Introduction: Worldwide, dental problems affect children’s health, causing millions of school hours to be lost each year. An&nbsp;effective community prevention program as a planned procedure prevents the onset of a disease among a group of individuals&nbsp;and the most cost-effective method is health education. Objectives: Assess the effectiveness of video-assisted teaching program&nbsp;on dental hygiene among primary schoolchildren. Methods and Materials: An experimental study was carried out in 60 primary&nbsp;schoolchildren between the age group of 5 and 10 years by dividing them into experimental and waitlisted control group. Pretest-&nbsp;post-test waitlisted control group design and simple random sampling were used. Standardized plaque index score and semistructured&nbsp;knowledge questionnaire used as tool. Results: The experimental group pre-test means rank (30.23) was significantly&nbsp;lower than the overall post-test rank (44.00) according to Mann–Whitney U-test. The control group pre-test means rank (30.77) was&nbsp;significantly higher than the post-test means rank (17.00) U = 442 (Z = −0.118), p &lt; 0.01. The difference between the experimental&nbsp;and waitlisted control group was large (μ = 0.906). Conclusion: The level of awareness among schoolchildren regarding correct&nbsp;dental hygiene practices is low. The video-assisted teaching program was found to be effective in improving the dental hygiene of&nbsp;the schoolchildren as measured by plaque index score. The knowledge regarding the importance of maintaining dental hygiene will&nbsp;help more and more schoolchildren to follow the correct dental hygiene practices

Chatterjee, Lt. Col. Keka

R, Lt. Col Rajanimole

Selvadhas, Lt. Col. Mary

Sharma, Major Sarita

Shukla, Capt. Mahima

English

Atharva Scientific Publications (E-Jounals)

