how and to what extent have university students utilized the school dental services

How & To What Extent Have University Students Utilized The School Dental Services? 2014

1 Final BDS part 1 Community Dentistry Project report

How and To What Extent Have University Students

Utilized The School Dental Services?

A PROJECT REPORT PRESENTED

BY

M.G.P.K. Gunawardhana (D/08/083)

N.B.H. Prabodha (D/08/052)

A.G.K. Silva (D/08/062)

H.R.L.S. Vimanshika (D/08/069)

To the

Division of Community Dentistry,

Faculty of Dental Sciences

In partial fulfillment of the requirement

For the award of

Degree of Bachelor of Dental Sciences

Of the

UNIVERSITY OF PERADENIYA

SRI LANKA. 2014



CONTENTS

Abstract ……………………………………………………………………………6

Introduction……………………………………………………………………....7

Methodology………………………………………………………………….….9

Results……………………………………………………………………………12

Discussion……………………………………………………………………….34

Conclusion………………………………………………………………………36

Limitations………………………………………………………………………37

Recommendations………………………………………………………….….38

References ……………………………………………………………………..39

Acknowledgement……………………………………………………….……40

Annexure …………….…………………………………………………..…...41



LIST OF ABBREVIATIONS

SDS - School Dental Services

SDT - School Dental Therapist

SDC - School Dental Clinic

WHO - World Health Organization

ART - Atraumatic Restorative treatment

OHE - Oral Health Education

OHI - Oral Health Instruction

UOP - University Of Peradeniya

SL - Sri Lanka

UGC - University Grants Commission

Rx – Treatments

DF- Degree of Freedom



LIST OF FIGURES

Figure1: Awareness of the university students about the SDS in Sri Lanka

Figure2: Utilization of School Dental Service among university students

Figure 3: Association of Utilization of SDS among university students with Gender

Figure 4: Association of Utilization of SDS among university students with the

Ethnicity.

Figure 5: Association of Utilization of SDS among university students with the faculties.

Figure 6: Association of Utilization of SDS among university students with the district.

Figure 7: From where they received SDS.

Figure 8: Difference between service providers.

Figure 9: Difference between reasons for not receiving treatment.

Figure 10: Amount of treatment types received by students.

Figure 11: Relationship between the gender of the student and type of treatment

received.

Figure 12: Relationship between type of treatment and ethnicity of students.

Figure 13: Relationship between faculty and the type of treatment received.

Figure 14: Relationship between guidance to utilize SDS and the ethnicity of male

students who had treatments.

Figure 15: Relationship between guidance of utilize SDS and ethnicity of female


Figure 16: Enthusiasm of parents to receive SDS for their Children

Figure 17: Relationship between importance of SDS and the gender.

Figure 18: Idea of the students about success of the treatments they have undergone.



LIST OF TABLES

Table1: Awareness of the university students about the SDS in Sri Lanka

Table 2: Utilization of School Dental Service among university students.

Table 3: Association of Utilization of SDS among university students with Gender.

Table 4: Association of Utilization of SDS among university students with the

Ethnicity.

Table 5: Association of Utilization of SDS among university students with the faculties.

Table 6: Association of Utilization of SDS among university students with the district.

Table 7: From where they received SDS.

Table 8: Difference between service providers.

Table 9: Difference between Reasons for not receiving Treatment.

Table 10: Amount of treatment types received by student.

Table 11: Relationship between the gender of the student and type of treatment received.

Table 12: Relationship between type of treatment and ethnicity of students.

Table 13: Relationship between faculty and the type of treatment received.

Table 14: Relationship between guidance to utilize SDS and the ethnicity of male


Table 15: Relationship between guidance of utilize SDS and ethnicity of female students

who had treatments.

Table 17: Relationship between importance of SDS and the gender.

Table 18: Idea of the students about success of the treatments they have undergone.



ABSTRACT

Objectives

The aim of this study is to determine how and to what extent university students have

utilized the school dental services.

Methods and Materials

This is a cross sectional study carried out using a non probable convenient sampling

method in 08 faculties of University of Peradeniya. A self-administered questionnaire

was distributed to collect data. The data was analyzed using Microsoft Excel 2007 and

SPSS v17.

Results

58% of University students have utilized SDS. From these students,

58.4% have received treatments from SDC s established at their own school. 37.8% of

students have been treated by school dental therapists. 40% of students have undergone

screening. 18% of students have received OHI. 17% of students have received restorative

treatments. 16% of students have scaled their teeth. 5% of students have undergone

extractions.

Conclusion

The study revealed that utilization of SDS among the University students is high at their

school age and is influenced by socio-demographic factors like Gender, Ethnicity and

District but not by the Faculty. Higher number of students have utilized SDS from the

SDC established at their own schools and due to the guidance from their school. Many of

them have been treated by SDT. Most of university students have undergone screening

and certain amount of students have received Restorative treatments, scaling and OHI

from SDS. To a lesser amount they have received Extractions, Referral to hospital dental

clinics and other type of treatments.

Key words

How and to what extent, University students, Utilization, School dental services.



Chapter 01 Introduction

1.1). General Introduction

chool dental service is one of primary health care services that are established in Sri Lanka as

school based dental clinics and mobile dental clinics. The service is provided by school

dental therapists for children between 2 ½ to 13years.And students above 13 years of age are

treated by dental surgeons.

382 school dental clinics have been established in schools all over the country and 369 of school

dental therapists are providing their services to uplift the oral health care for school children in Sri

Lanka.

School dental service play a major role to promote oral health care specially in rural areas where

there’s less accessibility to appropriate oral health services. SDS provides basic dental care

tackling oral diseases among children in preventive and curative manner.

Worldwide, the scope of a SDS generally include,

Scale and polish teeth

OHE, Dietary counseling

Extraction of deciduous teeth under infiltration

Restoration of deciduous teeth and permanent teeth with Amalgam

and Composite

Topical fluoride, Sealant application

Pulp therapy for deciduous teeth

Placing preformed stainless steel crowns in deciduous teeth

ART

Taking dental radiographs

Understanding the extent of utilization of SDS is important for social, functional, psychological

and economical reasons.

