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Year : 2017  |  Volume : 5  |  Issue : 1  |  Page : 16-24

Oral health knowledge, attitude, and practices among secondary school teachers and students in Ekiti State

1 Dental Department, State Specialist Hospital, Ekiti State, Nigeria
2 Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
3 Department of Dental, Shehu Idris College of Health Sciences and Technology, Kaduna, Nigeria

Date of Web Publication28-Sep-2018

Correspondence Address:
Mr. Henry Ifeanyi Onwudi
Dental Department, State Specialist Hospital, Ikole, Ekiti State
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/njecp.njecp_34_15

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Background: The important role of teachers in oral health education of their students cannot be ignored. Regrettably, many teachers especially in secondary schools in Nigeria lacked the knowledge and skills to play this part. This study was carried out to assess the oral health knowledge, attitude, and practices among secondary school teachers and students in Ekiti state. Materials and Methods: A self-structured questionnaire was used to collect the necessary information. Results: A total of 100 teachers and 180 students participated in the study. The participants displayed a pattern of incomplete oral health knowledge, inappropriate oral health practices but positive oral health attitude. Females demonstrated better oral health-care practices than their male counterparts. Furthermore, the oral health knowledge, attitude, and practices of the teachers were average while that of the students are less than satisfactory. Conclusion: Therefore, health educational programs to encourage healthy dental habits among teachers and students should be introduced into the school curriculum.

Keywords: Attitude, knowledge, oral health, students, teachers

How to cite this article:
Onwudi HI, Taiwo AO, Stellamaris OC. Oral health knowledge, attitude, and practices among secondary school teachers and students in Ekiti State. Niger J Exp Clin Biosci 2017;5:16-24

How to cite this URL:
Onwudi HI, Taiwo AO, Stellamaris OC. Oral health knowledge, attitude, and practices among secondary school teachers and students in Ekiti State. Niger J Exp Clin Biosci [serial online] 2017 [cited 2022 Jul 1];5:16-24. Available from: https://www.njecbonline.org/text.asp?2017/5/1/16/242445

  Introduction Top

Oral health is an essential part of general health. One of the WHO goals is “Health for All by the Year 2025,” of which oral health is an integral component. Oral health can be defined as the optimal health of the oral and related tissues which enables an individual to eat, speak, and socialize without active disease, discomfort or embarrassment, thus, contributing to the general well-being.[1]

School age is a crucial stage in the development of the individual. Students spend majority of their time in school with teachers; therefore, the knowledge and skills needed to attain future goals and to nurture hidden potentials are acquired during the school years. Education not only empowers students to distinguish between the beneficial from the harmful but in addition helps in the enhancement of knowledge as well as lifestyle practice.

The role of the school teachers in student oral health education cannot be overemphasized. Hamilton and Coulby pointed out that teachers and parents augment their wards dental health education. Hence, for the teachers to discharge this responsibility effectively, it is imperative that their own oral health behavior, knowledge, and attitude conform to expectations.[2] Furthermore, evidence from the oral health literature linked strong knowledge of oral health with better oral health-care practice.[3] Consequently, individuals with positive attitude toward oral health are influenced by better knowledge of oral health care. In addition, Ab-Murrat and Watt stated that appropriate health education is necessary for the cultivation of healthy oral health practices.[4] However, assessment of knowledge, attitude, and practice of oral health of such group is crucial to the design of an appropriate oral health education.[5]

Sparse information is available concerning the knowledge, attitude, and oral health practices of Nigerian teachers and students, especially in Ekiti state. Therefore, the purpose of the study is to assess the knowledge, attitude, and oral health practices of secondary school students and their teachers in Ekiti state, Nigeria. It is hoped that the result of the study will serve as baseline information for the design of oral health education program tailored at improving the oral health care of secondary school teachers and students in Ekiti state, Nigeria.

  Materials and Methods Top

This is a cross-sectional study conducted between October to December 2014 that assessed the oral health knowledge, attitude, and practice of 100 and 180 secondary school teachers and students, respectively, from schools across Ekiti state, Nigeria.

Systematic random sampling was done to select the schools, students, and teachers. The schools were divided into rural and urban areas. In the first stage, 4 schools were randomly selected from each category. In the second stage, at the assembly ground of each school, students were randomly selected while that of the teachers was done at the staff room. Eight secondary schools were selected; four each from urban and rural areas. Two types of simple structured questionnaires (one to be answered by the teachers and one to be answered by the students) were provided [Appendix 1 and 2 [Additional file 1] [Additional file 2]]. Respondents were instructed to choose/tick answers to question from available options provided. Each type of questionnaire comprised of five sections, namely, demographic, knowledge, attitude, practice, and other questions related to oral health. The questionnaire administered to the students [Appendix 1] was modified for administration to the teachers [Appendix 2].

