Effectiveness of Train the Trainers Program in Improvement of Oral Health of Children in Tamilnadu – A Randomized Trial

Abstract

School years are influential stages in people's lives where lifelong substantial oral health-related behaviours, as well as beliefs and attitudes, are being developed. Children are particularly receptive during this period, and the earlier habits are established, the long-lasting, and the impact. The aim of the study is to assess the Effectiveness of Train the trainers program in improvement of oral health of children in rural Tamilnadu. In this double blinded trial, 100 schools were selected from each Tiruvallur and Kanchipuram districts by computer generated randomized sequence (CGRS). 50 schools in each district were chosen as control and the other 50 in the test group.The oral hygiene of the children was assessed with DMFT and QH plaque index (with dissolved disclosing solution) and fracture of teeth was assessed with Elli's Classification. The children were enquired regarding their diet sugar intake frequency, brushing frequency, fluoride toothpaste etc. Oral health education , brushing techniques and oral hygiene instruction were taught to Block Resource Teacher Educators (BRTE) and trainers in the test group schools alone. After that a follow up has been done after 6 months for the final data. The data was entered in Google forms and analysed in IBM SPSS software version 20.0.Student T test was used to compare the baseline data and 6 month follow up data between the 2 groups and p value was kept at <0.05 for significance. Results showed that in baseline DMF components were 1.47±0.95, 0.12±0.08 and 0.1±0.04 respectively and after the follow up, it was 1.26±0.71, 0.09±0.05 and 0.1±0.07 respectively. Likewise in primary dentition, dmf components were 1.71±0.92,0.14±0.09 and 0.019±0.02 in the baseline data and 1.2±0.8 ; 0.11±0.06 and 0.15±0.082 final data respectively. Before intervention,only 30.9% were brushing twice daily but after the intervention, 69.5% were brushing twice. Similarly 11.5% were using the proper brushing technique before the intervention but it increased to 81.2% after the intervention. The present study shows significant difference in brushing frequencies, oral hygiene status which shows the train the trainees program was successful even with limitations.