|Year : 2015 | Volume
| Issue : 2 | Page : 174-178
Do the supportive staff have enough oral health knowledge? - A study at a teaching health care institution in South India
Venumbaka Siva Kalyan1, AS Kalyana Bhargava1, T Madhavi Padma1, KVNR Pratap1, G Venkateswara Rao2, Anitha Akkaloori3
1 Department of Public Health Dentistry, Mamata Dental College, Khammam, Telangana State, India
2 Department of Oral Pathology and Microbiology, Mamata Dental College, Khammam, Telangana State, India
3 Department of Public Health Dentistry, Malla Reddy Dental College for Women, Hyderabad, Telangana State, India
|Date of Web Publication||18-Jun-2015|
Venumbaka Siva Kalyan
Department of Public Health Dentistry, Mamata Dental College, Khammam, Telangana State
Source of Support: None, Conflict of Interest: None
Introduction: Oral hygiene plays an imperative role in preventing oral diseases. The assessment of knowledge, attitude and practice in relation to oral hygiene among the supportive staff members would help the professional, to inculcate in their patients the acceptable oral habits to thwart oral diseases as these staff members are a bridge between healthcare professional and the patient. Materials and Methods: A cross-sectional questionnaire-based study was conducted at a teaching health care institution in South India. The staff members who gave their consent after detailing the objective and rationale of the study were included in the study. Data were collected about their oral health knowledge, attitude and oral hygiene practices. Descriptive statistics was calculated. Results: Nearly 79% brushed their teeth only in the morning; 95% used a tooth brush and toothpaste regularly. Dental floss (0.5%) was the least used cleaning aid. About 57% of the participants visited the dentist only when necessary. The majority of the participants had no reason for not visiting the dentist. 72% were aware of the role of sugar in causing dental caries, and 55% were unaware of the role of fluoride in dental caries. Conclusion: This study demonstrates that the majority of them brush their teeth only once, and most of them used both tooth brush and tooth paste to brush their teeth. The participants visited dentist only in emergency, and their oral health knowledge is low.
Keywords: Dental auxiliaries, knowledge, oral hygiene, paramedics, tooth brushing
|How to cite this article:|
Kalyan VS, Kalyana Bhargava A S, Padma T M, Pratap K, Rao G V, Akkaloori A. Do the supportive staff have enough oral health knowledge? - A study at a teaching health care institution in South India. J Indian Assoc Public Health Dent 2015;13:174-8
|How to cite this URL:|
Kalyan VS, Kalyana Bhargava A S, Padma T M, Pratap K, Rao G V, Akkaloori A. Do the supportive staff have enough oral health knowledge? - A study at a teaching health care institution in South India. J Indian Assoc Public Health Dent [serial online] 2015 [cited 2020 Jul 13];13:174-8. Available from: http://www.jiaphd.org/text.asp?2015/13/2/174/159059
| Introduction|| |
The World Health Organization has set its social target as "attainment of a level of health enabling them to lead a socially and economically productive life" by all people of the world. Health, being influenced by factors such as genetics, lifestyle, environment, socioeconomic status and many others, is considered to be multi-factorial and multidimensional and oral health being inseparable from general health. ,
For the past two decades, there has been a wide improvement in oral health among children and adolescents regarding dental caries and periodontal diseases. This dramatic change is attributed to the change in the living pattern, modified dietary habits, effective use of fluorides, improved oral hygiene practices and establishment of prevention based oral care programs. ,
Oral hygiene plays an important role in oral disease prevention. The use of toothbrushes and toothpastes is common in most industrialized countries, but in many third-world countries the use of toothbrush is still uncommon, chewing sticks obtained from local trees and shrubs are being commonly used. ,
Oral health knowledge is an important prerequisite for health care practices owing to the association between increased knowledge and better oral health. People those who are informed about the health care regimens and feel the importance of oral health are more likely to cultivate self-care practices. ,
The literature mentions that the utilization of oral health services are mostly symptom oriented, and regular oral hygiene habits are infrequent. ,,, The development of comprehensive dental health care programs involves training of the adult population as they influence future generations. For this, the key step of planning would be conducting an analysis of oral health behavior of the population, as it being essential for the patterning of oral health messages and various behavior modification strategies. ,
The supportive staff is a body consisting of people other than the health care provider (doctor) who assist in providing care to the patient. They act as a link between the doctor and the patient when the patient approaches them regarding suggestions given to them after the treatment is performed as this staff is exposed to procedures performed either by being assistants or viewers. The information that is absorbed will be shared among their environs. , Thus this study was conducted with an aim to assess the oral health knowledge of these staff as there are lacunae in the information, so that appropriate oral health programs can be introduced targeting those behaviors which are responsible for causing disease. The objectives are to assess the oral hygiene practices of the staff members, to know the reasons for visiting and not visiting the dentist.
