Educational intervention on oral health in a school

educational-intervention-on-oral-health

Appreciating Stomatology as a source of well-being and happiness has prompted us to study communication, affective-participatory techniques, creativity and other topics that apparently could be seen as alien to stomatological work, but which are actually fundamental tools in this task that many we already embraced: keep the Man Healthy. ^one

Health education must be geared towards the construction of life projects, with this premise it must overcome the character of training against damage and become an education for life, whose training goes beyond the narrow space of the disease and is go back to the field of health. Health education should not be separated from the medical act but should characterize it, expressed in an exchange of knowledge, through clear and respectful communication, overcoming technical and instrumental language. ^4.5

Oral health constitutes an important component of general health and even though oral diseases generally do not endanger the life of the individual, they become an important problem for public health ⁶.

Maintaining correct oral hygiene is essential for the prevention of the main and most frequent oral diseases: dental caries and periodontal diseases, neglect of which would lead to the accumulation of dentobacterial plaque and therefore the ideal medium for the action of microorganisms in the oral flora, especially streptococcus mutans, which in contact with plaque produces acids that are responsible for triggering the carious process by decalcification of tooth enamel; as well as the onset of gum diseases whose initial symptoms are inflammation and bleeding will be caused.

Although the population knows the importance of oral hygiene, it lacks an argument that allows it to maintain it so that satisfactory results can be obtained; thus, it is common to see that the first brushing of the day is usually done when getting up and not after breakfast, as it should be, the most important brushing (before going to bed), because it guarantees a clean mouth and more hours without consuming food, it has not just been made aware. ⁷

Oral hygiene is part of personal hygiene: a pillar that promotes the health of the individual; However, to achieve this, the quality of brushing should be promoted, aimed at a correct removal of dental plaque and food remains, adequate nutrition and periodic stomatological controls. ⁸

The final result of education for health must be a change in behavior, and not simply a cognitive change, therefore: promoting health, is promoting knowledge to the people to improve their health and exercise greater control over it., to achieve a state of physical, mental and social well-being. ⁹

Currently there is great interest in oral health education, which has as one of its main objectives, to achieve a modification of attitudes in relation to oral health. For these modifications to be achieved, the motivation of the patient is of vital importance. ¹⁰

It is a fully accepted fact that the school period is the most suitable for introducing health education, and it is therefore around the school where it seems to be more advisable to concentrate efforts to achieve favorable attitudes in students, since attitudes they are formed and developed throughout the life of the individual conditioned by the social context to which they are exposed, depending on the groups to which they belong, which are structured according to the prevailing value system in their environment. ^eleven

Experience and research have shown that children positively grasp enough in the learning process, and will learn and understand faster and more effectively if teaching makes them interesting and enjoyable, so try to find the best methods for promote new knowledge and get students to participate in the learning process that is based on the production of a change in the student's behavior, but gradual, adaptable, selective and continuously towards the selection of a relative permanence as a result of practice. ^12.13

Attitudes are acquired throughout life, one is not born with them, however it is of greater importance than in childhood and adolescence, the work of education for health is oriented, because if you are able to form positive attitudes in these stages in this regard, you will not have to work on its modification later, which is a much more difficult and complex process. ¹⁴

Children between the ages of 8-9 years are psychologically prepared to clearly understand the meaning of rules for their daily compliance, these become internal or organic heritage of their personality, thus making them responsible for their own health and preparing them to By incorporating them into the wider community, they adopt healthier lifestyles. ^15.16

If we see the child as the man of the future, we must act on him when he is still a malleable mind, in which it is easier to modify lifestyles and behavior patterns, which becomes difficult in adulthood. ^{17, 18}

Barber, states that prevention work is committed to leading the child to adulthood devoid of all kinds of dental disease, training him in brushing techniques, oral hygiene, nutritional education and correction of habits. ¹⁹

It is necessary to carry out educational work on health promotion and prevention, transfer the oral counseling consultation to primary schools to increase the motivation of the child population for brushing and in general, for correct habits. This prevention in children under 6 years of age must be carried out with an emphasis on health education, not only by the professional and parents but also by educators. Parents must be trained in plaque removal techniques, assuming the responsibility of doing it in the mouth of their children.From 6-12 years of age, parents still have a fundamental mission in caring for the oral health of their children, however the child has a sufficient comprehension capacity to understand the information and develop a greater skill in preventive processes.^twenty