Since the SDS approach in the level of primary health care, it can minimize the cost for advanced

dental treatments, improve oral health and minimize the inequalities in health care services.

So for the implementation of standardized dental health service require the surveys and studies

investigating the extent of utilization of school dental service in Sri Lanka in order to achieve

WHO goals.

S



1.2). Research Background

When looking out for studies of similar literature we come across with a research conducted in

Nigeria determining the utilization of school dental service among secondary school students. But

studies have not been done to determine the utilization of school dental services by University

students at their school age.

Moreover, there are no data pertain to this study for the Sri Lankan university students. Therefore

as a preliminary attempt to obtain such information, the aim of this study is to determine How &

to what extent have university students utilized the school dental service.

1.3). Objectives

General Objective

To determine how and to what extent students of UOP have utilized the SDS which may reflect

the level of utilization of SDS of all University students.

Specific Objectives

1. Assess the level of Utilization of SDS according to

Gender

Ethnicity

District

Faculty

2. To determine the common treatments procedures that have obtained during their school

age.

3. To determine the awareness and the attitude towards the SDS among University students.

4. To assess the aspects which should be improved in SDS.



Chapter 02

Methodology

2.1). Research Questions

Primary- How and to what extent have university students utilized school dental

services?

Secondary- What is the relationship between level of utilization of SDS by university

students and certain socio-demographic data (Gender, Ethnicity, Faculty, District)?

2.2). Study Design

This is a cross sectional descriptive study.

2.3). Study Area

This study was undertaken in eight faculties (Faculty of Medicine, Faculty of Dental

sciences, Faculty of Engineering, Faculty of Veterinary Sciences, Faculty of Agriculture,

Faculty of Science, Faculty of Arts, Faculty of Allied health sciences) in University of

Peradeniya.

2.4). Population

University students of Sri Lanka.

2.5). Sampling Method

Non probability, convenient sample.

2.6). Sample

246 students from eight faculties of University of Peradeniya.

Faculty of Medicine

Faculty of Dental Sciences

Faculty of Engineering

Faculty of Veterinary Sciences

Faculty of Agriculture

Faculty of Science

Faculty of Arts

Faculty of Allied health Sciences

(Distributed 250 questionnaires, but only 246 responses were usable)



2.7). Instruments Used for Study

After taking student’s verbal consent data was collected by using a self-administered

questionnaire worded in Sinhala and Tamil which was supervised by Prof. Lilani

Ekanayake (Professor in Community Dentistry, faculty of dental sciences, university of

Peradeniya)

(Annexure no 1) The types of questions put forward were 15 closed ended questions and

01 open ended question.

2.8). Pilot Study

The pilot study was undertaken using 10 university students who resident at

Wijewardhana girls’ hostel, University of Peradeniya, Sri Lanka.

The purpose of the pilot study was to assess the suitability of the survey instrument and

the method used. Prepared questionnaire was tested in pilot study and could not find any

errors in understanding questions and the answers were satisfactory.

2.9). Data Collection

Using pilot tested questionnaire the data was collected from 250 students of University of

Peradeniya.

(But 246 responses were usable)

2.10). Processing and Analysis of Data

The data was entered and analyzed using Microsoft Excel 2007 and SPSS v17.

Percentages are shown by bar charts and pie charts. Chi square test is used to test the

relationship between level of utilization of SDS by university students and selected socio-

demographic data.

Chi - Square test

Chi - Square test is a statistical test that can be used to test the association between

categorical variables.

� − is the value for chi square

� − is the sum

O -- is the observed frequency

E -- is the expected frequency.



P- Value

This determines the appropriateness of rejecting the null hypothesis in a hypothesis (H1)

test by representing the probability of incorrectly rejecting the null hypothesis (H0) when

it is actually true.

When the significance level (alpha) = 0.05 (95%),

p -value > 0.05: Do not reject H0 Vs. p -value < 0.05: Reject H0

2.10.1). Dependent Variables

Utilization of SDS

Type of treatments

Guidance for utilizing SDS

Attitude of the student about the success of the treatments

Contribution of SDS to improve oral health

2.10.2 Independent Variables

Gender – Male, Female

Ethnicity - Sinhala, Tamil, Muslim

Faculty - 08 Faculties of UOP

District - 25 Districts in SL



Chapter 03

Results

3.1). Socio-Demographic Data of the Study Population

Size of the sample – 246

According to Gender

o Male – 126 (51.2%)

o Female – 120 (48.8%)

According to Ethnicity

o Sinhala – 198 (80.5%)

o Tamil – 33 (13.4%)

o Muslim – 15 (6.1%)

According to Faculty

o Faculty of Medicine – 30 (12.2%)

o Faculty of Dental Sciences – 37 (15%)

o Faculty of Engineering – 27 (11%)

o Faculty of Veterinary Sciences – 30 (12.2%)

o Faculty of Agriculture – 37 (15%)

o Faculty of Science – 34 (13.8%)

o Faculty of Art – 26 (10.6%)

o Faculty of Allied Health Sciences – 25 (10.2%)



According to District

o Ampara – 2 (0.8%)

o Anuradhapura – 10 (4.1%)

o Badulla - 7 (2.8%)

o Batticaloa – 8 (3.3%)

o Colombo – 28 (11.4%)

o Galle - 17 (6.9%)

o Gampaha-17 (6.9%)

o Hambanthota -12(4.9%)

o Jaffna -13(5.3%)

o Kalutara-16 (6.5%)

o Kandy - 4 (5.7%)

o Kegalle - 18(7.3%)

o Killinochchi – 3 (1.2%)

o Kurunegala-22(8.9%)

o Mannar - 2 (0.8%)

o Matale - 9 (3.7%)

o Matara - 17 (6.9%)

o Monaragala - 5 (2%)

o Mulativ - 1 (0.4%)

o Nuwaraeliya- 4 (1.6%)

o Polonnaruwa - 2 (0.8%)

o Puttalam - 4 (1.6%)

o Rathnapura - 11 (7.5%)

o Trincomalee - 3 (1.2%)

o Vavuniya - 1 (0.4%)

How & To What Extent Have University Students Utilized The School Dental Services?

