|Year : 2018 | Volume
| Issue : 3 | Page : 203-207
“Assessment of oral health status among teaching and non-teaching employees of Maharishi Markandeshwar (deemed to be University) Mullana Ambala” – A cross-sectional study
Anshuman Swamy, Girish M Sogi, Jasneet Sudan, Archita Vedi, Heena Sharma
Department of Public Health Dentistry, M M College of Dental Sciences and Research, Ambala, Haryana, India
|Date of Submission||09-Jan-2018|
|Date of Acceptance||11-Jun-2018|
|Date of Web Publication||6-Aug-2018|
Dr. Girish M Sogi
Department of Public Health Dentistry, M M College of Dental Sciences and Research, Mullana, Ambala, Haryana
Source of Support: None, Conflict of Interest: None
Background: Oral diseases are identified as one of the most common of noncommunicable diseases affecting varied population. It is an important public health problem owing to the prevalence, socioeconomical aspect, expensive treatment, and lack of awareness. Aim: The aim of the study was to assess oral health status and treatment needs among teaching and nonteaching employees of a deemed university. Materials and Methods: A cross-sectional study was carried among employees of the deemed university and systematic random sampling was employed for the selection of study participants. A total of 400 employees were included in the study. Demographic details along with medical history and history of deleterious habits were obtained from the participants by direct interview. Clinical examination was carried out according to the World Health Organization Oral Health Surveys 2013. Statistical Analysis: The data so collected were analyzed using SPSS Software Version 20.0 (Chicago, USA). Means and proportions were compared using Mann–Whitney U test and Chi-square test, respectively. Results: A total of 400 participants, 237 from teaching and 137 from nonteaching were included in the study. The prevalence of dental caries was 78.7% among teaching faculty and 86.1% among nonteaching staff. Of the total sample, 48.7% (195) and 48.0% (169) self-reported dental needs and need for dental treatment, respectively. Conclusions: From the present study, we conclude that a statistically significant difference in the prevalence of dental caries, intervention urgency, and utilization of dental services was observed among the teaching and nonteaching staff belonging to different socioeconomic status and educational qualifications from different institutes within the deemed university.
Keywords: Felt barriers, intervention urgency, oral health status, perceived needs
|How to cite this article:|
Swamy A, Sogi GM, Sudan J, Vedi A, Sharma H. “Assessment of oral health status among teaching and non-teaching employees of Maharishi Markandeshwar (deemed to be University) Mullana Ambala” – A cross-sectional study. J Indian Assoc Public Health Dent 2018;16:203-7
|How to cite this URL:|
Swamy A, Sogi GM, Sudan J, Vedi A, Sharma H. “Assessment of oral health status among teaching and non-teaching employees of Maharishi Markandeshwar (deemed to be University) Mullana Ambala” – A cross-sectional study. J Indian Assoc Public Health Dent [serial online] 2018 [cited 2018 Dec 12];16:203-7. Available from: http://www.jiaphd.org/text.asp?2018/16/3/203/238583
| Introduction|| |
According to the World Health Organization (WHO), noncommunicable diseases (NCDs) have replaced communicable diseases as the most common cause of morbidity and mortality and almost one half of the disease burden in middle-income countries like India is now from NCDs. Associations of oral diseases with NCDs such as diabetes, cardiovascular diseases, chronic respiratory diseases, osteoporosis, and chronic renal failure are widely reported in the literature.,, Commonality of risk factors, changes in systemic inflammatory mediators, and body metabolism play a role in this association. Hence, oral diseases are one of the most common NCDs with dental caries and periodontal disease being the most prevalent chronic oral diseases affecting 50%–60% and 95%–100% adult population in India, respectively. They may lead to impairment of functions due to pain, disruption of daily performance leading to loss of working hours, income, education, and other social activities. Thus, they affect the quality of life and overall productivity of an individual and therefore present an economic burden to society.