Several studies have confirmed that thorough plaque removal can prevent tooth decay and other diseases such as gingivitis as well as substantially limit the progression of periodontitis. Most motivated and trained people can perform satisfactorily using available hygiene techniques and auxiliary products. But patients who lack the required degree of motivation or manual dexterity will continue to deteriorate progressively even under the care of a therapist. ²²

To achieve the quality of life and health of the community, it is necessary to foster in people the ability to act on their own health and to achieve the agreement of all the institutional, community and personal political wills and resources in the process. ²⁵

There is no healthy life without a healthy mouth and health for all can only be achieved through primary care activities that start from the early stages of life, confident that the achievement of satisfactory oral health in childhood represents a great psychological advantage, social and economic for the whole family and the community.

All of the above, and the results achieved in previously carried out work, constituted the motivation to carry out this research in which we propose to modify the level of knowledge of schoolchildren through the application of an educational intervention where the child actively participates in the acquisition of knowledge, valuing that the school period is the most suitable for the introduction of health education.

OBJECTIVE

Increase knowledge about oral health through an educational intervention in 4th grade schoolchildren at Escuela Bolivariana Los Magallanes, Municipality of San Diego, generalizing the educational instructional Happy Smile

Method

- Medical Bioethics.

Prior to the investigation, authorization was requested from the students and their parents or guardians to carry out this work, it was explained to them what it consisted of. They were also informed that participation in the research was voluntary, that it did not constitute a risk or harm to their health, that it did not represent any commitment and that they would be completely free to accept it or not, but that it would be important and necessary to carry out the the investigation. The approval of the work agreement was achieved at the Los Magallanas Bolivarian School. Permission was requested from the Board of Directors and the rules set forth in the Declaration of Helsinki were followed for the preparation of the Informed Consent.

- General Characteristics of the Research.

An experimental study of educational group intervention was carried out to increase the level of knowledge about oral health in fourth grade schoolchildren at the Los Magallanes ¨ Bolivarian School of the San Diego municipality in the period between October 2011- February 2012, using group techniques and Didactic games guaranteed interactive participation in the acquisition of knowledge through an educational program designed to achieve the proposed objectives.

- Universe.

The universe was made up of the total number of students (60) of the 4th grade of the Bolivarian School Los Magallanes.

The following criteria were taken into account:

Inclusion:
Exclusion:
- That they refuse to participate in the study.
Departure:
- Abandonment of the study for any reason.

The investigation consisted of three stages: diagnosis, intervention and evaluation.

In the diagnostic stage, the following was carried out: Meeting with the students in which a lecture was given on the content of the topics that would be explained, with the aim of sensitizing and motivating them to cooperate with the research, all of which was prepared with a language appropriate for its total understanding. Compilation of information from the survey forms (Annex I) that were applied to each student to measure knowledge about oral health and that includes the following topics: Item 1. My Teeth.

Objective: Teething, tooth brushing and its importance.

Unit 2. Why do your teeth get sick?

Target: Tooth decay and gum disease.

Unit 3. Taking care of my teeth.

Objective: Cariogenic diet and its control. Fluoride in the prevention of dental cavities.

Unit 4. The most important thing about my beauty: The teeth.

Objective: Deforming habits of the oral cavity.

For each topic, 5 questions were formulated, corresponding from 1 to 5 to topic 1, from 6 to 10 to topic 2, from 11 to 15 to topic 3, and from 16 to 20 to topic 4, of them 4 will correspond to a single solution (only one correct answer) and a multiple choice solution (several correct answers).

In single-choice questions, 5 points will be awarded when they choose the correct answers, for any other inappropriate selection, no points will be awarded.

In the multiple-choice question, the grade will be awarded as follows:

5 points, when they select 3 correct answers. 3 points, when they select 2 correct answers. 0 points, when they select a correct answer or none.

