International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 14 , ISSUE 3 ( May-June, 2021 ) > List of Articles


Incorporation of Storytelling as a Method of Oral Health Education among 3–6-year-old Preschool Children

Tulika Shruti, Harikiran A Govindraju, Jyotsna Sriranga

Keywords : Experimental study, Game-based oral health education, Oral healthcare, Oral health knowledge, Pediatric oral health, Preschool children

Citation Information : Shruti T, Govindraju HA, Sriranga J. Incorporation of Storytelling as a Method of Oral Health Education among 3–6-year-old Preschool Children. Int J Clin Pediatr Dent 2021; 14 (3):349-352.

DOI: 10.5005/jp-journals-10005-1946

License: CC BY-NC 4.0

Published Online: 29-09-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Purpose: To find the effectiveness of storytelling as a method of oral health education among 3–6-year-old preschool children. Design: A non-randomized experimental pre–post study design. Setting: Preschools located in urban Bengaluru. Subjects: Two hundred, 3–6 years, preschool children. Intervention: An age-appropriate story with oral health messages was delivered using hand puppets during the storytelling session in preschool. Measures: A self-administered 11-item picture-based, closed-ended questionnaire assessed children's knowledge and attitude at baseline and post-intervention. A 1-week audit sheet to monitor the brushing, eating, and mouth rinsing pattern was administered for the parents to measure the change in behavior post-intervention. Analysis: Change in KAP mean scores was assessed using the “Wilcoxon Sign Rank test” at p < 0.05. “Cohen's d” was used to calculate the “Effect size”. Results: Significant improvement was observed in mean KAP score (pre 7.52 ± 1.95 post 8.60 ± 1.55, p = 0.0001) with effect size 0.2. There was a significant increase in the knowledge and attitude and practice score, knowledge (pre 2.97 ± 1.02, post 3.63 ± 0.78, p = 0.0001, effect size: 0.3), attitude (2.27 ± 0.81, 2.77 ± 0.60, p = 0.000, effect size: 0.3), and practice (2.04 ± 1.07, 2.28 ± 0.60, p = 0.0001, effect size: 0.1). Conclusion: The storytelling method was effective in improving the oral health-related KAP of children aged 3–6 years. Significance: This study attempts to inculcate good oral hygiene practices at a very early stage by targeting 3–6-year-old preschool children. Storytelling being humankind's oldest form of teaching and motivating change, can not only address the prevailing oral disease burden but also the oral health inequality by reaching out to every community.

  1. Watt RG, Heilmann A, Listl S, et al. London charter on oral health inequalities. J Dent Res 2016;95(3):245–247. DOI: 10.1177/0022034515622198.
  2. Petersen PE. The world oral health report 2003 WHO global oral health programme. Community Dent Oral Epidem 2003;31(Suppl 1):3–23. DOI: 10.1046/j.2003.com122.x.
  3. Shilpi Singh VS. Oral health inequality and barriers to oral health care in India. Eur J Dent Ther Res 2015;4(1):242–245.
  4. Ala Alwan. Global status report on noncommunicable diseases 2010. Italy: World Health Organization; 2011.
  5. Nøhr C, Aarts J. Information technology in health care: socio-technical approaches 2010: from safe systems to patient safety. IOS Press; 2010. p. 228.
  6. Andersson J. Health education in top shape-governing and communication strategies in the edutainment series top shape. Int J Commun Heal 2013;2:20–27.
  7. Blakely G, Skirton H, Cooper S, et al. Educational gaming in the health sciences: systematic review. J Adv Nurs 2009;65(2):259–269. DOI: 10.1111/j.1365-2648.2008.04843.x.
  8. Bochennek K, Wittekindt B, Zimmermann S-Y, et al. More than mere games: a review of card and board games for medical education. Med Teach 2007;29(9):941–948. DOI: 10.1080/01421590701749813.
  9. Importance of storytelling for children - Times of India [Internet]. The Times of India. [cited 2016 Sep 15]. Available from:
  10. Larkey LK, Lopez AM, Minnal A, et al. Storytelling for promoting colorectal cancer screening among underserved Latina women: a randomized pilot study. Cancer Control 2009;16(1):79–87. DOI: 10.1177/107327480901600112.
  11. LeBron AMW, Schulz AJ, Bernal C, et al. Storytelling in community intervention research: lessons learned from the walk your heart to health intervention. Prog Community Health Partnersh 2014;8(4):477–485. DOI: 10.1353/cpr.2014.0066.
  12. Story Telling [Internet]. [cited 2015 Nov 29]. Available from: http://www.preschool
  13. Morris SB, DeShon RP. Combining effect size estimates in meta-analysis with repeated measures and independent-group designs. Psychol Methods 2002;7(1):105–125. DOI: 10.1037//1082-989X. 7.1.105.
  14. Ages 3–5: Developmental Overview [Internet]. Parent Further. 2015 [cited 2016 Oct 6]. Available from:
  15. CDC - Child Development, Preschooler (3-5 years old) - NCBDDD [Internet]. [cited 2016 Oct 6]. Available from:
  16. Al-Omiri MK, Al-Wahadni AM, Saeed KN. Oral health attitudes, knowledge, and behavior among school children in North Jordan. J Dent Educ 2006;70(2):179–187. DOI: 10.1002/j.0022-0337.2006.70.2.tb04074.x.
  17. Lian CW, Phing TS, Chan CS, et al. Oral health knowledge, attitude and practice among secondary school students in Kuching, Sarawak. Arch Orofaci Sci 2010;5(1):9–16.
  18. Shenoy R, Sequeira P. Effectiveness of a school dental education program in improving oral health knowledge and oral hygiene practices and status of 12- to 13-year-old school children. Indian J Dent Res 2010;21(2):253. DOI: 10.4103/0970-9290.66652.
  19. Makuch A, Reschke K. Playing games in promoting childhood dental health. Patient Educa Couns 2001;43(1):105–110. DOI: 10.1016/s0738-3991(00)00142-7.
  20. Amaro S, Viggiano A, Di Costanzo A, et al. Kalèdo, a new educational board-game, gives nutritional rudiments and encourages healthy eating in children: a pilot cluster randomized trial. Eur J Pediat 2006;165(9):630–635. DOI: 10.1007/s00431-006-0153-9.
  21. Sinor MZ. Comparison between conventional health promotion and use of cartoon animation in delivering oral health education. Int J Humanit Social Sci 2011;1(3):169–174.
  22. Gladwell M. The tipping point: how little things can make a big difference. London [etc.]: Little, Brown; 2001.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.