AN EVALUATION OF THE EFFECTIVENESS OF ORAL HEALTH EDUCATION PROGRAMS IN SECONDARY SCHOOLS IN LAGOS STATE

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Globally, oral diseases are highly frequent and can be substantially prevented. Dental caries, often known as tooth decay, impacts a significant proportion of school children (60-90%) and the majority of adults in developed nations. This issue is becoming more widespread in developing countries and is particularly prominent in some Asian and Latin American countries (Petersen, 2019). Periodontal disease is widespread worldwide, affecting 5-15% of most populations with severe periodontitis. This condition is strongly linked to diabetes and weakened immune function. Based on the National Oral Health Survey, dental caries affects 63.1% of 15-year-olds and a significant 80.2% of individuals aged 35-44 in India. Periodontal disorders affect a significant proportion of the population, with a prevalence of 67.7% among 15-year-olds and up to 89.6% among individuals aged 35-44, according to the National Oral Health Survey conducted in 2004. Edentulism prevalence is elevated in certain nations among those aged 65 and above. Beyond that, oral cancer ranks as the 8th most prevalent form of cancer globally. It is the 3rd most common in South-central Asia and is twice as widespread in less developed nations compared to more developed ones.

In Nigeria, children are susceptible to several oral illnesses, such as periodontal diseases, dental caries, traumatic dental traumas, and dental difficulties connected to human immunodeficiency virus (HIV) (Oyedeji et al., 2018). Dental caries and gingivitis are the most prevalent oral illnesses, affecting more than 80% of school children in certain nations.The involvement of plaque, bacteria, immunological factors, and genetic variables in the development of periodontal diseases and tooth caries has been well-documented (Nyvad & Takahashi, 2020). Moreover, oral diseases significantly impede activities in educational, professional, and domestic settings, resulting in the loss of countless hours of productivity worldwide each year. These diseases frequently have a substantial negative effect on the psychosocial well-being, leading to a major decrease in the overall quality of life (Petersen, 2019). 

According to Sofola, Folayan & Oginni (2019),disorders of the craniofacial complex have a significant impact on an individual's overall well-being, leading to adverse effects on nutrition, physical function, and psychological well-being. Moreover, oral disorders impose a significant financial burden on people, families, and nations, regardless of their level of development. Adeniyi, et al (2018) maintained that it is widely acknowledged that maintaining proper oral hygiene practices plays a crucial role in preventing and managing serious oral diseases. The basic objective of any community aiming to ensure a satisfactory standard of living for its citizens should be the prevention of sickness, disability, and pain. Implementing preventive measures at the community or population level is the most efficient and impactful technique, regardless of whether it is targeted at a school, community, or nation. 

Notably, the World Health Organization has implemented a fundamental oral health care programme for less industrialized nations. This programme focuses on providing oral health education and integrating it with other oral health activities, such as offering preventive, restorative, and emergency dental care. An efficient community preventive programme is a carefully designed process that aims to hinder the initiation of a disease within a specific group of persons. There are various strategies available for avoiding dental diseases, and the most economical option is through health education. Health education refers to a collection of educational activities aimed at promoting voluntary behaviours that contribute to well health. These activities or behaviours might originate from people, families, institutions, or communities. 

Therefore, the range of health education can encompass instructional activities targeting children, parents, policy makers, or health care providers. Extensive evidence in oral healthcare and other health fields has established that possessing accurate health information or knowledge does not automatically result in favourable health behaviours. Therefore, a survey will be conducted in order to evaluate the effectiveness of oral health education programs in  secondary schools in Lagos state.

1.2 Statement of the Problem

Schools are optimal environments for promoting health because they have the ability to reach the majority of children of school age and establish valuable connections with their families and communities (WHO, 2023). Implementing oral healthcare programmes within schools will effectively enhance children's ability to obtain dental treatments, particularly for those who come from socio-economically disadvantaged households (Gargano et al, 2019). Furthermore, the school years encompass the stage of childhood and adolescence, a crucial period for establishing lifelong sustainable practices, beliefs, and attitudes towards health (WHO, 2023). Various school-based initiatives aimed at promoting oral health have been suggested, including oral health education (OHE), tooth-brushing activities, the application of fissure sealant, and other treatments (Yekaninejad et al., 2022; Tai et al.,2019). 

Although the programmes' success has been studied, there is still a lack of comprehensive evidence from a worldwide perspective.In most cases, treatments for all oral diseases are readily available in industrialised and more developed countries. However, these treatments can be costly and not always easily accessible. Consequently, many persons lack access to dental care due to a lack of insurance or financial resources to cover the expenses. In underdeveloped and impoverished nations, access to suitable medical interventions is typically nonexistent. Thus, it is in the light of these that the study seeks to evaluate the effectiveness of oral health education programs in  secondary schools in Lagos state.

1.3  Objectives of the Study

The main purpose of this study is to evaluate the effectiveness of oral health education programs in  secondary schools in Lagos state. Specifically, the study will;

1.Assess the extent education programs improved the oral hygiene practices of students in Lagos state.

2.Assess the extent oral health education contributes to the reduction of dental caries among secondary school students.

3.Determine whether oral health education programs influences the attitude of students towards maintaining good oral hygiene.

1.4 Research Questions

The following questions have been prepared for the study:

To what extent have education programs improved the oral hygiene practices of students in Lagos State?

To what extent does oral health education contribute to the reduction of dental caries among secondary school students?

Does oral health education influence the attitude of students towards maintaining good oral hygiene?

1.5 Research Hypotheses

H0: Oral health education programs in secondary schools in Lagos State are not effective.

Ha: Oral health education programs in secondary schools in Lagos State are effective.

6 Significance of the Study

The findings of the study will provide insights into the best practices for teaching oral health in schools. It will  help teachers identify which teaching methods, materials, and activities are most effective in engaging students and improving their oral health knowledge and habits. Moreover, students and their families will also benefit from the increased awareness and adoption of healthy oral hygiene practices at home and in school. Additionally, subsequent researchers will use it as a literature review. This means that other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review. Invariably, the result of the study contributes immensely to the body of academic knowledge with regard to the effectiveness of oral health education programs in  secondary schools in Lagos state.

1.7 Scope of the study

The scope of this study is boarded on the effectiveness of oral health education programs in secondary schools in Lagos state. Geographically, the study will be delimited to some secondary schools in Lagos state.

1.8 Limitation of the study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed. 

More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other schools, local governments, states, and other countries in the world.

1.9 Definition of Terms

Oral health: the condition of the teeth, gums, and general mouth, which is characterised by the absence of disease, adequate hygiene practices, and effective functioning of oral structures.

Education: the process of acquiring knowledge, skills, attitudes, and values through formal instruction, learning activities, and experiences

Education programs: structured initiatives and courses designed to impart knowledge and skills related to oral health.