Correct answer per question:

Question # Correct answer (s)

b) a), b), d) a) b) b) a), c), d) c) c) b) b) b) a), b), d) b) c) a) a), b), c) a) b) a) c)

Evaluation criteria:

Students who accumulate at least 70% of the possible points will be classified with adequate general knowledge. Students who do not reach 70 points on the questionnaire will be classified with inadequate general knowledge. Those who achieve when less than 70% of the points of the topic (at least 18 points). Those who do not reach at least 70% of the points will be considered with inadequate knowledge of the topic.

A program of educational activities was carried out through 6 meetings, 4 corresponded to the chosen topics and 2 corresponded to the presentation and conclusion of the intervention, one topic per week was given by the author of the work.

The students were divided into 4 subgroups with the same number of participants, that is, 15 students and received the same program separately, to ensure that all children participated actively in the didactic techniques and games designed to modify their knowledge

To teach the topics, 20 minutes were dedicated, followed by participatory techniques consisting of the recognition of attitudes and presentation of experiences regarding the topics taught, using 10 minutes, the remaining 20 minutes were dedicated and distributed between the demonstrations and the different didactic games that were used, in total each work session was developed in a time of 50 minutes.

Educational program:

MEETING 1.

Introduction.

Presentation of the coordinator.

Children's presentation technique to activate the potential of the group.

Goals:

Create group cohesion. Motivation towards activities Achieve the framing of activities.

Development.

The coordinator, after making himself known, said the qualities that identify him. Each one was asked to introduce themselves in the same way.

The coordinator explained promoting reflection on the qualities of some; as well as those that are repeated in several and therefore characterize the group.

The need to apply the questionnaire was explained to them; then, they proceeded to collect the expectations left by the applied questionnaire. The intervention program and methodology were explained to them.

The problem of oral brushing was introduced to maintain oral health and the drawing of the brush was motivated and they were encouraged to actively participate in the meetings to become at the end of the meetings ¨Promotors of Oral Health¨.

Finally two ships showed up; one red carrying the names of the males and one blue carrying the names of the females.

The males took a paper from the blue boat and the females from the red boat, and the partner was given a kiss on the cheek that has corresponded to him as a manifestation of friendship.

It was oriented to bring each student's toothbrush to the next meeting.

The group was dismissed until the next meeting.

MEETING 2.

Topic 1: My teeth.

Contents: Teething. Tooth brushing and its importance.

Goals:

Identify the importance and function of teeth Describe the correct brushing method and frequency Identify the first permanent molar and its importance

Development.

The activity began by explaining that there are two dentitions: temporary teeth (milk or primary) and permanent teeth; the characteristics of both dentitions were described.

Teeth begin to sprout from the first six months of life and this first teething is completed around two and a half years. Later, around the age of six; first permanent molar sprouts; which does it behind the last temporary tooth and does not replace any of them; Hence the importance of attending to it from the moment it sprouts, since it is the one that maintains the balance of the other teeth, it is the guide of these in their sprouting.

The teeth play an important role in the chewing of food, in aesthetics and in the pronunciation of words; In addition, temporary teeth preserve the space for the permanent ones to emerge; for this reason it is necessary that they be preserved until the age of normal change and that they remain healthy.

They were taught about the taipodont, the primary and permanent dentitions and the importance of keeping the teeth clean so that they remain healthy was discussed; Thus the subject of tooth brushing was introduced, they were informed that brushing is one of the most effective methods in the prevention of dental cavities and gum disease, in addition to being a basic element of personal hygiene that contributes to the individual health.

A demonstration of brushing the tooth surface with the taipodont and brush was carried out, it was explained:

The way it is done: from the gum to the tooth Frequency: after breakfast, lunch, dinner and before going to bed.

Volunteers were asked to prove it.

A Didactic Game was made to check what was learned.

GAME 1: Zero and modified cross .

Author. Maylen mendez gonzalez

Goals:

Encourage exercise.

Materials:

Board with grids.

Chips with zero or cross symbols.

Nine cards with questions.

Development:

Two teams were organized and the members who are going to participate were chosen for each one, to whom a card with questions was given. The game, which consists of answering the questions properly, was explained to them, and whoever does so has the right to place one of the tiles of their choice (zero or cross) on the grids.

