care takers working in baby day care centres to evaluate their oral health knowledge regarding oral health and diet. Distribution of study subjects based on their knowledge that caries can effect infants below 2 years of age. (Fig 1) Distribution of study subjects based on their knowledge of appearance of first milk tooth.(Fig 2) Distribution of study subjects based on their knowledge of changing feeding from baby bottle to sipping cup at the age 8-9 months(Fig 3) Distribution of study subjects based on their knowledge about when the child should be consulted by a dentist.(Fig 4) Distribution of study subjects based on their opinion about using pacifier dipped in honey/ sugar if the kids acted troublesome is better.(Fig 5).
Discussion
This study presents the oral health knowledge of care takers working in baby day care centres of Greater Hyderabad. Inspite of the reduction of the prevalence of dental caries in many countries the children are still experiencing dental caries. The underlying cause for this might be lack of education attainment, poverty and also due to different cultures in different communities. Parents and the caretakers of the children are held responsible for their oral hygiene, and their dietary practices and in turn the dental caries experience also1.
A total of 160 subjects were approached from different day care centres of Hyderabad city and a total of 150 subjects who were interested in participation of the study were noted and the response rate was 93.75%. In the present study according to 93.3% of the subjects brushing baby’s teeth is important whereas in a similar study done by Vinay S et al1 only 78% of the subjects believed so and these findings give the awareness of the subjects regarding the oral condition of the child. About 38.7% of the subjects correctly answered that the first tooth appears between 6 months –one year these results contradict the results of similar study done by Chan et al2 where only 15% of the subjects answered correctly and this might be due to the subjects inability to recall the time though it is one of the important moment in a child’s life time and this has been given importance in the present study. According to 47% of the subjects caries can effect infants below 2 years of age and this was contradicted in the similar study done by Mani et al4 where 32% of the subjects had the knowledge about this and this might be due to lack of their attention towards this.
74.7% of the study subjects in the present study did not know that a child should be consulted/taken to a dentist before one yr of age whereas in other similar studies atleast 45% of the study subjects had the knowledge about this. The result of the present study shows that unless the child have some problem/pain the caregiver/the parent did not feel necessary to consult a dentist and also due to the false perception of the parents that no dental problem exists in children. 64% of the study subjects disagreed that a pacifier dipped in honey/sugar must be used if the child acted troublesome and in contradiction to this in a similar study done by Chan et al2 30% of the study subjects had to use this. In the present study the subjects say that once this will be used it becomes as a habit for the child and it is difficult to break the habit and also it may cause dental caries. 56% of the study subjects agree that a sugar added fruit juice should be given to the child before naptime and this was observed similarly in a study done by Fathima et al5 and the reason for this is the study subjects did not know that the hidden sugars in the fruit juice and the consumption of this through bottle also may lead to tooth decay. 70% of the study subjects strongly agreed that the lunch box should be given to the child by the parents so that it also helps them in noticing the oral health of the child by the type of food consumed by the child and it helps them to reduce in the sugar intake of the child and helps the child in maintainance of better oral health of the child and this was observed in a similar study done by Aisha et al10. Limitations of the present study were that the sample size was small because the care takers present on the day of the study were taken into consideration. This study done on caretakers gives us an information of their knowledge towards oral health but they are not able to encounter the barriers due to lack of education, their working schedule and the knowledge about what type of diet should be given at what age and this is the main drawback in giving good preventive care to the child.
Conclusion(s)
Care givers knowledge towards oral health plays an important role in maintaining the oral hygiene and oral health of the child. Dental care needs should be improved and the study gives us an insight to so far an unknown domain.
Reference(s)
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