RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

PERFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1) Name of the candidate and address Ms. Elizebeth Susanna 1st Year M.Sc Nursing Holdsworth Memorial college of Nursing, Mysore -21.

2) Name of the Institution Holdsworth Memorial college of Nursing.

3) Course of Study & subjects Master’s degree in Nursing Child Health Nursing.

4) Date of Admission of the Course 14.6.2010

5) TITLE OF THE TOPIC:

KNOWLEDGE REGARDING DENTAL CARIES AMONG DEAF AND DUMB SCHOOL CHILDREN

1 6) BRIEF RESUME OF INTENDED WORK INTRODUCTION.

Oral health is an integral part of over all health; Oral cavity plays a vital role in the

life of human beings. Through functions like mastication, esthetics, phonetics,

Communication, emotional expressions. It is highly essential to safe guard oral health

of all children from childhood otherwise poor oral health will lead to various dental

diseases like dental caries, periodontal diseases which adversely affects the overall

health.1

Dental caries are one of the common problem found in children, today caries remains

one of most common diseases throughout the world.2 Dental caries also known as

tooth decay or cavity, is a disease where bacterial processes damage hard tooth

surface. These tissues progressively break down, producing dental caries, If left

untreated, the disease can lead to pain, tooth loss, infection and in severe cases

death .Depending on the extent of tooth destruction, various treatments can be used to

restore teeth to proper form, function, and aesthetics, but there is no known method to

regenerate large amounts to tooth structure, though stem cells related research

suggests one possibility. Instead dental health organization advocate preventive &

prophylactic measures such as regular oral hygiene & dietary modifications health

teachings to avoid dental caries.3

NEED FOR THE STUDY 6.1 Dental caries is one of the serious health problems and its prevalence has increased

2 dramatically in school children. The prevalence of dental caries and treatment needs in the age group of 5-12 years, There is no much difference in the prevalence of dental caries when the developed and developing countries are compared. The main reason behind the occurrence of dental caries in developing countries is the introduction of junk foods and chocolates by the developed nations. The incidence of dental caries increased as civilization advanced mainly because of dietary habits.4

Research studies demonstrated that the children with lower social –economic group living in rural areas are significantly affected with dental caries than do those of middle class and upper class families. Dental caries pose a major rick for serious diseases related to heart (RHD) musculo-skeletal system (RA) and brain. The health consequences ranges from wild to serve condition that reduces overall quality of life.5

Worldwide most children an estimated 99% of have appeared DC, with the most prevalent in Asia & Latin counties, over 40% of Indian children are found to be affected with dental caries and the recent studies shows that it has increased from

40% to 80% In Karnataka the prevalence of dental caries among school children aged between 5-12 years is about 54.5%.5

In almost any community, it is possible to see few individuals suffering from handicaps of varying types. These handicapped individuals also have the same fundamental rights as any other normal individual. Handicapped children no way differ from the normal children. They have got equal rights to live and sustain a economically productive life. But their life style has to be adjusted according to their

3 capabilities.5

Most handicapped individuals start their life with teeths and gums that are as strong and healthy as those of normal people. However their diet, eating pattern, medications, physical infections, lack of cleaning habits and attitudes of parents and health providers all contribute to poor oral health of the handicapped.4

A normal child gets the benefit of love and care from parents and the society, where as the under privileged groups such as physically handicapped, mentally handicapped & socially. Handicapped are neglected by their own kith & kin as well as the society. As dental diseases is one of the common problem in children, good oral hygiene is important to normal children but it is even more important for handicapped children.4

As today children are tomorrow’s citizen, it is desirable to safe guard oral health of all children from their childhood. Education regarding upkeep of oral health should be given to growing children both normal & handicapped in addition to occupation and speech therapy.2

In our country many of the researchers have focused to improve the health status of the normal children, where as the physically challenged are neglected by their families and the society too in all the aspects. During a visit to deaf and dumb school the researcher found that there was lack of knowledge and good oral hygienic habits in children, so the present study is an effort to make the physically challenged to be aware of their dental health through an informational booklet containing information

4 regarding causes signs and symptoms treatment and more about prevention of dental

caries which will help to promote their health status.

REVIEW OF LITERATURE 6.2 A study was conducted among 179 & 142 males & females respectively aged and to

22 years, to determine the caries and periodontal states and treatment needs of

handicapped school children. Majority of them in the studies were deaf (71%) and

remaining 29% were blind, mentally retarded etc among them 33 of them had decayed

permanent teeth and 31 had missing permanent teeth. Forty one (12.8%) children had

at least one decayed deciduous tooth and the deaf had the highest mean decayed

surfaces.6

A cross-Sectional study was conducted to assess the prevalence of caries and

treatment needs among 12% institutionalized subjects aged 5-22 years attending a

special school for students with hearing impairment in Udaipur city, Rajasthan in the

year 1997. ANOVA, chi-Squared test and multiple regression analysis were

conducted and mean was 2.61 of the 12% subjects, 111(87.4%) needed treatment.

