KNOWLEDGE OF PROPER BRUSHING METHODS AMONG SECONDARY SCHOOL STUDENTS IN NIGERIA

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

The oral cavity serves as the primary entry point to the body, and any factors that impact oral health can also have implications for overall health (Nyong, 2022). Oral health refers to the condition of the mouth, teeth, and facial structures that allows individuals to carry out necessary functions like eating, breathing, and speaking. It also includes psychological aspects such as self-assurance, overall happiness, and the ability to interact socially and work without experiencing pain, discomfort, or embarrassment. Oral health undergoes changes throughout a person's lifespan, starting from infancy and continuing into old age. It is closely connected to overall health and plays a crucial role in enabling individuals to actively engage in society and reach their full potential (WHO, 2023).

The oral tissue is an essential component of the human body and is very susceptible to disease due to its close association with the external environment. Additionally, it is exposed to many mechanical, chemical, and bacterial interactions (Philip, 2021). Petersen (2023) asserts that oral diseases might be regarded as a public health concern because of their widespread occurrence and substantial societal consequences. In his study, Singh (2022) elucidated that tooth decay, periodontal disease, and halitosis are the prevailing oral health concerns worldwide. As stated by the World Health Organisation (WHO) in 2023, oral diseases refer to a variety of ailments and illnesses, including dental caries, periodontal disease, tooth loss, oral cancer, oro-dental trauma, noma, and birth deformities such cleft lip and palate. Oral diseases are prevalent non-communicable diseases on a global scale, impacting around 3.5 billion individuals. The prevalence of oral health conditions is increasing worldwide, especially in low- and middle-income countries. This is primarily due to population growth and the ageing population, which will continue to put a greater strain on oral health services. 

It is important to note that oral diseases have a greater impact on vulnerable and disadvantaged populations. Individuals with lower socioeconomic position experience a greater prevalence of oral disorders, and this correlation persists throughout their entire lives, spanning from early childhood to old age, irrespective of the overall income level of the country. Oral diseases are associated with a range of environmental and lifestyle factors, including nutritional status, tobacco smoking, alcohol consumption, poor oral hygiene, stress, and systemic problems (Watt & Brown, 2020). Singh (2022) elucidated that a significant number of individuals have subpar oral health without possessing an understanding of their condition. Consequently, this leads to detrimental consequences such as impaired mastication and digestion of food, as well as a diminished quality of life. Singh (2022) stated that an individual's oral health care is influenced by their oral health attitude and behaviour, which are shaped by their experiences, cultural perception, familial beliefs, and lifestyle situations.

Multiple studies have been carried out in developing nations to evaluate the oral health knowledge, attitudes, and behaviours of secondary school students. These studies aim to determine their level of awareness regarding the presence and prevention of oral diseases, as well as their willingness to seek proper treatment for conditions like dental caries and periodontal diseases (Sofola, 2017). In a study conducted by Carneiro et al. (2018), it was found that the oral health knowledge of secondary school students in Tanzania was generally satisfactory, with 84% of students having a sufficient level of knowledge. However, the study also revealed that these students had a poor level of oral health practices. The researchers found that the pupils had a good level of awareness of oral health. This is likely because oral health education has been included in the primary school curriculum in Tanzania since 1982, and it has been taught by instructors at primary schools (Carneiro et al., 2018).

Harry (2020) conducted a descriptive cross-sectional study to assess the knowledge, attitude, and practice (KAP) regarding oral health among secondary school students in rural Nepal. The findings revealed that a mere 35.1% of the individuals involved in the survey possessed adequate understanding of oral hygiene, while a little 20% indicated that they regularly attended dentist appointments for check-ups. According to Harry (2020), the kids had a low level of knowledge, negative attitudes, and inadequate practice about oral health.

Nigeria, characterized by its heterogeneous population and disparate healthcare accessibility, encounters distinctive obstacles in the realm of oral health education (Ogundele, 2023). A significant number of students in secondary schools may lack sufficient instruction on appropriate brushing methods. Factors such as socioeconomic position, availability of dental treatment, and educational resources have a substantial impact on the spread of knowledge about oral health (Harry, 2020). Seun et al. (2021) found that Nigerian students generally had a limited understanding and use of effective oral hygiene techniques. A significant number of individuals depend on conventional approaches or incorrect methodologies, resulting in less than optimal results in terms of oral health. Contributing factors include insufficient attention on oral health education in schools and restricted availability of dental care services (Ogundele, 2023).

1.2 Statement of the problem

Adolescence is a crucial phase for developing enduring health behaviours. Adolescent students are in a phase of development where they are prone to forming habits that can have long-term effects on their health. Providing kids with information on correct brushing techniques can result in a reduction in oral health problems and enhance overall health outcomes during maturity.

Adopting proper oral hygiene practices and maintaining a positive mindset towards oral health are crucial for overall well-being as they help prevent prevalent oral conditions including tooth decay and gum infections. This behaviour encompasses consistent oral hygiene practices such as frequent tooth brushing and flossing, as well as preventive measures like fluoride and sealants. It also involves maintaining healthy food habits and making regular appointments to the dentist (Sa’adu 2022). Ani et al., (2018) documented that secondary school kids and adolescents in Nigeria encounter difficulties with their oral health due to their regular use of sugary foods and beverages, which increases their susceptibility to dental caries and periodontal disease. Akpan (2023) states that dental cavities are a significant oral health issue, affecting around 30 to 45% of young children and adolescents in Nigeria, namely those between the ages of 12 and 15 years.