Maharishi Markandeshwar Deemed University (MMU), Mullana-Ambala, comprises 12 teaching institutes with more than 1000 staff (teaching and nonteaching) consisting of employees of different cadres. The oral health assessment of these employees will establish oral health database to present information for framing policies for their well-being. Thus, the present study was designed to assess and compare the oral health status and treatment needs of teaching and nonteaching staff of MMU. An attempt was also made to identify felt needs and barriers to utilization of services by the employees.
| Materials and Methods|| |
The present cross-sectional study was conducted for 40 days (i.e., November 22, 2014–January 2, 2015) after obtaining ethical clearance from university ethical body and is reported conforming to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. The visits were scheduled after obtaining permission from university registrar and principals of respective institute. A pilot study was conducted on 30 patients to check the feasibility of the study and to validate the recording pro forma and these patients were not included in the final sample.
A total of 400 patients were included in the study as estimated using statistical formula 4 pq/L2 with the prevalence of outcome variables taken as 50% at 95% confidence interval. The systematic random sampling method was employed for the selection of study sample and proportionately 50% of the total employees present on the day of visit were included in the sample to achieve calculated sample size. List of all the employees was obtained from the office of registrar (establishments) that constituted the sampling frame and every alternate employee present at the day of examination who consented to participate was included in the study. The data was recorded on a prestructured format by a trained recorder. Demographic details along with medical history and history of deleterious habits were obtained from the participants. The literacy level was assessed by level of education as per Census 2011, Government of India, patients were categorized into socioeconomic classes and occupational divisions. To address the perceived dental needs and utilization of dental health-care resources, a self-structured validated interviewer-administered questionnaire with multiple responses was used. Type III dental examination was carried out with the participant seated on the stool or chair as per availability. Oral Health Assessment was done according to the WHO Oral Health Surveys 2013. Dental caries experience was assessed using dentition status. Decayed missing and filled teeth (DMFT) scores were deduced from it and periodontal status was assessed using community periodontal index (CPI) modified and loss of attachment (LOA). The intraexaminer reliability was assessed using Kappa statistics dentition status (κ = 0.80), CPI modified (κ = 0.79), and LOA (κ = 0.77). Infection control and sterilization measures were strictly followed throughout the study and biomedical waste generated during the course of the study was handled according to the standard guidelines.
The data so collected were handled using IBM SPSS Statistics for Windows, Version 20.0. (IBM Corp, Armonk, NY). A confidence interval of 95% and significance level of 5% (P < 0.05) were established for all statistical tests used. Proportions and means were compared using Chi-square test and Mann–Whitney U-test, respectively. Proportions of participants belonging to specific group of parameter were expressed in mean values, absolute numbers, and percentages.
| Results|| |
A total of 400 participants, 237 from teaching and 137 from nonteaching were included in the study. The mean age of teaching faculty was 31.69 ± 6.61 years, while it was 32.07 ± 8.47 years for nonteaching staff. Among 237 teaching faculty, 55.1% (154) were female and 44.9% (118) were male, whereas among nonteaching staff 17.5% (24) were female and 82.5% (113) were males [Table 1]. A statistically significant difference (P < 0.001) was found among the socioeconomic status of teaching and nonteaching staff of the university [Table 1]. In this study, a significant difference was observed in the prevalence of tobacco habit among teaching faculty and nonteaching staff with P < 0.001 for smoked forms and P = 0.016 for smokeless forms. 6.6% of teaching faculty and 21.2% of nonteaching staff reported use of smoked forms. However, 2.2% of nonteaching staff reported use of smokeless forms and none of the teaching faculty reported its use. The prevalence of dental caries was 78.7% among teaching faculty and 86.1% among nonteaching staff and mean DMFT was 2.18 ± 1.99 (teaching) and 2.62 ± 2.35 (nonteaching) [Table 2]. Difference between the presence of bleeding and presence of pocket 4–5 mm, as well as LOA among two groups, was not found to be statistically significant [Table 3]. Out of the total participants, 14.5% (58) immediate treatment and only 1% (4) required referral for comprehensive evaluation [Table 4]. Of the total sample, 48.7% (195) and 48% (169) self-reported dental needs and need for dental treatment, respectively [Table 5]. A statistically significant difference (P = 0.03) was observed for barriers to utilization of dental services between both groups [Table 6].