The team that was able to first place its symbols consecutively three times in the same direction (vertical, horizontal or diagonal) won.

MEETING 3.

Topic 2: Why do your teeth get sick?

Contents: Tooth decay and gum disease.

Introduction.

It was briefly and simply commented that tooth decay and gum disease are the most widespread oral diseases in the world and cause tooth loss if not treated in time, but both can be prevented with easy procedures. carry out.

Goals:

Identify cavities and gum diseases as the main causes of tooth loss. Identify plaque as the cause of the most frequent oral diseases. Mention preventive methods of dental caries.

Development.

The activity began by guiding groups in duos or trios and a volunteer expressed what he remembered from the previous activity. The information was corrected or rectified.

Three volunteers were asked to dramatize a child who attends the stomatologist accompanied by his mother and in great pain.

Afterwards, they proceeded to explain that dental caries is a destructive process of the crown of the tooth, produced by bacteria that are found in the mouth and act when the right conditions are propitiated, it was explained to them that because caries is not very frequent, normal.

Gum disease is caused by the accumulation of bacteria on the teeth in contact with the gum, they can begin with inflammation and if not treated, the disease progresses.

It was explained that both diseases have a common cause: dental plaque, which is nothing more than the accumulation of microorganisms or bacteria on the surface of the teeth or gums; that is, the soft substance that is deposited on the teeth when they are not cleaned properly.

Then the group was encouraged and we guided the realization of a didactic game.

GAME 2: The questioning ball .

Author. Maylen mendez gonzalez

Goals:

Encourage execution.

Development.

Questions were drawn up on thin strips of paper and pasted on the ball.

A circle was organized and the ball was thrown to one of the participants, the one who received it read the question that was left in front of him and gave the answer.

The strip of paper was removed and the ball was thrown to another child who repeated the same procedure.

MEETING 4.

Topic 3: Taking care of my teeth .

Content: Cariogenic diet and its control. Fluoride in the prevention of tooth decay.

Introduction.

Fluoride is a chemical element that exists in food and also in small amounts in the human body, which provides greater hardness to tooth enamel against the attack of bacteria that cause cavities.

The consumption of certain foods can favor the appearance of dental caries, this is known as a cariogenic diet.

Goals.

Identify cariogenic foods Identify the function of fluoride Determine the different methods used for fluoride.

Development.

The children were grouped in duets and trios and discussed the previous meeting.

A volunteer was asked to explain what happened. The comments were corrected or verified.

It was suggested that another aspect would be addressed to prevent caries, the control of the cariogenic diet. The word cariogenic was placed on the board in large letters.

The following question was raised: how important is diet in dental caries?

Discussion was promoted in the group. We confirm or correct children's information.

The teeth are a living part of the body and like any body it needs a balanced diet to be well trained and stay healthy. The basic diet requires dairy foods, meats, vegetables, fruits, eggs, etc.

The more sugar you consume, the greater the chance of tooth decay.

The foods that make up the cariogenic diet are those that mainly contain carbohydrates such as: candies, chocolates, sweets, bread, cookies, etc.

The bacteria present in the oral cavity act on these foods, producing acids that cause tooth enamel decay, so we must limit their consumption only to the moments when after ingestion you can brush your teeth.

Pictures of these foods were shown to aid recognition.

Then the preventive methods of caries were shown starting with fluoride. In our country, different methods of applying fluoride are being used in order to reduce dental caries in the population, mainly in children in nursery schools, primary and secondary schools, as well as in non-institutionalized children under five years of age.

In kindergartens and non-institutionalized children under five years of age, the fluoride lacquer method is used, which is a varnish that is applied to the surface of the teeth twice a year.

The Duraphat (fluoride lacquer) was shown and applied to a volunteer.

In primary, secondary, and pre-university schools, fluoride is used following the rinse method for a minute, applying it every 15 days.

It was explained that you should not rinse or eat any food for two hours; Furthermore, fluoride can be added to drinking water, it is also added to drinking salt and toothpastes. The methodology of the game "My little world" was explained, and a demonstration of it was made. A game was given to the group.

Opinion was asked about the activity carried out and the group was fired until next week.

GAME 3: My little world .

Development.

It is played between four or eight children, one or two for each color.