14 Final BDS part 1 Community Dentistry

3.2 ). Awareness of the university students about the SDS in

Table1: Awareness of the university students about the

Figure1

88% of university students kno

12% of university students

Awareness of the university students about the SDS in SL

SDS Service


Community Dentistry Project report

Awareness of the university students about the SDS in

Awareness of the university students about the SDS in Sri Lanka

Figure1: Awareness of the university students about SDS in SL

88% of university students know about the presence of SDS in Sri

% of university students don’t know about the presence of SDS in Sri

Known88%

Unknown12%


Frequency Percentage %

SDS rvice

Known 216 87.8

Unknown 30 12.2

Total 246 100.0


Awareness of the university students about the SDS in Sri Lanka.

w about the presence of SDS in Sri Lanka.

know about the presence of SDS in Sri Lanka.




3.3) Utilization of School Dental Service among university students

Table 2:

Figure 2: Utilization of School Dental Service among university students

58% of university students have utilized the SDS

42% of university students have not utilized the SDS in Sri Lanka.

Not Utilized42%

Utilization of SDS among University students.

Utilized

Not Utilized

Total



3.3) Utilization of School Dental Service among university students

Table 2: Utilization of School Dental Service among university students

Utilization of School Dental Service among university students

58% of university students have utilized the SDS in Sri Lanka.


Utilized58%

Not Utilized42%

Utilization of SDS among University students.

School Dental Service

Frequency Percentage

143 58.1%

103 41.9%

246 100.0%


3.3) Utilization of School Dental Service among university students.



in Sri Lanka.


age



3.3 ). Association of Utilization of SDS among university students with

Gender

Table 3: Association of Utilization of SDS among university students with Gender

Figure 3: Distribution of Utilization of SDS among university students with Gender

Percentage of female students who utilized the SDS (72.5%) is higher than the

percentage of male students who utilized the SDS (44.4%).

According to chi square test,

P=0.000 (P<0.05)

There is a significant association between gender and utilization of SDS.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Female Male

Pe

rce

nta

ge

Gender

Distribution of utilization of SDS among university students with gender

Not Utilized

Utilized

SDS service

Total

Utilized Not Utilized

Ge

nd

er

Female 87 33 120

72.5% 27.5% 100.0%

Male 56 70 126

44.4% 55.6% 100.0%

p value = 0.000 DF=1



3.4). Association of utilization of SDS among university students with the

Ethnicity

SDS service

Utilized Not Utilized Total

Eth

nic

ity

Muslim 4 11 15

26.7% 73.3% 100.0%

Sinhala 128 70 198

64.6% 35.4% 100.0%

Tamil 11 22 33

33.3% 66.7% 100.0%

Total 143 103 246

58.1% 41.9% 100.0%

P value = 0.000 DF =2

Table 4: Association of Utilization of SDS among university students with the Ethnicity

Figure 4: Distribution of utilization of SDS among university students with the ethnicity

Percentage of Sinhala students who utilized the SDS (64.6%) is higher than the

percentage of Tamil students (33.3%) and percentage of Muslim students (26.7%) who

utilized the SDS.


P=0.000 (P<0.05)

There is a significant association between ethnicity and utilization of SDS

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Sinhala Tamil Muslim

Pe

rce

nta

ge

Ethnicity

Distribution of utilization of SDS among university students with the Ethnicity

Not Utilized

Utilized



3.5). Association of utilization of SDS among university students with the Faculties

SDS service

Total

Utilized Not Utilized

Fa

cu

ltie

s

Agriculture 19 18 37

51.4% 48.60% 100.0%

Allied H.S 17 8 25

68.0% 32.0% 100.0%

Art 14 12 26

53.8% 46.2% 100.0%

Dental 22 15 37

59.5% 40.5% 100.0%

Engineering 17 10 27

63.0% 37.0% 100.0%

Medicine 22 8 30

73.3% 26.7% 100.0%

Science 15 19 34

44.1% 55.9% 100.0%

Veterinary 17 13 30

56.7% 43.3% 100.0%

Total 143 103 246

58.1% 41.9% 100.0%

P value = 0.350 DF = 7

Table 5 Association of Utilization of SDS among university students with the faculties

Figure 5: Distribution of Utilization of SDS among university students with the Faculties

The highest percentage (68%) of SDS utilization is recorded from the faculty of AHS & the least

percentage (44.1%) of SDS utilization is recorded from faculty of science.

According to chi square test ,

P=0.350 (P>0.05)

There is no significant association between faculty of student & utilization of SDS

0%

20%

40%

60%

80%

100%

Pe

rce

nta

ge

Faculty

Association of who Utilized the School Dental Service with Faculties

Not Utilized

Utilized



3.7). Association of utilization of SDS among university students with the District

SDS service

Utilized Not

Utilized

Ampara 0 2

.0% 100.0%

Anuradhapura 6 4

60.0% 40.0%

Badulla 1 6

14.3% 85.7%

batticaloa 3 5

37.5% 62.5%

Colombo 22 6

78.6% 21.4%

Galle 12 5

70.6% 29.4%

Gampaha 8 9

47.1% 52.9%

Hambantota 6 6

50.0% 50.0%

jaffna 4 9

30.8% 69.2%

SDS service

Utilized Not

Utilized

Nuwaraeliya 0 4

.0% 100%

Kaluthara 16 0

100.0% .0%

Kandy 8 6

57.1% 42.9%

Kegalle 11 7

61.1% 38.9%

Killinochchi 1 2

33.3% 66.7%

Kurunegala 17 5

77.3% 22.7%

Mannar 0 2

.0% 100.0%

Matale 3 6

33.3% 66.7%

Matara 13 4

76.5% 23.5%

SDS service

Utilized Not

Utilized

Polonnaruwa 1 1

50.0% 50.0%

Puttalam 2 2

50.0% 50.0%

Rathnapura 5 6

45.5% 54.5%

Trincomalee 0 3

.0% 100.0%

Vavuniya 1 0

100.0% .0%

Mulativ 0 1

.0% 100.0%

Monaragala 3 2

60.0% 40.0%

Total 143 103

59% 41%

P value = 0.000 DF = 24

Table 6 Association of Utilization of SDS among university students with the district

The highest percentage (100%) of SDS utilization is recorded from the Kalutara and

Vavunia districts and the least from the Ampara, Mulativ, Trincomalee & Mannar (0%).


