EFFECT OF MOTHER’S KNOWLEDGE ON CHILD’S ORAL HYGIENE

STATUS IN IBADAN NORTH, OYO STATE, NIGERIA.

BY

ODOH GODWIN IZUCHUKWU.

MATRIC NO: 191148

Justicebk98@gmail.com

08074010757

To

Community Dentistry Unit

Department of Periodontology and Community Dentistry

College of Medicine

University of Ibadan

A RESEARCH PROPOSAL SUBMITTED TO THE FACULTY OF DENTISTRY IN

PARTIAL FULFILMENT FOR THE AWARD OF DEGREE OF BACHELOR OF

DENTAL SURGERY.

JUNE, 2023
 SUPERVISOR'S ATTESTATION

I write to attest that the proposed study titled "Effect of Mother’s Knowledge on Child’s Oral

Hygiene Status" will be undertaken by ODOH G.I, an undergraduate dental student of the

University of Ibadan.

_________________________

Sign/Date

Dr. Ibiyemi Olushola

BDS (Ibadan, Nigeria), MPH (Ibadan, Nigeria)

FMCDS (Nigeria), PhD (Newcastle upon Tyne, UK)

Senior Lecturer/Honorary Consultant Community Dentist

Department of Periodontology and Community Dentistry

University of Ibadan and University College Hospital, Ibadan, Nigeria.

 CERTIFICATION

I write to certify that the proposed study titled "Effect of Mother’s Knowledge on Child’s

Oral Hygiene Status" will be undertaken by me, ODOH G.I, an undergraduate dental student of

the University of Ibadan, Nigeria.

___________________

Sign/Date

Odoh G.I
 TABLE OF CONTENT

Page

SUMMARY

EXPECTED RESULT

CHAPTER ONE- INTRODUCTION

1.1 Background

1.2 Problem Statement

1.3 Justification of study

CHAPTER TWO- AIMS AND OBJECTIVES

2.1 Aims

2.2 Objectives

2.3 Research questions

CHAPTER THREE- LITERATURE REVIEW

CHAPTER FOUR- METHODOLOGY

4.1 Study design

4.2 Study location

4.3 Study population

4.3.1 Inclusion criteria

4.3.2 Exclusion criteria

4.4 Sample size determination

4.5 Sample technique

4.6 Data collection

4.7 Data management

4.7.1 Data handling and entry

4.7.2 Data analysis

4.8 Ethical consideration

4.8.1 Confidentiality

4.8.2 Non-maleficence

4.8.3 Voluntariness

4.8.4 Beneficence to participants

4.8.5 Dissemination

4.9 Work schedule

4.10 Budget

REFERENCES

APPENDIX 1 (INFORMED CONSENT FORM)

APPENDIX 2 (QUESTIONNAIRE)

APPENDIX 3 (CERTIFICATE)
 CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND

The World Health Organization defines oral health as 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. It varies over the life

course from early life to old age and it is integral to over all good health and also, supports

individual participation in the society and achieving their potentials (WHO, 2020). Oral diseases

constitute a neglected epidemic in Low and Middle-Income Countries (LMICs). An

understanding of its distribution and severity in different settings can aid the planning of

preventive and therapeutic services (Osuh et al., 2022). However, mechanical and

chemotherapeutic approaches to oral hygiene aim to modify the oral microflora to promote

healthy periodontal and dental tissues, and the current oral hygiene measures, appropriately used

and in conjunction with regular professional care, are capable of virtually preventing caries and

most periodontal disease and maintaining oral health. Toothbrushing and flossing are most

commonly used, although interdental brushes and wooden sticks can offer advantages in

periodontally involved dentitions. Chewing sugar-free gums as a salivary stimulant is a

promising caries-preventive measure. Despite new products and design modifications,

mechanical measures require manual dexterity and cognitive ability. Chemotherapeutic

supplementation of mechanical measures using dentifrices, mouthrinses, gels and chewing gums

as delivery vehicles can improve oral hygiene. The list includes anticalculus, antibacterial and

cariostatic agents. For the population at large to make effective use of these oral hygiene

measures, oral hygiene promotion needs to be implemented and the considerations include the

role of parents, school and the media for children and the workplace, social environments,

