Group 5.1 Oral Health Education Visit 1 & 2

TASK

To educate 42 pre school children about oral health care at KEMAS tabika which is a government pre school.

The government pre-school at Semeling town.

Part of the children in the classroom.



PLANNING

Identify Problem -

To impart oral health education to pre-school children in Semeling.

Design strategy, aims and objectives –

Our group was assigned to 42 students in a class which was the largest group. We decided the best way to teach oral health to children with more personal attention given to the children was to split them in 6 groups. As there are 7 of us in a group, there is one student manning each station except for the tooth brushing station where there are two students. On the second visit, we reduced to 5 stations with 2 students in the tooth brushing station and 2 students in the role play station.

Our aims and objectives are to cover various important topics of basic health education, to be able to give more personal attention to the children and to merge learning and fun together.

Implement strategy –

We implemented our station strategy by arranging desks with enough space in between in a circle in the classroom. The tooth brushing station was stationed outside of the classroom near the drain so the children are able to spit into it.

Monitor and evaluate strategy –

We returned to the kindergarten 2 weeks later to reinforce the oral health education that we taught them in the first visit, to evaluate if they understood what we taught in the first visit and also introducing them the role of the dentist and a dental clinic.

We also distributed brushing charts in the first visit so we are able to collect them during the second visit. From the brushing charts we are then able to evaluate the frequency of the children brushing their teeth. The second visit focused more on questioning the children on what we had taught rather than repeating everything again. Questions were asked to see if the children recalled what we had taught them in the stations. The tooth brushing drill was carried out again to ensure that the children are brushing the right way and to reinforce the method again.



STRATEGY

We started off our visit with 6 stations where 6 groups of children will rotate from station to station. After their break, we gather the children as a whole for some fun and games where there is more interaction between us students with the children. It is the same for the second visit except that there are 5 stations instead of 6.


STATION 1- INTRODUCTION TO TEETH
DESCRIPTION

During the first visit, a brief introduction is given to the children regarding the types of teeth and the main function of every single tooth. The materials used are the Typodont model and a diagram of permanent and deciduous teeth.

Children with Poh Yee at the 1st station.

Recreating a dental clinic setting with the child pretending to be a patient on the dental chair.


During the second visit, the members of the dental team and their roles were being introduced to the children using PowerPoint presentation. The children were also given a chance to play the role as patients. A study lamp, 2 kindergarten chairs and other dental instruments such as mouth mirror, mask, gloves, etc were shown to the children to simulate the setting of a dental clinic.

OBJECTIVE

To teach the children the different types and functions of each tooth and to expose the children to the clinical setting of a dental clinic in a friendly manner.

OUTCOME

The children are able to tell the name and the functions of each tooth of the deciduous dentition. Besides that, some of them are also able to tell the differences between the permanent and deciduous dentition.

On the second visit, the selected child of each group had the chance to play the role as a patient while we pretended to be the operator. The children enjoyed the clinic simulation session and did not show any fear towards dentist.


STATION 2 - TAKING CARE OF TEETH
DESCRIPTION

On the first visit, station 2 was assigned to educate the children on causes of tooth decay and ways of preventing it. This was done using drawings of cartoons in which a story was narrated telling the children how sugary food could cause caries. This drawings were made as simple as possible with the least amount of words in it to accommodate preschool children's understanding. Simple but bright colors were added too to captivate their attention. The children followed the narration of the story, and also helped in with the narration by guessing ahead what could be the next possible outcome.

Explaining the relation between sugar and caries through comic drawings.

On the second visit, station 2 was assigned to test the extent to which the incorporation of knowledge and its effects were with the children. The second visit also functioned as a reinforcer of what was taught earlier in the first visit. Questions were asked in accordance with what all the 6 stations have demonstrated in the first visit. A simple box was filled with small ping pong balls each marked with a number on it. The children were later asked to take a ball out and the questions were asked according with the number that was picked.

With ping pong balls and question cards to make the Q and A session more fun.

OBJECTIVE

On the first visit, station 2 was aiming to make aware to the children what were the causes of tooth decay and ways of preventing it. Co relation between caries and high consumption of sugar were highlighted. They were advised to reduce eating of chocolates and sweets. Instead, healthy food such as milk, green vegetables and various fruits were asked to be increased in their diet. The children were advised to brush their teeth at least twice a day, once when they wake up in the morning, and the other when they are about to sleep at night. Brushing was advised to be carried out using a fluoridated toothpaste.
When having a dental emergency, the children were advised to consult the dentist.

