Dental Services and their Awareness and Utilization among the Health Care Workers in a South Indian District – A Cross Sectional Study

ABSTRACT

Aim:

The present research was carried out to evaluate the amount of usage of dental care opportunities and also to assess the problems faced by health care workers (HCWs) of a south Indian district in using dental services.

Methodology:

This study had around 500 participants who belonged from various health care sectors who were selected with the help of multistage sampling. The data obtained from this cross-sectional research was analysed statistically using SPSS 22.0.

Results:

It was noticed that around 35% of participants went for a dentist’s appointment in past 1 year where male members predominated (45%). One of the commonest reasons for utilizing dental care services was pain as an dental emergency factor (70%). Other reasons were dental caries (18%) restoration, breakage of tooth (10%) and a host of other factors (11%). Around 350 participants felt that going to the dentist was only necessary when there was an emergency (61%).

Conclusion:

The target population less frequently visited the dentist to maintain their teeth as they believed when you have pain, that is the time you go to a dental specialist.

INTRODUCTION

For overall health of an individual, maintaining health of the oral cavity should also be prioritized since various oral diseases like caries, cancer, and periodontitis can totally alter the quality of life and are more prevalent in the modern day world. These diseases not only affects the overall health but also affects the confidence of a person and has a bad effect in their social life for both children and adults like at school or work. Mostly rural areas suffer due to income disparity and less knowledge as compared to urban city population of India.[1] Due to advancements in technology and education, dental care has also grown leaps and bounds, with many people who were earlier not very inclined towards maintaining their oral health, have now taken an active role in preventing many dental diseases. Around 30,000 dental graduates pass out every year yet the disparity between rural and urban health care is evident, where villages do not have knowledge or awareness for utilizing dental health services.[2] If this disparity is under consideration, then in urban cities this dentist: target population ratio is 1:10,000 whereas in case of rural areas the ratio is very large which is 1:150,000.[3] Only a few states in India can boast that their dental care services are at a decent level as compared to other health care services at primary level. Also, mostly patients who opt for these health care facilities, do not have any insurance while visiting public or private dentists. In many areas, even if adequate dental care services are available, still the actual attendance or utilization of these services are less.[1]

AIM OF THE STUDY

The present research was carried out to evaluate the amount of usage of dental care opportunities and also to assess the problems faced by health care workers (HCWs) of a south Indian district in using dental services.

METHODOLOGY

We conducted a questionnaire- based survey amongst 500 HCWs in a south Indian district containing 13 small villages, between Jan to Feb 2023. The participants were chosen with the help of multistage cluster sampling method. This cross-sectional type of study was also approved by the ethical committee and informed consent was taken from all the participants after explaining them about the study. Uncooperative participants were not included in the study. The questionnaire was designed in their local language which questioned them about their education, socio-cultural dynamics, dental history related to past 1 year, their preferences in dental health care services. Their responses were then statistically analysed using SPSS version 22, where the analysis was carried out with descriptive measurements like mean, standard deviation, where multiple logistic regression analysis was performed using Chi-square test. The analysis was considered significant when the P value was < 0.05.

RESULTS

We observed that the mean age of all 500 participants were between 34 ± 6.40 years where male population was around 56.72% and rest were female HCWs. Only 35% of participants reported visiting dentists for some or the reasons related to teeth, in past 1 year. Usually the major chunk of population (70%) went for treatment of pain. 18% of the participants went for filings and other restorative treatment whereas 12% went for denture rehabilitation or cleaning of their teeth. It was noticed that mostly men (55%) visited the dental clinic for treatment or prophylaxis as compared to female participants but the result was not statistically noteworthy. Majority (74%) of the participants had a view point that if there is pain, then only we should visit the dentist. Even though the participants went for the dental emergencies like pain, they considered that saving teeth is not important and they would rather go for extraction of teeth instead of restoring it using root canal treatment as there were time constraints for them due to multiple sittings (45.9%). Female participants mentioned that their reason for not going to dentist is fear from the dental treatment (49.7%) as compared to men, who didn’t want to go due to time constraint (52%) (P < 0.05). For many of them, getting dental treatment was not in their budget (34.4%) whereas distance constraint was the reason for some (25.2%) [Table 1]. Through analysis by regression model which was performed logistically, we noticed that most important reason for not going to dentist in past 1 years-time was their view that without pain, no need to go for a dental check-up with odds ratio of 1.89 (Confidence interval (CI)-1.69–2.32). Mostly older participants above 45 years, females, participants with lower socio-economic status, less educated, had less visitations to a dentist in the past 1 year, these included mostly ward boys and Anganwadi workers [Table 2].

Table 1.

Based on last dental visit in past 1 year, the comparison rates between male and female HCWs

Query	Reply	Male participants	Female participants	Total responses received (%)	χ 2	P
During past 1 year, visit to a dentist	Yes	105	99	204	37.00	2.3080
	No	123	173	296	61.00	0.147

*χ² -1056.48 (11), *P < 0.05 – statistically noteworthy

Table 2.

Logistic analysis based on regression model over factors associated with visitation to a dental clinic in past 1 years- time

Factors	OR	CI	P
Age (years)
20–40	1.03	1.18–1.68	0.002
40–60	1.43
Gender
Female	1.07	1.14–1.64	0.005
Male	1.39
Time constraint
No	1.09	1.39–1.89	<0.001
Yes	1.64
Going only when there is dental emergency - pain
No	1.03	1.71–2.22	<0.001
Yes	1.95
Fearful of treatment related to dental reasons
No	1.01	1.27–1.78	<0.001
Yes	1.51

*OR – Odds ratio, CI – 95% confidence interval

DISCUSSION

Health care workers have basic health knowledge and are trained by government-based programs which also gives them employment opportunities.[4,5] However, even though they have basic knowledge of health care facilities, still many of them are not aware of maintaining their oral health, which was also evident in studies of many other nations like China, Spain etc., where the utilization of dental services by the HCWs was around 20–40%.[6] In developing nations, rural areas are not aware of health insurance schemes many a times, let alone dental insurance. They are more aware about the importance for maintenance of teeth for improving quality of life. In contrast, few studies show that elderly people above age of 40 years who are still employed in healthcare sectors, go to a dentist, possibly due to prosthetic rehabilitation.[7] Females in these smaller districts face a lot of challenges to go for a dental check-up as they have to depend on their family as well and many a times distance also proves as a barrier for them.[8,9] The awareness is directly proportional to the level of education in people as it helps to shape their attitude towards dental treatments.[10,11,12]

CONCLUSION

We noticed that more awareness is needed in these HCWs for visiting dentists as only 35% had visited one in past 12 months, showing that they were not aware of importance of teeth. Mostly through government and local initiatives for their education, treatment cost, distance etc., can be tackled in a better way.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.