Oral Health Knowledge, Attitudes, and Practices Among Secondary School Students in Nigeria

Oral Health Knowledge, Attitudes, and Practices Among Secondary School Students in Nigeria by Johnson John Omale Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University November 2014 Abstract Secondary school students in Nigeria face challenges regarding their oral health. Few researchers have investigated oral health knowledge, attitudes, and behaviors in Nigerian populations. The purpose of this study was to assess the level of oral health knowledge, behaviors, and practices among secondary school students in Enugu State, Nigeria, in relation to their oral health status. The theoretical framework of this study was based onSecondary school students in Nigeria face challenges regarding their oral health. Few researchers have investigated oral health knowledge, attitudes, and behaviors in Nigerian populations. The purpose of this study was to assess the level of oral health knowledge, behaviors, and practices among secondary school students in Enugu State, Nigeria, in relation to their oral health status. The theoretical framework of this study was based on the health belief model. A cross-sectional study was conducted to collect data from 12 secondary schools in Enugu State, using a close-ended questionnaire as well as oral examination (dental caries and periodontal diseases) of the students who attended junior secondary (JSS) I, II, and III classes. A total stratified sample of 671 students was included in the study. Bivariate nonparametric tests and logistic regression were used to analyze the data. According to the results of the study, the levels of dental caries and periodontal diseases were relatively low. However, only one fourth of the students had received professional fluoridation, and almost 50% of the participants had never visited a dentist. Students from a missionary school had lower levels of periodontal diseases than those from public schools, with an odds ratio of 0.612 (95% CI [0.402, 0.934]). Students from JSS III class tended to have a lower level of periodontal diseases than those of JSS I class (OR: 0.567, 95% CI [0.363, 0.886]). The social change implications of this study can be the development and incorporation of oral health promotion programs into the school curriculum. These programs may increase the adoption of preventive oral health strategies by students, such as regular dental attendance, to maintain their good oral health for a life time. Oral Health Knowledge, Attitudes, and Practices Among Secondary School Students in Nigeria by Johnson John Omale Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University November 2014 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, MI 48106 1346 UMI 3665814 Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author. UMI Number: 3665814 Dedication This dissertation is dedicated to God Almighty for His grace and mercies over me, and to my parents Mr. Sule Peter Omale and Mrs. Ashamawo Juliana Omale for the sacrifices they made for their children and for their continual support for me. Acknowledgments The journey of 10,000 miles starts with a step; as my dissertation journey is coming to an end, there is need to thank those who have helped contributed to the successful completion of this degree. I am most grateful to my committee chair, Dr. Vasileios Margaritis, for his encouragement, love, tolerance, and guidance. He is an “Angel” in human form. My God will always bless him and his family and meet him always at his point of needs (Amen). My being under his supervision had really exposed me more to what research is all about; I am challenged to show the same affections to my students. I will also thank my dissertation committee member, Dr. Jeff Snodgrass, for his contributions in my study, especially in the areas of methodology. I feel highly honored to have him serve in my dissertation committee. I am also grateful to the management and staff of Walden University (especially every lecturer that acted as my facilitator) for making my dream of becoming an academic doctor in Public Health come true. As for Dr. K.B. Sofoluwe (KSC), the Rector of Federal School of Dental Technology and Therapy, can I ever repay her for her positive impacts in my life right from my undergraduate day until today. She refused to give me fish, but rather taught me how to fish. Her words of encouragement and moral supports gave birth to this degree. God will always meet her at her family at their points of needs. Special thanks also to my uncle, DSP Anthony Bala Omale (rtd.), for laying the foundation for my academics during my days in the secondary school. Special thanks also to Brig Gen Sofoluwe (rtd), Lt-Col H Obigho (rtd), Maj Smith (rtd), and Dr S Ebigwe (former FSDTT without their supports, my completing this program would have being like a mirage. Mrs. Ofor, Mrs. Agbo (Deputy Director, PPSMB), words are not enough to thank you for all your supports during the data collection process. Special thanks to the Management and staff of the schools I used for my study. I also thank the management, staff, and students of Federal School of Dental Technology and Therapy, (I refused to mention names because they were all wonderful people) for their encouragement, criticism and moral supports. My special thanks also to Dr. Amadi, S.E. , Prof Onyido A. and other part-time lecturers who encouraged me into taking up this program. Mrs. Ijemba Vivian “Business Centre at the Red Gate,” a million thanks to her for being available always to type my dissertation right from the prospectus stage till the completion of the study. Finally, my special thanks to my siblings, Abah, Monday, Christopher, Sunday, Mathew, Philip, Alex, and Justina for their prayers, encouragement, and moral support.