Oral hygiene is an essential component of general well-being, and employing correct brushing techniques is crucial to preserving good oral health. There is a notable disparity in the understanding and application of effective brushing methods, particularly among secondary school students, in various regions worldwide, including Nigeria. This dental gap can result in a range of oral health problems, including dental caries, periodontal disease, and halitosis, all of which can impact kids' overall health and academic achievements. Akpan (2023) further elucidated that the curriculum employed in the majority of Nigerian schools lacks provisions for oral health education. Consequently, Nigerian students possess a limited awareness of the detrimental consequences of inadequate oral health (Peter, 2017). Peter (2017) identified several detrimental effects of inadequate oral health, which encompassed physical discomfort, limitations in functionality, and a diminished standard of living. An analysis of existing literature on the knowledge, attitudes, and behaviours related to oral health among students in Nigeria reveals unsatisfactory findings (Ene, 2023). Consequently, this research aims to address the existing vacuum in the literature. 

Objectives of the study

The primary objective of this study is to critically evaluate the knowledge of proper brushing methods among secondary school students in Nigeria. Specific objectives of this study are to:

To evaluate the current level of knowledge regarding proper brushing techniques Among Secondary School Students in Nigeria

To identify common misconceptions and incorrect practices related to brushing

To investigate potential barriers that hinder students from adopting correct brushing techniques

To provide recommendations for improving oral health education in Nigerian secondary schools

1.4 Research Questions

The following research questions will be answered in this study:

What is the current level of knowledge regarding proper brushing techniques Among Secondary School Students in Nigeria?

What are the common misconceptions and incorrect practices related to brushing?

What are the potential barriers that hinder students from adopting correct brushing techniques?

What are the recommendations for improving oral health education in Nigerian secondary schools?

1.5 Research Hypotheses

The following research hypotheses are formulated to guide the study:

Ho: The current level of knowledge regarding proper brushing techniques Among Secondary School Students in Nigeria is low.

Ha: The current level of knowledge regarding proper brushing techniques Among Secondary School Students in Nigeria is high.

1.6 Significance of the study

This study is important because it will offer valuable insights into the present level of oral health knowledge among secondary school students in Nigeria. The results can assist policymakers, educators, and healthcare practitioners in creating specific programmes to enhance oral hygiene behaviors and general health in teenagers.

Maintaining good oral hygiene is essential for general well-being, since neglecting oral health can result in a range of dental concerns including tooth decay, periodontal disease, and even systemic health complications. The project aims to enhance oral health outcomes in Nigeria by evaluating and enhancing secondary school students' understanding of appropriate brushing techniques. This is especially crucial considering that dental health problems can have a significant influence on both the quality of life and academic achievement. Enhancing dental hygiene among secondary school students can have wider societal and economic advantages. Optimal oral hygiene can bolster self-confidence and facilitate interpersonal connections, while mitigating school absences attributable to dental ailments. In addition, upholding oral hygiene can reduce the financial strain on families and the healthcare system by averting expensive dental procedures.

Moreover, the results of the study can provide valuable insights for shaping educational policies and designing curricula pertaining to oral health education in Nigerian secondary schools. By including thorough oral hygiene education into the curriculum, children can be certain to acquire precise knowledge and cultivate enduring habits that foster optimal oral health.

Furthermore, advocating for correct brushing techniques might enhance preventive healthcare initiatives by decreasing the prevalence of dental disorders. This has the potential to reduce the strain on the healthcare system and lower healthcare expenses related to dental procedures.

Finally, this study adds to the existing knowledge on oral health behaviours among teenagers, specifically in the Nigerian environment. This research can provide a basis for future investigations into various facets of oral health education and behaviour among diverse age cohorts and communities.

1.7 Scope of the study

Broadly, this study focus is to critically evaluate the knowledge of proper brushing methods among secondary school students in Nigeria. Specifically, this study seeks to evaluate the current level of knowledge regarding proper brushing techniques among Secondary School Students in Nigeria, identify common misconceptions and incorrect practices related to brushing, investigate potential barriers that hinder students from adopting correct brushing techniques and provide recommendations for improving oral health education in Nigerian secondary schools.

1.8 Limitations of the study

As with any human endeavour, the researchers faced many minor constraints during the investigation. The main limitation was the lack of extensive literature on the subject, due to the limited availability of data regarding the awareness of appropriate brushing techniques among secondary school students in Nigeria. Hence, a significant allocation of time and exertion was necessary to ascertain the appropriate materials, books, or information and amass data. 

Furthermore, this study is constrained by its small sample size and narrow geographical scope, focusing solely on Nigeria. Therefore, the conclusions of this study cannot be extended to other situations, thus requiring further investigation. 

Moreover, the researcher's restrictions were mostly due to financial constraints, as they are a student without any source of income to sustain themselves. The exorbitant transportation costs at the research location, exacerbated by the prevailing inflation in Nigeria, posed a significant challenge in meeting the expenses associated with transportation.

Furthermore, the researcher faced a time constraint due to the need to do this research while still fulfilling the obligations of attending lectures and participating in other educational activities.

1.9 Definition of terms

Oral disease: Oral diseases encompass a range of diseases and conditions that include dental caries, periodontal (gum) disease, tooth loss, oral cancer, oro-dental trauma, noma and birth defects such as cleft lip and palate.

Oral health: Oral health is the state of the mouth, teeth and orofacial structures that enables individuals to perform essential functions such as eating, breathing and speaking, and encompasses psychosocial dimensions such as self-confidence, well-being and the ability to socialize and work without pain, discomfort and embarrassment.

Oral practice: This is an activity undertaken by people in order to protect, promote, or maintain oral health and prevent dental diseases. The practices include tooth brushing and sugar consumption practice among others.

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