Tabika Kemas An Nur Semeling (Group 5.2)

Group 5.2
Kindergarten: Tadika Kemas An Nur, Semeling.
Members: Jamie Tham (Group Leader)
Gan Pei Zhi
Geh Chee Wen
Goh Nien Cze
Harveen Kaur
Heng Lie Yuen
Jayasutha


Day 1 at Kemas Kindergarten

1)Greetings and intro by Jaya
2)Explanation on functions of teeth by Jaya
3)Icebreaker game by Chee Wen
4)First Educational talk by Nien (numbers and types of teeth)
5)Break
6)Toothbrushing method and drill by Pei Zhi and Harveen
7)Secondnd Educational talk by Lie Yuen (diet talk) and Jamie (plaque and caries and song)
8)Velcro game by Lie Yuen
9)Consent form distribution (Nien)


First Visit:

Introduction
On the 11th October 2009, we, Group 5.2 had our first visit to the Tabika Kemas An Nur, Semeling to educated the students on their oral health care. The first activity which we carried out in the kindergarten was the introduction. The aim of the introduction is to let the children know the purpose of our visit to their kindergarten and also to give them a brief idea of the activities that are to be carried out throughout the visits. The children were very excited and happy to receive visitors, each of them looked curiously at us as we entered their class with our materials, props and posters for the activities planned.


On that day, our group reached the kindergarten earlier than expected. We were greeted by the teacher and the children with their cheery face and happy smile as they were curious to know the activities that are going to be carried out for them. One of our group members, Jayasutha started the introduction by greeting the children and we were greeted back by the children enthusiastically. After the greetings each of us introduced ourselves to the children which is then followed by a brief explanation on the activities which will be carried out that day.


Through this introduction we learnt how to initiate communication with children and also learn that we have to keep using different tone and body languages to gain their attention.

After the introduction the second activity to be carried out was to educate the children about the teeth. This activity was done to explain the importance of having teeth to the children and to let the children understand the use of the teeth in our daily live.

Few questions were asked about the function and the importance of the teeth and almost coherently, the children gave us a right answer. However, we still further emphasized the importance of the teeth by simplifying the usage of teeth into 3 main functions, that is to chew, to speak and to smile. While the explanation was given, pictures depicting the three main functions were also presented to allow the students to have a better impression on the importance of teeth to them. The pictures shown got the children’s attention as the pictures were very colorful and simple to be understood.

In the end of this second activity we learned how to present information to children without making it difficult and boring for them.


Toothbrush and Toothpaste Matching Icebreaking Game
After all this, before going on to other activities and topics, we decided to have a little ice-breaking game with the children. The aim of this game is to break the ice between the children and us. Children tend to be scared of strangers, so we hoped that this game will make them more comfortable and familiar with us. This matching game will also divide the children into several small groups for future activities that need them in smaller groups.



In this game, each child was given a blue/red colored toothbrush/toothpaste picture to hang on them. Then the children were asked to find their respective partner. E.g. blue coloured toothpaste should match up with a blue colored toothbrush, and a red coloured toothpaste with a red toothbrush. So in the end there will be 2 main groups of children, blue toothpastes and blue toothbrushes together, red toothpastes and red toothbrushes together. If need be, we could further divide them into 2 smaller groups each with a total of 4 small groups, namely, red toothpastes, red toothbrushes, blue toothpastes and blue toothbrushes.


In the process, we learnt that children easily lose their concentration when we try to give them instructions or direction or a speech. We need to show them that we are the authority so that they will listen to us by methods such as raising our voices above all the noise and getting their attention. We also learnt that children don’t easily understand what we say and we need to direct them when the game begins. We also need to keep repeating ourselves to make sure they fully understand us.


Educational Talk: Number and Types of Teeth
After the game, we gave our first educational talk. It is important to educate the children about their dentition and hence some simple dental terms were introduced to them before we proceeded with oral healthcare.

