PREVENTIVE ORAL HEALTH PRACTICES OF SCHOOL PUPILS IN UYO, AKWA IBOM STATE. A CASE STUDY OF UYO HIGH SCHOOL, UYO

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Oral health encompasses several aspects such as the capacity to communicate verbally, display facial expressions with assurance, experience taste and touch, chew and swallow food, and transmit emotions without experiencing pain, discomfort, or craniofacial complex diseases (Glick et al, 2017). Oral health encompasses the maintenance of your teeth and gums, necessitating consistent attention to prevent the occurrence of cavities, infections, and other related problems. Maintaining good oral hygiene can have positive effects on various aspects of your overall health, including as your cardiovascular system (Son et al., 2021). Failing to follow proper oral hygiene practices can result in additional oral health concerns that are more preventable than they are correctable.

During puberty, there is a rise in the secretion of hormones, specifically progesterone and oestrogen. This hormonal surge leads to enhanced blood flow to the gums and heightened sensitivity to dental plaque. Consequently, this can result in gum irritation (Amadi et al., 2023). During this time, it is crucial to maintain proper oral hygiene practices in order to prevent oral illnesses. Gums can become swollen (gingivitis) and bleed more easily (puberty gingivitis) when they are irritated. According to Rashford et al. (2022), this has the potential to result in juvenile periodontitis. During their time at school, these students consume a significant amount of refined carbs, particularly in the form of cariogenic snacks. This makes them vulnerable to dental cavities. These oral conditions result in severe pain and suffering. Students who experience discomfort or pain should seek treatment at the dental clinic. This results in a deprivation of hours that may have been dedicated to educational pursuits or used for the betterment of society (Vidic et al., 2021). The adolescent period is characterised by various physiological changes that can lead to substantial dental issues. These changes encompass the loss of primary teeth, the emergence of permanent teeth, the maturation of the gums, facial growth, and hormonal fluctuations (American Academy of Paediatric Dentistry [AAPD], 2017).

Oral health refers to the maintenance of a functioning, visually pleasing, and natural set of teeth consisting of at least twenty teeth, without the need for artificial dental appliances throughout one's lifetime (World Health Organisation, 2017). The World Health Organisation (WHO, 2019) reiterated that dental health is a crucial determinant of general health, well-being, and quality of life. Conversely, oral illnesses refer to changes in the structures associated with the mouth that hinder its regular functioning (Memphis, 2020). Infections of the teeth and other oral tissues can have a detrimental impact on overall health, perhaps resulting in disease or health complications.

Individuals can prevent common oral disorders such as dental caries and periodontal disease by practicing adequate oral hygiene and maintaining a disciplined diet. Additional approaches include the implementation of preventive dental techniques, the promotion of oral health, and the provision of oral health education to individuals and communities (Kent, 2019). The presence of dental caries and periodontal disease has been noted in individuals from various socio-economic backgrounds. The impact of socioeconomic situations on human health has been widely recognised for a considerable period of time. The level of socio-economic development significantly determines oral health. Individuals with greater socio-economic level generally display superior oral health compared to individuals from lower socio-economic backgrounds. This is because individuals from higher socioeconomic backgrounds have the ability to access and are exposed to superior oral health facilities due to the resources available to them (Centres for Disease Control & Prevention [CDC], 2019).

Preventive health care, often known as prophylaxis, involves implementing methods to avoid the occurrence of diseases. Disease prevention is based on proactive measures that can be classified into four categories: primordial, primary, secondary, and tertiary prevention (Parks, 2023). Primordial prevention in oral health refers to the measures taken by the mother to protect the unborn child from conception to one year. Primary prevention involves maintaining a proper diet and practicing good oral hygiene. Secondary prevention includes the use of fissure sealants and filling materials. Tertiary prevention focuses on restoring and rehabilitating oral health once the disease has started. It is necessary for individuals to follow appropriate oral hygiene habits in order to prevent common oral diseases (Aballa, 2017).

Oral hygiene practices encompass the act of brushing the teeth twice a day, consuming nutritious diets, refraining from consuming processed carbohydrates, and regularly scheduling appointments with oral health professionals every six months for examination and preventive treatment (Aballa, 2017). Kent (2022) outlines several preventive treatments for common oral disorders, such as enhancing tooth resilience, employing physical and mechanical techniques to combat microbial dental plaque, modifying nutrition, implementing preventive interventions, and scheduling regular dental examinations. According to Van (2021), preventive oral health focuses on the avoidance of dental illnesses. These services encompass dietary counselling, guidance on oral hygiene, and the administration of fluoride and fissure sealants to the teeth. Given the increasing prevalence of common oral disorders, it is crucial to establish and implement effective preventative strategies to avoid their spread (Aballa, 2017).

Oral health is an essential aspect of general health and well-being, especially for children of school age. Implementing preventative oral health measures is crucial in order to prevent dental problems such as cavities, gum disease, and other oral infections. These disorders can have a substantial impact on children's overall well-being, self-confidence, and academic achievements (Kent, 2022). This study examines the preventative oral health habits of students in Uyo, Akwa Ibom State, specifically focusing on Uyo High School. Uyo, the administrative hub of Akwa Ibom State, is experiencing significant urbanisation and boasts a cosmopolitan population. Although dental health services are accessible and there is growing awareness about oral health, a significant number of students still demonstrate insufficient preventative oral health habits. Gaining a comprehensive understanding of these behaviours as they relate to Uyo High School might offer significant perspectives for developing efficient public health interventions. Therefore, the necessity for doing this investigation arises.