P=0.000 (P<0.05)

There is significant association between district of the school and utilization of SDS



Figure 6: Distribution of Utilization of SDS among university students with the District

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Am

par

a

An

ura

dh

apu

ra

Bad

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bat

tica

loa

Co

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Gal

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Gam

pah

a

Ham

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ta

jaff

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Kal

uth

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Kan

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Keg

alle

Kill

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Ku

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Man

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Mat

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Mat

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Mo

nar

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Nu

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Po

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nar

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Rat

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Trin

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Vav

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Mu

lati

v

Pe

rce

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ge

District

Distribution of utilization of SDS among university students with the districts

Not utilized

Utilized



3.8 ). From where they received SDS

SDC in own school

Sinhala

Tamil

Muslim

Total

percentage

The highest percentage of students have received treatments from SDC

established in their schools (58.4%).

The lowest percentage of students have taken treatments from SDC established in

another school (17.4%).

24.2% of students had taken treatments from mobile clinics

SDC in another



From where they received SDS

SDC in own school SDC in another school Mobile dental

85 26

5 2

4 0

94 28

58.4% 17.4% Table 7: From where they received SDS

Figure 7: From where they received SDS.


tablished in their schools (58.4%).


another school (17.4%).

24.2% of students had taken treatments from mobile clinics.

SDC in own school

58%

SDC in another school

18%

Mobile dental clinics24%

From where they recieved SDS


Mobile dental clinics

31

7

1

39

24.2%





3.9 ). Difference between

41.3% of students did not know exactly who treat them.

37.8% of students have

21% of students ha

School Dental Therapist

Dental Surgeon

Don’t Know

Total



Difference between service providers

Table 8: Difference between service providers

Figure 8: Difference between service providers

of students did not know exactly who treat them.

37.8% of students have been treated by school dental therapists.

21% of students have been treated by dental surgeons

School Dental Therapist

38%

Dental Surgeon

21%

Don’t Know41%

Difference between service providers

Frequency Percentage %

School Dental Therapist 54 37.8%

Dental Surgeon 30 21.0%

59 41.3%

143 100.0%


37.8%

21.0%

41.3%

100.0%



3.8 ). Difference between Reasons for not receiving Treatment.

Reasons Fear for

Rx Missed Rx No time for Rx No service available Not enough guidance other

Total Reasons

Amount 8 8 4 56 34 24 134

6% 6% 3% 42% 25% 18% 100%

Table 9: Difference between Reasons for not receiving Treatment.

Figure 9: Difference between Reasons for not receiving Treatment.

Highest response (42%) from total responses for not having treatment is not

having SDC in their schools. Lowest percentage (3%) from total responses for not

having treatment is due to inadequate time.

6%6% 3%

42%

25%

18%

Difference between Reasons for not recievingTreatment.

Fear for Rx

Missed Rx

No time for Rx

No service available

Not enough guidance

Other reasons



3.9 ). Distribution of the extent of ut

the socio-geographic variables

3.9.1 ). Amount of treatment types received by student.

Table 10:

The highest percentage of students (40%) have undergone screening and the leas

percentage of students (1%) have received other type of treatment except screening,

restorations, extractions, scaling, referrals & OHI from SDC at their school age.

extractions5%

Scaling16%

Referrals3%

Amount of treatment types received by student.



Distribution of the extent of utilization of SDS according to

geographic variables


Rx Amount Persentage

Screening 112 40.4%

Restorations 47 17.0%

extractions 15 5.4%

Scaling 43 15.5%

Referrals 8 2.9%

OHI 49 17.7%

Other 3 1.1%

Total 277 100.0% Table 10: Amount of treatment types received by student.

Figure 10: Amount of treatment types received by student.

The highest percentage of students (40%) have undergone screening and the leas



Screening40%

Restorations17%

extractions

Scaling

OHI18%

Other1%



ilization of SDS according to


Figure 10: Amount of treatment types received by student.

The highest percentage of students (40%) have undergone screening and the least





3.9.2 ). Relationship between the gender of the student and type of

treatment received.

Male Utilized Male Female Utilized female

Screening 44 44/56 *100 78.6% 68 68/87 *100 78.2%

Restorations 17 17/56 *100 30.4% 30 30/87 *100 34.5%

extractions 7 7/56 *100 12.5% 8 8/87 *100 9.2%

Scaling 24 24/56 *100 42.9% 19 19/87 *100 21.8%

Referrals 4 4/56 *100 7.1% 4 4/87 *100 4.6%

OHI 19 19/56 *100 33.9% 30 30/87 *100 34.5%

Other 0 0/56 *100 0.0% 3 3/87 *100 3.4%

Table 11: Relationship between the gender of the student and type of treatment received

Figure 11: Relationship between the gender of the student and type of treatment received

Male and female students who had undergone screening are more or less equal.

Female students had received more restorative treatments than male students.

Male students had undergone more extractions than female students at their school age.

Students who received scaling is twice as common in males than females.

More male students had been referred to hospital dental clinics than female students.

Receiving OHI is approximately equal in male and female students.

Only female students have received other type of treatment from SDS.

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

Pe

rce

nta

ge %

Rx Types

Relationship between the gender of the student and type of treatment received

Male

Female



3.9.3 ). Relationship between type of treatment and ethnicity of

student

Sinhala Sinhala% Tamil Tamil% Muslim Muslim%

Screening 102 79.69% 6 54.55% 4 100.00%

Restorations 42 32.81% 4 36.36% 1 25.00%

extractions 15 11.72% 0 0.00% 0 0.00%

Scaling 41 32.03% 1 9.09% 1 25.00%

Referrals 6 4.69% 1 9.09% 1 25.00%

OHI 46 35.94% 3 27.27% 0 0.00%

Other 2 1.56% 1 9.09% 0 0.00% Table 12: Relationship between type of treatment and ethnicity of students

Table 12: Relationship between type of treatment and ethnicity of student

Sinhala, Tamil, Muslim students have been mostly undergone screening.

