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Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge and Practices Towards their Preschool Children's Oral Health Sobhy Doaa Mohamed Zagazig Nursing

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Background: Mothers play a basic role in the oral health of children. They decide whether
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Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Effect of Educational Health Program on Mothers' Knowledge and
Practices Towards their Preschool Children’s Oral Health
Amina Abdelrazek Mahmoud & Doaa Mohamed Sobhy
Lecturers - Community Health Nursing Department-,Faculty of Nursing- Benha University
Abstract
Background: Mothers play a basic role in the oral health of children. They decide whether
their children need oral treatment or not. The aim of this study was to evaluate the effect of
educational health program on mothers' knowledge and practices toward their preschool
children’s oral health. Research design: A quasi-experimental design was used in this study.
Setting: The study was conducted at dental outpatient clinic of Benha University Hospital. The
sample: A convenient sample was used in this study, the total number of mothers of preschool
children in the above mentioned setting were 60.Tools: A structured interviewing questionnaire
sheet: it consisted of 4 parts used to assess: 1) the socio-demographic characteristics of
mothers, 2) the dental history of the children, 3) knowledge of mothers regarding child's oral
health, 4) practices of mothers regarding their children oral health. Results of this study
showed; 43.3% of the mothers aged from 20 to less than 30 years old. 55 % of them were living
in rural area, and 28.3% had secondary education. As regard total knowledge of mothers
regarding their preschool children oral health; before the program implementation; 47 % of them
had good total knowledge scores, while after the program implementation increased to 77 % of
them. Concerning to total practices of mothers regarding their preschool children oral health;
43.3 % of them were satisfactory before the program implementation and increased to 80 %
after the program implementation. This study concluded that: Educational health program
has showed a highly statistically significant effect on knowledge and practices of the mothers
post program and improving their knowledge and practices regarding their preschool children
oral health. The study recommended that: Well-designed educational health program are
needed in dental outpatient clinics at large sample and further research is needed for the
maintaining children oral health.
Key words: Preschool children, oral health, and educational health program.
Introduction:
Oral health is an integral
component of preschool children’s
health and well-being. Unfortunately,
many children suffer from dental caries
at an early age, even before they
become 12 months of age. Those
affected often have a reduced oral
health-related quality of life as
compared to their caries-free
counterparts. Children with early
childhood caries may also develop
associated problems such as local
infections, oral pain that also manifests
as difficulty in eating and sleeping,
reduced growth, psychosocial
problems and increased risk of caries
in permanent dentition. The primary
dentition affected by dental caries at
such a young age mostly has to be
treated under sedation or general
anesthesia, which carry its own risks 3
A number of risk factors have
been cited in literature for early
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
childhood oral health problems that
include; prolonged or at-will breast
feeding, prolonged/frequent/nocturnal
bottle feeding, family size or the child’s
birth order, oral hygiene practices,
dietary habits, and timing/reason for
child’s first dental visit. Preschool
children’s oral health maintenance and
outcomes are influenced by their
mothers' knowledge and beliefs, which
affect oral hygiene and healthy eating
habits. Mothers' knowledge and
practices toward good dental care are
very important in the preventive cycle 1
Preschool children form an
innocent and compassionate segment
of the society and their oral health care
is given due priority as it determines
the oral health status of the future
generations. Children under the age of
5 years generally spend most of their
time with parents and guardians,
especially mothers, even when they
attend preschools or nurseries. These
early years involve ―primary
socialization‖ during which the earliest
childhood routines and habits are
acquired. These include dietary habits
and healthy behaviors established as
norms in the home. These are
dependent on the knowledge and
behavior of parents and elder siblings 2.