In order to create a friendly environment, we tried not to appear superior to them but to try to bring everything down to their level, both physically and mentally in terms of the language and terms and approach we used. Nien, who was teaching the children about the number and types of teeth they have, purposefully sat on a small chair which made her almost the same height as the children, closer to them and able to reach out to them.


Nien asking questions to engage the children and trying to be like a child herself which was something she did not need much effort to do

In order to have more interaction with the children, Nien started by asking them whether they knew how many teeth they had in their mouth. The children responded well by shouting multiple and varying answers. However, we found that the girls were very quiet, more so than the boys. Hence, Nien asked one of the girls, named Sabrina, to step up to the front to help to review the correct answer.

Sabrina counting the teeth with Nien's help.

We stuck a poster consisting of the primary dentition and Nien asked Sabrina to count the total teeth number on the poster. While Sabrina was counting, Nien asked the whole class to listen for the correct answer. Then she asked them for the correct number of teeth. One of the children shouted loudly “12!”

It was clear that the children were not paying attention to Sabrina, so another child was asked to come up and count but this time the whole class was asked to count together with him.



After that, we taught them each and every term for their teeth in Bahasa Malaysia, which was as follows :

Central incisor – Gigi Kacip Besar
Lateral incisor – Gigi Kacip Kecil
Canine –Gigi Taring
First molar – Gigi Geraham Kecil
Second molar – Gigi Geraham Besar

When Nien finished telling them the terms, the children were busy seeing and counting each other’s teeth. Some of them were very observant and noticed that some of their friends had different sized teeth; some were obviously bigger than others. The bigger teeth were actually permanent teeth.


In order to help them understand, we asked one of the children to stand up to show all his friends his bigger teeth and explained to them as they grow older, their small teeth will shed and change into bigger teeth, and it would look just like what some of their friends already had.

To further illustrate the point, Nien also showed them her teeth to them to let them know what it would look like to have a mouth full of permanent teeth. We have no idea how much they could appreciate what we were trying to explain, but in any case, they seemed interested enough, and with that, we were well pleased.

We learned that children are always curious and they like to learn new things. However, it depends on us how we attract their attention and how we explain things according to their ability to understand. We need to approach the children in a way that is almost like a peer to them so that they would not be shy to respond to us. Too formal language and gestures do not serve the purpose of getting them to respond and interact with us, and would make learning ineffective.

Making our talks short, interesting and interactive, not condemning them if they answer wrongly, but always encouraging them to try and answer, are some ways we found effective to impart our messages to the children. We hope they learned something through it all. We know we surely have.

One requirement which we learnt is very important while educating children is patience because kids sometimes get hyperactive and bored very easily. So, it is important to have the patience to deal with them. Remembering that we were once kids helps us in dealing with them gently yet firmly.

The children happily posing and showing off each other’s teeth



Toothbrushing Method and Drill
After their break, we grabbed the chance to teach them about toothbrushing and hopefully be able to instill in them the message to try and brush their teeth after meals. We gave a talk and taught the children on how to brush their teeth the correct and proper way. This was implemented to educate them on how to keep their teeth and gums healthy.

In the talk that was given, the children understood the importance of brushing teeth properly, to differentiate between an adult and a kid’s toothbrush and to make comparisons of a new and old toothbrush and when to dispose them and change to a new one.

Harveen and Pei Zhi showing the children what a good smile with nice teeth looked like

Harveen and Pei Zhi teaching the children on how to brush using colourful hand-made self-coloured illustrations

Using tooth typodont models to show the attentive children the toothbrushing method before commencing the drill

Some of us busy trying to teach the children the most effective way to brush

The objective of tooth-brushing drill is to teach the students the proper brushing technique and to tell the students the importance of tooth-brushing to maintain good oral hygiene.