On the second visit, station 2 was assigned to test the childrens knowledge in all that was thought to them by all the 6 stations. The prime objectives were centered around

i)Avoiding food which had a high content of sugar.
ii)Increasing the consumption of food which are healthy.
iii)Brushing the teeth at least twice daily.
iv)Consulting the dentist when there is toothache.


OUTCOME

We can strongly say that we were very successful in stressing the harmful effects of sugar. Some of the children were already aware of the co relation between high intake of sugar and caries and what we had taught reinforced what they knew. Second, the children now understood the importance of brushing twice daily. The two visits were conducted in a very friendly manner to eliminate fear within the children towards the dentist. The children too were happily mixing around with us with no barriers being set.



STATION 3 - HEALTHY AND UNHEALTHY FOOD
DESCRIPTION

During the first visit, the types of food that are beneficial and also nutritious for oral health were demonstrated to the children through charts and pictures. Games like puzzle and ‘right or wrong’ were incorporated into it as to make it more fun.

The children were also shown the types of food that have high contents of sugar that will be harmful to their teeth through posters and props. Consequences of taking food with high sugar content were also explained through charts and posters. In addition, caries were demonstrated as well in the children’s teeth as most children have caries in anteriors.

Teaching the children

In second visit, a puppet show was carried out, which involved children’s participation in answering questions regarding the mentioned topic. Here, children were asked to come forward one by one to identify and mark out foods that are beneficial and harmful to teeth from a mixture of food shown on a paper board.

Handmade puppets which the children loved so much.


OBJECTIVE.

In first visit, the objective is to show the students that the food we eat are just as important keeping our teeth healthy as they are keeping their bodies healthy. Children should be able to identify the types of food that is healthy for teeth in the end.

Also we have to teach the children to reduce consumption of sugary food and the consequences of eating sugary food. Children should be able to identify the types of food that is bad for their teeth in the end. Reminder was given that they should brush their teeth after they take sugary food if they happen to take any, besides the routine twice-per-day tooth brushing.

In second visit, the objective this station is to assess the ability of children to identify the types of food that is beneficial and harmful to teeth, as well as to make them recall what had been taught in first visit, and reinforce what had been taught i.e. the consequences of eating sugary foods and the benefits of eating healthy food.


OUTCOME

In the first visit, the children were able to understand what was being taught to them and were responding positively although some minority could not pay full attention. The children seemed to have been informed on food that is beneficial and harmful to their teeth as they can name out quite a number of food that is beneficial and harmful to teeth. However, most of them, despite of knowing the fact to reduce sugary food and brushes twice daily, have most of their anteriors grossly decayed and reflected on the appearance. This clearly shows that a regular reminder and family support are important as they tend to forget or being lack of determination.

In second visit, the children were all actively participated and excited over the activity held. The children were able to differentiate the types of food that is good and bad for teeth though some confusion is still present in few. For instance, there was one child mistook cake as food that is beneficial to teeth. Hence, explanation was given as cake contains high sugar and it is harmful to teeth, and the child accepted it.



STATION 4 - STORY-TELLING
DESCRIPTION

During our first visit to the KEMAS kindergarten in Semeling, station 4 was the story-telling station. In running this activity, pictures were stuck on a Styrofoam according to its chronology.

Ebe donning a mask depicting a tooth while narrating the story to the children.

Using these pictures, a story was told based on a child who had toothache after eating a lot of sugary food and had to go for a visit to the dentist. At the dental clinic, the dentist removed the caries from the child’s tooth and the child was happy after that because the pain was gone. The story concluded with the dentist giving a toothbrush to the child for her personal use.


OBJECTIVE

The objective of the story telling station was to educate the children on reducing the consumption of sugary food that can lead to caries formation and the consequence of it. Children are more prone to caries because they love consuming sweets, chocolates and other sugary food substances. Children were also taught to brush their teeth twice a day to remove any plaque after meals. Children were told to brush their teeth in the morning and at night just before sleeping. The other objective of telling this story is to introduce the role of the dentist. Children were also given advice on visiting the dentist once every six months for a general dental checkup. This is to make sure that the children maintain their oral hygiene at a good level.