Vol 4 | Issue 4 | Oct - Dec 2017 Indian J Child Health 492
Original Article
Effectiveness of video-assisted teaching program on dental hygiene among 
children
Lt. Col. Keka Chatterjee, Lt. Col. Mary Selvadhas, Lt. Col. Rajanimole R, Major Sarita Sharma, 
Capt. Mahima Shukla
From College of Nursing, Armed Forces Medical College, Pune, Maharashtra, India
Correspondence to: Lt. Col. Rajanimole R, Military Hospital, Jalandhar Cantonment, Jalandhar - 144 005, Punjab, India. 
E-mail: rajanimoler@gmail.com
Received - 28 July 2017 Initial Review - 21 August 2017 Published Online - 12 November 2017
Dental hygiene is an important aspect of general health and well-being. A healthy mouth helps an individual to talk, eat, and socialize without experiencing discomfort 
and embarrassment [1]. Children with poor dental hygiene are 
12 times more likely to suffer with dental caries [2]. Video-assisted 
teaching program improves dental hygiene of the participants [3]. 
Worldwide, dental problems disturb activities in schools, causing 
millions of school hours to be lost each year. Moreover, the 
psychosocial impact of these problems often significantly 
diminishes the quality of life. Prevention is the most cost-
effective approach and has the greatest impact on a community. 
Many different approaches to prevent dental problems exist and 
the most cost-effective method is health education [2]. Dental 
problems are one of the most prevalent yet preventable conditions 
in the world [4]. Children are fond of more sugary foods compare 
to adults who will result in dental caries at an early age if dental 
hygiene is not taken care [5]. Treatments for all dental problems 
are available in developed countries but may be expensive and 
not always accessible. In less developed and poor countries, 
appropriate treatment is generally not available. Further, dental 
problems increase economic burden for individuals, families, and 
nation [2]. Dental hygiene education in the form of demonstration 
and video-assisted teaching program will establish good dental 
health habits among children and also enhance the knowledge of 
their parents about good dental hygiene [2].
MATERIALS AND METHODS
The research design used in this study was experimental in nature. 
The study was conducted for duration of 14 days at a Primary 
School in Pune, India. Approval to conduct the study was 
obtained from the institutional ethical committee. The purpose 
of the study was outlined to the participants and explained that 
the respondents would remain anonymous. The sample included 
60 primary schoolchildren on the basis of inclusion and exclusion 
criteria. A list of children from the class attendance register of 
Class II, III, IV, and V, and 15 samples from each class were 
selected by lottery method. Total 60 selected samples were 
collected in project hall and divided into control (30) and study 
group (30) by lottery method. Pre-test and assessment of plaque 
index score were conducted for the respondents. Video-assisted 
teaching program was administered to the experimental group. 
Post-test knowledge and assessment of plaque index were done 
for both groups after 14 days. Video-assisted teaching program 
ABSTRACT
Introduction: Worldwide, dental problems affect children’s health, causing millions of school hours to be lost each year. An 
effective community prevention program as a planned procedure prevents the onset of a disease among a group of individuals 
and the most cost-effective method is health education. Objectives: Assess the effectiveness of video-assisted teaching program 
on dental hygiene among primary schoolchildren. Methods and Materials: An experimental study was carried out in 60 primary 
schoolchildren between the age group of 5 and 10 years by dividing them into experimental and waitlisted control group. Pre-
test-post-test waitlisted control group design and simple random sampling were used. Standardized plaque index score and semi-
structured knowledge questionnaire used as tool. Results: The experimental group pre-test means rank (30.23) was significantly 
lower than the overall post-test rank (44.00) according to Mann–Whitney U-test. The control group pre-test means rank (30.77) was 
significantly higher than the post-test means rank (17.00) U = 442 (Z = −0.118), p < 0.01. The difference between the experimental 
and waitlisted control group was large (µ = 0.906). Conclusion: The level of awareness among schoolchildren regarding correct 
dental hygiene practices is low. The video-assisted teaching program was found to be effective in improving the dental hygiene of 
the schoolchildren as measured by plaque index score. The knowledge regarding the importance of maintaining dental hygiene will 
help more and more schoolchildren to follow the correct dental hygiene practices.
Key words: Effectiveness, Video-assisted teaching, Dental hygiene
Vol 4 | Issue 4 | Oct - Dec 2017 Indian J Child Health 493
Chatterjee et al. Dental hygiene in children after video assisted teaching
was administered to the control group after collecting the data on 
the day of post-test.
The tool used in the study is structured interview questionnaire 
and assessment of plaque index score. The tool is divided into 
three sections. Section A (demographic data such as age of student, 
gender, standard, number of siblings, educational qualification 
of the parents, and family income). Section B (knowledge 
questionnaire consists of a set of five multiple choice questions 