There was a high prevalence 83.92% of decayed tooth, the findings of this study

demonstrate that young people with impaired hearing in their region have a high

prevalence of dental caries, poor oral hygiene and extensive unmet needs for dental

treatment.7

A similar study was conducted to determine the caries experience and oral hygiene

5 status in blind, deaf and mentally retarded female children in Riyadh. A total number of 218 children of 6-7, 11-12 year old blind, deaf and mentally retarded female children were examined for dental caries and oral hygiene in a dental operator setting.

The blind 6-7 year-old had caries with a mean score of 6.586 and 11-12 years old was

88.2% with a mean score of 3.89. The caries prevalence in deaf 6-7 years old was

95.7% with a mean score of 7.35. The caries prevalence in 11-12 years old deaf children was 93% with a mean of 5.12 less than one fifth (17.4%) of 6.7 year old deaf children and only 7.0% of 11-12 year old children had good oral hygiene.8

A cross sectional study was conducted to assess the prevalence of caries and treatment needs among 127 institutionalized subjects aged 5-22 years. Attending a special school for students with hearing impairment in Udaipur city, Rajasthan, the data was collected using the methods and standards recommended by the with for oral health surreys 1997. ANOVA, chi squared test multiple regression analysis were conducted using the SPSS software package. The mean DFIT was 2.61 of the 127 subjects 111

(87.4%) needed treatment. There was a high prevalence (83.92%) of decayed teeth, where as only 7.14% of subjects, had filled teeth.9

A Study was done among 6,9,12 & 15 year old school children of Chandigarh and result revealed that high prevalence of dental caries in these children, it was due to the lack of use of fluoride tooth paste 180% children Ninety eight percent of children were affected due to the lack of knowledge about etiology of dental caries and 30% children were affected due to increased frequency of sugar exposure, that is more than

6 5 times per day.10

A study was conducted to describe the dental health status and associated factors of 12 year old school children – in thiruvanthapuram, and to identify the sociodemographic factors, oral heath behaviors, attitudes and knowledge related to dental caries experience. The prevalence of dental caries in the permanent dentition was 27% the mean number of decayed, missing and filled teeth was 0.5 the decayed component constituted 91% of the total number of decay, missing and filled teeth. The present study indicated that urban living conditions were associated with more dental caries

Since urbanization is rapid in India, Oral health promotion at the prevent increased caries prevalence.11

A cross sectional study was conducted by David J et al among 12 years old school children to assess the prevalence of dental caries .Data was collected using clinical examination and questionnaire. The clinical oral health status was recorded using

Decayed, Missing, and Filled Teeth (DMFT) out of 838 samples 23% of them reported the state of teeth as bad. Multivariate logistic regression showed significant association between bad teeth , poor school performance , having bad breath and food impaction , having visited a dentist being dissatisfied with teeth appearance and having caries experience ,information from self reports of children night help in planning effective strategies to promote oral health.12

An epidemiological study was conducted Azlar U et al among 430 school children of

6 and 12 years studying in V V Puram school Bangalore .To assess the prevalence of

7 dental caries. A total of 430 school children were surveyed. Out of which 229 were in

6 years and 201 in 12 years age group. No significant difference was observed

between the age group 6 and 12 years with respect to the proportion of dental caries,

highly significant difference was notified between the age groups with respect to

calculus and malocclusion.

6.3 STATEMENT OF THE PROBLEM

“ A STUDY TO ASSESS THE KNOWLEDGE REGARDING DENTAL

CARIES AMONG DEAF AND DUMB SCHOOL CHILDREN (6th STD-10th

STD) AND TO DEVELOP AN INFORMATIONAL BOOKLET ON DENTAL

CARIES AT MYSORE”.

6.4 OBJECTIVES OF STUDY

1. To assess the knowledge regarding dental caries among deaf and dumb school

children.

2. To determine the association between the selected base line variables and the

knowledge regarding dental caries.

3. To develop an informational booklet on dental caries

8 6.5 HYPOTHESIS

There will be inadequate knowledge regarding Dental caries among deaf and dumb

school children.

6.6 OPERATIONAL DEFINATION

KNOWLEDGE: in this study refers to the idea they have regarding dental caries.

INFORMATIONAL BOOKLET: refers to the booklet consisting of information

regarding in pictorial form.

DENTAL CARIES : refers to the children those who are having black colored

cavities or hole

DEAF OR DUMB: in this study deaf or dumb refers to children who cannot hear or

speak respectively.