OUTCOME

In the first visit, the children were excited to hear the story that was being told. From this story, the children were able to know the types of foods that need to be avoided and reduced in order to maintain their oral health. They were also able to know when to brush their teeth as well as knowing the importance of visiting the dentist for their regular dental checkups.



STATION 5 - ROLE PLAYING
DESCRIPTION

In this station the activity which was carried out was role playing. The children were required to play the role of patients, dentists and dental surgery assistant (DSA). They were divided into two small groups of 3.The “dentist” was required to count the number of teeth present and identify the “bad” teeth with mouth mirror while the DSA shined light into the patient mouth.


Zhu Zen, one of the group members in charge of Station 4 with the necessities prepared for role playing.

Children role playing as the dentist and patient.
OBJECTIVES
The aim of role playing is to let the children to experience and have a better understanding of the roles of dentists and DSA besides ensuring them to co-operate with the dentists when they are the patients. This indirectly reduces fear of dentists among the children.

Zhu Zen telling the children on what to do with the mouth mirror and torch light.

The children will be able to identify the number of teeth present and decayed teeth which present in their mouth. They will understand that inadequate tooth brushing will lead to decayed teeth and therefore they need to seek treatment from the dentists.


OUTCOME

The children responded well in this station and they were anticipating playing the role of dentists and liked putting on lab coats. Initially, they were quite confused with the position of dentists, patients and DSA. But after explaining and guiding them, the ‘dentist’ stands at the correct position while examining the patient and the DSA sat on the left to the patient. They were able to identify the decayed teeth in their peer’s mouth easily but have difficulty in counting the number of teeth present. After guiding them, they could tell both the number of teeth present in the upper and lower arches.

The tooth brushing chart we distributed to the children.

We managed to randomly chart the number and which teeth that are decayed in the children. Below are the readings of each decayed teeth for 36 children in which 4 children were absent.


Upper right

Tooth number------------------- 51 52 53 54 55
No of children with decayed teeth 10 3 1 4 1
No of children with missing teeth 2 2 0 0 0

Upper left

Tooth number------------------- 61 62 63 64 65
No of children with decayed teeth 11 6 1 3 1
No of children with missing teeth 3 3 1 0 0


Lower right

Tooth number------------------- 71 72 73 74 75
No of children with decayed teeth 0 0 2 11 4
No of children with missing teeth 1 0 0 1 0


Lower right

Tooth number------------------- 81 82 83 84 85
No of children with decayed teeth 0 0 2 12 4
No of children with missing teeth 1 0 0 0 0



STATION 6 - TOOTH BRUSHING DRILL
DESCRIPTION

Station 6 was accountable as the centre of tooth brushing drill. Major responsibility was placed in this station as it was a main headline of which the children would have a clear understanding on the way and the correct techniques used in tooth brushings for children.

Brenda and Bala in charge of Station 6.

Our group felt that this was a major section as it played an imperative role preventing dental problems in children and reducing their risk in developing dental problems (i.e. carries, gingivitis etc).

The first activity started inside the kindergarten. We entertained the kids by playing a funny animated tooth brushing drill on the screens for them to observe. This was done in the idea to amuse the children and to get their attention towards our activity.


The next thing we did was to show the children on the Typodont model the correct way of tooth brushing. Our crew always maintained to be hilarious in the purpose of maintaining their concentration.

The next half of the drill was conducted outdoors within the vicinity of the kindergarten. Here we handed out free colored children’s tooth brush to each child. They were able to pick their favorite colors. Each of them was than given a plastic cup to get water.

Children eager to start tooth brushing.

Bala distributing cups of water.

Next, tooth paste was placed on their toothbrush and here emphasis was placed on quantity of toothpaste to be used. Each child was given the plaque disclosing solution to be rinsed. They were then showed to a mirror telling them that the stains are plaque and have to be cleaned away. The children then were thought to brush via the correct technique thought to them earlier. We were guiding them on each stage by stage. The correct techniques were again being emphasized here. A mirror was placed in front of these children so that they could see their action on the correct way of tooth brushing. The drill ended with the children washing off their mouth and bushes. The children were happy looking at their tooth in the mirror after the plaque disclosing solution was removed via the correct technique of tooth brushing. The children were now aware that with the correct tooth brushing techniques the plaque on their tooth can be removed and dental caries can be prevented. We concluded this station by educating the children on oral hygiene instructions.


On the second visit, we again emphasize on the correct technique used in tooth brushing.