with four options to assess the practice regarding the dental 
hygiene among schoolchildren) and Section C consists of plaque 
index score to assess the practice of dental hygiene as shown 
in Table 1. The content validity of structured questionnaire was 
ensured by submitting to the experts in the field of pediatrics and 
periodontology for content validation. Pilot study was conducted 
on 10 subjects (who were not included in the study) at a different 
primary school in Pune. The reliability of tool was established 
using Cronbach’s alpha. The coefficient of internal consistency of 
the knowledge questionnaire was α = 0.77.
RESULTS
The majority of students were from the age group of 8–10 years 
in both experimental (14,47%) and control group (13,43%). As 
per gender, 16 (53%) of students were males in the experimental 
group and 15 (50%) were males in the control group. Most of the 
students in the experimental (43%) and control group (50%) had 
three and more siblings in the family (Table 2).
Most of them in both experimental 19 (63%) and control 
group 16 (53%) had illiterate mother. It is also seen that 17 (57%) 
in experimental and 19 (64%) in control groups had father with 
less than secondary education. Again, a majority of subjects 
21 (70%) in the experimental and 25 (83%) in the control group 
came from family with an income of Rs. 5000-10,000/per month. 
8 (27%) students in the experimental group were brushing the 
teeth twice a day in the pre-test, whereas 16 (53%) of students 
started brushing the teeth twice a day in the post-test. In the 
control group, 8 (27%) students in pre-test and 9 (30%) in the 
post-test were brushing teeth twice a day. There is a significant 
score improvement observed in the experimental group as 
compared to the control group. Total 25 (83%) students in the 
experimental group were brushing the teeth using toothpaste 
and tooth brushing the pre-test, whereas in the post-test, 30 
(100%) students started brushing the teeth using toothpaste and 
toothbrush. In the control group, 23 (77%) students in pre-test 
and 25 (83%) in the post-test were brushing the teeth using 
toothpaste and toothbrush.
All 30 (100%) students in the experimental group were 
brushing the teeth independently of both pre-test and post-test. 
In the control group, 1 (3%) student in pre-test and post-test was 
assisted by the parents for brushing the teeth. 17 (57%) students 
in experimental group were not at all rinsing the mouth after 
having any eatables and 11 (37%) were rinsing the mouth after 
the major meals in the pre-test, whereas 23 (77%) students started 
rinsing the mouth after every major meal and 7 (23%) were 
rinsing after having any eatables in the post-test. In the control 
group, 24 (80%) students were not at all rinsing the mouth in 
pre-test and no significant change seen in the post-test. 27 (90%) 
students in the experimental group did not have knowledge 
regarding the frequency of changing the toothbrush in pre-test, 
whereas 25 (83%) students answered correctly in the post-test. In 
the control group, 27 (90%) students did not have any knowledge 
regarding the change of toothbrush in pre-test which did not 
change significantly in the post-test.
In the experimental group, total 22 (73%) students in 
the experimental group had poor plaque index score and 6 
(20%) had fair plaque index score in the pre-test. The score 
improved to 8 (26%) good and 12 (40%) fair in the post-test 
(Fig. 1). In the control group, 21 (70%) had poor plaque index 
score in the pre-test which did not show any improvement 
in the post-test (Fig. 2). In the experimental group, pre-test 
means rank (30.23) was significantly lower than the overall 
Table 1: Distribution of students as per sociodemographic 
variables (n=60)
Parameters Frequency (percentage)
Experimental 
group (n1=30)
Control 
group (n2=30)
Age 
5-6 years 2 (7) 2 (7)
6 years 1 day-8 years 8 (26) 8 (27)
8 years 1 day-10 years 14 (47) 13 (43)
>10 years 6 (20) 7 (23)
Gender
Male 16 (53) 15 (50)
Female 14 (47) 15 (50)
Standard
II 8 (27) 7 (23)
III 6 (20) 9 (30)
IV 7 (23) 8 (27)
V 9 30 6 (20)
Number of siblings
None 2 (7) 1 (3)
1 5 (17) 4 (14)
2 10 (33) 10 (33)
3 & more 13 (43) 15 (50)
Education of mother
Illiterate 19 (63) 14 (47)
<Secondary 11 (37) 16 (53)
Higher Secondary - -
Education of father
Illiterate 13 (43) 10 (33)
<Secondary 17 (57) 19 (64)
Higher secondary - 1 (3)
Graduation & above - -
Per capita income per 
month (INR)
<5000 9 (30) 5 (17)
5001-10000 21 (70) 25 (83)
Vol 4 | Issue 4 | Oct - Dec 2017 Indian J Child Health 494
Chatterjee et al. Dental hygiene in children after video assisted teaching
post-test means rank (44.00). In the control group, pre-test 
means rank (30.77) was higher than the post-test means rank 
(17.00), (Tables 3 and 4).
DISCUSSION
Health education has been shown to be an important means of 
improving the dental practices in schoolchildren. Dental hygiene 
education in the form of video-assisted teaching program will 
establish good dental habits among children and also enhance 
the knowledge of their parents about good dental hygiene. In a 
quasi-experimental study conducted by Hebbal et al. to assess 
the knowledge and plaque score in schoolchildren before and 
after the health education at Belgaum, the mean plaque scores of 
0.627 in Group I, 0.8826 in Group II, and 1.0156 in Group III [6]. 
Within the group, comparison revealed a statistically improved 
Table 2: Plaque index score (Silness and Loe plaque index)