nursing homes and trained carers for adults and the elderly (Audrey et al., 2001). Oral health

literacy is the degree to which individuals have the capacity to obtain, process, and understand

basic health information and services needed to make appropriate oral health decisions; scientific

evidence showed the relationship between the oral health literacy of caregivers and the children’s

oral health-related quality of life (Velasco et al., 2022). Moreover, poor oral hygiene may impact

a child's development and growth in several ways, because the oral health of children plays a

crucial role in their overall well-being and development. They may suffer from pain and

discomfort, low self-esteem, and inability to perform their daily activities. However, study

conducted in Bernardino County, California to assess the relationship between oral health

knowledge and oral health related quality of life among older adults with different ethnicities

showed that there is a gap in oral health knowledge (OHK) and how it relates to perceived oral

health related quality of life. Thus, there is a need to assess OHK as a component of oral health

literacy and identify areas in which knowledge gaps exit to develop educational strategies that

address the need of the elderly population (So Ran kwon et al., 2021). Also, study sought to

explore the relationship between children's oral health behaviors, parental oral health knowledge,

parental choices of pit and fissure sealants, and parents' education proved that families with

children at the early mixed dentition stage, parents with higher education levels tend to have

better oral health knowledge and more oral health care needs, such as pit and fissure sealants. In
addition, children of parents who have better educated parents tend to perform better oral

hygiene practices (Liangwen et al., 2020). Community oral hygiene promotion must be

employed to maximise opportunities for oral health for all and reduce inequalities by removing

financial and other barriers. Oral health approaches should be tailored to lifestyles and abilities

of children, adults and the elderly in order to enable them to make decisions to improve personal

oral hygiene and oral health. Also, studies have shown that mothers play a significant role in

determining the oral health status of their children, as they are the primary caregivers responsible

for their children's oral hygiene practices.

PROBLEM STATEMENT

Poor oral health affects quality of life; and oral health literacy studies are increasing as it plays
an essential role in promoting oral health (Chia Jung et al., 2022). Oral health is closely linked
with overall health and poor oral hygiene practices in children can lead to various health
problems, including tooth decay and gum disease, which in turn can affect their overall health.
Studies have shown that mothers play a crucial role in determining the oral health status of their
children, as they are responsible for their children's oral hygiene practices. The family is the first
institution that influences child behaviour and development, especially mothers, who are the
primary model for developing behaviour. It is important to initiate basic good oral health habits
in childhood so that the appropriate dental norms are established and then maintained into adult
life (Sharayu et al., 2021).

JUSTIFICATION OF STUDY

Children aged 6-7 years are in the early mixed dentition, which is a period of high prevalence of
dental caries and other dental diseases and a critical period for the formation of oral health
behaviors. Therefore, good oral hygiene habits of children and oral health knowledge of parents
are very important. Oral diseases such as tooth decay and gum disease are among the most
common health problems in children, and poor oral hygiene practices contribute significantly to
their development. Moreover, the primary responsibility for a child's oral hygiene lies with the
parents, particularly the mother, who often takes on the primary caregiver role. A mother's
knowledge about oral health and hygiene practices can significantly impact a child's oral hygiene
status. Also, assessing the level of knowledge about oral health among mothers helps to
determine the extent to which their children are at risk of developing oral health problems, as
previous study showed that mothers’ knowledge of the child’s oral health care was inadequate
(Sharayu et al., 2021).
This research aims to assess the effect of a mother's knowledge on her child's oral hygiene status
and this assessment is of great importance as it can help identify the factors that influence oral
hygiene practices, leading to possible interventions aimed at improving the oral health status of
children.
 CHAPTER TWO

AIM AND OBJECTIVES

AIM

To assess the effect of mother’s knowledge on child’s oral hygiene status in Ibadan North L.G.

A, Oyo State, Nigeria.

SPECIFIC OBJECTIVES

a) To assess the level of oral hygiene knowledge among mothers.

b) To evaluate the oral hygiene status of children.

c) To identify factors that influence a mother's oral hygiene knowledge.

d) To determine the association between the mother's knowledge and the child's oral hygiene

status.

