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 Table of Contents  
ORIGINAL RESEARCH
Year : 2020  |  Volume : 12  |  Issue : 3  |  Page : 221-225

Oral health handling behavior counseling to improve dental health knowledge of parents in choosing a proper toothache medicine for children: A cross-sectional study


Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia

Date of Submission01-Oct-2018
Date of Decision13-Nov-2019
Date of Acceptance28-Nov-2019
Date of Web Publication02-Jun-2020

Correspondence Address:
Dr. Gilang Rasuna Sabdho Wening
Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga, Mayjend Prof. Dr. Moestopo No. 47, Surabaya, East Java.
Indonesia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JIOH.JIOH_214_18

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  Abstract 

Aim: The aim of this study was to increase the knowledge of elementary school students’s parents about the proper way of choosing medicine for toothache. Materials and Methods: This descriptive study with quasi-experimental method was conducted on 12 respondents who were parents of Grade 2 students of elementary school in Surabaya, and the inclusion criteria of the study were those who experienced toothache in the last 6 months and those who were using painkillers. Respondents were given a pretest to measure the level of knowledge and systematic selection of drugs for their children, and an interview was conducted for the respondents. Moreover, counseling was carried out with the material that had been prepared, and a posttest was carried out to measure the level of knowledge. The data obtained were then analyzed using the paired t-test and linear regression test (degrees of freedom = 11, confidence interval = 95%, and P < 0.05) by using the Statistical Package for the Social Sciences software, version 22.0. Results: There was a significant correlation between the pretest and posttest score (P = 0.00), and this significant correlation affected by respondent’s level of knowledge (P = 0.017). Conclusion: This counseling program was able to increase the knowledge of parents about the risk of using painkillers in children’s toothache.

Keywords: Handling Behavior, Parents’ Knowledge, Toothache Medicine


How to cite this article:
Wening GR, Alvita D, Ramadhani A, Kartikasari F, Faisal M. Oral health handling behavior counseling to improve dental health knowledge of parents in choosing a proper toothache medicine for children: A cross-sectional study. J Int Oral Health 2020;12:221-5

How to cite this URL:
Wening GR, Alvita D, Ramadhani A, Kartikasari F, Faisal M. Oral health handling behavior counseling to improve dental health knowledge of parents in choosing a proper toothache medicine for children: A cross-sectional study. J Int Oral Health [serial online] 2020 [cited 2020 Aug 4];12:221-5. Available from: http://www.jioh.org/text.asp?2020/12/3/221/285569




  Introduction Top


Dental and oral health is part of the body’s health that cannot be separated from one another as it affects the overall health of the body. Teeth are one part of the body that serve to chew, talk, and maintain the shape of the face. Thus, it is important to maintain healthy teeth so that teeth can last long in the oral cavity.[1]

Caries is one of the biggest problems faced by individuals in Indonesia and other developing countries because of its high prevalence with significant social impacts.[2] National Institute of Health in the United States reported that dental caries is the most common chronic disease among children aged 5–17 years, which is five times more common than asthma and seven times more common than allergic fever. If left untreated, dental caries can cause toothache, impaired food absorption, affects child growth, and leads to loss of school time.[3]

Toothache in children can be overcome with the provision of pain medication. However, the provision of pain medication is not able to provide the best solution because on one hand it minimizes side effects to a particular organ, but on the other hand, it may increase side effects on other organs. Painkiller medication has side effects on vital organs (kidneys, heart, and gastrointestinal tract), especially in children where the vital organs are in the process of growth so that drug administration needs to be considered.[4]

On the basis of the research conducted on September 15–16, 2017, at the Keputih Elementary School and Medokan Semampir Elementary School, it was found that 53% of mothers of students in Keputih Public Health Center chose pain killers as a solution of children’s toothache. Furthermore, mothers who used medicines as a solution of children’s toothache had children with many cavities. On the contrary, the administration of incorrect drugs in children can jeopardize their health. They rather give their children some random medicines than bring them to the dentist.

In many low-income countries, much of the drug supply is bypassing the official health-care system. Costumers with limited buying capacity often acquire medicines from acquaintances, relatives, and unregistered vendors who have little or no health-care training. In these countries, medicine may often be obtained without a prescription from the markets and chemists. This situation is associated with adverse consequences because of poor-quality medicines being taken and the absence of information on how to use medicine in general.[5],[6],[7]

Counseling is one way to disseminate information and instill confidence, especially related to handling dental pain in children to improve mothers’ knowledge to change their behavior to be better. The counseling about hazardous medicines was for toothache treatment, which aimed to improve mothers’ knowledge about the risks of using painkillers in children’s toothache and to provide the right solution to manage toothache in children.