On this visit, the children were first given the models to show the correct way in tooth brushing. We then took them outside to conduct the tooth brushing drill. Here again the emphasis was placed on the quantity of tooth paste to be used. The children were then guided in front of the mirror on the correct technique of tooth brushing. In this visit we did not give them the plaque disclosing solution but we were monitoring each stage of their brushing techniques giving them a good understanding on the correct techniques to be used. The drill ended with the children washing off their mouth and bushes. We concluded this station by educating the children on oral hygiene instructions.


OBJECTIVE

On the first visit, to educate the children on the right and effective way of brushing their teeth was the main objective. We emphasized to the children the importance of brushing the correct way because it prevents future dental problems. Also we taught them when to brush, how to choose a suitable toothbrush, when to change their toothbrush and how much toothpaste should be used.

On the second visit, we reinforced the right method of tooth brushing by repeating the tooth brushing drill. We also asked questions regarding tooth brushing and other things that we had taught them on the first visit to see if they could recall.

OUTCOME

The children seem to understand the method of brushing teeth when we taught them on the Typodont model. However when they were brushing their own teeth, they tend to forget the circular method and they return to scrub method so we have to guide their hand to brush the correct way.

Other than that, the children are able to answer all the questions that we asked in regards to tooth brushing which showed that they understood and remembered what we taught them in the previous visit.


GAMES

After the station activities, we gathered all the children to play some games so they can now interact as a class with us rather than groups.

DESCRIPTION

Oral Health Quiz –

To ensure that they understood and paid attention to what we had taught them at the stations, we had a short oral health quiz. There were 10 questions asked to the class.


Singing –

To liven things up, we taught them a simple song in Malay about brushing teeth.

Bala preparing the music while Ebe teaches the children how to sing.
Coloring –

We had a picture of a tooth brushing itself with a toothbrush with the words ‘Jagalah Gigi Kita’ which meant take care of our teeth for the children to color.
There were prizes to be won for the best colored pictures.

Children colouring.

We had Dr. Rohani giving out the prizes to the winners of our colouring competition.

Musical Chair –

Due to insufficient chairs, we used newspapers to substitute a chair. The tooth brushing song was played as the children walked around in circles and stepping on to a newspaper when the song was stopped. The children that did not manage to step on a newspaper are eliminated from the game and have to answer some questions about oral health.

Preparing the newspapers on the floor.

Children clapping and singing along to the toothbrush song we taught them in the first visit during the musical 'chair' game.

Two children left in the game.


Picture Hunt –

We hid 10 pictures of unhealthy food and 10 pictures of healthy food around the classroom. The class is divided into 2 groups. One group will be in charge of locating the pictures of unhealthy food and the other one will be locating the healthy food. Whichever group that manages to find all 10 pictures first will be declared winner. This is to ensure the children to be able to identify which ones are healthy foods and which ones are not.

Photos of the hidden food pasted on the whiteboard by the 2 groups of children.

OBJECTIVES

As children's attention span is short, we need to diverse our ways in teaching oral health education to them hence we incorporated fun into learning so the children maintains their interest in what we have to teach. There are plenty of questions asked during the games session as described above to evaluate how much the children knew and recall. Asking them questions is also crucial in reinforcing what we had taught them.

OUTCOME

The children enjoyed the games thoroughly and able to follow instructions of the games. They were also very enthusiastic to answer when questions were being asked. Majority of the students knew the answers to the questions posed.



WHAT WE HAVE LEARNT

TEAMWORK

Teamwork was one of the essential qualities we acquired when we did this oral health project. It is crucial as there are 7 members in our group and we have to co-ordinate and plan our activities together as a whole. We split the children into 6 groups as there were 6 stations, we require co-ordination and co-operation among ourselves as we have to start simultaneously and end our station activity approximately the same time then each of us have to move the group of children to the next station so the children would not be confused and unsure where to move next.



Teamwork is demonstrated also when all the group members willingly stayed back after clinical sessions to discuss ideas together. We also learnt to work as a team when we have brainstorming sessions where each of us contribute different ideas and then uniting these ideas to make a successful oral health activity for the children.

Our team worked hard to ensure the kids enjoy themselves!


Each of us carried out our delegated task in preparing the materials for the oral health activities and compiled them together as a group. If anyone had trouble finishing their task, everybody chipped in to help complete the task.