Young children’s oral health
maintenance and outcomes are
influenced by their mothers' knowledge
and beliefs, which affect oral hygiene
and healthy eating habits. Mothers'
knowledge and positive attitude toward
good dental care are very important in
the preventive cycle. It has been found
that the more positive is the mothers’
attitudes toward dentistry; the better
will be the dental health of their
children 1
Child oral health (COH) is the
foundation upon, which preventive
education and dental care must be built
to enhance the opportunity for life-time
freedom from preventable oral
diseases. Parents are the decision
makers in matters of health-care for
children; thus, they play an important
role in achieving the best oral health
outcomes for their young children. It is
therefore expected that preventive oral
health behavior of parents for children
would influence their children's
behavior in adapting preventive oral
health practices as they grow along 4
Significant of the study
5 World Health Organization,
2012; reported that; Worldwide, 60
90% of preschool children have dental
cavities.
Oral health is essential to general
health and well-being at every stage of
life. A healthy mouth enables not only
nutrition of the physical body, but also
enhances social interaction and
promotes self-esteem and feelings of
well-being. The mouth serves as a
―window‖ to the rest of the body,
providing signals of general health
disorders. Oral conditions have an
impact on overall health and disease.
Bacteria from the mouth can cause
infection in other parts of the body
when the immune system has been
compromised by disease or medical
treatments (e.g., infective endocarditis).
Systemic conditions and their treatment
are also known to impact on oral health
(e.g., reduced saliva flow,
altered balance of oral
microorganisms).
Aim of the study:
The study aimed to evaluate the
effect of the educational health
program on mothers' knowledge and
practices toward their preschool
children’s oral health at Benha City
through: assess mothers' knowledge
regarding child's oral health, assess
mothers' practices regarding their
child's oral health and develop
educational program regarding children
oral health.
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Research hypotheses:
To fulfill the aim of this study the
following research hypotheses
formulated: 1-The educational health
program will improve knowledge and
practices of mothers toward their
preschool children’s oral health.
2- There is relationship between the
mothers' socio-demographic data and
their knowledge & practices toward
their preschool children’s oral health.
Subjects and methods:
Research design:
A quasi experimental design was
utilized to carry out this study.
Study setting:
This study was conducted at dental
outpatient clinic of Benha University
Hospital.
Study subjects: A convenient sample was used in
this study, the total number of mothers
of preschool children in the above
mentioned setting were 60 followed by
home visits.
Tools of data collection:
A structured interviewing
questionnaire: It consisted of the
following four parts:
Part one: Socio-demographic
characteristics of the pre- school
children' mothers included five items as
age, residence, education, occupation
marital status and the number of family
members.
Part two: Concerned with the dental
history of child.
Part three: Designed to assess
mothers' knowledge regarding child's
oral health which included (87) items
divided into: 19 items about teeth and
its importance, 52 items about dental
problems, and 16 items about proper
nutrition toward oral health. Scoring
system; for each question was given
as follows: 3 if good knowledge, 2 if
average knowledge, and 1if poor
knowledge. The total knowledge
scores were considered good if the
score of the total knowledge ≥ 75 % (≥
65), considered average if it is equals
50- < 75% (43- < 65), and considered
poor if it is less than 50% (< 43).
Part four: It consisted of two session:
The first session: designed to assess
mother's practices regarding their
preschool child teeth cleaning; which
included 10 items as clean the child's
teeth twice a day, choose the form of
the brush which the child prefers,
choose flavor toothpaste favored child,
use the brush and tooth paste, learn
child holding brush and use tooth
paste, use dental floss, clean the
tongue, teach child how to rinse the
mouth and spit out the remaining tooth
paste, change the toothbrush every 3
months, and follow-up with the dentist
every 6 months. Scoring system;
each item was assigned a score of
zero if not done and 1 if done.
The second session: Designed to
assess mother's practices regarding
tooth brushing technique of their
preschool child which included 5 items
as place the tooth brush at a 45°angle
against the gum line and sweep or roll
the brush away from the gum line,
gently brush the outside, inside and
chewing surface of each tooth using
short back-and-forth strokes, brush the
chewing surface (top) of each tooth,
use tip of brush to brush behind each
tooth front and back, top and bottom
and up and down strokes, and gently
brush the tongue to remove bacteria
and freshen breath.
The total practices were considered
satisfactory if the score of total
practices equals ≥ 65 % (≥ 10), and
considered unsatisfactory if it is < 65%
(< 10).