Characteristic Teeth
Index teeth 1 6 1 2 2 4 3 6 3 2 4 4
D F M P D F M P D F M P D F M L D F M L D F M L
Score
Total Score
Plaque index = Total score of all index teeth ÷ 24
Key
1 6 – Maxillary right first molar    D – Distofacial
1 2 – Maxillary right lateral incisor    F – Facial
2 4 – Maxillary left first premolar    M – Mediofacial
3 6 – Mandibular left first molar    L - Lingual
3 2 – Mandibular left lateral incisor    P - Palatal
4 4 – Mandibular right first premolar
Scoring criteria
Score Criteria
0 No plaque
1 A film of plaque seen only by running a probe across the 
tooth surface
2 Moderate accumulation of soft deposits on the tooth 
surface can be seen by naked eye
3 Abundance of soft matter within the gingival pocket and/or 
margin and adjacent tooth surface
Plaque index=Total score of all index teeth÷24
Interpretation as per total plaque index score
Excellent 0
Good 0.1-0.9
Fair 1.0-1.9
Poor 2.0-3.0
Figure 1: Comparison of pre- and post-test plaque index score in 
experimental group
Figure 2: Comparison of pre-test and post-test plaque index score in 
control group
Vol 4 | Issue 4 | Oct - Dec 2017 Indian J Child Health 495
Chatterjee et al. Dental hygiene in children after video assisted teaching
oral hygiene with decreased plaque scores in all the three groups 
after the health education using audiovisual aids. Our study also 
proved that there is a significant reduction in the mean plaque 
index score after post-test (mean = 1.6873) when compared to 
pre-test (mean = 2.0320) in the experimental group, whereas no 
significant change observed in the control group.
An experimental study on the effectiveness of video-assisted 
learning package on knowledge regarding oral hygiene among 
children by Singh et al. revealed that there was a statistically 
significant difference in pre-test and post-test knowledge score [7]. In 
our study, we found that there was an improvement in the knowledge 
related to dental hygiene and plaque index score after video-assisted 
teaching program. A similar study on the effectiveness of video-
assisted teaching program regarding the prevention of swine flu 
among children was conducted by Udaykar et al. (2013) where 
the post-test level of video-assisted teaching program (26.13) was 
higher than the pre-test mean score of only 13.
An experimental study conducted by Reddy et al. (2016) to 
assess the impact of oral health education on plaque score with 
and without periodic reinforcement among 12-year-old children at 
Telangana. Findings revealed that reduction of plaque index score 
was 61.7% in the study group and 32.6% in control group. In our 
study, 73% students had poor plaque index score and 20% had fair 
plaque index score in pre-test in the experimental group which 
improved to 26% (good) and 40% (fair) plaque index score. In the 
control group, 70% students had poor plaque index score in the pre-
test which did not show significant improvement in the post-test.
A study conducted to assess the effectiveness of structured 
teaching program to improve the knowledge regarding dental 
hygiene among 60 schoolchildren at Jalandhar by Manveer 
Kaur (2013) revealed that overall mean score of 14.91 (standard 
deviation [SD] = 3.84) was as in post-test mean score of 23.01 
(SD = 3.72). In our study, pre-test mean score was 2.200 
(SD = 0.6540), whereas post-test 2.250 (SD = 0.626). Therefore, 
the video-assisted teaching program was highly effective in 
increasing the knowledge of students regarding the particular 
subject. Our study shows that nursing professionals by simple 
health education can make a big difference in overall oral health 
of the population contribute toward the achievements of the WHO 
oral health goals. The nursing curriculum should incorporate 
various educational activities such as preparation of booklets and 
pamphlets to be given to health-care workers to circulate in the 
school as well as in the community.
The strength of our study was that it was a case–control study 
where the controls were well matched with the cases. A limitation 
of our study could be that the variations in the plaque score due 
to midday meal consumption before the data collection were not 
taken into account and also because it was done in a single school, 
it may not be truly representative of all the schools of Taluka, 
District, and State.
CONCLUSION
The level of awareness among schoolchildren and their parent 
regarding correct dental practices is low. Community nurses can 
play a key role in providing expert assistance to schoolchildren 
by simple tools for health education. This will also contribute 
toward optima policy making and implementing various teaching 
programmers regarding various aspects of dental hygiene and 
oral care in hospital and community.
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Table 3: Mann–Whitney U-test
Ranks
Group N Mean rank Sum of ranks
PlI_pre
1 30 30.23 907.00
2 30 30.77 923.00
Total 60
Change
1 30 44.00 1320.00
2 30 17.00 510.00
Total 60
Table 4: Statistic test
Test statisticsa
PlI_pre Change
Mann–Whitney U 442.000 45.000
Wilcoxon W 907.000 510.000
Z −0.118 −6.032
Asymp. Significant (two-tailed) 0.906 0.000
Funding: None; Conflict of Interest: None Stated.
How to cite this article: Chatterjee K, Selvadhas M, Rajanimole R, Sharma 
S, Shukla M. Effectiveness of video-assisted teaching program on dental 
hygiene among children. Indian J Child Health. 2017; 4(4):492-495.


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