Angelika Kobylińska1, Dariusz Gozdowski2, *Dorota Olczak-Kowalczyk1
Teachers’ knowledge on caries aetiology and prevention – a pilot survey
Wiedza nauczycieli w zakresie etiologii próchnicy i jej zapobiegania – pilotażowe badanie ankietowe
1Department of Paediatric Dentistry, Medical University of Warsaw
Head of Department: Professor Dorota Olczak Kowalczyk, MD, PhD
2Department of Biometry, Warsaw University of Life Sciences
Head of Department: Elżbieta Wójcik-Gront, MD, PhD
Streszczenie
Wstęp. W kształtowaniu zachowań i postaw zdrowotnych dotyczących zdrowia uzębienia dzieci ważną rolę odgrywa edukacja prowadzona przez nauczycieli, którzy powinni posiadać aktualną wiedzę z zakresu etiologii i zapobiegania chorobie próchnicowej.
Cel pracy. Ocena wiedzy nauczycieli nauczania początkowego dotyczącej etiologii próchnicy zębów i jej zapobiegania.
Materiał i metody. Elektroniczne badania ankietowe nauczycieli nauczania początkowego przeprowadzono w 10 województwach w ramach programu pt. „Monitorowanie stanu zdrowia jamy ustnej populacji polskiej w latach 2016-2020”. Pytania oceniały wiedzę ankietowanych dotyczącą etiologii choroby próchnicowej u dzieci, korzyści płynących z korzystania przez dzieci z opieki stomatologicznej i profilaktyki próchnicy zębów.
Wyniki. W badaniu wzięło udział 55 nauczycieli nauczania początkowego. Większość respondentów wskazała: bakterie (92,7%), cukier (96,4%) i ich współwystępowanie (98,2%) jako czynniki etiologiczne próchnicy. Za czynniki prewencyjne wszyscy nauczyciele uznali regularne wizyty kontrolne u dentysty i szczotkowanie zębów. 85,5% wskazało stosowanie nici dentystycznej i tylko 74,5% znało profilaktyczne działanie związków fluoru. 23,6% respondentów zadeklarowało udział w szkoleniach dotyczących profilaktyki chorób jamy ustnej, 45,5% przeprowadziło w przeszłości zajęcia o tematyce związanej ze zdrowiem jamy ustnej wśród uczniów.
Wnioski. Niewystarczający poziom wiedzy polskich nauczycieli o etiologii próchnicy zębów i jej zapobieganiu wskazuje na koniczność ich merytorycznego przygotowania do prowadzenia edukacji prozdrowotnej dzieci. Niezbędne jest objęcie badaniami większej liczebnie grupy w celu zdiagnozowania ich potrzeb edukacyjnych.
Summary
Introduction. Education conducted by teachers, who should have up-to-date knowledge of the aetiology and prevention of caries, plays an important role in shaping dental health behaviours and attitudes in children.
Aim. To assess the knowledge of primary school teachers on the aetiology and prevention of caries.
Material and methods. Online surveys were conducted among primary school teachers in 10 voivodeships as part of the “Monitoring the oral health of the Polish population in 2016-2020” programme. The survey assessed the respondents’ knowledge of the aetiology of caries in children, as well as the benefits of dental care and caries prevention.
Results. A total of 55 primary education teachers participated in the study. Most of the respondents pointed to bacteria (92.7%), sugar (96.4%) and their combination (98.2%) as aetiological factors of caries. Regular dental check-ups and tooth brushing were reported as preventive factors by all teachers. A total of 85.5% of respondents indicated the use of dental floss and only 74.5% knew the preventive effect of fluoride compounds. Participation in training courses on the prevention of oral diseases was declared by 23.6% of respondents, and 45.5% of teachers conducted classes on oral health among students in the past.
Conclusions. The insufficient level of knowledge among Polish teachers about the aetiology and prevention of dental caries indicates the need for their substantive training so that they can conduct pro-health education for children. Studies in a larger group is needed to identify their educational needs.
Introduction
The aetiology of dental caries is multifactorial, with social, behavioural and environmental factors, as well as diet and bacteria being involved.