Content validity:
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
The tools were revised for content
validity by 3 juries who were experts in
the Community Health Nursing
Specialties, for clarity, relevance,
comprehensiveness, and applicability.
According to their suggestions, the
modifications were applied.
Content reliability:
Reliability of the tools was applied by
the researcher for testing the internal
consistency of the tool, by
administration of the same tools to the
same subjects under similar condition
on one or more occasion. Answers
from repeated testing were compared
(test- re test reliability).
Operational Design:
Preparatory phase
Preparation of study design and data
collection tools based on reviewing
current, past, local, and international
related literature about various aspects
of oral health of children by using
journals, periodicals books and internet
search to construct the tools and
prepare the health educational
program.
Ethical considerations
Personal communication was done
with older adults to explain the purpose
of the study, assure their best possible
cooperation and ensuring
confidentiality of the data. The
researchers emphasized to older
adults that the study was voluntary and
anonymous. Mothers had the full right
to refuse to participate in the study or
to withdraw at any time without giving
any reason.
Administrative design
Official permission was obtained by
submission of an official letter from the
Faculties of Nursing to the responsible
authorities of the study settings to
obtain the permission for data
collection.
Pilot study
After the development of the tools,
a pilot study was carried out on 10% of
the sample (6 mothers) to ascertain the
clarity, applicability, feasibility of the
tool, to estimate the exact time needed
to fill in the questionnaire, and to detect
any problems that might face the
researcher and interfere with data
collection. After conducting the pilot
study, minor necessary changes were
done, the tool was then finalized. The
pilot sample was not included in the
main study sample.
Field work
Preparation of data collection tools
was carried out over a period of six
months from the beginning of January
2016 to end of July 2016, including
experts' opinions, validity, and reliability
test.
Official permissions were obtained
from the deans of the Faculty of
Nursing- Benha University, also from
administrator of Benha University
Hospital.
• A pilot study was carried out to test
clarity and simplicity of questions.
Program construction:
The current study was carried out on
four phases, preparatory phase,
development phase, implementation
phase and evaluation phase.
1. Program assessment phase: The
program was designed after extensive
review of related literature, by the
researchers. Based on results obtained
from pre-assessment tools, it was
revised and modified.
2. Program development phase: The
program was developed based on the
actual results that were obtained from
pre-program assessment using a
structured interviewing questionnaire
sheet, literature review which aimed to
enhance the mothers’ knowledge, and
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
practices toward their preschool
children’s oral health
An objective of the program was
to improve mothers' knowledge and
practices toward their preschool
children’s oral health.
Contents of program: The content of
the program was designed to meet
mothers needs toward their children'
oral health and to fit into their interest
and level of understanding. Its contents
were:
Teeth and its importance:
- Important of teeth.
- Important of primary teeth.
- Types of teeth.
- The common dental problems in children
- The role of fluoride in the tooth paste.
Dental problems e.g.,
discoloration of teeth, tooth decay,
gingivitis, dental injuries, and missing
of teeth or extraction.
Proper nutrition toward oral health:
included the importance of proper food,
the needed nutrients to maintain oral
health, and the foods that harm oral
health.
Practices regarding child' teeth
cleaning.
Tooth brush technique.
3.Program implementation phase:
The program was implemented in a
period of six months, from the
beginning of January 2016 to the end
of July 2016.Implementation of the
program was carried out at Benha
university hospital followed by home
visits. The subject material used has
been sequenced through the 6
sessions (4 sessions for theory and 2
sessions for practices). The duration of
each session ranged from 30 to 45
minutes including times for discussion
according to mothers’ achievement,
progress and feedback. The sessions
contained knowledge about teeth and
its importance, dental problems, and
proper nutrition toward oral health, also
practices about teeth cleaning and
tooth brushing technique.
Mothers were divided into small
groups; each group included about 6
mothers. The six sessions were
implemented for each group separately
for 2 weeks (2 days/week), in addition
to one week for pre and posttest.