The exit was discussed with a die, corresponding to initiate the shots to who took the greater number.

The first to leave, threw the dice and walked his token as many spaces as the dice indicate, took a card of the same color from the space where he stopped and its content was read; then the answer was said.

Everyone had to be attentive to decide if the answer is correct, if it was not, it returned to the place where it was previously. The dice were then handed to the player on her right.

If the token stopped at a blank space, a card called a reflection was taken, which is interesting information, not a question.

The player who reaches the goal first won; then he took one of the encouragement cards.

MEETING 5.

Topic 4: The most important thing about my beauty. Teeth .

Content: Deforming habits of the oral cavity.

Introduction.

The growth and development of the maxillary bones and of the entire arch is affected if inappropriate habits are practiced.

Goals.

Identify deforming habits of the oral cavity.

Development.

Demonstration. Didactical games. Group dynamic.

The activity began with the question: Do you mention some deforming habits of the oral cavity that you know?

Group discussion was encouraged, the best known habits. Knowledge was corrected or reaffirmed and conclusions were reached in groups.

Inappropriate habits affect the positions of the teeth, and that is why they are called deforming; within these we have:

The tongue thrust (this is when the tongue is projected against the anterior teeth when swallowing) which causes deviations of the teeth forward and the anterior bite opens Sucking of a finger or other object causes the anterior teeth to tilt forward Mouth breathing causes irritation and inflammation of the gums, dry lips, alters the normal characteristics of the face Biting the nails alters the correct position of the teeth Biting the lips with pencils and other objects can divert the jaw towards a side of the face, or the correct position of the teeth involved. Supporting the jaw on one side of the face can deflect the jaw to one side of the face. Sleeping with the chin on one closed hand can deflect the jaw to one side of the face. face.

Plaster models with dental malocclusions produced by deforming habits were shown.

The group was divided into two teams to explain the methodology and demonstrate the integrative didactic game of the intervention ¨Checkers game¨, a game was given to the group and it was directed that it be played in free hours.

GAME 4: Game of checkers (integrating game).

Author. Maylen mendez gonzalez

Objective.

Consolidate and integrate the knowledge of the educational program.

Materials.

Board with molar silhouette.

Cards with questions.

Development.

The game was organized like a game of checkers with black and white pieces corresponding to two teams, (one walked diagonally and all on the white squares).

In each square there was an orientation to be solved, the team had to discuss the answer collectively and if they failed, they lost the piece. To make the initial move they had to answer the starting question. If they landed in a square marked with a question mark or exclamation mark, then they had to answer a question from the group of corresponding cards. If when they ate they could not correctly answer the question of the square where they fell, they had to return the tile to the opposing team. The team with the most points won.

MEETING 6.

(6 months later)

Introduction.

The research questionnaire was applied.

Goals.

Identify the opinion of the group on the research carried out Identify the students who stood out as promoters of oral health.

Development.

At the voice of the coordinator; The group was subdivided into duos and trios and they were directed to comment on the positive, negative and / or interesting effects that they could detect during the entire educational intervention.

The most outstanding students with the best performance during the intervention were collectively selected and declared ¨Promotores de Salud Oral¨, to which they were given an accrediting diploma designed for this intervention (Appendix II).

All students were encouraged for having actively participated in the educational intervention.

The activity was concluded.

Resources that were used for learning:

