Awareness about Dental Fluorosis among Parents of School Children in Selected Schools in Dimbulagala Educational Zone, Polonnaruwa District, Sri Lanka

Abstract

Dental fluorosis (DF) is a preventable, common oral health problem characterised by abnormalities in the formation of the enamel structure resulting from repeated exposure to high quantities of fluoride, during critical stage of tooth development. This is the most prevalent among children aged 12-15 years, particularly in regions of Asia and Africa where groundwater contains naturally high levels of fluoride. Parental awareness plays a crucial role in the prevention and early detection of DF, as an essential focus in improving the oral health of children. This study was designed to assess the parental awareness about DF and its associated factors among school children in selected schools in Dimbulagala Educational zone, Polonnaruwa District, Sri Lanka. A descriptive cross-sectional study was conducted among 273 parents of the school children, aged 12-14 years in Dimbulgala Educational zone. Students were selected using multi-stage cluster sampling method and data were collected using a self-administrated questionnaire. Data were analysed using SPSS version 26.0. A greater proportion of the parents (n=154 (56.4%) were female and most of the parents were engaged in farming (n=127, 46.5%). A significant proportion of them (n=267, 97.8%) lived in rural areas. Overall, parental awareness of DF was low. Little more than half of the parents (61.9%) were unaware of DF and the role of fluoride as its primary cause. A majority (86.8%) did not know that fluoride was present in their drinking water and toothpaste. Similarly, most parents (n=230, 84.2%) were unaware that excessive fluoride exposure is the main factor contributing to DF. Furthermore, 44.7% of the participants (n=122) were not aware of water sources with high fluoride concentrations. Although no statistically significant association was found between DF awareness and socio-demographic characteristics such as age, gender, and monthly income, there was a significant association between awareness of DF and both the area of residence and parents’ occupation. This study highlights a low level of parental awareness regarding DF including its causes, and the presence of fluoride in commonly used sources. Despite no significant association were observed between awareness and socio-demographic factors such as age, gender or income, significant associations were found with parental occupation and rural residence. Therefore, targeted public health interventions, particularly in rural communities to enhance parental knowledge are essential for the prevention and early identification of DF, ultimately contributing to improved oral health in children.