Sometimes the researcher worked with
two groups in the same day. At the
beginning of the first session, an
orientation to the program and its
purpose took place. After each
session, a feedback about the previous
session was done as well as the
objectives of the new topics were
mentioned. Methods of teaching
included lectures, group discussions,
demonstrations, re-demonstration and
role play. An instructional media was
used including an illustrated booklet
and purchure.
4. Program evaluation phase: After the
implementation of the program, the
post-test was done to mothers to
assess knowledge, and practices by
the same format of the pre-test to
evaluate the effectiveness of the
implemented program. This was done
immediately after the intervention of
program implementation.
Statistical Design
The collected data were verified
prior to computerized entry; statistical
analysis was done by using the
Statistical Package for Social Science
(SPSS) version 20. Data were
presented in tables by using mean,
standard deviation, number,
percentage distribution, and Chi-
Square. Statistical significance was
considered at: P- Value > 0.05
insignificant,P- Value < 0.05 significant,
P- Value < 0.001 highly significant.
Results:
Table (1) shows that, 43.3% of
mothers aged from 20 to < 30 years
old, 55 % of them were living in rural
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
area, 28.3% had secondary education,
58.3% of were housewife, 88.3% of
them married. As regard the number of
family member 51.7% had 3-4
members
Table (2) Elaborated that; 71.7% of the
children were suffering from oral and
teeth problem. As regard the children's
oral problem; 60% of them had tooth
decay, 35.0% had abscess in teeth,
while only 6.7% of them had discolored
teeth. On the other hand 50 % of
children had injury in teeth, 35% of
these injury occurred at nursery.
Table (3) Explains that;the mothers'
total knowledge about oral health
(teeth and its importance, dental
problems, and proper nutrition)
improved significantly after the
implementation of the program (P <
0.001).
Figure (1) illustrates that, before the
program implementation; 47% of the
mothers had good total knowledge
scores regarding their children oral
health, while after the program
implementation; total knowledge
scores increased to77%.
Table (4) shows that, the variable
"use the brush and tooth paste" was 65
% before the program implementation
and increased to 96.3 % after the
program. While the variable "clean the
child's teeth twice a day" was 48 %
before the program implementation
and increased to 90 % after the
program implementation, and the
variable "clean the tongue" was 31.7%
before the program implementation
and increased to 78.3% after the
program implementation. There were
high statistically significant differences
(P <0.001).
Table (5) explains that; before the
program 65% of mothers place the
tooth brush at a 45°angle against the
gum line and sweep or roll the brush
away from the gum line, while
increased to 96.7% after the program.
Before the program; 46.7% of them
were gently brush the outside, inside
and chewing surface of each tooth
using short back-and-forth strokes,
while increased to 78.3% after the
program. Before the program; 26.7% of
them were brush the chewing surface
(top) of each tooth, while increased to
58.3% after the program. Before the
program; 16.7% of them were use tip of
brush to brush behind each tooth
front and back, top and bottom and up
and down strokes, while increased to
51.7% after the program. Before the
program; 43.3% of them were gently
brush the tongue to remove bacteria
and freshen breath, while increased to
90% after the program. There were
high statistically significant differences
(P <0.001).
Figure (2) illustrates that, the total
scores of mothers' practices was
satisfactory for 43.3 % of them before
the program implementation and
increased to 80 % after the program
implementation.
Table (6) shows that; there were
high statistically significant differences
between the mothers total knowledge
scores and their age, residence,
educational levels, occupation and
their family size (P < 0.001). While
there were not statistically significant
differences regarding their marital
status (> 0.05).
Table (7) shows that; there were
high statistically significant differences
between the mothers total practices
scores and their age, residence,
educational levels, occupation and
their family size (P < 0.001), while
there were not statistically significant
differences regarding their marital
status (> 0.05).
Discussion:
Oral health is an important
component of individual health and has
a significant impact on overall health
and well-being, so it must be included
in the provision of health care and the
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
design of community based programs.
Oral health is precipitated as a
separate from general health and,
therefore, less important. This
perception can be changed by raising
oral health awareness, the prevention,
early detection, and management of
dental, oral problems 6
This study was aimed to evaluate
the effect of educational health
program on mothers' knowledge and
practices toward their preschool
children’s oral health. The aim was
achieved through: assessing
knowledge of mothers regarding oral
health.