| Materials and methods|| |
A cross-sectional descriptive questionnaire based study has been carried out over a period of a month (December 2014), which received ethical clearance from the Institutional Research Ethics Committee prior to its commencement. The questionnaire was designed in the regional language (Telugu), which was adopted from a study conducted by Ahmed et al.  and it was checked for cross-cultural sensitivity using forward and backward translation process with the help of both monolingual and bilingual experts,  which was found to be good. The translated questionnaire was checked for reliability by test-retest method among ten participants who completed the questionnaire twice with 2 weeks apart.
The questionnaire has 18 questions, which included demographic data (4 questions), questions regarding oral hygiene practices (5 questions) and regarding their dental visits, reasons for visits (3 questions) and their knowledge regarding oral health (6 questions).
All the supportive staff members (dental and medical) who were present on the days of the survey were invited to participate. Prior verbal consent was obtained from the staff members and the absentees and those not willing to participate were excluded from the study.
The questionnaires were distributed to the staff members after obtaining permission from the concerned authorities during clinical hours. The collected data was entered into Microsoft Excel sheet. Descriptive statistics such as counts and percentages were calculated.
| Results|| |
Demographics of the participants
A total of 376 staff members were invited to participate, 342 completed questionnaires yielding a response rate of 91%. Of the completed questionnaires, 220 (64.3%) were males. The mean age of the study population was 34.77 years with an age range between 20 and 55 years. The education level of the participants varied from high school to graduate or postgraduate. Most of them 204 (60%) have done their graduation or postgraduation. About 312 (91%) had <10 years of experience with a mean of 4.57 years experience [Table 1].
Oral hygiene practices
Almost three-fourth (79.2%) brushed their teeth only in the morning, 95.6% used a tooth brush and 93.57% used toothpaste regularly. Only one-fourth (25%) used cleaning aids in addition to the tooth brush and tooth paste, and the dental floss (0.5%) was the least used cleaning aid [Table 2].
Reasons for visiting dentist and treatment received
About 194 (57%) reported to the dentist only when they experienced tooth ache, and 84 had never reported to the dentist earlier. Those who visited the dentist, the most common type of treatment they received were scaling and polishing (20.4%) and less received treatment being dental extractions (11%). The majority (57%) of the participants had no reason for not visiting the dentist ever [Table 3].
|Table 3: Reasons for visiting the dentist and types of treatment received|
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Knowledge regarding oral health
Regarding their "dental knowledge," about 48% of the subjects knew the correct number of the deciduous teeth, while 75% knew the correct number of permanent teeth. The majority of the study population (72%) were aware of the role of sugar in causing dental caries, and 55% were unaware of the role of fluoride in dental caries. Drinking water and salt had been considered as a source of fluoride by 44% and 41% of the study population respectively [Table 4].
| Discussion|| |
The awareness on the contributory factors for dental diseases, the attitude towards oral health and related habits play an imperative role in determining the oral health status of individuals.  To the best of our knowledge, this is the first study of its kind in India conducted on supportive staff (medical and dental) working in a teaching health care institution. Only two studies , were conducted till date exclusively on non - teaching dental staff. Hence, results were also compared with the studies conducted on the general population and administrative staff.
The majority of the respondents (79%) brushed their teeth only in the morning and 18% of them brushed twice which is less compared to studies conducted elsewhere. ,,,, A study reported that 76% of the participants brushed once daily similar to our study.  On the other hand, few studies reported the low prevalence of tooth brushing compared to the present study. , These differences in the frequency of tooth brushing could be due to lack of awareness and the impact of dental/oral health education programs being organized at different places. 
