A survey about awareness of periodontal health among the students of professional colleges in Dakshina Kannada District

Abstract

Introduction:

Oral health is an important factor in maintaining sound psychological and physical health. Association between knowledge and better oral health has been well documented.

Aim:

To assess the oral health awareness and knowledge about periodontal diseases among the students of medical, Ayurveda, and Engineering Colleges.

Materials and Methods:

A survey was conducted among the students of medical, Ayurveda, and engineering colleges. Three hundred students were selected using a simple random sampling method and a self-constructed 15 items questionnaire was distributed to all subjects. Chi-square test was applied to individual questions and Kruskal–Wallis test was used to compare overall oral health awareness and knowledge about periodontal diseases among the students.

Results:

A substantial lack of oral hygiene understanding and limited knowledge of oral hygiene practices even in health professionals and engineering students.

Conclusions:

Hence, there is an urgent need for comprehensive educational programs to promote good oral health and impart education about the correct oral hygiene practices at an elementary level.

INTRODUCTION

Health is a universal human need for all strata of society. General health cannot be maintained without good oral health. The mouth is regarded as the gateway to the body and acts as a mirror that reflects the status of general health.[1] Oral health plays an important role to maintain the overall health.[2] There is evidence that the oral health depends on social, biological, and environmental factors.[3] Recent literature study reveals a strong relation between the effects of chronic oral inflammation and general health. Periodontal diseases have been linked to systemic diseases; and similarly systemic diseases can also have an impact on oral health. There is a bidirectional relationship that exists between the two.[4] Knowledge of oral health is considered to be an essential prerequisite for health-related behavior.[5] Budding health professionals and engineers belong to the strata of society considered to have a better knowledge and awareness than the general population, but assessment of actual status demands a proper-channeled study. This survey was therefore initiated with a prime focus to determine the oral health awareness levels among the medical, Ayurveda, and engineering students in Dakshina Kannada District.

Aims and objective

It is a common notion that educated strata of society are more aware about the general health and diseases including oral, but very minimal data are present in literature to substantiate this view. Therefore, this study is designed with the aim of attaining information about the level of awareness of periodontal health and disease in that section of society which is considered to be more informed and educated than the normal population. The main objectives of our study are:

1. To evaluate and assess the knowledge of oral health in the educated strata which forms the foundation of society including the professionals of medical, engineering, and Ayurveda

2. To compare the oral health awareness among the students of medical, Ayurveda, and engineering college

3. To assess and compare the knowledge about periodontal diseases among the students of medical, Ayurveda and engineering college.

Inclusion criteria

Undergraduate students having age of above 17 years.

MATERIALS AND METHODS

Ethical clearance was obtained from the Institutional Board, and data were collected from the Institutes.

Questionnaire design

Development of questionnaire was based on the pilot study and items previously reported in various studies[6,7] whereas some questions which were related to the knowledge about periodontal diseases were constructed by the author based on the understanding of the diseases. The proforma consisted of two parts. The first part includes general information like age, gender, and profession of students. The second part consisted of 15 questions in which question number 1–6 and question number 14 were related to the awareness about the oral hygiene based on previous studies[6,7] and question number 7–13 and question number 15 were related to knowledge about periodontal diseases.

Sample size estimation

A pilot study was conducted among 50 students to calculate the sample size. As per pilot study conducted we got a result of 50% awareness among the students by following formula:

(p = Prevalence, q = 1−p, e = Percentage error of 6%). The minimum sample size required for the study was calculated to be 278 which were rounded off to 300.

Sampling method

Out of 6 medical, 5 Ayurveda, and 10 engineering colleges in Dakshina Kannada District one college in each category was randomly selected. A total number of students in three colleges according to the inclusion criteria were 1250, with 410 medical, 240 Ayurveda, and 600 engineering, students. Based on which 300 students was selected using a simple random sampling method by lottery method: 100 students each of medical, Ayurveda, and engineering colleges were selected eliminating any age and gender bias.

A self-constructed questionnaire [Figure 1] was distributed to all subjects above 17 years of age consisting of 32.7% males and 67.3% females. After distribution of questionnaire, 10 min was allotted for completing the questionnaire. Each question of the questionnaire had four options in which most appropriate answer were scored as one, and least appropriate answer scored as zero.

Figure 1.

Proforma of questionnaire

Statistical analysis

Data were analyzed using SPSS Version 11.5 software (Free Online version of software was used, Chicago, North America, USA) and P < 0.05 was considered as statistically significant. Chi-square test was applied to the individual question to analyze the result and Kruskal–Wallis test was used to compare overall oral health awareness and knowledge about periodontal diseases among the students.

RESULTS

Out of 300 participants, 32.7% were male, and 67.3% were female. The mean age of the students was 20.36 ± 1.93 years with minimum age of 17 years and maximum age of 27 years.

Although, brushing was the commonly used method of cleaning, it was found that the percentage of subjects brushing their teeth twice daily regularly was 55% in medical, 66% in Ayurveda, and 55% in engineering students. This comparison between different professional students made by Chi-square test was significant (P < 0.05). Although, the average percentage of students, who brushes twice daily regularly was 61% [Table 1], subjects who change their toothbrush in 3 months were 59% in medical, 56% in Ayurveda, and 84% in engineering students and this difference was highly significant (P < 0.01). However, the average percentage of students who changes their toothbrush in 3 months was 66%. Subjects who were aware about correct method of brushing technique were 39% in medical, 23% in Ayurveda, and 26% in engineering students and the difference between different students was highly significant (P < 0.01). Although, the average percentage of students who were aware about the correct method of brushing technique were only 29% percentage of subjects who were aware about dental floss were only 9% in medical, 10% in Ayurveda, and 18% in engineering students and the difference in the behavior between different students was highly significant (P < 0.01). Although, the average percentage of students who were aware about the dental floss was only 12% only 16% of medical, 11% of Ayurveda, and 35% of engineering students were aware about correct method of using mouthwash and the difference in the behavior between different students was highly significant (P < 0.01). Only 2% of medical, 8% of Ayurveda, and 17% of engineering students regularly visit their dentist for cleaning their teeth every 3 months and the difference in the behavior between the students was highly significant (P < 0.01) [Table 1].