Except that,

Among Sinhala students’ highest percentage (35.94%) have received OHI,

while the least percentage had received other type of treatment (0%).

Among Tamils highest percentage (36.36%) have received restorative treatment

while least percentage had been undergone extractions (8%).

Among Muslim students similar percentages (25%) received restorative

treatment, scaling and referrals.

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

pe

rce

nta

ge %

Rx type

Relationship between type of treatment and ethnicity of student

Sinhala%

Tamil%

Muslim%



3.9.4 ). Relationship between faculty and the type of treatment

received.

Agriculture Allied H.S Art Dental

Screening 17 52% 13 33% 12 40% 17 36%

Restorations 3 9% 8 20% 7 23% 5 11%

extractions 0 0% 3 8% 1 3% 2 4%

Scaling 5 15% 7 18% 3 10% 7 15%

Referrals 2 6% 0 0% 0 0% 3 6%

OHI 6 18% 9 23% 7 23% 10 21%

Other 0 0% 0 0% 0 0% 3 6%

Total 33 100% 40 100% 30 100% 47 100%

Engeneering Medical Science Veterinary Total

Screening 15 41% 18 56% 12 36% 8 32% 112 40.4%

Restorations 7 19% 5 16% 3 9% 9 36% 47 17.0%

extractions 4 11% 0 0% 2 6% 3 12% 15 5.4%

Scaling 6 16% 4 13% 8 24% 3 12% 43 15.5%

Referrals 1 3% 2 6% 0 0% 0 0% 8 2.9%

OHI 4 11% 3 9% 8 24% 2 8% 49 17.7%

Other 0 0% 0 0% 0 0% 0 0% 3 1.1%

Total 37 100% 32 100% 33 100% 25 100%

Table 13: Relationship between faculty and the type of treatment received.



Figure 13: Relationship between faculty and the type of treatment received

Screening is the most common treatment procedure that has received by students of

all faculties except faculty of veterinary sciences.

The highest percentage of veterinary students has undergone restorative treatments

(36%).

Only students of faculty of dental sciences have received other type of treatments

(0.38%).

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

Pe

rce

nta

ge %

Faculties

Relationship between faculty and the type of treatment received

Screening

Restorations

extractions

Scaling

Referrals

OHI

Other



3.9.5 ). Relationship between guidance to utilize SDS and the

ethnicity of male students who had treatments

Table 14: Relationship between guidance to utilize SDS and the ethnicity of ma

Figure 14: Relationship between guidance to utilize SDS and the ethnicity of male students who had treatments

Highest percentage of all ethnic groups has utilized SDS due to guidance from school.

Sinhala: 67.4%

Tamil: 71.4

Muslim: 66.7%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Pe

rce

nta

ge %

Relationship between guidance to utilize SDS and the ethnicity of

Guidance

school directed

when Rx need

as a habit

Total



Relationship between guidance to utilize SDS and the

ethnicity of male students who had treatments

Relationship between guidance to utilize SDS and the ethnicity of male students who had treatments



Sinhala: 67.4%

Tamil: 71.4%

Muslim: 66.7%


Ethnicity


as a habit

when Rx need

school directed

Guidance Sinhala Tamil Muslim Total

school directed 31 5 2 38

67.4% 71.4% 66.7% 67.9%

when Rx need 10 2 0 12

21.7% 28.6% 0.0% 21.4%

as a habit 5 0 1 6

10.9% 0.0% 33.3% 10.7%

Total 46 7 3 56

82.1% 12.5% 5.4% 100.0%


Relationship between guidance to utilize SDS and the

le students who had treatments



as a habit

when Rx need

school directed

38

67.9%

12

21.4%

6

10.7%

56

100.0%



11.3.6 ). Relationship between guidance to

of female students who had treatments

Guidance

school directed

when Rx need

As a habit

Total

Table 15: Relationship between guidance of utilize SDS and ethnicity of female students who had

treatments.

Figure 15: Relationship between guidance of utilize

Highest percentages of Sinhala (75%) & Tamil(66.7%) students have utilized SDS due to

guidance from their schools.

Muslim students have utilized SDS due to guidance from school & when they need

treatments in similar percentages.

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Pe

rce

nta

ge %

Relationship between guidance of utilize SDS and ethnicity of



Relationship between guidance to utilize SDS and ethnicity

of female students who had treatments.

Guidance Sinhala Tamil Muslim Total

school directed 57 6 1 64

75.0% 66.7% 50.0% 73.6%

when Rx need 11 1 1 13

14.5% 11.1% 50.0% 14.9%

As a habit 8 2 0 10

10.5% 22.2% 0.0% 11.5%

Total 76 9 2 87

87.4% 10.3% 2.3% 100.0%Table 15: Relationship between guidance of utilize SDS and ethnicity of female students who had

Figure 15: Relationship between guidance of utilize SDS and ethnicity of female students who had treatments


guidance from their schools.


ents in similar percentages.


Ethnicity

Relationship between guidance of utilize SDS and ethnicity of femalestudents who had treatments

as a habit

when Rx need

school directed


utilize SDS and ethnicity

64

73.6%

13

%

10

11.5%

87

100.0% Table 15: Relationship between guidance of utilize SDS and ethnicity of female students who had

SDS and ethnicity of female students who had treatments



female

as a habit

when Rx need

school directed



3.10 ). Enthusiasm of parents to receive SDS for their Children

Table 16:

Parents of 60% of students have had enthusiasm to receive treatments for their children

while 40% have not had.

Enthusiasm of parents to receive SDS



Enthusiasm of parents to receive SDS for their Children

Table 16: Enthusiasm of parents to receive SDS for their Children


40% have not had.