RESEARCH QUESTIONS

1. What is the level of knowledge about oral hygiene practices among mothers?

2. What is the oral hygiene status of their children?

3. What are the factors that influence mother's knowledge about oral hygiene practices?
 4. Is there a significant relationship between mother's knowledge and their child's oral

hygiene status?

HYPOTHESIS

Null: There is no association between mother’s education and child’s oral hygiene.

Alternative: There is an association between mother’s education and child’s hygiene.

 LITERATURE REVIEW

The national oral epidemiological survey conducted every decade has become an indispensable
means of detecting changes in oral disease patterns. A recent study undertaken to investigate the
oral health status and related factors in 12–15-year-old students in Gansu, China showed that
adolescents in Gansu Province had high prevalence of caries experience along with low filling
rate, and low prevalence of healthy periodontium. Therefore, it is necessary to vigorously
strengthen oral health education, disease prevention and control programs in the province as this
would help improve the oral health-related quality of life of these individuals (Zhidong et al.,
2023). According to Asmaa & Hasaan, 2023 , early childhood caries (ECC) is one of the most
prevalent chronic childhood diseases affecting the primary teeth of children younger than 6
years of age. ECC remains a significant problem in many parts of the world including the GCC
region because the disease etiology is complex and includes social, biological, and dietary
factors. However, many oral health promotion programs were identified globally including oral
health education, nutritional programs, the use of fluoride and pit-and-fissure sealants, and inter-
professional population-based oral health promotion and prevention programs such as school-
based oral health programs, motivational interviewing, and anticipatory guidance. Oral health
prevention programs have been established within the GCC region. Nevertheless, the GCC
region has some unique characteristics that need to be investigated to contextualize the western
model of the dynamics of ECC prevention and promotion programs locally.
Nevertheless, poor oral health is still a major burden for populations throughout the world,
particularly in developing countries because it could not receive proper attention. Present study
in India to investigate oral health behavior of school going children and adolescents reported
high prevalence of oral health problems and lack of awareness regarding good oral hygiene
practices among respondents. Thus, oral health education should be imparted among children
and adolescents for adopting good hygiene practices and timely seeking dental health care
(Ashima et al., 2023).
 CHAPTER THREE

METHODOLOGY

Description of the Study Area

badan North is a Local Government Area in Oyo State, South western, Nigeria. Its headquarters
located at Agodi in Ibadan. It has an area of 27 km2 and a population of 856,988 according to the
Oyo State Government in 2017.

Study design

A cross-sectional study design will be employed in this study.

Study Population

The study will involve the recruitment of a sample of mother-child pairs between the ages of 6

months to 10 years from the selected communities in Ibadan North, Oyo State, Nigeria.

Eligibility Criteria
Inclusion criteria
Participants that will be included in this study will be both old and new pediatric dental patients

between ages of 6 months and 10 years and their mothers seeking dental care in UCH Dental

Center within the duration of the study.

Exclusion criteria
Participants not willing to participate in this study will be excluded. Critically ill patients will

also be excluded from the study.

All patient who already participated will be excluded to avoid duplication of data.

Data set fewer than 5 answered questions will be removed from the final data set.

SAMPLE SIZE ESTIMATION

From previous cross-sectional study on the prevalence of oral health,

Using Lesli-Kish formular,

Z 2 pq
n
d2
Z=

P=

Q=

D=

Sampling Technique

Study participants will be selected through convenience sampling technique from mothers and

children at the selected community in Ibadan North, Oyo State, Nigeria.

Data Collection
An interviewer administered questionnaire written in English language and translated in Yoruba

language will be administered to the mother. Information on the age, gender, family structure,

and number of siblings, position of the child in the family, and the socioeconomic status of each

study participant would be gotten. The socioeconomic status of each mother would be

determined with the following parameters, income, education and occupation.

Clinical examination of the children would be done using natural light and the simplified oral

hygiene index (Greene and vermillion, 1964) would be used to evaluate the clinical level of oral

hygiene.

The clinical level of oral hygiene associated with oral hygiene index score 0–1.2 would be

recorded as good, 1.3–3.0 as fair and 3.1–6.0 would be recorded as poor.

Other clinical findings such as carious teeth, mobile teeth, missing teeth and the status of the oral

soft tissues would be recorded.