SELECTED BASE LINE VARIABLES: refers to age, sex frequency of brushing the

teeth and rinsing the mouth after consuming food, presence of dental caries.

6.7 DELIMITATIONS

The result of the study will be limited to deaf and dumb school children studying from

6th – 10th standard.

9 7 MATERIAL AND METHODS

7.1 Source of data

Data will be collected from 80 deaf and dumb school children.

7.1.1 Research design

In this study the knowledge regarding dental caries among deaf and dumb school

children will be assessed by a structured knowledge questionnaire and an

informational booklet on dental caries will be distributed at the end of the study.

7.1.2 Setting

The study is planned to conduct at Govt Deaf & Dumb school, tilaknagar, Mysore.

7.1.3 Population

Population for the study will be the children studying in Govt deaf & dumb school,

tilak nager, mysore.

7.2 Methods of data collection.

7.2.1 Sample and Sampling technique :

In view of the nature of the problem and to accomplish the objectives of the study

convenient sampling techinque will be used to select 80 deaf and dumb school

10 children studying between 6th -10th standard.

7.2.2 Inclusion criteria

1. Students studying 6th -10th standard.

2. Students who are willing to participate

3. Students who knows read and understand kannada.

7.2.3 Exclusion criteria

1. Students who are not willing to participate in the study.

2. School children who cannot understand Kannada.

7.2.4 Instruments intended to be used :

Instrument intended to be used is structured knowledge questionnarie which will be

validated by experts before conducting study.

7.2.5 Data collection method

Prior to data collection, permission will be obtained from the concerned authority for

conducting the study. 80 deaf and dumb will be selected based on the inclusion

criteria. The pre- existing knowledge of students will be assessed using a structured

knowledge questionnaire.

11 7.2.6 Plan for data analysis

Data in section – 1 and section -2 will be analysed by using descriptive

statistics such as mean, standard deviation. Inferential statistics such as 2 (Chi-

square) test will be used to find the association between selected baseline variable and

the knowledge scores.

7.3 Does the study require any investigation/ intervention to be

conducted ?

No

7.4 Has ethical consideration been obtained from institution in case of ?

No

8 List of references

1. www.oralhealth.org

2. www.oralhealth.org

3. Marilyn J hockenberry .WONGS ESSENTIALS OF PEDIATRIC NURSING . 7th

edition ,Elsevier publication ; page no 728-9.

4. http://www.academicjournal.org/JDOH

5. http://www.indianpediatric.org

6. Saimon.EN,Matee.MI,scheutz.F. Oral health status of handicapped primary school

12 pupils .vol 7 (2) april 2007. 234-7. retrieved from

.http://www.deptoforalpathology.com.

7. Jain.M, Mathur.A,Kumar.s,Dagli.RJ,Duraiswamy.P,Kulkarni.S. Dentition status

and treatment needs among childrenwith impaired hearing .vol 5,june 2008 . 161-5

. retrieved from . http://www.joralsci.com.

8. Al.qahtani z, wyne AH . Caries experience and oral hygiene status of deaf and

blind . vol 6 (10) . march 2004. 37-40. retrieved from .

http://www.ondonstomatol.com.

9. Manish jain ,Santosh kumar , Rushabh J, Sushas Kulkani . Dentition status and

treatment needs among children with impaired hearing .vol 5(2). april 2008,161-

5 .retrieved from . http://journalof oralscience.org .

10. Goyal A , Gauba K ,Chawla HS , Kaur M ,Kapur A . Epidemiology of dental

caries. vol 25(3) ,july- sept 2007.115-8. retrieved from .http;//www.ncbi.nlm.gov.

11. David J,Wang NJ,Astrom AN, Kuriakose.S . Dental caries and associated factors

in 12 year old children.vol 15 (6) nov 2005.420-8. retrieved from . http://deptof

oralsci.norway.org.

12. David J, Astrom AN, Wang NJ . Prevalence and correlational of self reported state

of teeth among school childre.vol 15 (7).jan 2006 .167-170. retrieved from .

http://deptof oralsci.norway.org.

13 9 Signature of Candidate

10 Remarks of the Guide

11 Name And Designation of

11.1 Guide MRS. PREYADARSHINI SURANJITH M.SC NURSING(PAEDIATRIC)

VICE PRINCIPAL

HOLDSWORTH MEMORIAL COLLEGE OF NURSING

MYSORE-21.

14 11.2 Signature

11.3 Head of the Department MRS. S. PARAMESWARI M.SC NURSING(PAEDIATRICS)

PROFESSOR

HOLDSWORTH MEMORIAL COLLEGE OF NURSING

MYSORE-21.

11.4 Signature

12.1 Remark of the principal

12.2 Signature

15 16