Concerning socio-demographic
characteristics table (1). The finding of
the present study showed that the
studied sample consisted of 60
mothers, more than two fifths of them
their age ranged from 20 to < 30 years
old. This finding is in the same line with
7, who conducted a study to investigate
influence of maternal dental anxiety,
attendance pattern, and perception of
children’s quality of life, reported that;
the mean age of the mothers was 29.3
years.
Regarding the study sample
residence, the current study found that,
more than half of mothers came from
rural areas. This finding was in
disagreement with 8. who conducted a
study to evaluate the effect of
educational intervention on quality of
life of school age children with dental
problems, reported that more than half
of children (58 %) were from urban
areas.
As regard educational level, the
finding of the present study revealed
that more than one quarter of the study
sample had secondary education, This
finding is disagree with 8 who reported
that two third of mothers had middle
education. Conversely, 9 who studied
oral hygiene practices, dental
knowledge, dietary habits and their
relation to caries among male primary
school children, reported that more
than one third of mothers were Illiterate
read and write.
Regarding family size, the current
study revealed that more than half of
study sample had 5-6 members.
Conversely 9 reported that more than
two thirds of children were belonged to
big-sized families (>6 persons).
Regarding dental history of child
table (2): the present study Elaborated
that; more than two thirds of children
were suffering from oral and teeth
problem, whereby, three fifth of
children had tooth decay and half of
children had injury in teeth. This finding
is consistent with 13 who conducted a
study to assess the impact of oral
diseases and disorders on oral health-
related quality of life of preschool
children, reported that; early childhood
caries was present in three fifth of the
sample and oral disorders are common
at preschool age, such as traumatic
dental injuries.
According to the thesis hypothesis
No.1 "The educational health program
will improve the mothers' knowledge
and practices regarding their children
oral health".
Concerning knowledge of mothers
regarding children oral health before &
after the program implementation Table
(3), the finding of the present study
showed that the mothers' total
knowledge about oral health (teeth and
its importance, dental problems, and
proper nutrition) improved significantly
after the implementation of the
program (P < 0.001). This finding is
consistent with 14 who conducted a
study to assess mother's knowledge
about preschool child's oral health,
reported that oral health of the children
is associated with oral health
knowledge of their mothers, as oral
health related habits (such as those
related to oral hygiene and diet) are
established during infancy and
maintained throughout early childhood.
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Also, 3 reported that high oral
hygiene awareness of the mothers had
an impact on child oral health. These
might be indicates to the adoption of
good oral health habits in childhood
often takes place at home with the
parents, especially the mother. Mothers
play an important role in shaping the
oral health, attitudes and behavior of
their children, as the mother’s oral
health, habits, attitudes and knowledge
affect on the child’s dental health
because mothers are traditionally
regarded as the main caregivers of
children.
Regarding mother's practices to
maintain the children's oral health
before & after the program
implementation Table (4, 5). The
results of the present study showed
that there were high statistically
significant differences in the mothers'
total practices after the implementation
of the program (P < 0.001). This finding
agreed with that of 10 who conducted a
study to investigate the relationship
between maternal related factors and
the dental health status of pre-school
children reported that dental health and
diseases in children were mainly
influenced by maternal dental health
knowledge, attitude and practices.
Emphasizing the development of good
dental health attitudes among mothers
as a tool for influencing not only their
own dental health but that of their
children, whereby, good dental health
knowledge is thought to be the
antecedent of good attitudes and this in
turn serves as the forerunner for good
dental health behavior. This may be
indicating that the program had great
role in improving the mother's practices
to maintain the children's oral health.
As well, 11, who conducted a study
of oral health behavior of parents'
status of their children as a predictor of
oral health, reported that interventions
targeting parental oral health beliefs
and practices are beneficial in the
prevention of children's oral health
problems such as dental caries.
As well, 3 emphasized that
prevalence of caries in those children
who practiced tooth brushing by
themselves was significantly higher
than in those children who brushed
under parental supervision.
