Summary:
Introduction
Early childhood caries (ECC) is a severe oral childhood disease affecting in
many ways the quality of life of preschoolers and their families.
Epidemiological data from an oral health program in preschool children
conducted in the prefecture of Attica showed that 36.3% had caries, while the
dmft index increases dramatically from 0.05 at age 2 to 2.79 at age 6.
Furthermore, mothers’ knowledge on children’s oral health issues was poor and
daily oral hygiene routine inappropriate for this age group.
In preschool years children adopt healthy behaviors more easily and the role of
preschool teachers is important in the development of healthy attitudes and
skills and in the promotion of oral health in children. There is limited
information in the literature on teachers’ knowledge regarding oral health,
which is fundamental for oral health education programs in preschools.
Aim
The aim of this study was to investigate the knowledge of teachers of the
Athens Municipal Creche on early childhood oral health and its association with
demographic and educational characteristics as well as with personal oral
health habits and attitudes.
Materials and methods
All preschool teachers (N=594) of the largest public preschooler institution in
Greece were invited to participate in this cross-sectional study. The study was
approved by Ethics Committee of Dental School of University of Athens and
involved the completion of a self-administered anonymous questionnaire by the
teachers. The questionnaire included 10 questions on demographic data, 12
questions on the knowledge on early childhood oral health issues, 10 questions
on personal oral health habits and attitudes and 8 questions on participation
in oral health educational programs at school. All questions, except one, were
"closed type".
Statistical analysis was conducted with descriptive statistics, Spearman
correlation coefficients, multiple linear and logistic regression modeling.
Statistical level of significance was set at p=0.05.
Results
The response rate was 85.2%. The participants had a mean age of 40.9 years (SD:
7.5) and a mean time of professional experience of 16.7 years (SD:7.6). From
them, 99.2% were females and 68.5% had children of their own.
In this population, 72.6% had not attended any oral health educational course
during their studies and their major source of information on oral health
issues was the dentist alone (39.7%) or in combination with other sources
(51.1%). The mean number of correct answer on early childhood oral health was
7, while only 1% of the participants answered correctly in all questions.
Regarding personal habits, 46.6% visited the dentist annually, 65.9% brushed
twice daily and 30% used dental floss. Most teachers (70%) believed that their
oral health knowledge was not sufficient, 44.6% had participated in an oral
health educational program and 92.4% of them included tooth-brushing at school
when running the program.
The most significant factors that influence overall teachers’ knowledge on
early childhood oral health were their participation in an oral health
educational programs (p<0.001), their belief that oral health courses during
their studies were necessary (p=0.01), their confidence on oral health
knowledge (p=0.03) and parenthood (p=0.05). The factors that influenced the
teachers’ implementation of an oral health program were the personal oral
health knowledge (OR 4.7, p<0.001), occupational duration (OR 1.09, p=0.002)
and educational level (OR 4.25, p=0.02).
Conclusions
Preschool teachers who participated in the study had poor knowledge on
important childhood oral health issues which was recognized by them and was
attributed mainly to the lack of official education. Educational programs for
them should focus on increasing knowledge and confidence in conducting such
activities. Finally dental professionals should support the teachers in the
implementation of these programs.
Key words: preschool teachers, early childhood oral health, early childhood
oral health knowledge, preschool age
