Ladera-Castañeda Marysela, Córdova-Limaylla Nancy Edith, Briceño-Vergel Gissela, Rosas-Díaz José Carlos, Cervantes-Ganoza Luis Adolfo, Cayo-Rojas César Félix
Academic Program of Stomatology, Universidad Privada San Juan Bautista, Lima, Peru.
Postgraduate School, "Grupo de Investigación Salud y Bienestar Global" and Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru.
J Int Soc Prev Community Dent. 2022 Jan 29;12(1):28-37. doi: 10.4103/jispcd.JISPCD_212_21. eCollection 2022 Jan-Feb.
The puppet theater, due to its artistic and educational characteristics, could allow children to develop oral health self-care in an attractive and fun way. The aim of this study was to evaluate the impact of puppet theater on oral health knowledge and oral hygiene in preschoolers from a Peruvian public school.
An analytical, longitudinal, and quasi-experimental study was conducted in 132 preschoolers divided into three age-matched groups (3, 4, and 5 years old) from August to November 2019 in a Peruvian public school. At 4 weeks and 4 months after performing the puppet theater, a validated questionnaire of five closed questions was used to evaluate oral health knowledge, and the Greene-Vermillion index [only bacterial plaque index (BPI) part] was used to evaluate oral hygiene, considering good (0-0.6), fair (0.7-1.8), and poor (1.9-3.0). The theater sessions were held every week for the first month and every 2 weeks for the following 3 months. To analyze the levels in the BPI, the Wilcoxon and Friedman test was used to compare related measures, and to compare the knowledge for each question of the questionnaire, the McNemar and Cochran's tests were used, considering a -value less than 0.05.
The BPI in relation to age (3, 4, and 5 years), before and after 4 months of performing the puppet theater, was 1.9 [confidence interval (CI): 1.7-2.0], 1.8 (CI: 1.6-1.9), and 1.8 (CI: 1.7-2.0), decreasing to 0.9 (CI: 0.8-1.0), 0.8 (CI: 0.7-0.9), and 0.9 (CI: 0.8-1.00), respectively. In relation to gender (men and women), it was 1.8 (CI: 1.7-2.0) and 1.8 (CI: 1.7-1.9), decreasing to 0.9 (CI: 0.8-1.0) and 0.8 (CI: 0.8-0.9), respectively. In relation to origin (urban or rural), it was 1.8 (CI: 1.7-1.9) and 1.8 (CI: 1.4-2.2), decreasing to 0.9 (CI: 0.8-0.9) and 0.8 (CI: 0.7-0.9), respectively. The level of BPI and oral health knowledge improved significantly ( < 0.001) over time in all preschoolers, except in those who came from the rural area ( > 0.05).
The application of the puppet theater positively influenced the preschoolers in such a way that it significantly improved their oral health knowledge and oral hygiene at 4 weeks and 4 months, in both genders of 3, 4, and 5 years of age, and in those whose origin was the urban area. However, no significant improvements in oral health knowledge and oral hygiene were observed in those preschoolers whose origin was the rural area.
木偶剧因其艺术和教育特点，能够让孩子们以一种有趣且吸引人的方式培养口腔健康自我护理能力。本研究旨在评估木偶剧对秘鲁一所公立学校学龄前儿童口腔健康知识和口腔卫生的影响。
2019年8月至11月，在秘鲁一所公立学校对132名学龄前儿童进行了一项分析性、纵向和准实验性研究，这些儿童被分为三个年龄匹配组（3岁、4岁和5岁）。在进行木偶剧表演后的4周和4个月，使用一份经过验证的包含五个封闭式问题的问卷来评估口腔健康知识，并使用格林 - 弗米利恩指数[仅细菌菌斑指数（BPI）部分]来评估口腔卫生情况，将其分为良好（0 - 0.6）、中等（0.7 - 1.8）和差（1.9 - 3.0）。第一个月每周举行木偶剧表演场次，接下来的3个月每2周举行一次。为分析BPI水平，使用威尔科克森和弗里德曼检验来比较相关测量值，为比较问卷中每个问题的知识情况，使用麦克内马尔和 Cochr an检验，显著性水平设定为小于0.05。
在进行木偶剧表演4个月前后，3岁、4岁和5岁年龄组的BPI分别为1.9[置信区间（CI）：1.7 - 2.0]、1.8（CI：1.6 - 1.9）和1.8（CI：1.7 - 2.0），之后分别降至0.9（CI：0.8 - 1.0）、0.8（CI：0.7 - 0.9）和0.9（CI：0.8 - 1.00）。按性别（男和女）划分，BPI分别为1.8（CI：1.7 - 2.0）和1.8（CI：1.7 - 1.9），之后分别降至0.9（CI：0.8 - 1.0）和0.8（CI：0.8 - 0.9）。按来源地（城市或农村）划分，BPI分别为1.8（CI：1.7 - 1.9）和1.8（CI：1.4 - 2.2），之后分别降至0.9（CI：0.8 - 0.9）和0.8（CI：0.7 - 0.9）。除来自农村地区（P > 0.05）的儿童外，所有学龄前儿童的BPI水平和口腔健康知识随时间显著提高（P < 0.001）。
木偶剧的应用对学龄前儿童产生了积极影响，在4周和4个月时显著提高了3岁、4岁和5岁男女儿童以及城市地区儿童的口腔健康知识和口腔卫生情况。然而，农村地区的学龄前儿童在口腔健康知识和口腔卫生方面未观察到显著改善。