Oral presentation: It is the use of language (the word) to explain a topic or activity to be developed. This is in charge of the author and is used in the introduction, part of the development and at the end to integrate the knowledge. Interrogation: It is the use of questions to obtain information, points of view or verify what has been learned, it was used to awaken the central interest, tension and reflection on important aspects. Cautions: Ask the question to the group and do not directly question the participant. Use: After the presentation of the topic and to summarize its sections. Demonstration: It consists of executing before an individual or group what We are explaining and repeating it until you understand it. It allows you to verify some aspect of learning and support opinions. This encourages the participation of group members.The activity to be carried out is explained. The activity is repeated step by step, emphasizing the central aspects and clarifying any doubts that may arise. Participants are invited to repeat the procedure and errors are corrected. We reinforce what is correct. Group dynamics: Discussion of a topic by a group of no more than 15 people under the guidance of a moderator (the author). It contributes to the modification of negative behaviors. It is used by defining the topic, it is encouraged by raising problems or questions. Conclusions are drawn with the help of the group. Dramatization: This is the staging of a problem before a group in which the participants have the opportunity to analyze tasks in circumstances similar to those presented in everyday reality. Use: We will define the topic to represent Organize the scene preferably with volunteers.The dramatization is interpreted Discussion of positive or negative behaviors is encouraged Conclusions are drawn with the help of the group Participatory techniques: Consists of the assistants carrying out specific tasks, guided by the group coordinator to promote cohesion, reflection, analysis We use: Animation and exercise dynamics during the training sessions, with the aim of consolidating knowledge in the subjects taught. They are used in order to achieve: Animation and presentation. Cohesion. Reflection. Consolidation of knowledge. Games didactics: Exercise, during the training sessions, to establish and increase knowledge about the topics taught. Meeting 2: "Zero and modified cross". Meeting 3: "The questioning ball". Meeting 4: "My little world". Meeting 5:"Game of checkers". Observation media: Mural with all the updates in education, promotion and prevention of oral health. Plaster model to offer the necessary explanations in a demonstrative way. Ear plug, toothbrushes and revealing substances of PDB, to demonstrate correct tooth brushing.

Evaluation stage:

The same survey used in the diagnostic stage was applied, being evaluated under the same qualification criteria, with the aim of evaluating the knowledge acquired by the students 6 months after the intervention was applied, thus checking the assimilation of the basic oral health messages, and the acquisition of new knowledge that was discussed through the topics that were taught.

2.4- Techniques and procedures.

Obtaining and collecting information:
- Obtaining the information. For this research, an exhaustive bibliographic review of the subject under study was carried out. Information collection. To collect the information, the survey prepared for the research was used, which was applied to each student who participated in the study. intervention.
Processing and analysis:
- A database was created in the Microsoft Office XP Excel application, on a Pentium 4 microcomputer, the data was taken to a spreadsheet produced in said application and processed through programmed calculations, and the information was poured into contingency tables of Double entry. Percentage was used as summary measure. The coefficient of variation was calculated to determine the increase in knowledge in each topic, the formula was used.

Initial value - Final value

CV = ------------- X 100

Initial value

Initial Value: Total of participants with inadequate knowledge before the Investigation.

Final Value: Total of participants with inadequate knowledge after the investigation.

The intervention was considered useful in all cases in which the result of the coefficient of variation is greater than 70%.

For the comparison of the results before and after the training and its statistical validation, the Mc Nemar test was used and worked with á = 0.05. The presentation was made by means of tables.

For discussion and synthesis:
- Once the analysis and discussion of the results were carried out, they were compared with those of other authors through an inductive-deductive method, which allowed reaching the proposed objective and issuing the conclusions and recommendations.

Analysis and discussion of results

Nothing is more rewarding or exciting in professional terms than keeping a mouth healthy for as long as possible, ideally for life; To achieve this, the dental philosophy must be changed from predominantly restorative to predominantly preventive. ^{2. 3}

The work carried out by the stomatologist is of vital importance to maintain patients with good health education, prevent diseases, restore the health of the patient and keep the patient healthy, in order to motivate him together with his family to maintain good health oral.

Knowledge largely determines a person's action. Any intervention aimed at raising the level of knowledge regarding oral health will be more effective the more and better oriented the students are in this regard.

When observing TABLE 1 we note that before the intervention 57 students had inadequate general knowledge about oral health, however later the figure dropped substantially, reaching only 6.67%, with only 4 students. When analyzing the coefficient of variation, we found a 92.98% increase in knowledge, results similar to those found by Limonta ²⁷ and Cueria ²³ in their investigations, finding a high statistical significance when applying the Mc Nemar Test (p <0.0001), which speaks to us in favor of the effectiveness of educational intervention.

The results are attributable to the attention, discipline and interest shown by the schoolchildren in the intervention, with a great difference between the level of knowledge before and after it, demonstrating that with activities that motivate students and being repetitive, good results are achieved.