Yes60%

No40%






Enthusiasm of parents to receive SDS



3.11 ). Relationship between importance of SDS and the gender.

Table 17: Relationship between importance of SDS and the gender.

Figure 17: Relationship between importance of SDS and the gender.

Highest percentages of male and female students who utilized the SDS think the

service is contributed in certain extent to improve their oral health.

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

Most To Certain extent Not No idea

Pe

rce

nta

ge

Impotance

Relationship between importance of SDS and the gender.

Male

Female

Importance Male Female Total

Most 15 28 43

10.5% 19.6% 30.1%

To Certain extent 22 37 59

15.4% 25.9% 41.3%

Not 7 9 16

4.9% 6.3% 11.2%

No idea 12 13 25

8.4% 9.1% 17.5%

Total 56 87 143

39.2% 60.8% 100.0%



3.12). Idea of the students about success of the treatments they have

undergone.

Table 18: Idea of the students about success of the treatments they have undergone.

Figure 18: Idea of the students about success of the treatments they have undergone.

36% of students who utilized the SDS have no idea about the success of treatments

which they have undergone.

34% of students think that the treatments they have received are success.

5% of students who utilized SDS think that the treatment they have received are

unsuccessful.

Successful34%

success to certain extent

25%

unsuccessful5%

No idea36%

Idea of the students about success of the treatments they have undergone.

Frequency

Successful 49 34.3%

success to certain extent 36 25.2%

unsuccessful 7 4.9%

No idea 51 35.7%

total 143 100.0%



Chapter 04

Discussion

Understanding the extent of utilization of SDS by studies and surveys is important for

social, functional, psychological and economical reasons. It contribute to the

implementation of standardized dental health services.

This cross sectional study was conducted at UOP using a convenient sample as it is less

costly and easy to access. 246 students from 8 faculties of UOP were taken as the sample.

Data was collected by self-administered questionnaire.

In the sample , number of female students and number of male students are

approximately equal and the number of Sinhala students are higher than the number of

Tamil & Muslim students as the number of Sinhalese is higher than the number of Tamil

& Muslim in the Sri Lankan population.

Sri Lankan university statistic, published by UGC on 31st December of 2012 shows Sri

Lanka has 88713 of university students and 9926 students belong to UOP.

The survey team expected that the results of the present study may reflect the whole

university students of Sri Lanka. Because it represents similar socio-demographic

distribution respective to all university students.

The UOP is the only university that has faculties that are not established in other

universities. Therefore the sample has a higher chance to represent the students of all the

districts of Sri Lanka.

The observation of this study showed that the 88%of the students know about the SDS

and 58% of students have utilized it. So it shows that Sri Lanka has an active and widely

distributed SDS.

Concerning about the gender variation, there is a significant association between gender

and SDS utilization. More female students have utilized SDS than male students at their

school age. This occurrence is possibly due to inadequate care of male students than

females towards oral hygiene & oral health care behaviors and may be due to fear for

dental treatments.

There is a significant association between ethnicity and SDS utilization. Percentage of

Sinhala students who utilized the SDS is higher than the percentage of Tamils &

Muslims.

According to the official web site of Ministry of health, the areas where most Tamils and

Muslims resident have less number of school dental therapists.(Annexure no 2 ). It may

be the reason for the less percentages of utilization of SDS among Tamil & Muslim

students. Also it may be due to less awareness of SDS among Tamils and Muslims.



There is no significant association between faculty of student and SDS utilization

according to chi square test. Because the faculty of student has no effect on utilization of

SDS in their school age.

SDS utilization of students shows a significant association with the district of schools of

those students. The study shows Kaluthara, Colombo, Galle, Matara districts have higher

percentage of students who have utilized the SDS. Students of Mulativ, Trincomalee,

Ampara & Mannar districts have not utilized SDS. But we can’t surely say that the all

students from those districts have not utilized SDS in population. Because the study

sample includes a small number of students from those districts.

The differences of utilization of SDS of students between district may be due to unequal

distribution of SDC & SDTs in Sri Lanka.

Concerning about the service provider ,most of the students have no idea about that

.From others , most of students have received their treatments from a school dental

therapist, while the rest from a dental surgeon. It may be due to presence of less number

of Adolescent clinics in Sri Lanka.

The study revealed most of students have undergone screening as every SDC screen the

students at particular Ages.(Grade 1,4 and 7)

Approximately equal percentages of Restorative treatments, Scaling and OHI have

received by students. Due to these treatments and OHE by SDS have helped to improve

oral health and less percentage of extractions among students.

Many of the respondents have utilized SDS according to the guidance from their schools.

This finding is mainly because at school ages they have lack of interest and knowledge

about the benefits of maintaining a good oral hygiene. So they need a guidance from

adults.

34% of students think that the treatments they received from SDS are successful while

5% of students think that the treatments are unsuccessful.

Higher percentage of Male and Female students think the service was contributed in

certain extent to improve their Oral health. This may be due to the acceptable service of

school dental therapists.

In this study most of respondents think the SDS should be improved with the new

facilities, technology, and new treatment procedures. They have suggested that SDC

must be established in every schools including both rural and urban, Mobile dental

clinics should be held in schools which do not have the SDC, Parents of the students must

be educated about the benefits of SDS, Oral health educating programs must be held in

practical manner for the children.



Chapter 05

CONCLUSION

The study revealed that utilization of SDS among the University students is high

at their school age and is influenced by socio-demographic factors like Gender,

Ethnicity and District but not by the Faculty.

Higher number of students have utilized SDS from the SDC established at their

own school and due to the guidance from their school and most have treated by

SDT.

Most of university students have undergone screening and certain amount have

received Restorative treatments, scaling and OHI From SDS.

To a lesser amount they have received Extractions, Referral to hospital dental

clinics and other type of treatments.



Chapter 06

LIMITATIONS

According to the survey topic, the target population was all University students of

Sri Lanka. But due to the large number of university students, time and cost, the

team selected only the University of Peradeniya. The sample was selected

according to non probability convenience sampling method. So sample may not

be represent the whole population.

The size of the sample may not be adequate. It may lead to sampling errors.

