Looking at the statistics, I see that the percentage of students with cavities and filled teeth decreases with age. Students in higher grades have lower numbers of cavities and filled teeth. This shows that in higher grades, students have been taught and guided on how to take care of their teeth and they are more aware of maintaining and cleaning their teeth.
The rate of students with unfilled cavities also shows that dental check-ups are not done regularly enough to detect cavities and take timely intervention measures. Relying only on regular medical check-ups at school is not enough, because students only get checked once a year. Therefore, if the condition of unfilled cavities is left for a long time, it can have many effects on the oral health of students.
For gingivitis
According to the school's 2019 oral health examination data, the rate of students with gingivitis is relatively low. The statistical results of the actual status of gingivitis in the whole school are as follows:
%
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10
9
8
7
6
5
4
3
2
1
0
9.17
3.27
0.16
Mild inflammation Moderate inflammation Severe inflammation
Figure 2.2. Level of gingivitis in students in 2019
The number of students with gingivitis in the school is 308 students, accounting for 12.61%. Although the percentage of students who are at the age of changing teeth and have loose teeth is relatively high, the percentage of students who show signs of swollen or bleeding gums is not high. The number of students with gingivitis is mainly concentrated in grades 1 to 3, because they are at the age of changing teeth and the majority of the gingivitis is at the position of newly growing teeth. The level of plaque
Tartar accumulation in the gum pockets accounts for a small percentage, so the number of students at risk of severe inflammation or gum recession is not too high.
Awareness and practice of oral hygiene of primary school students
I selected grade 3 of Nghia Tan primary school to conduct a survey on students’ knowledge and practice of tooth decay and gingivitis. The total number of students participating in the survey was 540 students. The survey results are as follows:
Awareness of causes and symptoms of dental diseases
%
50
40
30
20
10
0
38.52
28.89
32.59
Toothache Bad breath Don't know
Figure 2.3. Knowledge about the symptoms of tooth decay
The chart above shows that students' understanding of the symptoms of tooth decay is not really complete. The percentage of students who know the symptoms of toothache is 38.52%. The percentage of students who know the signs of bad breath is a symptom of tooth decay is 28.89% and 32.59% of students do not know the symptoms of tooth decay. Of these, very few students can choose both symptoms of tooth decay: toothache and bad breath.
%
60
50
40
30
20
10
0
50
37
25
1.48
Swollen gums Bleeding gums Red gums Unknown
Figure 2.4. Knowledge about the manifestations of gingivitis
According to the data in the table above, the percentage of students who know the symptoms of swollen gums is nearly half. However, students do not fully understand the symptoms, most students only choose one symptom when completing the survey. The number of students who choose bleeding gums is 25% and red gums is 37%. Some students choose both swollen gums and red gums. However, 1.48% of students do not know about gingivitis.
%
60
50
50
40
37
30
24.45
25
20
10
0
0
Eat hot, do not brush teeth cold
Eat a lot of sugar
Due to bacteria Unknown
Figure 2.5. Knowledge about the causes of dental diseases
The percentage of students who have knowledge about the factors that cause dental diseases is relatively high, there is no student who does not know the cause of the disease. Most of them choose eating too much sugar, because in reality, all children with tooth decay are due to this cause. In addition, many students choose bacteria as the cause because they rely on the knowledge they learned in class.
%
100
90
80
70
60
50
40
30
20
10
0
92.23
1.85
0
3.5
2.42
Inedible
Tooth loss
Toothache, Pain Effects Unknown
profit
to health
Figure 2.6. Knowledge about the harmful effects of dental diseases
Most students chose based on the effects of oral diseases they encountered. In general, they had mild tooth decay and gingivitis, so they chose the most harmful effects of toothache and gum pain. They did not really understand the serious consequences of this oral disease. No student knew that the most serious consequence of oral diseases was tooth loss. Most students took oral diseases lightly and only 3.5% of students chose the answer that it affected their health and 1.85% of students chose the option that they could not eat. In addition, the percentage of students who did not know the harmful effects of oral diseases was 2.42%.
%
70
60
50
40
30
20
10
0
62.4
28.7
8.9
Is it normal?
Figure 2.7. Knowledge about the danger level of dental diseases
At the same time, during the survey, many students thought that oral diseases were of normal danger, accounting for 62.4%. In addition, the percentage of students choosing oral diseases as not dangerous was 28.7% and only 8.9% thought that they were dangerous. This shows that students do not have a thorough understanding of the harmful effects of oral diseases.