To ensure the face and content validity of the questionnaire copies of the research questions, research questionnaire and purpose of the study were sent to three experts in the area of management, measurement, and evaluation. Validators examined both the content and language and further ascertained the extent of language clarity and the suitability to serve the purpose for which they were intended.

The reliability of the questionnaires was determined through a process of test and re-test. The questionnaires for this study were tested on twenty students and ten teachers drawn randomly from two schools. This was repeated after 2 weeks. The results from these forms were compared for each respondent. The result of the forms was correlated and analyzed using Pearson product–moment correlation coefficient, and the correlation coefficient value stood at 0.68 which was confirmed to be reliable.

Twenty-five students were selected from each school, of which a total of 180 students consented to participate in the study. Furthermore, 15 teachers were selected from each school, of which a total of 100 teachers consented to be included in the study. Approval for the study was obtained from the selected secondary school authorities.

Analysis of the study was conducted using Statistical Package for the Social Sciences (SPSS) version 16.0 (IBM Corp., Armonk, NewYork, USA). A P = 0.05 or less was considered statistically significant.

  Results Top

Of the 100 questionnaires that were distrib uted to teachers, 94 (94%) were completely filled and returned. There were 54 (57.4%) females and 40 (42.6%) males with a ratio of 1:1.25. Their age ranged from 23 to 50 years with a mean age (standard deviation [SD]) of 36.7 years (7.62) and median age of 36 years. The 31–40 years' age group was the most frequent (37.2%) followed by 41–50 years' age group [Table 1].
Table 1: Distribution of school teachers based on demographic characters

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Of the 180 questionnaires distributed to the students, a total of 176 (97.8%) were answered and returned. The male-to-female ratio was 1:1 and their age ranged from 13 to 20 years with a mean age (SD) of 15.89 (1.5) and median/modal age of 16 years. There was a statistical difference in the ages of each gender with males being younger than females (χ2 = 32.853; df = 7; P = 0.0001).

[Table 2] and [Table 3] showed that majority of the teachers 88 (93.3%) had better knowledge of dental anatomy, 79 (84%) role of sugar, and 72 (76.6%) fluoride in dental caries than the students 140 (79.5%), 130 (73.9%), and 75 (42.6%), respectively.
Table 2: Oral health knowledge of teachers and students

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Table 3: Oral health attitude of teachers and students

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Majority of both the groups [67 (71.3%) for teachers and 131 (74.4%) for students] had never visited the dentist, and those who visited did so because of pain [Table 3]. However, more students 155 (88%) brush once in a day with fluoride toothpaste than the teachers 63 (66.7%) [Table 4].
Table 4: Oral health practice of teachers and students

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A preponderance of both groups 32 (34%) for teachers and 55 (31.3%) for students use toothpicks [Table 4].

[Table 4] further shows that over half of the participants were observed to spend adequate time brushing with 59 (62.8%) for teachers and 91 (51.7%) of students using the up and down method of brushing.

Most of the students 94 (53.4%) agree that their major source of knowledge of oral health were their parents with their teachers the least source 24 (13.6%) [Table 5].
Table 5: Teachers' and students' response on other oral health-related issues

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[Table 5] demonstrates that about 17 (18.1%) and 20 (11.4%) of the teachers and students, respectively, had lost their teeth. Thirty-five (37.2%) of the teachers and 63 (35.8%) of the students agreed that both artificial and natural teeth are the same. Tooth brushing supervision of students by parents was observed in 43 (24.0%) of students.

  Discussion Top

The results of the study revealed that majority of the teachers are females. This was in agreement with the result of Dawani et al (2013). where female teachers were more in their Pakistan study.[6] The result also indicated that the male teachers were younger. This could be attributed to the fact that the recent improvement in teachers' welfare and remunerations had attracted young men into the profession.

The study demonstrated that <20% of the participants know the correct number of the deciduous teeth suggesting a poor knowledge of dental anatomy. This is in concordance with the findings of Mohammad et al.[7]

This current study also showed that many of the teachers are unaware that toothpaste contains fluoride. This finding is in agreement with a 2014 nationwide study by Olusile et al. which observed that a good number of Nigerians are uninformed of the fluoride content of toothpaste.[8] Using toothpaste containing fluoride helps the teeth to resist the destruction caused by cariogenic bacteria or in reversal of active dental caries. The mechanism involves the substitution of the hydroxyl in the structure of the enamel with fluoride in apatite crystal which is more resistance to acid attack.[1],[2]

The present study also demonstrated that although majority of respondents had a positive attitude as regards intent to visit the dentist (78.4%); however, the actual frequency of dental visit was observed to be low (29%). This result is similar with several reports from developing countries [9],[10],[11],[12],[13],[14] but at variance with findings from developed Western countries [15] that embrace preventive oral health. This observation has been blamed on ignorance, illiteracy, poverty, and lack of universal health insurance that covers preventive oral health to majority of the vulnerable population.[13],[14]

This research highlights that students brush daily more than their teachers. This could be attributed to high workload of teachers, thus, leaving them little time to attend to personal hygiene. This suggests that more enlightenment should be directed at the teachers on the danger of neglecting their oral health.