The sample contain very small number of students from some districts of Sri

Lanka. It may lead to have an effect on results.

The results do not show the current situation of SDS as the data is corresponded

to the time of more than 10 years back. Because the University students have

utilized SDS at their school age.

The students respond to the questionnaire according to their memory. It can be

affected the accuracy of the responses.



Chapter 07

RECOMMENDATIONS

Increase community awareness about benefits of SDS.

The government should invest more in the oral health sector to increase facilities

and number of SDC s.

SDC should be expanded to rural areas.

New technologies and new treatment procedures should be introduced to SDS.



REFERENCES

1) Final BDS part 1 Community dentistry lecture notes by Prof. S.L.E.Ekanayake,

Faculty of Dental sciences, University of Peradeniya.

2) Final BDS part 1 Community dentistry statistics lecture notes by Prof. Samath D

Dharmaratne Faculty of medicine, University of Peradeniya.

3) J Oral Health Comm Dent 2013;7(2)91-94

4) D. Nash et al., “Dental Therapists: A Global Perspective,” International Dental

Journal, 2008 April; 58 (2): 61-70.

5) D. Coates et al., “Dental Therapists and Dental Hygienists Educated for the New

Zealand Environment,” Journal of Dental Education, 2009; 73(8): 1001-8.

6) Friedman JW, Ingle JI. (1973a) New Zealand dental nurses.Journal of the

American Dental Association, Vol. 87, No.7, (December, 1973), pp.1331, ISSN

0002-8177

7) World Health Organization.Report of an expert committee on auxiliary dental

personnel. Tech. Rep.Series No. 163. Geneva: WHO, 1959.

8) Utilization of dental services among secondary school students in Lagos, Nigeria.

E A Akaji , FA Oredugba, SO Jeboda, Nigerian Dental Journal Vol. 15 (2) 2007:

pp. 87-91

9) www.dental.health.gov.lk /statistics/hr

10) www.ugc.ac.lk/en/university-statistics-2012.html

11) www.en.wikipedia.org/wiki/Dental_therapist



ACKNOWLEDGEMENT

We express our heartfelt and sincere gratitude to Prof. Lilani Ekanayake, Professor

in Community Dentistry, Division of Community Dental Health, Faculty of Dental

Sciences who guided us to bring out successful completion of our survey project.

We’re really appreciating her attention towards us, though she was very busy at the

moment.

Also our greatest gratitude goes to University students who actively participated for

the questionnaires. Without their support and participation, we will not be able to

collect unbiased data for this research.

Our special and heartfelt gratitude to our dearest parents without their blessings we

may not have been typing these words. Thank you for all that you have done for us.

We sincerely extend our gratitude to the staff members of the dental faculty library

who helped us to do this study successfully.

We also extend our gratitude to all our undergraduate fellows who helped us to do

this study successfully.



ANNEXURE

01. Questionnaire Sinhala and Tamil

02. Distribution of SDTs in Sri Lanka

1

�ශ්ව �ද�ාල �� පාස� කාලය �ල පාස� ද�ත ෛවද� ෙස�වය ලබාගැ�මට

දැ�� නැ��ව ස��ෂණය ��ම.

1) �ඨය:- ................................................................................

2) වයස :- ...............................................................................

3) ස්�/��ෂ භාවය :-

ස්� ��ෂ

4) ජා�ය :- �ංහල ෙදමළ �ස්�� ෙවන�

5) ඔබ ඉෙගනග� පාසල අය� �ස්��කය :-...........................................

6) � ලංකාෙ� පාස� �ල �යා�මක වන පාස� ද�ත ෛවද� ෙස�වාව� පව�න බව ඔබ ද�නවද?

ඔ� නැත

(ඔෙ� ��ර ඔ� න� පහත සදහ� �ශ්නවලට �� සපය�න.)

7) පාස� කාලය �ල ඔබ එම පාස� ද�ත ෛවද� ෙස�වය ලබාෙගන �ෙ�ද?

ඔ� නැත

8) ඔබ පාස� ද�ත ෛවද� ෙස�වාව ලබා ෙන�ග�ෙ� න� ෙහ� එම ෙස�වාව මග හැ�ෙ� න� ෙහ� එයට ෙහ�� ෙ�,

ද�ත ෛවද� ��කාර සදහා ඇ� �ය

අතප� �ම

කාලය ෙන�ෙම� �ම �සා

ඔබ පාසෙ� එම ෙස�වය �යා�මක ෙන�වන �සා

��ෙව� ෙ� ෙය�� ම� �� ෙන�� සා

ෙවන�

9) ලබාෙගන �ෙ�න� ඔබ එම ෙස�වාව ලබා ග�ෙ�, තම පාසෙ� ද�ත ෛවද� සායනෙය�

ෙවන�/ අවට පාසලක ද�ත ෛවද� සායනෙය�

පාසෙ� පැවැ�� ජංගම ද�ත ෛවද� සායන/ කද�� ම��

10) ඔබ ��කාර ලබාග� පාස� ද�ත ෛවද� ෙස�වය ලබා��ෙ�,

පාස� ද�ත ෛවද� ��සකව�ය�

ද�ත ශල� ෛවද�වරෙය� /ව�ය�

ඒ ��බදව ෙන�ද�

2

11) ඔබ පාස� ද�ත ෛවද� සායන �� ලබාග� ��කාර,

ද� ප��ෂා කරවා ගැ�ම

ද� �ර�ම

ද� ගැල�ම

ද� ��ද ��ම

ෙවන� ද�ත ෛවද� ��කාර සදහා ෙර�හ� කරා ෙය�� ම

�ඛ ෙස�ඛ� ��බඳ දැ�ව� ��ම

ෙවන�

12) ඔබ පාස� ද�ත ෛවද� සායනයට ෙය�� ෙ�,

පාසෙල� ෙය�� ෙම�

��කාර අවශ� � �ටක�

��ද� වශෙය� ,

වසරකට වර�

මාස හයකට වර�

ෙවන�

13) ඔබ ලබා ග� එම ද�ත ෛවද� ��කාර,

සා�ථක� තරම� �රට සා�ථක�

අසා�ථක� අදහස� ෙන�මැත

14) පාස� ද�ත ෛවද� ෙස�වාව ඔබට ලබා�මට ෙදමා�ය�ෙ� උන��ව� පැව� ෙ�ද?