Ferrer ²⁴ in his work on the effect of educational and affective-participatory techniques in the change of attitude about oral health, he found that they were effective in raising knowledge, since he achieved at six months within the categories of acceptable and excellent 80, 6% of the students included in the research.

In Table 2 highlights the advantages of the Educational Program in knowledge about teething, tooth brushing and importance, since initially 53 of respondents had limited knowledge and inadequate achieving change after the intervention where only 2 for 3 % of the participants maintained difficulties regarding the subject, achieving an increase in knowledge by 96.23%.

The results were higher than those achieved by Ruiz Feria ²⁷ regarding the subject in his research, which obtained 72.06% of children with adequate knowledge after the intervention.

In our study, it is worth highlighting how productive the intervention was, since the schoolchildren acquired knowledge about the subjects taught, related to oral health, which allowed them to prepare them to take responsibility for their health, and to adopt a healthier lifestyle.

Caries lesions or periodontal diseases can be prevented by the individual through easy and inexpensive procedures to carry out such as mechanical removal with toothbrush, dental floss and other adjuvants, this was demonstrated with the use of the taypodont and brush dental.

We can see in TABLE 3 that before the application of the educational program 56 of the students had inadequate knowledge about dental caries and gum diseases, achieving that after applying it the students with adequate knowledge increased to 55 for a 91.67% which evidences and justifies the advantages of the applied techniques.

Cobas Pérez ⁶¹ and López Vancour ⁶² obtained superior results to our investigation, with 97% and 100% of adequate knowledge, respectively, after interventions carried out by them where the issue was addressed, however Legrá Matos ⁶³ obtained inferior results.

The foregoing shows that the educational group intervention studies are favorable for any age group, but the earlier they are carried out, the better the later results will be.

By carrying out this educational intervention, we were able to help the students who participated in the study to identify the cariogenic diet, how to control it, as well as to master the use of fluoride to prevent the appearance of dental cavities, results that are observed in TABLE 4, where we found that before the intervention only 6 people knew about the subject, while at the end 56 students (93.33%) dominated it, results similar to those found by Limonta Vidal ²¹ in her research.

The diet that our population consumes is rich in carbohydrates, however, educating them to ensure that they ingest these with meals would be decisive to achieve the reduction of harmful habits, which constitute risks to oral health. After eating a meal that contains carbohydrates, an acid is produced in the dental plaque, as well as a demineralization of the enamel when it depresses the pH below 5.5, which generally constitutes the first phase of the onset of dental caries. ²⁴

For this reason it is very necessary to use fluorides as preventive methods to reduce the incidence of said disease and those that may be present in drinking water, toothpastes and rinses, providing greater resistance to enamel against acid dissolution.

If we evaluate in TABLE 5 the knowledge about the deforming habits of the oral cavity, we find that prior to the intervention only 5 children had adequate knowledge on the subject, which was later modified when 54 students obtained good results for 90% knowledge with the educational intervention, obtaining an 89.09% increase in knowledge, these results are similar to those found by Cueria Basulto ²³ in Guantánamo province, who obtained 91.8% of students with adequate knowledge after their intervention.

The effects produced by the finger sucking habit are related to the repetition and force with which it is exercised and to the child's facial and occlusal pattern. Some malocclusions produced by this habit are self-correcting, if it is eliminated early and if there is a favorable skeletal pattern. ²⁶

When the child breathes through the mouth, the air that is inhaled is not purified in the nostrils and, therefore, it is not cleaned of harmful particles; hence, people who breathe through the mouth are more prone to throat conditions, bronchitis, etc. In addition, breathing through the nose is necessary for the development of the nasal passages and the palate, and therefore affects the shape of the mouth. ²⁷

CONCLUSIONS

The educational intervention was effective because it managed to increase knowledge about oral health in 4th grade schoolchildren of the "Escuela Bolivariana Los Magallanes" of the Municipality of San Diego, Carabobo State.

RECOMMENDATIONS

Continue to generalize the educational instruction "Happy Smile" to the rest of the schoolchildren in our municipality to achieve greater motivation and self-responsibility towards oral health. Disseminate the results of this work to achieve motivation in Primary Health Care to carry out educational interventions that promote healthier lifestyles.

BIBLIOGRAPHY

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