RESPONSIBILITY

One major thing we have learnt is responsibility, and it started from the time our group received the assignment to the preparation of reports. From the planning phase itself, we had learnt to take responsibility in informing the teacher of our coming and to do a survey before our visit to find out the facilities available in the kindergarten. Also, the group was responsible for collection of materials from the lecturers and returning of them in proper condition.

On the days of visit, we had been responsible for the morning schedule for the children including letting them having their break at a proper time. We learned to take our responsibility in all the activities (station-wise and group-wise), as in preparation of materials and settings, preparation of talks, children’s discipline control, time management, and clearance of any leftover after activities. We had especially learnt of responsibility in in-charging each own station; preparation wise and discipline wise, for instance in ensuring the fluency of the children switching from station to station i.e. to keep them in place while waiting for the next station, preparation of water and cups for TBD, and carrying out talks in each station.

However, the greatest responsibility falls to the group leader. The mentioned responsibility here includes, to make sure everything is in flow and the materials are ready before-hand, as well as any doubts are being answered from the lecturers. In addition to responsibility learned, skill of leadership is cultivated as well.

Ebe taking a break while the children were on break as well.


MANAGING CHILDREN

Before we went to the kindergarten our group had discussion including the how to manage 40 children and the activities to ensure the children learn and at the same time to behave themselves. We placed the children into smaller groups in 1 dental student to 6 children. In this way all the children will be able to benefit from the activity and their behavior are under controlled.

When children are broken up into smaller groups in the classroom.



When the activities were carried out, the children were placed into groups as according to the plan. The reward approach is applied here where the children who behave and show good performance in each activity will be rewarded. Some children tend to be more active and noisy were controlled by separating them and instructing them to sit in front of the classroom and telling them only those who behave will be rewarded and allow to join the games.
The children were easily distracted and again dividing them into smaller groups enables us to cater the information and get their attention. Voice control technique is used by using a different tone of voice and facial expression if the children do not respond or start making noise.
Modeling approach is also used in which children who show good behavior and performance in their activities are praised and showed as role model.


INTERACTING WITH CHILDREN COMPARED TO ADULTS

This activity has showed us the clear differences between an adult patient and a child. We have to get hold of their attentiveness and treat them as gentle as possible. This experience has put us in the light of knowing how to communicate with children and has given us an understanding of the approach to be used whilst treating children.

Children in their playful state of mind constantly loose their attention; hence we have learned methods in which we are able to maintain their attention during this visit. An example of this would be the use small gifts and colourful teaching material. This is different compared to our normal routine of adult patient as treating and advising an adult patient is much easier as they have the maturity level to understand.






















Children are easily amused with simple things like our Typodont model.



By this visit as well we have learnt that teaching children would not be as easy as teaching an adult patient as a child tends to get nervous and impatient more rapidly compared to adults. Hence we have learned that while teaching children we have to make learning exciting. Also we have to repeat what we said several times to ensure the children grasp what we are teaching them.

Our group mascot, Mister Gigi (Tooth).


PLANNING ORAL HEALTH EDUCATION FOR CHILDREN

In general, doing presentation to small children has to be made as attractive and simple as possible. All our activities were carried out under this consideration.

First of all, children are more easily drawn to bright colored materials. It brings a sense of interest in them. Little decorations and fancy colored substances could keep their attention always on the presenter. Cartoons may be included, as it adds humour to the concept.

Colourful posters

Secondly, presentation to children should be kept as simple as possible. This would allow an easier understanding mode. Very little amount of words should be used. If can, the main point of focus should be centered around pictures with soothing, harmonious and bright colors.The presentation to children, if can, should be delivered in the early part of the day. They are more aware of their surroundings and are able to resorb better this way. Latter part of the day may not be as effective as the morning, as they may come tired. Must be kept into consideration that children normally are actively running and tend to get tired as the day goes by.

We also rewarded children with little gifts as a positive reinforcer when the children answered our questions correctly as an encouragement for them to participate more in our activites.

The children choosing their gifts




It was an incredible experience as this is the first time where we actually work with small children. Our group had an enjoyable time during this two visits and we hope that the children will be able to remember what we taught them and continue to apply good oral health care.

Group 5.1 with Dr. Kalyan and the children.







DONE BY:

GROUP 5. 1

Bala Saravanan
Brenda Sim Pei Ling
Cheow Poh Yee
Cho Zhu Zen
Desmond Lourdes
Ebenezer Jerome Abraham
Gan Ee Chia