HEALTH EDUCATION ROLE IN IMPROVING PERIODONTAL HEALTH STATUS AMONG PRIMARY SCHOOL STUDENTS IN DUHOK GOVERNORATE, KURDISTAN REGION, IRAQ

Background: Data from numerous epidemiological studies revealed that the prevalence and severity of periodontal disease is wide spread in children and adolescents, with approximately 50% to 100% of 12-years-old children having the signs of gum inflammation. Aim: This study was designed to assess the role of health education program in improving periodontal health status among primary school students in Duhok governorate. Participants and methods: The study investigated students 11-15 years old selected from 12 schools out of (892) primary public schools in Duhok governorate. For better socio demographic representation, the schools were purposely categorized into three equal groups representing rural, suburban and urban sectors. Four schools were randomly selected from each of the three sub-counties, two schools were randomly assigned for health education programs with the other two schools regarded as controls. All students of the first 6th grade class from the selected schools were enrolled. Thus a total of 615 students were assigned to intervention and controls (304 and 311 students respectively). A questionnaire was used to obtain information on age, gender, medical diseases and drug history. Utilizing a variety of learning and teaching methods a specially constructed health education program was administered to the intervention group by the researcher. The program included lectures, discussions, practical experiments, group work, problem-solving exercises, debates and role-play with appropriate stimulating visual aids and posters, accompanied by distribution of brushes and paste to the students. This was followed by clinical dental examination for each student. The effects of health education have been evaluated by using two outcome variables namely; Plaque index and gingival index. Results: The results revealed high scores of plaque and gingival indices at the baseline pre-intervention assessment among the participants. These scores have been reduced significantly at post intervention assessment in the intervention group compared to the controls p ≤ 0.05. This improvement in the intervention group was maintained at follow up assessment six weeks after the intervention. Females in the intervention and the control groups exhibited lower mean plaque and gingival scores than males. Both gingival and plaque scores in this study were consistently higher in rural than in urban communities p ≤ 0.05 (Significant).