The result of this study shown that majority of the respondents had good knowledge of the proper brushing technique; however, compliance with this gold standard was poor. This resonates with that of Bamigboye and Akande in their study of oral hygiene status of secondary school students in Osogbo [16] but divergent to the result obtained by Saadu et al. in Ilorin, where horizontal method was predominant.[17]

About one-third of the respondents still use potentially traumatic materials such as toothpick for interdental cleaning which could lead to serious periodontal problem that could result in tooth loss.[14] This concurs with the finding of Ehizele et al. from Benin City, Nigeria.[18]

More than half of the students gave the source of their oral health knowledge to be from their parents. This contradicts the findings of Saadu et al. where the students gave the source as their teachers.[17] Teachers owing to the vast knowledge that they possess and the quantity/quality of time they spend with the students and their status as role model are expected to have greater influence on their students than others.[6] Hence, this study suggests the need to encourage the teachers as oral health advocates to their students.

  Conclusion Top

This current study found a female preponderance among the teachers, especially in the 31–40 years' age group. The study further demonstrated that the teachers and students had deficiency in their oral health knowledge but showed that the students had better oral health practices than the teachers. Moreover, it showed that the students trust their parents more for oral health information than their teachers. Therefore, health educational programs to encourage healthy dental habits among teachers and students should be introduced into the school curriculum, thus facilitating the reduction of ravages of oral diseases among our secondary school population.


We wish to acknowledge the support and cooperation of all the teachers and students who participated in the study. We also thank the Ekiti state ministry of Education, management, and principal of the participating schools for their invaluable time and effort toward the successful conclusion of the study.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Kay EJ, Locker D. Is dental health promotion effective? A systematic review of current evidence. Community Dent Oral Epid 1996;24:231-5.  Back to cited text no. 1
Hamilton ME, Coulby WM. Evaluating the effectiveness of school-based dental health education programme among children of different socioeconomic groups. J Public Health Dent 1991;51:212-19.  Back to cited text no. 2
Smyth E, Caamano F, Fernández-Riveiro P. Oral health knowledge, attitudes and practice in 12-year-old schoolchildren. Med Oral Patol Oral Cir Bucal 2007;12:E614-20.  Back to cited text no. 3
Ab-Murrat N, Watt RG. Chief dentists' perceived strengths and weakness of oral health promotion activities in Malaysia. Ann Dent J 2006;13:1-5.  Back to cited text no. 4
Al-Omiri MK, Al-Wahadni AM, Saeed KN. Oral health attitudes, knowledge, and behavior among school children in North Jordan. J Dent Educ 2006;70:179-87.  Back to cited text no. 5
Dawani N, Afaq A, Bilal S. Oral health knowledge, attitude and practices amongst teachers of public school set up in Karachi, Pakistan. J Dow Univ Health Sci 2013;7:15-9.  Back to cited text no. 6
Mohammad SA, Ahmed B, Khalid A, Ziad A. Oral health knowledge and practices among administrative staff at Taibah university, Madina Kingdom of Saudi Arabia. Eur J Gen Dent 2013;2:308-11.  Back to cited text no. 7
Olusile AO, Adeniyi AA, Orebanjo O. Self-rated oral health status, oral health service utilization, and oral hygiene practices among adult Nigerians. BMC Oral Health 2014;14:140.  Back to cited text no. 8
Mehta A, Kaur G. Oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India. Indian J Dent Res 2012;23:293.  Back to cited text no. 9
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Fotedar S, Sharma KR, Bhardwaj V, Sogi GM. Barriers to the utilization of dental services in Shilma, India. Eur J Gen Dent 2013;2:139-43.  Back to cited text no. 12
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Varenne B, Msellati P, Zoungrana C, Fournet F, Salem G. Reasons for attending dental-care services in Ouagadougou, Burkina Faso. Bull World Health Organ 2005;83:650-5.  Back to cited text no. 14
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Saadu L, Musa OI, Kamaldeen AB, Buhari AM. Knowledge and practices on oral health among junior secondary school students in Ilorin West local government area of Nigeria. J Dent 2012;2:170.  Back to cited text no. 17
Ehizele A, Chiwuzie J, Ofili A. Oral health knowledge, attitude and practices among Nigerian primary school teachers. Int J Dent Hyg 2011;9:254-60.  Back to cited text no. 18


  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]

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