Page 46 - FINAL COMPENDIUM 2020-2021 27.2.2022

oral hygiene kit and OHE materials, improve oral hygiene kit storage and tooth brushing
area, increase parental involvement, increase frequency of oral health seminar for
teachers, reinstate dental treatment at preschools, provide financial aid for oral health,
and conduct OHE exhibition at preschools. For impact evaluation of POHP, the response
rate was 69.8% for preschool children and 76.5% for preschool teachers. A significantly
higher proportion of children from the preschools with POHP used fluoride toothpaste at
home than children from the preschools without POHP (p = 0.021). In terms of teacher’s
OHL, a significantly higher proportion of teachers who worked at the preschools with
POHP had a higher mean score of knowledge domain of the DHLAI than teachers who
worked at the preschools without POHP (p = 0.033) and more teachers who worked at
the preschools with POHP had good level of knowledge domain of DHLAI than teachers
who worked at the preschools without POHP (p <0.001) . In terms of OHRA and OHRF at
preschools, a significantly higher proportion of teachers who worked at preschools with
POHP taught oral health syllabus at preschools (p = 0.009), displayed oral health-related
posters/pamphlets at preschool (p = 0.029), performed oral health-related role play at
preschools (p <0.001), performed toothbrushing activity (p <0.001), performed
toothbrushing activity everyday/alternate days (p = 0.042), brushed teeth using
toothpaste (p = 0.001), used fluoridated toothpaste (p <0.001), examined children’s teeth
(p = 0.046), examined children’s teeth ≥1x/6 months (p = 0.043), provided toothbrush
storage at preschool (p <0.001), provided toothbrushing facilities at preschool (p <0.001),
and provided a mirror for children to use after toothbrushing (p <0.001) than teachers
who worked at preschools without POHP. In terms of significant factors associated with
children having better OHB at home when other factors were controlled were children
living in urban location (p = 0.025), parents with good OHK (p = 0.001), parents who
brushed ≥2/day (p <0.001), parents who visited dentist <6 months (p = 0.015), parents
with no oral health problem in the past 3 months (p = 0.001), parents who had low
perceived oral health impact on daily life (p = 0.006), and female children (p = 0.022). A
significantly higher proportion of teachers who worked at the preschools with POHP
implemented better OHRA and OHRF at preschools than teachers who worked at the
preschools without POHP when other factors were controlled (p <0.001). Conclusion: The
DTs and preschool teachers perceived that the POHP, OHRA and OHRF at the preschools
could help to control caries and suggested that parents should be involved in the
programme. However, lack of financial support is a barrier for the DT to implement POHP
and the teachers to implement OHRA and OHRF at the preschools. Nevertheless, the
POHP in Selangor has positive impact in providing conducive oral health environment at
the preschools. Further improvement of POHP to include parents should be considered as
parents’ factors were significant factors for children’s OHB apart from location and child’s
gender.

Keywords: preschool oral healthcare programme (POHP), children’s oral health behaviour (OHB),
oral health literacy (OHL), oral health related activities (OHRA), conducive oral health environment.

Thesis submitted for the requirements of the degree of Doctor of Dental Public Health, University of Malaya

Dr Muhammad Farid bin Nurdin
Petaling District Dental Office
Shah Alam
Selangor, Malaysia
22