From this activity, we have learnt how to communicate with the children. Medical terms shouldn’t be used in the conversation because the children will not understand them plus they may scare off the children. Besides, we realized that disclosing tablets is not suitable for children as they will swallow it accidentally. Some just spit the tablets out the minute they put them into their mouths. The floor where we had our toothbrushing drills were quite artistically decorated with many half-eaten, half-chewed, half dissolved purple disclosing tablets.

In addition, we find it difficult to teach the children on how to clean their teeth properly as there is sure some region that will be missed out while the children try their best to follow our instructions on how to brush. Their manual dexterity is limited such that simple movements as changing the angulation of their brush while brushing different regions of the oral cavity are rather a challenge to them, although they really did put in the excellent effort to follow our instructions and directions.

In the end, we just did what we could and hoped that they would at least remember to brush their teeth and with practice, get better at it.

We also tried to emphasize on the importance of using fluoridated toothpaste, but if the message gets through to the children that they should just use toothpaste, we’ll be happy. We will keep endeavouring to instill the message of using fluoridated toothpaste in them.


Educational Talk: Diet, Plaque and Caries

Diet Talk
We divided the 2nd educational talk into 2 parts, first about diet, and second, about plaque and caries. A diet talk regarding the various types of foods was given to the children with the aid of illustrations. Colourful pictures of fruits, vegetable, snacks, confectioneries and carbonated drinks were displayed on a flip chart to show the children the food which are healthy to the teeth and food which are harmful to the teeth. The objective of giving the talk is to explain the relation of sugar, plaque and dental caries to the children using simple words and attractive pictures.

At the end of the flip charts, pictures of children with healthy teeth and beautiful smiles were shown to the children and it was explained to them that if they take care of their teeth properly, they would have nice teeth like those children, and if they don’t, they would not.


Plaque and Caries
After the “Diet talk”, we talked about plaque and caries. We used a brightly coloured model of a tooth painted on a huge piece of polysterene which had actual punch-out pieces which could be removed to showcase a black background, representing caries. We thought this would be a good way to catch the children’s interest in our talk and help them to understand how caries works and looks like. In order to illustrate the relationship between plaque accumulation and its resultant caries, we used cotton to stick to the surfaces of the tooth model to represent plaque.


The model of the tooth on polysterene


We told the children that plaque is the remnant of food stuff like the pieces of cotton which stick to their teeth after a meal. If they were to brush their teeth, the plaque or cotton can be easily removed and their teeth would look clean and bright. But if they didn’t clean their teeth after a meal, then the plaque will continue to stick to their teeth and the bacteria or “kuman” on their teeth will have a feast!

We even used a fork and spoon to show that the bacteria were like “eating” the plaque and their tooth. Soon, what would happen? Their teeth would be eaten away, and here we removed the cut-out pieces of polysterene, and their teeth will have black holes! This is called caries.

The children paid the utmost attention during this whole talk and they seemed very interested and curious when seeing parts of the teeth removed to show black holes. They listened attentively and quietly. It was one of the few moments where the atmosphere was quiet, it is no easy feat with kindy kids. We learnt that such illustrations help us get our message across in a more effective way. We also did our best to familiarize them with the terms ‘plaque’ and ‘caries’ by getting them to repeat these words many times throughout the talk. They showed plenty enthusiasm, which encouraged us a lot.


Pulling away the cut-out pieces to reveal black carious holes

We also thought of helping them remember when and how to brush their teeth by changing the lyrics of a well-known kiddy song. We did our best to teach it to them but it took them some time to learn the lyrics. The lyrics were in Bahasa Malaysia and went like this:

Berus Gigi Pagi-Pagi
Selepas makan
Sebelum tidur
Mesti guna Ubat Gigi
Berus seperti
Kereta api

In English the translation is to brush our teeth in the morning, after meals and before sleeping, using toothpaste and brushing like a train. It was a good thing that it was to children we were singing to as we all did not have vocal training. The children did not seem to mind and did their best to follow us. We were very impressed and gave the song to their teacher to continue to teach them the song, so that by our next visit, they would be able to sing it better.

