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Indian Journal of Community Medicine

A KAP Study on Dental Health in Anganwadi Workers

Author(s): P. Sequeira, N. Anup, P. Srinivas

Vol. 25, No. 3 (2000-07 - 2000-09)

College of Dental Surgery, Mangalore (Karnataka).


Research question: What is the knowledge, attitude and practices regarding dental health in anganwadi workers?

Objective: To study KAP on dental health in anganwadi workers.

Study design: Cross-sectional.

Setting and Participants: Anganwadi workers from rural and urban areas of Mangalore, Karnataka.

Sample size: 316 Anganwadi workers.

Statistical analysis: Percentage.

Results: A sizeable percentage (42%) of both the urban and rural anganwadi workers (AWWs) felt that teeth cannot be retained for a life time. A comparable percentage of both urban and rural respondents reported that extraction of teeth is associated with various problems.

Keywords: Anganwadi worker, Knowledge, Attitude, Practice, Dental health.


The Integrated Child Development Services (ICDS) scheme was started in 1975 in 33 blocks. After 20 years, this programme covers 3654 blocks out of 5239 blocks, i.e., 70% of the country1. The principal worker in the project is the Anganwadi Worker (AWW). Included in the functions of the AWW are health check-up and health education to nursing mothers, other women (15-45 years) and children below 6 years of age2. The Primary Health Care approach has been advocated as the strategy to achieve health for all. Integrating dental strategies into this approach would also require that oral hygiene instruction, as part of general hygiene instruction, be carried out by community health workers, social workers and so on in addition to dental personnel3. As studies on dental health in anganwadi workers are scarce, a study was conducted to find out the knowledge, attitudes and behaviour of the anganwadi workers.

Material and Methods:

Mangalore is having anganwadis in both urban and rural areas. Information about the objectives of the study was conveyed to the person in charge of the centre. Having obtained the consent and the date when the AWWs assemble at the location, a questionnaire in a regional language was made available to the anganwadi workers present on that date.


85 urban (Response 77%) and 231 rural (Response 79%) AWWs participated in the study. The age range of the subjects varied from 18 years to 50 years. The majority (60%) of the workers in the urban centre were in the age range of 28-37 years, while in the rural about 70% were in 18-27 years age range. As to the question on the importance of teeth, 3 AWWs in the rural centre considered teeth as not important, while none of the anganwadi workers in the urban centre had that opinion.

A sizeable percentage (about 42%) of both the urban and rural AWWs felt that teeth cannot be retained for a lifetime. 60% of subjects in the rural and 73% in the urban centre reported to have had dental problems, predominant being cavities. 75% of those with dental problems in rural and 79% in urban centres mentioned that they had gone for consultation for these problems, with periods ranging from within a week to 'when it starts aching. Home remedies like keeping salt and garlic on the affected tooth; clove oil and saline gargles have also been tried out by the respondents. Money, lack of time, 'if missing tooth is replaced, there will be difficulty in eating', have been mentioned as some of the reasons for not seeking treatment.

About 50% of both urban and rural respondents had mentioned that tooth extraction causes problems. The open-ended nature of the question elicited answers like - 'affects the nerves', 'eye problems', 'affects the brain', 'teeth connected to the 5 sense organs, so problems', 'harmful to life, may become septic', 'bleeding', 'affects ears', 'swelling', 'pain in jaws', 'pain when eating', 'giddiness'. Mentioned also are 'may injure tongue', 'should get it extracted by a good dentist, if not problems', 'at the most 2 teeth can be extracted'.

Most of the subjects had reported being aware that teeth cannot be filled if there is gross decay. To the question, what happens if deposits on the teeth are not removed, apart from gum problems, halitosis, 5 subjects had mentioned cancer. About half the anganwadi workers noted that materials (including specifically curry leaves) other than toothbrush can be used. Only 8 out of 316 respondents did not like to know more about dental health.


The anganwadi worker can be a vital link in the health system as she is to provide a package of services to mothers and children. Even though oral health is not considered to be of sufficient importance by them now, an awareness of dental health among most of the AWW itself could be a beginning. 42% of respondents reported that teeth cannot be retained over a lifetime and almost an equal percentage reported complications following extractions. The findings of the study suggest that education on preventive and certain curative aspects of dental diseases and maintenance of dental health may need to be incorporated.


  1. Ghosh S: ICDS Service Programme, Health for the Millions. 1995; 21: 31-6.
  2. Park's Text book of Preventive and Social Medicine, Jabalpur. M/s. Banarsidas Bhanot, 1995; 520.
  3. Workshop on 'Exploring New Frontiers In Dental Public Health - Planning for The Future' Sept. 7-10-1991. Dental council of India Publ., New Delhi.
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