1.2 Statement of the problem

There is a clear disparity in the adoption of preventative oral health practices among students at Uyo High School. This discrepancy frequently leads to a significant prevalence of dental issues, which could otherwise be averted by adhering to proper cleanliness habits and scheduling regular dental examinations. It is essential to determine the causes of these insufficient practices in order to create successful preventive measures.

Research has indicated that a notable proportion of secondary school students in Nigeria may lack adequate knowledge about basic oral hygiene practices, such as proper brushing techniques, the importance of regular dental check-ups, and the relationship between dietary and lifestyle choices and oral health (Promise, 2023). Lack of understanding about oral health can lead to inadequate oral hygiene habits and increase the chances of dental diseases. Akpan (2023) emphasised the lack of oral health education in the curriculum implemented in the majority of Nigerian schools. Nigerian students possess a restricted comprehension of the detrimental consequences of inadequate dental hygiene (Peter, 2017). In his 2017 study, Peter emphasised the numerous negative outcomes associated with inadequate dental health, such as physical discomfort, poor functionality, and a diminished quality of life. 

Furthermore, as stated by Sanchez et al. (2021), it is crucial to develop and uphold effective oral hygiene habits and foster a favourable mindset regarding oral health. Regular oral hygiene is crucial for maintaining optimal physical health by effectively reducing the risk of prevalent oral ailments such as dental caries and periodontal infections. Abiola (2022) asserts that this assertion is backed by the inclusion of consistent dental hygiene practices, such as frequent tooth brushing and flossing, together with preventive treatments like the application of fluoride and sealants. Furthermore, it includes the implementation of healthy eating habits and regular dental check-ups (Sa'adu 2022). Ani et al. (2018) identified that Nigerian secondary school children and adolescents encounter difficulties with their oral health due to regular consumption of sugary meals and beverages. This practice heightens their susceptibility to tooth cavities and periodontal disease. Akpan (2023) argues that dental caries is a significant issue for oral health, affecting around 30 to 45% of Nigerian adolescents aged 12 to 15. This study intends to examine the unique deficiencies and difficulties in preventative oral health behaviours among pupils. The focus is on identifying obstacles to effective oral health practices and evaluating viable options for enhancement."

1.3 Objectives of the study

The primary objective of this study is to critically evaluate preventive oral health practices of school students in Uyo, Akwa Ibom State. A Case Study of Uyo High School, Uyo. Specific objectives of this study are to:

To assess the current oral health knowledge among students at Uyo High School, Uyo.

To investigate the oral health practices among students at Uyo High School, Uyo

To identify the factors influencing preventive oral health behaviors among studentss at Uyo High School, Uyo

To evaluate the effectiveness of current oral health education programs at Uyo High School, Uyo, in promoting preventive oral health practices.

To propose recommendations for enhancing oral health education and promoting better preventive practices among students at Uyo High School, Uyo.

1.4 Research Questions

The following research questions will be answered in this study:

What is the current level of current oral health knowledge among students at Uyo High School, Uyo?

What are the oral health practices among students at Uyo High School, Uyo?

What are the factors influencing preventive oral health behaviors among students at Uyo High School, Uyo?

How effective are the current oral health education programs at Uyo High School, Uyo, in promoting preventive oral health practices?

What are the recommendations for enhancing oral health education and promoting better preventive practices among students at Uyo High School?

1.5 Research Hypotheses

The following research null hypotheses have been formulated to guide the study:

Ho: The current oral health education programs at Uyo High School, Uyo, in promoting preventive oral health practices is not effective.

Ha: The current oral health education programs at Uyo High School, Uyo, in promoting preventive oral health practices is effective.

1.6 Significance of the study

This study is important because it focuses on a crucial part of children's health that has lasting consequences. Enhancing preventive oral health behaviours can result in improved overall health outcomes, heightened academic achievement, and a better quality of life. The findings obtained from this study will be crucial in shaping public health policies and school health programmes designed to enhance oral health among school-aged children in Uyo and other areas.

Moreover, the data obtained from this study can make a valuable contribution to the development of evidence-based policies for oral health teaching in schools. It has the ability to support and promote improvements in the curriculum that give priority to oral health, which could potentially have an impact on policies at the local and state levels. 

Furthermore, Findings can actively include parents, teachers, and local communities in advocating for improved oral health practices among school kids. This comprehensive strategy can cultivate a conducive atmosphere for long-term enhancements in oral health.

Also, improving the comprehension, convictions, and actions associated with dental health in adolescents attending secondary school can lead to long-lasting health benefits. Optimal oral hygiene is linked to overall well-being, which includes improved nutrition, clear communication, and increased social interaction. Timely intervention in oral health issues might mitigate the economic burden associated with the management of intricate dental disorders.

Finally, this study enhances the existing comprehension of oral health behaviours among adolescents, specifically within the Nigerian context. This research can provide a basis for future investigations into many elements of oral health education and behaviour among different age groups and populations.

1.7 Scope of the study

Broadly, this study focus is to critically evaluate preventive oral health practices of school pupils in Nigeria. Specifically, this study seeks assess the current oral health knowledge among pupils in Nigeria, investigate the oral health practices among pupils in Nigeria, identify the factors influencing preventive oral health behaviors among pupils in Nigeria, evaluate the effectiveness of current oral health education programs in Nigeria in promoting preventive oral health practices and propose recommendations for enhancing oral health education and promoting better preventive practices among pupils in Nigeria.

The study is carried out in Uyo High School, Uyo, Akwa Ibom. The respondents of this study includes the staff and students of Uyo High School, Uyo.

1.8 Limitations of the study

As with any human endeavor, 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 preventive oral health practices of school pupils in Uyo, Akwa Ibom State. A Case Study of Uyo High School, Uyo. 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 Uyo High School, Uyo. 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.