Maternal influences are of significant
importance at this age, because pre-
school children are unable to care for
themselves and are dependent on their
caregivers for their day to day care.
According to the thesis
hypothesis No.2 "There is relationship
between the mothers' socio-
demographic data and their knowledge
& practices toward their preschool
children’s oral health"
Concerning relations between the
mothers' total knowledge scores & their
socio-demographic characteristics
(Tables 6). The finding of the present
study revealed that, there were high
statistically significant differences
between the mothers' total knowledge
scores and their age, residence,
educational levels, occupation and
their family size (P < 0.001).
Similarity 11, who found that there
was a significant relationship between
education of mothers and plaque index
of children. Education of mothers can
increase their knowledge, followed by
increasing their ability to supervise
hygienic practices of their children.
Conversely 10, who reported that
maternal age, location of residence,
and social class showed weak
correlation with maternal oral health
knowledge with no statistical
significant difference (P > 0.05).
Concerning relations between the
mothers' total practices scores & their
socio-demographic characteristics
(Tables 7). The finding of the present
study revealed that, there were high
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
statistically significant differences
between the mothers total practices
scores and their age, residence,
educational levels, occupation and
their family size (P < 0.001), this result
in the same line with 15, who conducted
a study to assess mother’s knowledge
and practice regarding oral hygiene
and challenges in the prevention of
dental caries of under-five children,
reported that mother's age and income
were significant predictors to keep
good oral hygiene practices.
Conversely 12 who conducted a
study of awareness of mothers
regarding oral health of their children,
found that mother age had no
significant correlation with either dental
health knowledge or practices.
Conclusion:
According to results & research
hypothesis concluded that: The
educational health program had a
positive effect to improve the mothers'
knowledge and practices regarding
their preschool children' oral health.
Moreover there was a highly
statistically significant relationship
between the mothers' total scores of
knowledge, practices and their socio-
demographic characteristics.
Recommendations: On the basis of the current study
findings, the following
recommendations are suggested:
1- Regulatory training program should
be strengthened to ensure good oral
health of children, and make training
courses for large number of mothers
about proper teeth cleaning and wright
tooth brushing technique.
2- All possible forms of mass media
such as T.V., Radio, and posters are
needed to help in disseminating
information about preschool children
oral health.
3- Further research is also needed on
the interventions that may contribute to
maintaining preschool children oral
health.
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Table (1): Distribution of mothers according to their socio-demographic characteristics
(n= 60).
Socio-demographic characteristics
(No.)
(%)
Age / years
< 20
6
10.0
20-
26
43.3
30-
21
35.0
40+
7
11.7
Residence
Rural
33
55.0
Urban
27
45.0
Education
Illiterate
9
15.0
Read and write
7
11.7
Basic education
13
21.7
Secondary education
17
28.3
High education
14
23.3
Occupation
Employee
25
41.7
Housewife
35
58.3
Marital status
Married
53
88.3
Divorced
6
10.0
Widower
1
1.7
The number of family members
3-4
28
46.7
5-6
31
51.7
7+
1
1.7
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Table (2): Distribution of preschool child according to their dental history (n= 60).
%
No.
Dental history
71.7
43
The child suffer from oral and teeth problem
The Children's oral Problem
60
36
Tooth decay
20.0
12
Gingivitis
6.7
4
Dislocated teeth
35.0
21
Abscess in teeth
16.7
10
Broken teeth
8.3
5
Bleeding gum
50.0
30
The child has injury in teeth
Where the injury occurred
13.3
8
Home
35.0
21
Nursery
16.7
10
Street
11.7
7
Club
N.B.: Answers were not mutually exclusive
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Table (3): Percentage distribution of the mothers' knowledge regarding child' oral
health before& after the program implementation (n=60).
N.B.: Answers were not mutually exclusive.