This program was conducted to improve the health behavior of choosing painkillers of elementary school students’s parents.


  Materials and Methods Top


Study design

This was a descriptive study with quasi-experimental method. The design of this study is pretest and posttest group. This study conducted on Keputih Sub-district, Surabaya and held for 6 months. This research had been approved to be conducted on the Keputih Public Health Center by Surabaya Health Office.

Ethical policy and institutional review board statement

All the procedures carried out in this study were approved by Health Research ethical committee of Faculty of Dentistry, Airlangga University, with letter number 129/KKEPK.FKG/VII/2016.

Sampling criteria

Respondents were taken by simple random sampling from student’s mother population. A total of 12 respondents who were parents of Grade 2 students of elementary school in Surabaya were included in the study, and the inclusion criteria of the study were those who experienced toothache in the last 6 months and those who were using painkillers.

Approach method

A formal approach was through communication with the principal, homeroom teachers, and mothers of Grade 2 students of the Keputih Elementary School. The approach included counseling about the risk of taking drugs for toothache after referring to socialization media. The indicator of success was that there was an increase of pretest and posttest results and was calculated using percentage computations to compare the knowledge of the mothers before the material in the program and after the material were given.

The method of this study was by conducting pretest and posttest during socialization and questionnaire. Respondents have filled the informed consent to be a part of this study and were told about objective, procedure, benefit, and confidentiality of research and approved it.

Questionnaire method

In this study, we prepared a questionnaire to measure the knowledge of the respondents. The questionnaire used in this study had been tested for its validity. The validity test for the questionnaire was carried out by finding a correlation between the scores of each question (r result) with the r value in the table. The validity test was carried out twice until all questions were considered valid. Each question was declared valid if r results had a positive value and r results > r table at the significance level of 5%. For n = x, then the value of r table = x. To be declared valid, all questions must have a positive r value and value > x. The results of the validity test showed all questions had positive r values.

The first segment was a pretest conducted in the form of filling out a questionnaire about the conditions that cause cavities, the type of food that can cause cavities, the effect of overdose of painkillers on the child, and the action to be taken if the child had a toothache. The questionnaire had been tested by dental public health experts with a focus group discussion (FGD) technique in the Department of Dental Public Health, Universitas Airlangga before. Then validity and reliability testing were carried out. The questions appeared in the questionnaire were based on health behavior theory.

The second segment was the storybook reading. The third segment was the socialization of the risk of drug use for toothache and the proper treatment of toothache in children. The fourth segment was discussion in the form of question and answer about the material that was still not clear to the subjects. The fifth segment was posttest in the form of replenishment of the questionnaire after the counseling.

For the additional data, we also conducted some interviews with the respondents about their health behaviors related to the drug-choice knowledge. The questions in the questionnaire includes the number of dental visit in a year, health behavior toward choosing painkillers, attitude toward dentist and dental treatment, and perception of tooth infection. After interview data were collected, we conducted a linear regression test with the difference score of pretest and posttest to see the relationship.

After the fifth segment, the data were collected from the pretest and posttest, and interviews were processed and presented in a descriptive table with percentage of respondents.

Statistical analysis

The data obtained were then analyzed by the paired t test and linear regression test (degrees of freedom = 11, confidence interval = 95%, and P < 0.05) using the Statistical Package for the Social Sciences software, version 22.0 (IBM, New York).


  Results Top


This study was conducted on 12 respondents who were mothers or guardians of Grade 2 elementary school students. The majority of the respondents were younger than 40 years and had children with high decayed, missing, and filled teeth (DMFT) score. All of the respondents gave painkillers to their children for the relief of toothache; however, majority of them (63.3%) gave the inappropriate drugs. The respondent’s distribution is shown in [Table 1].
Table 1: Respondents’ distribution

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In the first segment, mothers were given with pretest in the form of questions in a multiple-choice format comprising 10 questions, namely the conditions that cause cavities, the type of food that cause cavities, the effects of drug overdose, the risk of excessive drug use on children, and efforts made if children had a toothache.