Despite its preventability, dental caries is common in the paediatric population, and its effects can be observed already in the group of children starting early school education. Children spend several hours at school each day, during which they are exposed to behavioural patterns and knowledge of their educators. As a professional group having direct contact with children in the period of shaping dental health behaviours, teachers should be involved in educational activities. Preschool and early school children are particularly susceptible to shaping appropriate behaviour, with teachers being their main authority, which is why education at this age is important (1, 2). Research has shown the effectiveness of health education conducted by teachers (3). School education and pro-health activities are also expected by parents (4). Teachers must have knowledge in this area in order to be able to effectively fulfil this task (3). The lack of basic training may limit the willingness of teachers to participate in educational programmes aimed at students, and, consequently, have an adverse impact on children’s oral health in the future (5-7).
Aim
To assess the knowledge of primary school teachers on the aetiology and prevention of caries.
Material and methods
Primary education teachers from schools participating in the programme “Monitoring the oral health of the Polish population in 2016-2020” financed by the Ministry of Health (contract no. 11/1/2019/1210/836, paragraph 3 section 23) were invited to take part in this online survey. This programme was implemented in 10 voivodeships (West Pomeranian, Greater Poland, Lubusz Voivodeship, Lublin Voivodeship, Łódź Voivodeship, Lesser Poland, Masovian Voivodeship, Podlaskie Voivodeship, Pomeranian Voivodeship, and Lower Silesia) in 2018. Educational institutions invited to participate in the monitoring were selected using multi-stratified sampling. Counties, communes, followed by cities and villages, as well as educational institutions in individual cities were randomly selected in each of the voivodeships. Electronic questionnaires for teachers of 6-year-olds contained questions assessing their knowledge about the aetiology of caries in children, the benefits of dental care and caries prophylaxis. The questionnaire was anonymous and allowed for comparing the data with those obtained in the 2008 survey. Approval was obtained from the Bioethics Committee of the Medical University of Warsaw (KB185/2018). The data was analysed statistically (Statsoft 10).
Results
A total of 55 completed questionnaires were returned. Most surveys were completed in Masovian Voivodeship (n = 20, 36.4%), whereas the fewest (n = 1, 1.8%) in the Lubusz Voivodeship and Greater Poland. There were 48 (87.3%) women and 7 (12.7%) men among the respondents. These were mostly young teachers aged < 30 years (38.2%), with a short period of professional practice of < 5 years (38.2%). The characteristics of the respondents’ age and work experience are shown in figures 1 and 2.
Fig. 1. Age of respondents
Fig. 2. Work experience of respondents
Teachers’ knowledge of the aetiology of dental caries was assessed based on true-false questions included in the questionnaire (tab. 1). Most of the teachers had no difficulty identifying the aetiological factors of caries, such as bacteria, sugar and their combination. All respondents were aware of the fact that primary teeth need as much care as permanent dentition. At the same time, one in three respondents were convinced that caries is caused by systemic or parasitic diseases, and one in five respondents considered caries to be a natural process associated with aging.
Tab. 1. True/false statements on the aetiology of caries
| No. | Statement (question number from the questionnaire) | True n/% | False n/% |
| 1. | Caries is caused by pregnancy | 8/14.55% | 47/85.45%# |
| 2. | Caries is hereditary | 7/12.73% | 48/87.27%# |
| 3. | Caries is caused by systemic diseases | 21/38.2% | 34/61.8%# |
| 4. | Caries is caused by parasitic diseases | 16/29.1% | 39/70.9%# |
| 5. | Caries is a natural aging-related process | 11/20% | 44/80%# |
| 6. | Caries is caused by bacteria | 51/92.7%# | 4/7.27% |
| 7. | Caries is caused by sugar | 53/96.4%# | 2/3.6% |
| 8. | Caries is caused by bacteria + sugar | 54/98.2%# | 1/1.8% |
| 9. | Primary teeth should be cared for the same way as permanent teeth | 55/100%# | 0/0% |
#correct answers
The knowledge of the respondents on caries prevention methods was assessed by asking them to indicate the true statements in the questionnaire (tab. 2). It is noteworthy that 100% of respondents were convinced that caries is preventable. All respondents were also aware of the benefits of regular dental visits and tooth brushing.
Tab. 2. Answers to the questions verifying the respondents’ general knowledge of caries prevention
| Please indicate true methods for caries prevention: | N/% |
| You can’t prevent caries | 0/0% |
| Rinsing with water | 24/43.6% |
| Using toothpicks | 15/27.3% |
| Using dental floss | 47/85.5% |
| Tooth brushing | 55/100% |
| Regular dental check-ups | 55/100% |
| Avoiding sugar | 46/83.6% |
| Using special medications | 9/16.4% |
| Using fluoride compounds | 41/74.5% |
| Using herbal mouthwashes | 14/25.5% |
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