** Highly statistically significant difference (P < 0.001).
Before- program (%)
After- program (%)
X2
P-value
Good
Average
Poor
Good
Average
Poor
Knowledge about teeth and its importance
8.3
4.2
37.5
58.3
13.4
28.3
27.2
<0.001**
13.4
8.3
78.3
35.0
28.3
36.7
21.4
<0.001**
63.3
3.4
33.3
95.3
1.3
3.4
18.8
<0.001**
10.0
15.0
75.0
50.0
30.0
20.0
38.1
<0.001**
18.3
13.4
68.3
43.3
36.7
20.0
29.0
<0.001**
Knowledge about dental problems
15.0
11.7
73.3
48.3
31.7
20.0
34.3
<0.001**
16.7
16.7
66.6
58.3
25.0
16.7
32.8
<0.001**
15.0
13.3
71.7
55.0
31.7
13.3
42.2
<0.001**
11.7
8.3
80.0
51.7
31.7
16.7
48.2
<0.001**
13.3
11.7
75.0
50.0
35.0
15.0
16.3
<0.001**
Knowledge about proper nutrition
15.0
13.3
71.7
45.0
25.0
30.0
21.3
<0.001**
11.7
13.3
75.0
41.7
38.3
20.0
36.4
<0.001**
10.0
6.7
83.3
40.0
36.7
23.3
43.6
<0.001**
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Figure (1): Percentage distribution for total knowledge scores of mothers regarding
their child's oral health before & after the program implementation (n=60).
Before-program After-program
47%
77%
25%
13%
28%
10%
Good
Average
Poor
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Table (4): Percentage distribution of mother's practices regarding their child teeth cleaning
before & after the program implementation (n=60).
N.B.: Answers were not mutually exclusive.
** Highly statistically significant difference (P < 0.001).
Teeth Cleaning
Before- program
(%)
After- program
(%)
X2
P-value
Done
Not
Done
Done
Not
Done
Clean the child's teeth twice a day.
48.3
51.7
90.0
10.0
24.4
<0.001**
Choose the form of the brush which the
child prefers.
18.3
81.7
53.3
46.7
10.9
<0.001**
Choose flavor toothpaste favored child.
16.7
83.3
48.3
51.7
13.7
<0.001**
Use the brush and tooth paste
65.0
35.0
96.7
3.3
19.4
<0.001**
Learn child holding brush and use tooth
paste.
26.7
73.3
58.3
41.7
12.3
<0.001**
Use dental floss.
23.3
76.7
58.3
41.7
15.2
<0.001**
Clean the tongue.
31.7
68.3
78.3
21.7
26.3
<0.001**
Teach child how to rinse the mouth and
spit out the remaining tooth paste.
46.7
53.3
78.3
21.7
12.8
<0.001**
Change the toothbrush every 3 months
25.0
75.0
76.7
23.3
32.0
<0.001**
Follow-up with the dentist every 6
months.
30.0
70.0
78.3
21.7
28.2
<0.001**
Total
65.0
35.0
96.7
3.3
19.4
<0.001**
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Table (5): Percentage distribution of mothers tooth brushing technique of their child
before & after the program implementation (n=60).
N.B.: Answers were not mutually exclusive.
** Highly statistically significant difference (P <0.001).
Tooth brush technique
Before- program
(%)
After- program (%)
X2
P-value
Done
Not Done
Done
Not Done
Place the tooth brush at a 45°angle
against the gum line and sweep or
roll the brush away from the gum
line
65.0
35.0
96.7
3.3
19.4
<0.001**
Gently brush the outside, inside and
chewing surface of each tooth using
short back-and-forth strokes
46.7
53.3
78.3
21.7
12.8
<0.001**
Brush the chewing surface (top) of
each tooth.
26.7
73.3
58.3
41.7
12.3
<0.001**
Use tip of brush to brush behind each
tooth front and back, top and bottom
and up and down strokes.
16.7
83.3
51.7
48.3
13.7
<0.001**
Gently brush the tongue to remove
bacteria and freshen breath.
43.3
56.7
90.0
10.0
29.4
<0.001**
Total
46.7
53.3
78.3
21.7
12.8
<0.001**
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Figure (2): Percentage distribution for total practices scores of mothers regarding
their child oral health before& after the program implementation (n=60).