With regard to aids used in brushing/cleaning teeth most of the participants used tooth brush (95%) and toothpaste (93%), which supports the finding that higher the education level, better the oral hygiene practices ,, as majority of our participants were either graduates or postgraduates. This can also be attributed to increasing sources of information available through mass media ,, and health education posters available in the dental hospital.
A total of three-fourth of the study participants did not use any other oral hygiene aids such as dental floss and inter-dental toothbrushes. Only a negligible (0.58%) reported using dental floss similar to various studies ,,, conducted elsewhere as the participants are ignorant of the role of dental floss in preventing periodontal problems  indicating the need to improve the oral health knowledge.
In order to explore the awareness of the participants towards the importance of visiting dentist they were enquired about dental visit, more than half (57%) reported that they visited dentist only when they had toothache which is in congruence with various studies. ,,,,,,,, This reflects that participants are unaware of the importance of regular dental check-ups  as a preventive dental behavior as they were visiting dentist based on their felt needs. It is also documented that pain is the motivating factor in visiting dentist. ,
Fifty-seven percent of the participants stated that they "had no reason" for not visiting dentist which is high compared to the study conducted on paramedical staff demonstrating lack of interest among the participants in spite of dental services available at their door step.  The same percentage of participants visiting dentist when they have toothache could probably support the above-mentioned statement. The other reason cited was "lack of time" which could be attributed to the fact that working hours of the staff coincides with the functioning of dental hospital. 
A total of 75% of the participants were aware of the number of teeth present in the oral cavity in accordance to a study on nonteaching dental staff.  More than 50% of the participants did not know the time of eruption of first permanent molar and the number of deciduous teeth as reported by others , which needs a mention emphasizing the need to educate the participants as it may influence their children s health. Most (72%) of the participants opined that sugar causes dental caries similar to studies conducted on administrative,  paramedical staff  and the general population. 
The participants (55%) were not aware of the role of fluoride on dental caries similar to a study conducted in Mumbai  which reflects the lack of knowledge on the preventive aspects of fluoride as the preventive oral health education in India is still in an intermediary arena.  Drinking water is considered as a major source of fluoride in our study, which could be because of media related information as mentioned earlier and the region  where the participants belong to is fluoride affected.
This study being evaluated on the basis of self-reported data derived from the supporting staff with varying levels of comprehension which may not reflect the actual knowledge and more over different auxiliaries and paramedics has different training methods and roles. This study used a non-random sampling technique in a single institution, so generalizing the conclusions may be done with caution.
There is a need to educate the supporting staff on various aspects of oral health and motivate them to utilize the services available at hand. Future studies have to be conducted involving other institutions, which would help us in designing programs to improve the oral hygiene aspects of the supporting staff in total.
| Conclusion|| |
The results of this study reveal that the majority of them brush their teeth only once, and most of them used both tooth brush and tooth paste to brush their teeth. The participants visited the dentist only in emergency, and their oral health knowledge is low.
| References|| |
Chandra Shekar BR, Reddy CV, Manjunath BC, Suma S. Dental health awareness, attitude, oral health-related habits, and behaviors in relation to socio-economic factors among the municipal employees of Mysore city. Ann Trop Med Public Health 2011;4:99-106.
Singh A, Gambhir RS, Singh S, Kapoor V, Singh J. Oral health: How much do you know? - A study on knowledge, attitude and practices of patients visiting a North Indian dental school. Eur J Dent 2014;8:63-7.
Ahmed MS, Bhayat A, Al-Samadani KH, Abuong Z. Oral health knowledge and practice among administrative staff at Taibah University, Madina, KSA. Eur J Gen Dent 2013;2:308-11.
Zhu L, Petersen PE, Wang HY, Bian JY, Zhang BX. Oral health knowledge, attitudes and behaviour of adults in China. Int Dent J 2005;55:231-41.
Al-Batayneh OB, Owais AI, Khader YS. Oral health knowledge and practices among diverse university students with access to free dental care: A cross-sectional study. Open J Stomatol 2014;4:135-42.
Hardie J, Ahmed K. The Miswak as an aid in oral hygiene. J Philipp Dent Assoc 1995;47:33-8.
Tagoo RA, Yaseen SM, Zakirulla M, Nasim VS, Al Zamzami M. Oral hygiene knowledge and practices among school children in a rural area of Southern Saudi Arabia. Int J Contemp Dent 2012;3:57-62.