Knowledge about preventing tooth decay
Based on the survey results, most students choose measures to prevent dental diseases, which are regular dental check-ups, regular brushing and a reasonable diet. However, some students do not understand how diet plays a role in preventing dental diseases and the benefits of everyday foods. Students only know not to eat too much cake, candy, sugar and often skip eating vegetables and fruits to supplement beneficial minerals and vitamins. Of these, 3 students do not have knowledge about preventing tooth decay, accounting for 0.55%.
%
100
90
80
70
60
50
40
30
20
10
0
91.85
86.11
16.48
0.55
Dental check-up Regular and proper nutrition
Brush your teeth every day
Don't know
Figure 2.8. Knowledge about preventing tooth decay
Practice dental care
%
100
90
80
70
60
50
40
30
20
10
0
88.89
9.82
1.29
0
1 time 2 times 3 times No rating
tooth
Figure 2.9. Number of times students practice brushing their teeth in a day
The percentage of students who practice brushing their teeth is relatively high, 88.89%; the percentage of students who brush their teeth once a day is 9.82% and the percentage of students who brush their teeth more than 3 times a day is 1.29%. Among them, there is no student who does not practice brushing their teeth every day. In general, children are aware of keeping their teeth clean.
%
70
60
50
40
30
20
10
0
59.82
21.67
8.89
9.63
Under 2 minutes 2-3 minutes 3 minutes or more Don't remember
Figure 2.10. Time spent brushing teeth by students
However, brushing your teeth enough times a day is not enough. When asked how much time they spend brushing their teeth, most students answered less than 2 minutes, accounting for 59.82%. In addition, only 21.67% of students brush their teeth for 2-3 minutes each time. This is also a reason why oral diseases in children still account for a high rate. Although children practice oral care by brushing their teeth, most of them do not spend enough time on this. Children also brush their teeth carelessly, so they are still at risk of tooth decay and gingivitis.
%
60
50
40
30
20
10
0
54.82
27.96
10.37
6.85
Brush in a circular motion Brush all three surfaces of the teeth Brush only the outside surfaces Brush across the tooth body
Figure 2.11. Students practicing brushing their teeth.
Based on the chart above, it shows that children are practicing brushing their teeth based on their feelings, not following a standard process. Therefore, brushing their teeth is not very effective in protecting their teeth and preventing tooth decay in students. The percentage of students practicing circular brushing is relatively low at 10.37% and the percentage of students practicing brushing all three surfaces of their teeth is very low at 6.85%. Almost all children only brush the outside of their teeth and brush across the body of their teeth, which makes it difficult for them to clean the spaces between their teeth as well as the surfaces of their teeth. Therefore, the rate of plaque in children is still high.
Sources of practical knowledge to prevent oral diseases for children After conducting a survey, it was shown that most children were instructed to brush their teeth by their parents. The number of students who were instructed by their parents was higher than by their teachers. However, the instructions from parents were not really thorough, only stopping at the step of introducing how to use: take a sufficient amount of toothpaste and use the toothbrush to brush all surfaces of the teeth, then rinse the mouth with water. In which, it did not mention how many surfaces the child needed to brush to clean the entire tooth surface or how to rotate the toothbrush properly. Therefore, children did not practice brushing their teeth correctly.
ways and procedures. Many children brush their teeth very quickly, sometimes not all the toothpaste in their mouth is washed away.
For children in grade 3, many students do not remember the knowledge about oral diseases that they learned in the younger grades. Therefore, when asked about the source of knowledge about tooth decay and gingivitis, students all chose a different answer, which was the doctor. Very few students chose their parents as the source of knowledge for them.
2.3. Current status of integrating oral health education for primary school students
Oral health is fundamental to overall health. Schools can provide a supportive environment to promote oral health. School policies and education on health-related issues are essential to achieving good oral health and controlling associated risk behaviors. The World Health Organization (WHO) recommends oral health promotion through schools to improve knowledge, attitudes and behaviors related to oral health and the prevention of oral diseases among schoolchildren. Treatments for all oral diseases are generally available in industrialized and more developed countries, but can be expensive and not always accessible.
Furthermore, oral diseases are a costly economic burden for individuals, families and nations - both industrialized and developed. Therefore, oral health education is the best way to improve knowledge and apply oral health protection measures to improve oral health.
According to Trinh Dinh Hai (2004), " It is necessary to educate and take care of children's health right from the moment they enter school and during the learning process, it is necessary to coordinate well between the school and the family to educate children to form oral hygiene habits ."[17].
2.3.1. In the World
Worldwide, several studies have shown that oral health education materials have been provided to students in schools. These materials are considered essential to provide students with knowledge about preventing tooth decay and gingivitis. At the same time, they contribute to reducing the incidence of oral diseases among students.
The Contra Caries Oral Health Education Program (CCOHEP) is a theory-based curriculum consisting of four interactive 2-hour classes.