The final segment was posttest to mothers comprising the same 10 questions as in pretest. The result was that 43% parents were able to answer the pretest questions correctly. The pretest result was considered good because parents had read the content of the socialization materials on the handouts distributed at the beginning of the session. The respondents did quite good on pretest (>35%). Therefore, it can be concluded that the program was successful because parents were able to increase their knowledge about risk of drug usage.

[Table 2] shows that the pretest and posttest score increased about 30% after the respondents were given counseling about choosing proper toothache medicine. A significant correlation was found between pretest and posttest scores.
Table 2: Correlation analysis of pre-test and post-test result

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The descriptive analysis result of interview data collected is shown in [Table 3]. The linear regression analysis is shown in [Table 4]. The result showed that knowledge of choosing medicine had a significant relationship with the increase of posttest score.
Table 3: Descriptive analysis results of interview data

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,
Table 4: Liner regression analysis of pretest–posttest differences score and interview data

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  Discussion Top


When a child feels a toothache, parents instinctively make efforts for the relief of pain, one of which is using painkillers. On the basis of the preliminary study, it was found that 53% of mothers of the students in Keputih Public Health Center chose painkiller as a solution of toothache. Furthermore, mothers who used medicines as a solution of children’s toothache had children with many cavities. This was due to the lack of knowledge about the handling of children’s dental health in the community.[8]

Unlike most adult patients, children’s doses need to be calculated on an individual basis according to their age, weight, or body surface area. A drug miscalculation in a child can have catastrophic effects and all care need to be taken to avoid this.[9] The minimum knowledge about drug management can jeopardize the health of the children. Moreover, painkillers are easily available at chemists and can even be obtained without a doctor’s prescription.[10] In a study conducted by Twycross et al.[11], it was observed that only 36% of parents thought that painkillers had side effects that needed attention.

Mother is the main provider of the primary care that her child needs during the first 5 years of life. The type of care she provides depends to a larger extent on her knowledge and understanding of some aspects of basic nutrition and health care.[12] In developing countries, many programs have been implemented that link the level of mother’s knowledge to the health status of children.[13]

Counseling on drug use in child is needed. This is relevant with the result of this study that the knowledge of choosing proper medicine is significant with the increase of posttest score. Health education is believed to promote active thinking and assessment of health-related issues by the public and encourage them to decide for themselves whether they want to change and in what manner.[14] In the context of health promotion research, casual research allows us not only to understand and predict health behavior but also to change health behavior. Making cause–effect statements, such as giving counseling about a thing that they believe after all this time, provides both theoretical and practical benefits.[15]

The posttest score of the participants increased from 40% to 70%. The majority of the parents did not know about the medicines they had given to their children when they had toothache. However, there was an increase in the level of parent’s knowledge after counseling.

This study based on the Health Belief Model (HBM). The HBM is the most commonly used theory in health education and health promotion to explain change and maintenance of health-related behaviors and as a guiding framework for health behavior interventions.[16] This model was one of the first-designed models to encourage people to take action toward positive health. The HBM is based on the belief that health-related behavior is determined by whether individuals (1) perceive themselves to be susceptible to a health problem, (2) see the problem as serious, (3) are convinced they will benefit from treatment of prevention activities, and (4) recognize to take action and any barrier that would interfere with this action.[17] With the counseling given to the mother, it can change their perspective about having a drug management for their children.

This activity aims to increase maternal knowledge about the risks of using painkillers in children’s toothache and provide appropriate solutions to deal with toothache in children. The target of this program is parents (mothers) of elementary school students in the work area of Keputih Public Health Center. The socialization media used are in the form of story books along with presentation materials.

This socialization will explain the causes of toothache that is often experienced by children, the types of drugs that are often used by mothers for the relief of toothache, the effects of using the drug, the correct selection and use of drugs, the risks of using drugs, and the right solution for toothache in children. The procedures for this socialization are as follows: gather parents (mother) of Grade 2 students at the Keputih Elementary School in the classroom, provide the pretest form to the parents of the students, provide counseling to the parents of students about the risks of using drugs and the right solution for toothache in children, provide a posttest form to measure the level of knowledge of the mother after counseling, and evaluate program results.

The program can be concluded as successful because parents were able to increase knowledge about the risks of using painkillers in children’s toothache. The involvement of parents in maintaining children’s health is very important, especially cultivating healthy living habits.[18] On the basis of the results of the linear regression test, it was found that the mother’s knowledge of the selection of drugs that are suitable for child illness affects the increase in posttest scores.

