Oral Health Knowledge, Attitudes and Practices among 9 - 12 Year Old Children Attending Primary Schools in Westlands, Nairobi County, Kenya

Oral health is not only the absence of disease but also the optimal functioning of the mouth and its tissues in a manner, which preserves the well-being of the oral cavity and the individual’s highest level of self-esteem. It is a state that enables an individual to eat, speak and socialize with minimal discomfort or embarrassment. In Kenya, a large number of children suffer from poor oral health largely due to poor oral health knowledge, attitude and practices.Since poor oral health in childhood often continues into adulthood, investing in oral disease prevention and health promotion is more cost effective in the long term than focusing on treatment of oral diseases. In order to achieve successful prevention of oral diseases and tooth decay, preventive measures should be implemented in early life hence the need to target children. This study used a cross-sectional design to determine the oral health knowledge, attitudes and practices among primary school children aged between 9 and 12 years in Westland’s, Nairobi County which houses high cost private schools, public middle class schools and low cost schools in the informal settlements. Data was analyzed in SPSS v17 using univariate (frequency tables and proportions), bivariate (chi-square tests) to show if there existed a statistically significant association between variables. A total of 16 schools and 436 pupils were interviewed: 248 (57%) girls and 188 (43%) boys representing the three school categories: A-low cost, B-public middle class and C-private high cost schools [186 (43%), 142 (32%) and 108 (25%) respectively. The type of school the child attended and child’s age had a significant statistical association with oral health knowledge (χ= 9.495; p = 0.009; χ2= 33.735; p = <0.001). Respondents from Type C School had higher knowledge compared to those from other schools. In contrast, this knowledge did not translate to better oral health practices. The type of school a respondent attended had statistically significant association with oral health practices. Similarly, the age of respondents was significantly associated with oral health practices (χ=28.903; p= <0.001) with children aged 12 years showing better practices. There was no statistically significant association between gender and oral health practices. Nearly half of the pupils aged 9-12 years attending schools in Westlands have low levels of oral health knowledge. Children who had an exposure to school dental health programs showed better knowledge. Similarly majority of the pupils had negative attitudes towards oral health. Attitudes and were not influenced by type of school, age or gender of the respondents. The practices were influenced by the level of knowledge respondents had, the age of child and the type of school a respondent attended. Oral health seeking behavior was low as majority of the pupils had not visited a dentist for routine preventive care. Since oral health knowledge influences practice as shown in this study, there is need to increase the oral health knowledge to pupils in Westlands through well planned school based oral health education programmes in primary schools. This study recommends inculcating routine preventive dental care among the children to improve oral health seeking behavior.