Table 1.

Percentage of students having knowledge about oral hygiene measures

Only 18% of medical, 36% of Ayurveda, and 18% of engineering students were aware about the common cause of bleeding gums and the difference in the behavior between students was highly significant (P < 0.01). About 86% of medical, 73% of Ayurveda, and 56% of engineering students were aware that poor oral hygiene is the common cause for bad breath, and the difference in the opinion between different students was highly significant (P < 0.01). Only 42% of medical, 50% of Ayurveda, and 56% of engineering students reported poor oral hygiene as the common cause of loosening of teeth. About 78% of medical, 64% of Ayurveda, and 70% of engineering students considered hypersensitivity as a treatable entity but the difference in opinion between the students was significant (P < 0.01). About 94% of medical, 80% of Ayurveda, and 80% of engineering students were aware that bad oral hygiene effects general health and the difference in the behavior between students was not significant (P > 0.05). Subjects who reported improper tooth brushing as the common cause for receding gums were 72% in medical, 72% in Ayurveda, and 70% in engineering colleges but the difference in the behavior between different students was not significant (P > 0.05). 0% medical, 2% Ayurveda, and 1% engineering students have the knowledge about aggressive periodontitis [Table 2].

Table 2.

Percentage of students having awareness about periodontal diseases

Mean awareness about the oral hygiene was found to be 10.8 ± 1.5 among medical students, 11.5 ± 1.94 among Ayurveda students, and 10.5 ± 1.7 among engineering students while the mean knowledge about various periodontal disease was 11.67 ± 2.39 among medical, 12.9 ± 2.94 among Ayurveda students, and 14.04 ± 3.238 among engineering students (P < 0.01) [Table 3].

Table 3.

Students having overall mean knowledge about oral hygiene measures and periodontal diseases

DISCUSSION

Most of the people are unaware about the relationship between oral hygiene and systemic diseases such as cardiovascular disease and diabetes. Therefore, oral hygiene has mostly remained as an ignored and unrealized social problem. A significant amount of emphasis is now being given for prevention of diseases rather than the treatment aspect. So, proper knowledge of preventive oral health and proper oral hygiene practice becomes the important way for maintaining good dentition. In this survey, we studied the status of awareness in that section of society which is considered to have a better knowledge and awareness than general population. This survey was therefore initiated with a prime focus to determine the oral health awareness levels among the engineering, medical, and Ayurveda students in Dakshina Kannada District.

Although, brushing was the commonly used method of cleaning, the percentage of subjects brushing their teeth twice daily regularly were less which is similar to 67% of the Chinese urban adolescents in a study by Jiang et al. in 2005.[8] 62% of the Kuwaiti adults in a study by Al-Shammari et al. in 2007.[9]

Average percentage of students who changes their toothbrush in 3 months was 66.3% in which engineering students seems to be more aware about the knowledge of changing toothbrush compared to medical and Ayurveda students which is quite surprising.

It is noteworthy that 26% of all the professional students brushed their teeth using horizontal method that might result in compromised tooth structure and gingival health which is significantly less than the study done by Zhu et al. in 2005[10] where 60% of the sample did the same.

In spite of being health professionals only 9%, the subjects were aware about dental floss. In contrast, Hamilton and Coulby in 1991 found that a high percentage (44%) of the sample in north eastern Ontario used dental floss.[11] The reason for this may be educational program that is carried out in Canada, which lacks in our society. This emphasizes the urgent need for educating and motivating the public to use this efficient method for oral health care.

In contrast to this significantly higher percentage of students (73% of Ayurveda, 86% of medical, and 56% of engineering) was aware that poor oral hygiene is common cause of bad breath and most of them (80% Ayurveda, 94% medical, and 80% engineering students) were aware that bad oral hygiene effects general health and the results obtained were better compared to the study conducted by Ali et al. in 2012 (81%) in Karachi.[12]

Very less students visits regularly their dentist for cleaning their teeth in 3 months though a comparatively higher number of professionals (43%) visited dentist over a period of 1 year, which was in par with the studies by Behbehani and Shah (49%),[13] Petersen et al. (37%),[14] and Al-Hussaini et al. (44%),[15] but was better than the study conducted by Johani (12.8%).[16]

The results of our survey surprisingly revealed that the well-educated professionals who are going to become the foundation of our modern society stands nowhere better than rest of the general population based on their educational knowledge whereas some results might be given intentionally by the students. But the level of awareness and knowledge about the oral health and oral diseases in these professionals is not very encouraging.

Limitations

There is no other previous study of its kind for this region from which a comparison can be drawn. Also, there is no study which compares the level of awareness among the professional students of medical, Ayurveda, and engineering.

CONCLUSION

Standards of oral health awareness are very poor in India, with a large proportion of the population being affected due to poor socio-economic conditions and many people have never even been to a dentist. The results obtained in our survey are an eye opener for the dental faculty not only in Dakshina Kannadda region but also throughout the country. From the results of our survey, we conclude that the level of awareness in the professional students of medical, Ayurveda, and engineering fields is not enough and presents a sorry picture. As dentists, we have to keep reinforcing the importance of correcting all aspects related with brushing and flossing along with the importance of regular checkups.

The task of spreading this awareness needs to be extended beyond our clinic to general masses, including school children, working and nonworking population, and even the professional students.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.