The children more interested in our drawings than the song


Good Food/ Bad Food Velcro Game
We then performed a “food game” with the children where they were first divided into two groups. Each child was given a picture of a food or drink that was used in the flip charts. The children were asked to place the picture they were holding into the right column with the label of either good food or bad food. They had to compete which group would get the most answers correct in the shortest time. This game was aimed to test the understanding of the children on whether they know what kind of food could cause harm to their teeth.

Our teammates helping the children set up the pictures accordingly


The winning team got themselves animal models made out of plaster of paris. Both groups were given new toothbrushes at the end of the gift presentation as an encouragement of their participation in the activities arranged for them for the day. In this way, we could discipline the children and reward them when they gave positive response or feedback.

So, again we teach the children they will only get gifts when they behave in a good manner. Some kids were impatient to receive their gifts and they had no choice but to behave properly. It was very effective to keep the class organized, quiet and the children were receptive to what was being taught. The more they learnt and responded to the questions asked, the more rewards they got and it worked pretty well.

The children proudly showing off their new toothbrushes and plaster of paris moulds

Our team with the children, their teacher and Dr. Arishiya

With the use of colourful pictures, the children were very much interested with the talk and they were very responsive to the questions asked. The only difficulty encountered was to coordinate and organize the children during the food game as they become too excited during the game.

After giving them their rewards, we attempted to sing the song once again. We decided to leave the song with their teacher in the hopes that she will be a more effective music teacher and the next time we return, the children will all be accomplished singers and vocalists.

We also gave consent forms to the teacher to pass to the children’s parents that will allow us to treat them in AIMST in the future. The forms will be collected in 2 week’s time during our next visit.

All in all, we considered it a good first day’s job. The children had fun and responded to us, we had fun and managed to impart our messages, and Dr. Arishiya seemed pleased. We looked forward to the 2nd day’s visit, where we hoped to bring even more fun and interesting activities and games.



Second Visit:

1)Greetings and intro by Nien
2)Reinforce about diet by Lie Yuen
3)Diet game by Chee Wen/ Lie Yuen
4)Rewards by Pei Zhi and Harveen
5)Puppet show intro by Pei Zhi
6)3 key msgs by Jamie (and song)
7)Break
8)Toothbrushing drill and colouring contest by Harveen
9)Rewards for colouring competition by Pei Zhi and Harveen
10)Role play by Jaya and Lie Yuen
11)Reinforce 3 main msgs by Nien


Greetings and Intro Once Again
We started the day of our 2nd memorable visit by re-introducing ourselves to refresh the children’s memories of seeing us two weeks before. Then we had a short Q & A session with them, asking them about the functions of their teeth which we taught them 2 weeks ago.

Surprisingly, most of them could remember at least one or two functions. In order to help them remember and reinforce the message on the functions of teeth, we once again showed the posters and asked them to repeat the functions after us a few times.



Diet Game
This was followed by reinforcement on the message regarding the various types of food which is healthy and harmful to teeth. This time we used real vegetables fruits and snacks.

Some of the yummy and tempting healthy and unhealthy snacks we used

A “food game” was again conducted. This time, the children were to put the real food into different columns labeled with good and bad food. At the end of the game, explanations were given to the children as to why some types of food are harmful to our teeth and some are beneficial. With the talk and game, we were hoping to reinforce the information related to the relationship of diet, plaque and caries.

It was a good thing that the children were very good and able to resist the temptation to grab a bite of the real yummy snacks such as chocolate and sweets, if not our efforts to educate them would have been in vain. Thankfully, that was not the case, and the children even seemed to exhibit somewhat supernatural strength in resisting such food, not even looking twice at them as they put them in either the category of good food or bad food.

All in all, the children did very well in the game and were rewarded with stickers, with which they were very happy to receive.

Jaya explaining to the children which column is bad food and which is good food


Puppet Show
After the game, we decided to treat the children to a puppet show which is full of oral health messages. We thought that this would be a more interesting and effective way of getting the dental health messages through to the children, instead of just talks.