The limitation of this study is the number of respondents used and the less-suitable questionnaire. For the further research, other advance questionnaire or instruments for measuring habit and health behavior could be applied.

Acknowledgement

We express our sincere gratitude to the staff of the Department of Dental Public Health, Faculty of Dental Medicine, Universitas Airlangga and Keputih Public Health Center, for their support.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Holt K, Barzel R. Promoting Oral Health in Young Children: A Resource Guide.2nd ed. Washington, DC: National Maternal and Child Oral Health Resource Center; 2018. p. 156-9.  Back to cited text no. 1
    
2.
Dharmalaksana D, Rahaswanti A, Ani LS. Description of the incidence of dental caries based on body mass index in children aged 48–60 months in TK Negeri Pembina Denpasar. Dentist Education Study Program, Faculty of Medicine, Udayana University. Bali Dent J 2017;1:19.  Back to cited text no. 2
    
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Yani R, Hadnyanawati H, Kiswaluyo, Mellawaty Z. Overview of dental caries severity of elementary school children in 10 districts of Jember Regency. Stomatognatic 2015;12:42-5.  Back to cited text no. 3
    
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Benzon HT. Acute and Chronic Pain Management in Children. [Internet]. New York, USA: Elsevier. c2018 [cited at 2018 Dec 20]. Available from http://nyosora.com/foundations-of-regional-anesthesia.  Back to cited text no. 4
    
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Holtkamp K, Peters-Wallraf B, Wüller S, Pfäaffle R, Herpertz-Dahlmann B. Methylphenidate-related growth impairment. J Child Adolesc Psychopharmacol 2002;12:55-61.  Back to cited text no. 5
    
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Allen DB. Inhaled corticosteroid therapy for asthma in preschool children: Growth issues. Pediatrics 2002;109:373-80.  Back to cited text no. 6
    
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Klein-Schwartz W. Abuse and toxicity of methylphenidate. Curr Opin Pediatr 2002;14:219-23.  Back to cited text no. 7
    
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Hong S, Cagle JG, Van Dussen DJ, Carrion IV, Culler KL. Willingness to use pain medication to treat pain. Pain Med 2016;17:74-84.  Back to cited text no. 8
    
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Blair K. Medicines Management in Children’s Nursing. London, UK: Learning Matters; 2011. p. 178.  Back to cited text no. 9
    
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Ratner KG, Kaczmarek AR, Hong Y. Can over-the-counter pain medications influence our thoughts and emotions? Policy Insights Behav Brain Sci 2018;5:82-9.  Back to cited text no. 10
    
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Twycross AM, Williams AM, Bolland RE, Sunderland R. Parental attitudes to children’s pain and analgesic drugs in the United Kingdom. J Child Health Care 2015;19:402-11.  Back to cited text no. 11
    
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Manohar B, Reddy NS, Vyshnavi P, Sruthi PS. Assessment of knowledge, attitude and practice of mothers with severe acute malnutrition children regarding child feeding. Int J Pharm Clin Res 2018;10:150-4.  Back to cited text no. 12
    
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Fadare O, Amare M, Mavrotas G, Akerele D, Ogunniyi A. Correction: Mother’s nutrition-related knowledge and child nutrition outcomes: Empirical evidence from Nigeria. PLoS One 2019;14:e0215110.  Back to cited text no. 13
    
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Catalan-Matamoros D. The role of media communication in public health. In: Health Management––Different Approaches and Solutions. Spain: University of Almeria Publishing; 2011. p. 57.  Back to cited text no. 14
    
15.
Salazar LF, Crosby RA, DiClemente RJ. Research Methods in Health Promotion. San Francisco, CA: Jossey-Bass; 2015. p. 79-82.  Back to cited text no. 15
    
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Diddana TZ, Kelkay GN, Dola AN, Sadore AA. Effect of nutrition education based on health belief model on nutritional knowledge and dietary practice of pregnant women in Dessie town, northeast Ethiopia: A cluster randomized control trial. J Nutr Metab 2018;2018:6731815.  Back to cited text no. 16
    
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Bensley RJ, Brookins-Fisher J. Community Health Education Methods: A Practical Guide. 4th ed. Sudbury, MA: Jones & Bartlett Learning; 2018. p. 107-9.  Back to cited text no. 17
    
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Salari R, Filus A. Using the health belief model to explain mothers’ and fathers’ intention to participate in universal parenting programs. Prev Sci 2017;18:83-94.  Back to cited text no. 18
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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