ORAL HEALTHCARE: THE NEED FOR ORAL HEALTH EDUCATION PROGRAM IN SCHOOLS IN NIGERIA

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

The prevalence of oral health issues is widely acknowledged. Oral illnesses have a significant impact on a substantial section of the population, including both males and females of all age groups (Bala, 2020). Oral illnesses induce pain, discomfort, and have a detrimental impact on quality of life. Regular dental checkups are essential for early detection and timely treatment of oral illnesses (Manny et al., 2022). Timely access to preventative and therapeutic treatment for oral health has the potential to significantly alleviate the prevalence of oral health conditions in both adults and children. Reducing the prevalence of caries is of utmost importance for children, as it continues to be the primary oral health issue for children globally (Fred et al., 2019).

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 protocols can result in additional oral health concerns that are more preventable than they are reparable. Inadequate oral hygiene leads to heightened buildup of plaque and debris in the oral cavity, including the mouth, teeth, and gums, which can result in the development of periodontal disease. Gum disease, also known as periodontal disease, is a bacterial infection that affects the tissues and bones surrounding and supporting the teeth (Banks et al., 2019). Ensuring the long-term health of one's teeth and gums requires a lifelong dedication. Developing good oral hygiene practices, including regular brushing, flossing, and reducing sugar consumption, at an early age can significantly reduce the need for expensive dental treatments and prevent long-term health problems (Peniel et al., 2023).

The occurrence and intensity of dental caries are decreasing in the majority of developed nations (Udensi et al., 2018). The observed phenomenon has been ascribed to alterations in living conditions and lifestyle, proficient utilisation of oral health services, execution of oral healthcare programmes in schools, adoption of consistent self-care routines, and the application of toothpaste containing fluoride (Bashir et al., 2022). However, nations that have not implemented community-based preventative oral care programmes have experienced a rise in the occurrence of dental caries (Martin, 2018). Considering this evidence, it is necessary to establish, monitor, and evaluate the impact of school-based oral health education and preventive programmes in countries like Nigeria, where there has been a rise in the occurrence and development of tooth decay in young children (Udensi et al., 2018).

A study conducted in Lagos, Nigeria revealed that the occurrence of caries is 9.9% and the overall presence of caries is 20.4% in both the primary and secondary dentition (Udensi et al., 2018). A baseline evaluation conducted in Ile-Ife, Nigeria, revealed that 9.1% of school students had caries, whereas 59.1% had fair or poor dental hygiene (Esan et al., 2019). Without organised interventions, it is probable that the occurrence of tooth decay in both the primary and secondary teeth will escalate over time (Akande, 2019). The study conducted by Esan et al.,(2019) shown a robust correlation between the presence of dental caries and oral hygiene level, indicating that the prevalence of caries rises as oral hygiene status deteriorates. Furthermore, they demonstrated that the sole determinant for tooth decay is the condition of one's oral hygiene. Therefore, a Nigerian oral health education programme implemented in schools will focus on promoting self-care practices to enhance and sustain oral cleanliness, reduce the occurrence of dental caries, and encourage timely seeking of oral healthcare (Udensi et al., 2018).

Oral health is a crucial component of general health and well-being, impacting multiple facets of life such as physical appearance, social relationships, and academic success (Daniel, 2023). Oral health is frequently overlooked, especially in underdeveloped nations such as Nigeria, despite its significant significance. Comprehensive oral health education programmes in schools are essential to tackle the prevalent problems of dental diseases and inadequate oral hygiene practices among young people. This study examines the imperative of introducing oral health education programmes in Nigerian schools.

1.2 Statement of the problem

Oral health is an essential aspect of general health and well-being, but it is frequently disregarded in various regions worldwide, including Nigeria. The incidence of dental ailments, including dental caries, periodontal disease, and other oral health conditions, is significantly elevated among school-age children in Nigeria (Omoniyi, 2023). These disorders can result in significant ramifications, such as persistent pain, challenges with eating, and diminished focus in school, consequently impacting children's scholastic achievement and overall well-being (Akeredolu, 2020).

Although there is a strong correlation between oral health and overall health, there is a notable deficiency in oral health instruction within the Nigerian educational system. According to Arinze (2021), a significant number of youngsters have insufficient understanding of fundamental concepts related to maintaining oral hygiene, the significance of regular dental examinations, and proactive actions to prevent dental ailments. The low availability of dental care facilities, especially in rural regions, exacerbates the lack of awareness in oral health. Therefore, it is imperative to prioritise oral health education in schools (Udensi et al., 2018). Due to the lack of organised oral health education programmes in schools, several children are deprived of the essential knowledge and abilities required to uphold proper dental hygiene. The lack of understanding in this area exacerbates the prevalence of avoidable oral ailments, resulting in enduring health complications and heightened healthcare expenses for both families and the community (Marvel, 2023).