|Table 1: Distribution of the study population according to gender and socioeconomic status|
Click here to view
|Table 3: Distribution of mean modified Community Periodontal Index and loss of attachment codes among the study population|
Click here to view
|Table 4: Distribution of intervention urgency among teaching and nonteaching employees|
Click here to view
|Table 5: Distribution of the participants according to self-reported need for dental treatment and dental need|
Click here to view
| Discussion|| |
This cross-sectional study describes oral health status, self-reported dental and treatment needs as well as reports intervention urgency among teaching and nonteaching employees of a deemed university. A contrasting sex distribution was observed among teaching faculty and nonteaching staff. Among the 263 teaching faculty, 55.1% were female compared to 44.9% males while the opposite trend was observed among the nonteaching staff where 82.5% were male and only 17.5% were female. This may be attributed to the fact that nonteaching staff was usually employed as attendants, sweepers, guards, and gardeners which are predominately male-dominated occupations. In the present study, a highly statistically significant difference was observed between socioeconomic status (P < 0.001) among the teaching and nonteaching employees. 10.3% of the participants had tobacco smoking habit with only 2.2% having smokeless tobacco consumption habit. Prevalence of tobacco habit was less than reported literature.,,,
The difference between DMFT scores was statistically nonsignificant between the teaching and nonteaching employees which were 2.18 ± 1.99 and 2.62 ± 2.35, respectively, which was less than reported by Bhardwaj et al. and Sendilkumar and Arun. A statistically significant difference in the decayed component DT was observed among the two groups. DT component accounts for maximum which clearly indicates a severe lack of treatment for dental caries. These findings were consistent with those of Bhardwaj et al. Mean score for bleeding on probing (0.44 ± 1.26) was less than reported by Shah and Sundaram and Singh et al., but more than reported by Veeresha and Goel. Gingival bleeding was more common among the nonteaching staff (0.50 ± 1.31) than the teaching faculty (0.40 ± 1.23). This may be attributed to the strong association between the oral hygiene practices, lifestyle, education level, socioeconomic position, and utilization of dental services with periodontal disease.,, Shallow pockets with probing depth of 4–5 mm were most prevalent with a higher predilection among the teaching staffs (0.08 ± 0.49) that were less than reported.,, Only 0.5% (2) of the total participants (400) had clinical LOA of 4–5 mm which was less than reported by Bhardwaj et al. and Veeresha and Goel. In the present study, 19.3% did not require treatment, 4.5% required preventive or routine treatment, 60.8% required prompt treatment, 14.5% immediate treatment, and only 1.0% required referral for comprehensive evaluation. A statistically significant difference was observed for the intervention urgency between teaching and nonteaching staff.
In the present study, 52.5% of the teaching and 39.4% of the nonteaching staff had “felt need” for dental treatment, however, 68.8% of the nonteaching staff and 60.5% of the teaching faculty did not avail the dental treatment. Felt treatment needs were more than reported by Srikandi et al. in South Australian employees. The chief dental complaints reported by teaching faculty were DT (15.6%), tooth pain (11.8%), and sensitivity of teeth (9.9%). Among the nonteaching staff, tooth pain (11.7%), decayed (8.0%), and malaligned teeth (10.2%) were the chief self-reported dental complaints. However, Veersha et al. observed tooth pain and tooth decay as the chief self-reported dental complaints.
A statistically significant difference (P = 0.025) for barriers to utilization of dental services was observed among two groups. Common reason cited for not seeking treatment were time constraints because of other priorities and overlapping work timings with dental college timings, long waiting hours in dental college, and dental anxiety as the main access barrier to utilization of dental services. Among the nonteaching staff, 10.2% felt lack of awareness regarding dental diseases and their treatments and only 5.8% felt financial constraint as other important access barriers to oral health. Similar findings were also reported by Gill et al. who also observed overlapping timings of the dental college with work timings of the patients as the main oral health barrier.
There may be some degree of over or underestimation regarding data pertaining to the oral health-related behaviors, utilization of dental services, and access barriers in the study. This could be a limitation of our study because the information was received from the face-to-face interviewing of the study participants due to which they tend to give more socially desirable answers.
| Conclusions|| |
From this study, it can be concluded that despite the availability of dental services available, there is a significant burden of dental caries and presence of deleterious oral habits in teaching faculty and nonteaching staff. Both the groups have unmet dental needs and face various barriers in utilizing dental services available. These differences in felt barriers to oral health may also be indirectly due to the income, and existing knowledge about oral diseases and their preventive and curative treatments. Information regarding felt needs and barriers and the disparity between these self-perceived and normative dental needs can be used to evaluate outcomes of care by measuring the reduction of the need and to prioritize and plan services to best meet them. Administration of this deemed university can formulate health policy for their employees including regular and compulsory biannual dental checkups or setting up evening clinics for the employees. Dental college in collaborations with other institutes of the deemed university can take initiative to formulate health education programs for the employees by various means such as health talks, lectures, demonstrations, and training to help create awareness regarding oral health maintenance and identify various oral health problems.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Seymour GJ, Ford PJ, Cullinan MP, Leishman S, Yamazaki K. Relationship between periodontal infections and systemic disease. Clin Microbiol Infect 2007;13 Suppl 4:3-10.