Freeman R, Maizels J, Wyllie M, Sheiham A. The relationship between health related knowledge, attitudes and dental health behaviors in 14-16 year-old adolescents. Community Dent Health 1991;10:212-9.
Dali M, Laleet R. A study on oral health knowledge, attitude and practice among population of SiswaniJahada VDC in Biratnagar City, Nepal - A questionnaire survey. Asian Pac J Health Sci 2014;1:51-6.
Manjunath G, Kumar NN. Oral health knowledge, attitude and practices among school teachers in Kurnool - Andhra Pradesh. J Oral Health Community Dent 2013;7:17-23.
WHO. Population Nutrient Intake Goals for Preventing Diet-related Chronic Diseases. Available from: http://www.who.int/nutrition/topics/5_population_nutrition/en/index18.html/;2011. [Last accessed on 2014 Dec 21].
Omili M, Ofili AN, Omuemu V. Oral health perception among officers and men of the Nigerian prisons service, Abuja. Eur J Gen Dent 2013;2:252-6.
Amith HV, Audrey MD, Sahima S, Shanima, Shazmi HD, Sheik MM, et al
. Oral hygiene practices among paramedical staff of a private dental institution in India. 206 RSBO 2013;10:205-10.
Shetty MS, Bhat V, Shenoy KK. Oral health awareness among non teaching staff of a dental institution in Dakshina Kannada. J Oral Health Community Dent 2014;8:76-8.
Su CT, Parham LD. Generating a valid questionnaire translation for cross-cultural use. Am J Occup Ther 2002;56:581-5.
Zeedyk MS, Longbottom C, Pitts NB. Tooth-brushing practices of parents and toddlers: A study of home-based videotaped sessions. Caries Res 2005;39:27-33.
Aunger R. Tooth brushing as routine behavior. Int Dent J 2007;57:364-76.
Bhat PK, Kumar A, Aruna CN. Preventive oral health knowledge, practice and behavior of patients attending dental institution in Bangalore, India. J Int Oral Health 2010;2:1-6.
Oswal KC. Oral hygiene practices among patients visiting Terna dental college. J Oral Health Community Dent 2013;7:33-6.
Jain N, Mitra D, Ashok KP, Dundappa J, Soni S, Ahmed S. Oral hygiene-awareness and practice among patients attending OPD at Vyas Dental College and Hospital, Jodhpur. J Indian Soc Periodontol 2012;16:524-8.
Fareed N, Shanthi M, Sudhir KM, Samatha M. Oral health related knowledge attitude and practices among the residents of Saraswati Nagar, Nellore, Andhra Pradesh. J Indian Assoc Public Health Dent 2011;18:117-20.
Parveen N, Ahmed B, Bari A, Butt AM. Oro dental health: Awareness and practices. JUMDC 2011;62:5-10.
Kapoor D, Gill S, Singh A, Kaur I, Kapoor P. Oral hygiene awareness and practice amongst patients visiting the Department of Periodontology at a Dental College and Hospital in North India. Indian J Dent 2014;5:64-8.
Paul B, Basu M, Dutta S, Chattopadhyay S, Sinha D, Misra R. Awareness and practices of oral hygiene and its relation to sociodemographic factors among patients attending the general outpatient department in a tertiary care hospital of Kolkata, India. J Family Med Prim Care 2014;3:107-11.
Farsi JM, Farghaly MM, Farsi N. Oral health knowledge, attitude and behaviour among Saudi school students in Jeddah city. J Dent 2004;32:47-53.
Thangavelu A, Elavarasu S, Saravanan J. Oral health practices and awareness among patients at the department of periodontics at J.K.K.N Dental College and Hospital, Komarapalayam. Int J Clin Dent Sci 2014;5:13-6.
Jain R, Oswal KC, Chitguppi R. Knowledge, attitude and practices of mothers toward their children's oral health: A questionnaire survey among subpopulation in Mumbai (India). J Dent Res Sci Dev 2014;1:40-5.
Central Ground Water Board. Ministry of Water Resources Government of India Ground Water Brochure Khammam District, Andhra Pradesh (AAP-2012-13). Available from: http://www.cgwb.gov.in/District Profile/AP_districtProfiles.htm. [Last accessed on 2015 Feb 10].
[Table 1], [Table 2], [Table 3], [Table 4]