ඔ� නැත

15) ඔෙ� �ඛ ෙස�ඛ� යහප�ව පව�වා ගැ�මට පාස� ද�ත ෛවද� සායන ෙස�වාව ඔබට වැදග� �ෙ� යැ� ඔබ

�තෙ�ද?

ෙබ�ෙහ� �රට තරම� �රට

නැත අදහස� ෙන�මැත

16) ඔබ �තන ආකාරයට පාස� ද�ත ෛවද� ෙස�වාව තව �රට� �� ය ��ද? එෙස� න� ඒ �මන ආකාරයටද? ...................................................................................................................................................................

...................................................................................................................................................................

...................................................................................................................................................................

...................................................................................................................................................................

...................................................................................................................................................................

(ඔබ දැ�� සහෙය�ගයට ස්��.)

1

gy;fiyf;fof khztu;fs; ghlrhiy gw;rpfpr;ir Nritia ve;j mstpw;F gad;gLj;jpAs;sdu; vd;gjw;fhd tpguk;

1) fy;tpg; gPlk; :- ................................................................................

2) taJ :- ...............................................................................

3) ghy:-

பபண் ஆண்

4) இனம் :- சிங்களம் திழ் முஸ்லீம் வேறு

5) . cq;fsJ ghlrhiy mike;Js;s khtl;lk :-...........................................

6) ,yq;ifapy; ghlrhiyfSf;fhd gw;Nrit ghlrhiyfspy; njhopw;gLtJ cq;fSf;Fj; njupAkh?

Mk ,y;iy

(Mk; vdpd;> fPo;tUk; tpdhf;fis g+u;j;jp nra;f.)

7) cq;fs; ghlrhiyf; fhyj;jpd;NghJ vg;nghOjhtJ ghlrhiyapy; gw;rpfpr;ir nra;Js;sPu;fsh?

Mk ,y;iy

8) ePq;fs; gw;rpfpr;irf;F fye;Jnfhs;stpy;iy my;yJ mjid Ntz;lhnkd;W tpl;lLtpl;Bu;fs; vdpd;>

mjw;fhd fhuzk;?

Rpfpr;ir nra;tjw;F gak

fye;J nfhs;s kwe;Jtpl;lik

Neuk; fpilf;ftpy;iy

vdJ ghlrhiyapy;

,e;j Nrit ,y;iy.

Vidait

9) Mk; vdpd;> vq;Nf cq;fsJ gw;rpfpr;iria Nkw;nfhz;Bu;?, cq;fsJ ghlrhiyapd; gw;rpfpr;ir epiyaj;jpy

cq;fs; ghlrhiyf;F mUfpy; cs;s ghlrhiyg; gw;rpfpr;ir epiyaj;jpy;

cq;fs; ghlrhiyapy; elkhLk; gw;rpfpr;ir Nrit eilngw;wNghJ

10) cq;fSf;F rpfpr;ir nra;jtu; ahu;?

ghlrhiy gw;rpfpr;irahsu

gy; mWitr; rpfpr;ir itj;jpau;

njupahJ

2

11) ePq;fs; vt;tifahd rpfpr;iriag; ngw;Wf;nfhz;Bu;?

gy; gupNrhjid

gy; epug;Gjy;

gy; gpLq;Fjy;

gy; mstply;

itj;jparhiyapy; rpfpr;ir ngw mwpTWj;jy;

gw; Rfhjhuf; fy;tp

Vidait

12) ePq;fs; vg;nghOJ ghlrhiyapy; gw;rpfpr;ir Nkw;nfhz;Bu;?

ghlrhiapd; topfhl;lypd; NghJ

NjitNaw;gLk; NghJ

xU tUlj;Jf;F xU Kiw

MW khjq;fSf;F xU Kiw

Vidait

13) ghlrhiyg; gw;rpfpr;ir epiyaj;jpy; nra;J nfhz;l rpfpr;ir.,

ntw;wpfukhdJ Fwpg;gpl;l mstpw;F ntw;wpfukhdJ

ntw;wpaspf;ftpy;iy vJTk; nrhy;tjw;fpy;iy

14) cq;fsJ ngw;Nwhu; cq;fSf;F ghlrhiyapy; gw;rpfpr;ir nra;tjw;F Mu;tk; fhl;baJz;lh?

Mk ,y;iy

15) cq;fs; tha;top Rfhjhuj;ij NgZtjw;F ghlrhiy gw;rpfpr;ir cjtpaJ vd epidf;fpd;wPuh?

epr;rakhf Fwpg;gpl;l msT

,y;iy vJTk; nrhy;tjw;fpy;iy

16) ghlrhiy gw;rpfpr;ir epiyak; NkYk; mgptpUj;jp nra;ag;gl Ntz;Lk; vd epidf;fpd;wPu;fsh? Mk; vdpd;> vt;thW vd Fwpg;gplTk;?

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(நன்றி..)

School Dental Therapist Numbers 2012

Province District Number

Western Colombo 59

Gampaha 35

Kalutara 21

NIHS 7

North western Kurunegala 36

Puttalam 9

Central Kandy 35

Matale 12

NuwaraEliya 7

North Central Anuradhapura 14

Polonnaruwa 10

Sabaragamuwa Rathnapura 21

Kegalle 23

Uva Badulla 16

Moneragala 11

Southern Galle 34

Matara 24

Hambantota 14

Northern Jaffna 10

Mullativu 1

Mannar 0

Vavuniya 3

Kilinochchi 0

Eastern Trincomalee 2

Ampara 4

Batticoloa 2

Kalmunai 3

Total 407

how and to what extent have university students utilized the school dental services

Documents

university students

ethnicity of students

gender figure

children figure

ethnicity of male students

ethnicity of female

importance of sds

faculty of dental sciences