MASTER OF DENTAL SURGERY PEDODONTICS AND PREVENTIVE DENTISTRY.
Date of admission to THE COURSE
Title of the dissertation:
“KNOWLEDGE AND ATTITUDE TOWARDS DENTAL AVULSION AMONG PUBLIC AND PRIVATE ELEMENTARY SCHOOL TEACHERS IN DAVANGERE CITY- A SURVEY.”
BRIEF RESUME OF INTENDED WORK
Need for the study:
Traumatic dental injuries have been one of the most important oral health problems in childhood, and their prevalence may be even higher than dental caries and periodontal disease.1Peaks in incidence of injuries have been shown between 2 and 4 years of age of both genders and also more prevalent among 8 and 10 years of boys.6 The incomplete root formation of central incisors and the lack of resiliency of the periodontal ligament at those ages may be the reason for which even light horizontal impacts can result in dislocation of the tooth from its alveolus.5
Dental avulsion is one of the most critical clinical conditions for children due to its great impact on quality of life. Accordingly, dental avulsion may lead to aesthetic complications, lower masticatory efficiency, difficulties in phonation, and even social and psychological problems. Regarding avulsed teeth, some emergency measures must be taken to keep periodontal ligament vital, increase the chances of successful re-implantation, and maintain the dental alveolus. The re-implantation procedure of the avulsed teeth has been recommended to be performed within 30 minutes after trauma.1Prior to its re-implantation, there is a primary need for cleaning and maintaining tooth in an appropriate storage medium until re-implantation of it takes place.5
Although dental re-implantation prognosis depends on the immediate and appropriate management given to avulsed teeth, the first–aid care procedures are normally performed by lay people, such as family members and school teachers who are close to the child at the moment of trauma.1
Immediate attention is required to improve the prognosis for tooth re-implantation, and most often such injuries happen to children at school premises, the role of teachers becomes crucial in successful management of tooth avulsion. Hence the purpose of this study is to evaluate and compare the knowledge and attitudes about dental avulsion among private and public elementary school teachers in the city of Davangere.
6.2 Review of literature:
A study was conducted to evaluate knowledge and attitude towards dental avulsion among public and private elementary school teachers by applying a questionnaire in a sample composed of 95 elementary school teachers (46 from public schools and 49 from private schools). 39% of private school teachers, 15% of public school teachers witnessed at least 1 case of dental avulsion at school (p=.009). 92% private and 62% public school teachers admitted the possibility of an avulsed tooth to be re-implanted (p‹.002). Both responses were statistically different when school type (public and private) was considered. Only 27% of private and 11% of public school teachers knew the procedure to be taken in case of avulsed teeth, and more than 95% of school teachers did not feel capable of executing tooth re-implantation. The study shows no statistical difference between private and public school teachers knowledge.1
A study was conducted to assess the knowledge level of emergency measures for tooth avulsion and determine if a short lecture about tooth avulsion and re-implantation could improve teacher’s knowledge on this topic. Descriptive statistics was used to describe and analyze the data. Improvement in teacher’s knowledge to an adequate or complete level was observed after the lecture in all five categories. The general knowledge of tooth avulsion and re-implantation improved from 39% - 97% and knowledge of avulsed permanent and primary teeth improved from 8% - 71%. Knowledge of how to clean an avulsed tooth improved from 5% - 93%. The knowledge level on the importance of extra-alveolar time before re-implantation increased from 1% - 74% and knowledge about a suitable storage medium for the avulsed tooth improved from 4% - 86%. Many avulsed permanent teeth in school children can be saved by re-implantation if school teachers know what to do when a tooth is avulsed.2 A study was done to assess the teacher’s knowledge regarding dental trauma management in two south European cities. A questionnaire was distributed among teachers in Porto and Istanbul. 78 teachers participated in the study, 23 had previous formal dental trauma education. From teachers interviewed, 58 of them admitted having no knowledge of dental trauma. 29 teachers from Porto and 12 from Istanbul thought dental trauma emergency dealt with immediately. Knowledge of optimal storage media for avulsed permanent tooth was especially poor.3 A study was conducted by means of a self-administered questionnaire, to assess the level of knowledge of school health teachers in northern Jordan with regards to the immediate emergency management of dental trauma. 