The necessity of implementing an oral health education programme in Nigerian schools is apparent. These programmes are crucial in providing necessary knowledge and promoting proper oral hygiene practices from an early age (Marvel, 2023). Integrating oral health education into the school curriculum enables children to grasp the significance of oral health, cultivate good behaviours, and diminish the occurrence of dental problems (Inyene, 2023). Consequently, this can result in greater overall health outcomes, superior academic achievement, and improved quality of life for children throughout Nigeria. Therefore, the necessity for doing this investigation arises. 

Objectives of the study

The primary objective of this study is to critically analyse oral healthcare and the need for oral health education program in schools in Nigeria. Specific objectives of this study are to:

To assess the current knowledge level of oral health among school children in Nigeria

To explore the attitudes and perceptions of school children towards oral health and oral hygiene practices in Nigeria

To examine the role of schools in promoting oral health and delivering oral health education in Nigeria.

To investigate the challenges to implementing oral health education programs in schools in Nigeria.

To propose recommendations for the development and implementation of an effective oral health education program tailored for schools in Nigeria

1.4 Research Questions

The following research questions will be answered in this study:

What is current level of knowledge of oral health among school children in Nigeria?

What are the attitudes and perceptions of school children towards oral health and oral hygiene practices in Nigeria?

What is the role of schools in promoting oral health and delivering oral health education in Nigeria?

What are the challenges to implementing oral health education programs in schools in Nigeria?

What are the recommendations for the development and implementation of an effective oral health education program tailored for schools in Nigeria?

1.5 Research Hypotheses

The following research hypotheses are formulated to guide the study:

Ho: Schools are not responsible for promoting and delivering oral health education in Nigeria.

Ha: Schools are responsible for promoting and delivering oral health education in Nigeria.

1.6 Significance of the study

This study is important because it focuses on a crucial but sometimes disregarded element of public health. The study seeks to establish the basis for treatments that can greatly enhance oral health outcomes for children and adolescents by emphasising the importance of oral health education in schools. Providing education to young individuals regarding oral health has the potential to create healthier communities and alleviate the impact of dental illnesses on the healthcare system.

Many areas in Nigeria have inadequate access to dental treatment, resulting in disparities in oral health outcomes. By including oral health education into the school curriculum, regardless of socioeconomic level, all kids can acquire vital oral health knowledge and resources, potentially mitigating these inequities. Oral health issues, such as oral discomfort and infections, can have a detrimental effect on school attendance and academic achievement. Through the implementation of educational programmes focused on oral health, schools can provide assistance to students in their pursuit of improved educational outcomes.

Furthermore, oral health education programmes implemented in schools have the potential to reach not only students but also their families and communities. Students have the ability to act as champions for oral health within their families, disseminating information and encouraging beneficial changes in behaviour pertaining to oral hygiene. An informed populace on oral health is more inclined to adopt preventative measures and promptly seek dental treatment, therefore alleviating the impact of oral diseases on the healthcare system and enhancing public health in general. 

Moreover, the results obtained from research on the necessity of oral health education might offer proof to support the promotion of policy reforms and financial backing to incorporate oral health into Nigeria's national education agenda.

Finally, future scholars will utilise it as a thorough examination of the current scholarly literature. Hence, individuals with a profound enthusiasm for this field of research can depend on this work as a reliable and meticulously evaluated source of information.

1.7 Scope of the study

Broadly, this study focus is to critically analyse oral healthcare and the need for oral health education program in schools in Nigeria. Specifically, this study seeks assess the current knowledge and awareness of oral health among school children in Nigeria, explore the attitudes and perceptions of school children towards oral health and oral hygiene practices in Nigeria, examine the role of schools in promoting oral health and delivering oral health education in Nigeria, investigate the challenges to implementing oral health education programs in schools in Nigeria and propose recommendations for the development and implementation of an effective oral health education program tailored for schools in Nigeria.

The study is carried out in Nigeria.

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 oral healthcare: the need for oral health education program in schools 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 health education: Oral health education is the process of imparting knowledge and skills to individuals on how to maintain good oral hygiene, prevent oral diseases, and promote oral health. It includes teaching children how to take care of their teeth and gums as well as understanding the importance of oral health.

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