Setting up the puppet show in front of the excited children

Our puppet show revolved around 4 main characters, Ali who likes to eat sweet things against his mother’s advice, Mimi who is Ali’s friend, Ali’s mother and the dentist.

Pei Zhi with the arduous task of introducing the characters

The story is about Ali who always sneakily eats sweet things and things that are unhealthy for his teeth, against his mother’s wishes. His friend Mimi who is very conscious of her oral health and takes care of her teeth well refuses to befriend Ali because he has ugly black teeth due to caries. Ali’s mother keeps trying to tell him how to take care of his teeth but he refuses to listen.

One night, Ali has a sever toothache and wakes up in the middle of the night screaming in pain. His mother takes him to see the dentist the very next morning. The dentist does a check on his teeth and “repairs” any damage. The dentist also addresses the children directly and gives them some good dental advice.

Ali’s teeth now look good and he is a changed boy who wants to take care of his teeth from now on. He meets Mimi again, who is now impressed by his teeth and agrees to be his friend once more. They end up feeling happy and singing the toothbrush song again. Here the children happily joined in the song with Ali, Mimi, Ali’s mother and the dentist.

The show in full swing albeit one mildly exposed puppeteer’s head

The children fully captivated by our puppet show

Throughout the whole story, we emphasized quite a few times on the 3 key messages we hoped to impart to the children, namely reducing sugary foods intake (and by that hopefully its frequency as well), brushing teeth 3 times daily, and visiting a dentist twice a year.

The great thing was that the children seemed completely mesmerized by the puppet show and gave us their fullest attention, laughing and chuckling and responding well to the characters. Thus, we enjoyed ourselves too.

We learnt that such methods of teaching are very effective. However, because we didn’t have the appropriate props, our puppet show was done at rather a high angle above the children, and they had to crane their necks a little bit to see the puppets. If we ever get the chance to do it again, we’ll find a more appropriate stand or curtain and bring it down, more to the level of the children’s visual field without exposing our puppeteers.

However, for a first time attempt, we consider it a great success!


Our puppeteers having fun behind the scenes


Reinforcement of 3 Key Messages
After the mesmerizing puppet show, we once again reinforced the 3 key messages we hope to impart to them over the course of these 2 visits. We used the posters we prepared and other hand-drawn illustrations.

These are the three messages we hope to impart, however, we understand that as they are kindergarten children, it is not that easy or even practical to expect them to learn and remember and apply what we tell them. For example, to tell them to reduce the frequency of sugary foods would not really make sense to them as they probably do not notice or count how many times they eat sweet things in a day.

Thus, to educate them on what are good and bad foods for the teeth and telling them to avoid the bad ones, we hope they will naturally eat them less, and in turn reduce the frequency of sugary foods. Also, on brushing their teeth 3 times a day, it is probably not very practical for them, but we hope that this message can become somewhat ingrained in them that when they grow up and get more exposed to dental education such as in primary school, they will remember this message and it will hopefully become a part of their life.


Reinforcing the message on toothbrushing

Our main goal is to familiarize them with dental messages so that they will not find dental care something alien, but rather something they accept as the norm. Through this, we hope that they will learn to apply this knowledge from a young age and thus have better oral health.

Reinforcing the message on good and bad foods

Showing the tooth model again

We also sang the song we taught them 2 weeks ago on how to brush their teeth, and guess what? We were delightfully surprised to find that they had memorized the song perfectly! Their teacher had done a wonderful and amazing job in teaching them the song. They were indeed accomplished singers and vocalists! Here, we learnt that children can be taught something well with constant teaching and training. So we hope that by exposing them to dental messages they will be accustomed to it and learn to apply what they learn from a young age. We also truly hope they will be aware of how important dental care is. We hope that when they hear these messages again, they will be further ingrained in them and one day produce people who are conscious of their oral health.