190 health teachers were included in the survey. 63% were females, 37% were male, 44% were in their twenties and 43% in their forties. Their school health teaching experience ranged from 1-7 years. Only 20% were officially trained in school health. Less than half of the teachers received first aid training only once in their teaching carriers, not necessarily as a part of school health training. Only 10 teachers were trained in dental first aid trauma, and more than half had a previous experience with handling dental trauma in children. Overall teacher’s knowledge with regards to the emergency management of the trauma cases presented in the report was deficient. The present report indicated the gross lack of knowledge among school health teachers with regards to dental trauma emergency management.4
A survey consisting of seven simple questions regarding dental avulsion was answered by 60 teachers from five different elementary schools in Rio de Janeiro, Brazil, in order to establish a guideline to be followed when an accident of this type happens. 11.7% of the teachers had an experience with dental avulsion while 88.3% had never experienced it. A lack of technical information was observed among the teachers, most of them answered intuitively rather than on an informative basis. This study showed the need for a more effective communication between dental professionals and school teachers in order to handle dental emergencies better.5
A study was conducted among 66 teachers of physical education within the Southampton telephone area who responded to a postal questionnaire related to their knowledge of first aid treatment of dental injuries. In a case study investigating tooth fracture, 64% gave appropriate answer. In a second case study relating to avulsion of permanent tooth, 43% gave an appropriate answer. There was an unclear relationship between the point in their careers at which teachers had received first aid training and their accuracy of their responses.6
6.3 Aims and Objectives of the Study:
To evaluate and compare the knowledge and attitude towards dental avulsion among public and private elementary school teachers.
MATERIALS AND METHODS:
7.1 Source of Data:
The present survey will be conducted among 150 school teachers, 75 from public elementary and 75 from private elementary school, teaching the children in 7 to 11 year age group, randomly selected from different elementary schools in Davangere city.
7.2 Method of Collecting Data
Permission to conduct the survey and collect the data will be obtained from concerned authorities. Voluntary consent from each participant will be obtained.
List of all schools in Davangere city will be obtained and subjects who fulfill the selection criteria will be included in the study. To obtain the required and relevant information pertaining to our study, self-designed questionnaire form will be used.
Sample size was determined on the following basis.
From an earlier study in the city of Curitiba, Brazil it was found that the approximate prevalence of knowledge regarding dental avulsion was 92% of private school teachers and 62% of public school teacher.
z- standard value for normal distribution. (2)
p- prevalence of knowledge in private school teachers.(92%)
q- prevalence of knowledge in public school teachers.(62%)
d-difference between p and q.(30)
By using the above formula, we arrived at a minimal sample size of 51. Keeping in mind factors such as co-operation and consent of school teachers, sample size has been increased up to 75 each from private and public school teachers for our present study.
Chi-square test or z- test for proportion and appropriate co-relation analysis test will be carried out to assess and compare the knowledge and attitude among the school teachers regarding avulsion.
7.3: Does the study require any investigation or interventions to be conducted on patients or other humans or animals? If so, please describe briefly.
7.4 : Has ethical clearance been obtained from your institution in case of 7.3
List of Rferences :
Gisele AH, Maria IAF, Sivio RCD, Carla CG, Flares B. Knowledge and attitude toward Dental Avulsion of Public and Private Elementary School teachers. J Dent Child 2010; 77: 49-53.
Adel Al-Asfour, Lars Andersson, Quomasha Al-Jame. School teacher’s knowledge of tooth avulsion and dental first aid before and after receiving information about avulsed teeth and re-implantation. Endod Dent Traumatol 2008; 24: 43-49
Caglar E, Ferreira LP, Kargul B. Dental trauma management knowledge among a group of teachers in two south European cities. Endod Dent Traumatol 2005; 21: 258-262
Al-Jundi SH, Al-Waeili H, Khairalah K. Knowledge and attitude of Jordanian school health teachers with regards to emergency management of dental trauma. Endod Dent Traumatol 2005; 21: 183-187.
Pacheco LF, Filho PFG, Letra A, Menezes R, Villoria GEM, Ferrera SM. Evaluation of knowledge of the treatment of avulsion in elementary school teachers in Rio de Janeiro, Brazil. Endod Dent Traumatol 2003; 19: 76-.78.