After- program
Before-program
20%
56.7%
80%
43.3%
Unsatisfactory
Satisfactory
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Part(V): Relationships between the knowledge, practices of mothers and their socio-
demographic characteristics (Tables 6 &7 ).
Table (6): Relations between the mothers' total knowledge scores regarding child's
oral health & their socio-demographic characteristics (n=60).
** Highly statistically significant difference (P < 0.001).
Socio-demographic
Characteristics
Total knowledge
Chi Square
Before- program (%)
After- program (%)
X2
P-value
Goo
d
Average
Poor
Good
Average
Poor
Age / years
28.6
< 0.001**
< 20
0.0
16.7
83.3
50.0
33.3
16.7
20-
53.8
30.8
15.4
69.3
23.0
7.7
30-
23.8
14.3
61.9
90.5
9.5
0.0
40+
14.3
28.6
57.2
100.0
0.0
0.0
Residence
20.87
< 0.001**
Rural
37.0
55.6
7.4
51.9
29.6
18.5
Urban
63.6
15.2
21.2
91.0
6.0
3.9
Educational levels
36.21
< 0.001**
Illiterate
22.2
11.1
66.7
55.6
33.3
11.1
Read and Write
0.0
0.0
100.0
57.1
42.9
0.0
Basic Education
0.0
30.8
69.2
61.5
23.1
15.4
Secondary Education
47.1
35.3
17.6
88.2
11.8
0.0
High Education
50.0
28.6
21.4
100.0
0.0
0.0
Occupation
13.04
< 0.001**
Employee
76.0
8.0
16.0
88.0
12.0
0.0
Housewife
5.7
34.3
60.0
60.0
22.9
17.1
Marital status
8.4
> 0.05
Married
32.1
26.4
41.5
75.5
13.2
11.3
Divorced
66.7
8.0
33.3
100.0
12.0
0.0
Widower
0.0
0.0
100.0
0.0
100.0
0.0
The number of family
members:
24.39
< 0.001**
3-
14.3
21.4
64.3
53.6
25.0
21.4
5-
54.8
25.8
19.4
83.9
9.7
6.4
7+
0.0
0.0
100.0
0.0
100.0
0.0
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
Table (7): Relations between the mothers' total practices scores & their socio-demographic
characteristics (n=60).
Socio-Demographic
characteristics
Total practices
Chi Square
Before- program (%)
After- program (%)
X2
P-value
Satisfactory
Unsatisfactory
Satisfactory
Unsatisfactory
Age / years
17.05
< 0.001**
< 20
16.7
83.1
66.7
33.3
20-
23.0
77.0
69.3
30.7
30-
76.2
23.8
95.2
4.8
40+
71.4
28.6
100.0
0.0
Residence
17.14
< 0.001**
Rural
14.8
85.2
59.3
40.7
Urban
21.2
78.8
45.5
45.5
Educational levels
34.54
< 0.001**
Illiterate
11.1
88.9
77.8
22.2
Read and Write
57.1
42.9
85.7
14.3
Basic Education
69.2
30.8
76.9
23.1
Secondary Education
58.9
41.1
88.2
11.8
High Education
57.1
42.9
100.0
0.0
Occupation
< 0.001**
Employee
36.0
64.0
92.0
8.0
15.04
Housewife
14.3
85.7
68.6
31.4
Marital status
5.51
> 0.05
Married
37.7
62.3
92.0
20.8
Divorced
33.3
66.7
68.6
16.7
Widower
100.0
0.0
100.0
0.0
Family size:
17.14
< 0.001**
3-4
14.3
85.7
57.1
42.9
5-6
71.0
29.0
93.5
6.5
7+
0.0
100.0
100.0
0.0
** Highly statistically significant difference (P < 0.001).
Amina Abdelrazek Effect of Educational Health Program on Mothers' Knowledge
and Practices Towards their Preschool Children’s Oral Health Sobhy Doaa Mohamed
Zagazig Nursing Journal July; 2017 Vol. , No.
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The effect of educational intervention on quality of life of school age children with dental problems
Abdel Salam A, (2011): The effect of educational intervention on quality of life of school age children with dental problems, Benha University.