The children performing the song to us


Colouring Competition and Toothbrushing Drill
After their break, we had a colouring competition. We made pictures of a friendly dentist treating a child who is very happy receiving treatment and above the picture was written “Doktor gigi kawan baik anda” (the dentist is your good friend). When the children were colouring, we emphasized the need for all of them to meet the dentist twice in a year and the importance of visiting the dentist.


The children putting their colouring skills to the test

Trying hard to out-colour each other for the prize


Also, we constantly reminded the children that the dentist need not be feared as they will take care of their teeth and not harm them in any way. After the colouring contest, we picked three winners and rewarded them with soft toy keychains. The others were given more stickers for their hard efforts. To say the least, they were all very happy to receive gifts after having a good time colouring!



Role Playing
After the toothbrushing drill and colouring competition, the children were divided into 2 groups so that one facilitator would be able to lead one group in the activity of role playing. This role play activity is done to familiarize the children with the dental clinic, dentist and the instruments being used in the dental treatment. Children generally would be afraid of visiting the dentist thus this activity is done to show the children that the dentists are friendly and the dental clinics are a safe place. This activity should help them be more comfortable with seeing a dentist in a white coat and not be afraid of them.

Our plan was to spilt the children into two groups and make them do the role play under the supervision of the group members. Before we started with the role play, we decided to talk to the children about dental clinics, the instruments in the clinic and most importantly the dental chair. Two sets of poster showing pictures of dental chairs and treatment being carried out on a child were shown to the children before the role play. We asked 3 children to participate in the role play at a time. One of them would be the dentist, the other the patient and the third would hold the light.

Showing posters to the children before the role play


One group was managed by Lie Yuen and the other by Jaya. The rest of our team members participated by helping out with disinfecting the mouth mirrors, sitting with the children and participating in answering questions by Jaya and Lie Yuen, and other small acitivites like picture taking.

Jaya teaching how to hold a torchlight so that its light shines into the mouth


The children were given the chance to act as a patient and dentist. The dentist has the chance of wearing a white coat and has to count the number of teeth and also spot for black carious teeth. A mouth mirror was used to visualize the upper teeth and also to familiarize the children with the instruments used in the dental clinic. While the activity was being conducted, the facilitator would explain to the children why some of them have lesser teeth than others. By spotting carious teeth, the child would also have a general idea on how carious teeth look like and understand that carious teeth affects the function and the esthetics of the student.

Lie Yuen teaching Rehan how to be a good dentist


Lie Yuen and her future team of dental associates


Reinforcing the 3 Key Messages One Last Time
Finally, we reached the end of our 2nd day visit. After settling the children down once again and quieting them, we once again ran through the 3 key messages which was a constant theme in all our activities and which we often referred to whenever we could.

We ended by once again singing the by now infamous toothbrushing song with the children. All of us sang heartily and with much enthusiasm. As a final parting gift, we gave more stickers and did lots of high-fives with the children. By now, we had become rather attached to the children and hope they enjoyed our presence.

Before we left, we collected the consent forms from the teacher. We hope to see many of them as our patients in the future.

It was a great experience and one that we are grateful for. It may not be easy to deal with children, but it sure can be fun. More than that, it is extremely rewarding when we are able to gain a child’s trust and friendship. We have learnt so many things and hope we have been able to impart something in return. It was also great fostering teamwork and friendship amongst ourselves. We truly look forward to treating any of these children in the near future.

A great many thanks to everyone who made this project possible. Our utmost thanks to the kindergarten teacher who diligently taught the children our song that we could sing it together with them fluently and enthusiastically. Our heartfelt thanks to the children who willingly and cheerfully bore with us during our visits. You have made a lasting impression on us. Thank you once again Dr. Kalyan and Dr. Rohani for arranging everything for us. We are glad to be a part of this project. We hope you have enjoyed reading about our experiences. Thank you!

Our happy and grateful team