All the data collected would be processed using SPSS.

Data Handling and Entering

All data collected will be checked for errors of omission and commission, and transferred

manually on to IBM Statistical Package for Social Sciences (SPSS). Statistics version 26 for the

data analysis.

Data Analysis

Data will be analysed using the IBMB SPSS Statistics version 26. Descriptive statistics of mean,

standard deviation, pie chart, bar chart, frequency table and percentages will be used to
determine percentages of responses on the attitude, knowledge and perception of ocular hazards

amongst Dental professionals. Chi-square test will be used to test the relationship between

categorical variables while Independent Student 1-test would be used to compare the means of

two groups. The significance level of p <0.05 will be used in all tests.

Ethical Considerations

The ethical approval would be obtained prior to the commencement of the study from the Joint

University of Ibadan University College Hospital Ethical Review Committee after Collaborative

Institutional Training Initiative (CITI) certification and will abide by the following rules of

ethics:

Confidentiality of Data

To ensure the confidentiality and anonymity of all subjects in this study, participants will be

given code numbers and no name will be recorded. Information collected cannot be linked to the

participants in any way and their names or identifiers will not be used in any publication or

reports from this study.

Non-Maleficence to Participants

This proposed study will be free of risk and harm to the participants as this study will not involve

any invasive procedures and all participants will be treated with respect. Only time for

participation will only be required of the participants.

Voluntariness
Participation in the study will be voluntary and the participants can choose to withdraw from the

study at any time if they want to.

Beneficence

Participants will receive no direct benefits from participating in this research study. However,

their responses may help us learn more about the influence of maternal knowledge on oral

hygiene status of children between ages 6 months and 10 years.

Dissemination

Findings from the study will be presented in academic meetings in the Faculty of Dentistry,

University of Ibadan, local and international conferences and published in peer reviewed

journals.
Work schedule

Timeline Research progress stage

Weeks 1-2 Proposal writing, ethical approval and selection of community

Weeks 2-4 Data collection

Week 5 Data analysis

Week 6 Manuscript writing

Budget

S/N Budget item Amount (Naira) Rationale

1. Expenses in processing ethical 10,000 Cost for processing
approval ethical approval
which includes
printing, transport
and call fees
2. Assessment (questionnaires) 10,000 Printing of
questionnaires
3. Transportation expenses 5,000 Transportation to
dental clinics
4. Communication expenses 2,000 Communication
between team
members and data
analyst
5. Data analyst 20,000 Stipend for data entry
and data analysis
Total 47,000 ---
 APPENDIX 1

INFORMED CONSENT FORM

IRB Research Approval Number ___________________________

Approval will relapse on _________________________

Title of Research: Effect of Mother’s Knowledge on Child’s Oral Hygiene Status in Ibadan

North, Oyo State, Nigeria.

Name and affiliations of researcher:

This study is being conducted by Odoh Godwin Izuchukwu, a final year student of the Faculty of

Dentistry.

Sponsor of research:

This research is self-sponsored.

Purpose of research:

The purpose of this research is to assess the relationship between the child’s oral hygiene and the

mother’s Knowledge on oral hygiene practices.

Procedure of the research:

Questionnaires will be administered in order to obtain information from participants that meet

the inclusion criteria on maternal occupation as one of the factors affecting Oral Hygiene Status

of Children. Participants in this study will be asked to provide information about their and their

children's oral hygiene routines and any dental problems or procedures they have had in the past.
Expected duration of research and participant's involvement:

This research will be carried out for four weeks. Each participant is expected to spend about 10

minutes on the data collection.

Risk:

The research is not expected to result in any harm; participants can withdraw from the study at

any point in the study.

Cost to the participants:

There is no financial involvement for participating in this research.

Confidentiality:

All information collected in this study will be given code numbers and no name will be recorded.

This cannot be linked to participants in anyway and their name or any identifier will not be used

in any publication or reports from this study.

Voluntariness:

Participation in this research is entirely voluntary. If any participant chooses not to participate,

this will not affect them in any way.

Due inducement:

Participants will not be paid any fee for participating in this research.
REFERENCES

WHO. Oral health: Key facts. The World Health Organization; 2020