Kim J, Amar S. Periodontal disease and systemic conditions: A bidirectional relationship. Odontology 2006;94:10-21.
Meurman JH, Sanz M, Janket SJ. Oral health, atherosclerosis, and cardiovascular disease. Crit Rev Oral Biol Med 2004;15:403-13.
Kumar A, Virdi M, Veeresha KL. Oral health status and treatment needs of rural population of Ambala, Haryana, India. Internet J Epidemiol 2010;8:1-6.
VonElm E, Altman D, Egger M, Pocock S, Gøtzsche PC, Vandenbroucke JP. The strengthening and reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. Epidemiology 2007;18:800-4.
Shankar RD. An updated Prasad's socio economic status classification for 2014. Int J Res Dev Health 2014;1:26-8.
Dunning JM. Surveying. In: Principles of Dental Public Health. Cambridge, Mass: Harvard University Press; 1986.
World Health Organization. Oral Health Surveys Basic Methods. 5th
ed. Geneva: World Health Organization; 2013.
Kohli A, Puttaiah R. Dental Infection Control and Occupational Safety for Oral Health Professionals. New Delhi: Dental Council of India; 2008.
Biomedical Waste (Management and Handling) Rules 1998. Ministry of Forest and Environment, Government of India. Available from: http://www.CPCB.nic.in
. [Last accessed on 2015 Mar 27].
Saraswathi TR, Ranganathan K, Shanmugam S, Sowmya R, Narasimhan PD, Gunaseelan R, et al.
Prevalence of oral lesions in relation to habits: Cross-sectional study in South India. Indian J Dent Res 2006;17:121-5.
] [Full text]
Manjunath C, Veeresha KL. Prevalence of oro mucosal lesions among outpatients attending government dental college, Bangalore. J Indian Assoc Public Health Dent 2011;17 Supp 1:459-63.
Jagadeesan M, Rotti SB, Danabalan M. Oral health status and risk factors for dental and periodontal diseases among rural women in Pondicherry. Indian J Community Med 2003;25:213-6.
Gill M, Pal K, Gambhir RS. Oral hygiene practices, attitude, and access barriers to oral health among patients visiting a rural dental college in North India. J Dent Res Rev 2014;1:114-7. [Full text]
Bhardwaj VK, Veeresha KL, Sharma KR. Periodontal status and treatment needs among state government employees in Shimla city, Himachal Pradesh (India): A cross-sectional study. Indian J Oral Sci 2012;3:28-9. [Full text]
Sendilkumar B, Arun KV. Oral health status in east coastal areas of Chennai Tamil Nadu. J Indian Assoc Public Health Dent 2002;2:11-5. [Full text]
Shah N, Sundaram KR. Impact of socio-demographic variables, oral hygiene practices, oral habits and diet on dental caries experience of Indian elderly: A community-based study. Gerodontology 2004;21:43-50.
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. [Full text]
Veeresha KL, Goel R. Assessment of oral health status and treatment needs and oral health care barriers among group D workers of M.M. University Ambala, Mullana. JOHS 2011;2:12-5.
Gundala R, Chava VK. Effect of lifestyle, education and socioeconomic status on periodontal health. Contemp Clin Dent 2010;1:23-6.
] [Full text]
Newman JF, Gift HC. Regular pattern of preventive dental services – A measure of access. Soc Sci Med 1992;35:997-1001.
Richard P, Gururajarao TR, Chava V. Influence of lifestyle, gender and socioeconomic status as determinants of dental health behavior, periodontal status awareness. J Pierre Fauchard Acad 2000;14:21-5.
Srikandi TW, Clarke NG. Periodontal status in a South Australian industrial population. Community Dent Oral Epidemiol 1982;10:272-5.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]