Raja Pandian M et.al. INTERNATIONAL JOURNAL OF PREVENTIVE DENTISTRY AND ORAL EPIDEMIOLOGY Research Article KNOWLEDGE, ATTITUDE AND PRACTICES OF DRIVERS ON ORAL HEALTH Raja Pandian.M, Sunayana Manipal, Indrajeet Gowder, Naveen Basavarajappa, Shiv Lingesh, Swathi Sharma, Sudarshan.G.M Abstract: BACKGROUND AND AIM: Health personnel s have an important role in oral health promotion when they graduate and start working in the health care system. Hence this study was to assess the knowledge, attitude and practice of drivers on oral health. MATERIALS AND METHODS: The study sample consisted of 160 drivers. The Chennai corporation area was divided into four zones- north, east, south and central Chennai. In each zone 40 drivers of various categories were selected. Data were collected by means of self-administered questionnaire and analyzed. Statistical significance was determined by chi-square test, and the level of significance was set as P < 0.05. RESULTS: The study reveals that 50% of study participants are aware of dental problems. Approximately 81% of subjects agree that dental problems can be prevented by dentists. The participants oral hygiene habits were found to be regular. One important finding in this survey was that, about 90% of the participants have not seen or heard about dental awareness program. CONCLUSION: The result of this study indicates that drivers attitude towards oral health and dental care needs to be improved, which could be achieved by means of comprehensive oral health educational programs. KEYWORD: oral health, knowledge, attitude and practice INTRODUCTION: Oral hygiene is the practice of keeping the mouth healthy and clean by brushing and flossing to prevent tooth decay and gum disease. The purpose of oral hygiene is to prevent the build-up of plaque, the sticky film of bacteria and food residues that form a layer on the teeth and on dorsum of the tongue. Plaque adheres to the crevices and fissures of the teeth and generates acid, that when not removed on a regular basis causes demineralization of enamel surface resulting in cavities. Plaque also irritates gums and can lead to gum disease (periodontal disease) which eventually leads to tooth loss. Tooth brushing and flossing remove plaque from teeth and fluoride in tooth paste helps to protect teeth by binding with enamel to make it stronger. In addition to such daily oral care, regular visits to the dentist promote oral health. Many people do brush their teeth at least once a day but they do not possess adequate knowledge of proper tooth brushing. Tooth brushing at least once a day was reported by 92.1% of the subjects and 71.9% used tooth paste 1. The prevalence of dental caries and periodontal disease has decreased with improvements in oral hygiene and a decrease in the consumption of sugar products. This general favorable trend in reducing dental caries, however, has not been seen in several developing countries 2 or middle east 3 4. While twice a day tooth brushing seems to be an established practice in several industrialized countries such as the United Kingdom 5 Italy 6 Sweden 7 and Norway 8 this goal is still very far from being realized in several other countries, including Turkey 9 Lebanon 10 Saudi Arabia and Kuwait 11, 12. This lacuna is seen in all sectors especially the most vulnerable sectors that include children, geriatrics, and special groups like mentally retards, factory workers, drivers etc. Oral health is integral to general health. Periodontal disease, for example is associated with general health conditions such as cardiovascular disease [International Journal of Advanced Research on Oral Science 1:1 [2012] : 1-7 ] Page 1
and diabetes. Those with complex health conditions are at greater risk of oral disease that, in turn, further complicates their overall health. This in particular is more exhaustive in the vulnerable groups. Oral disease qualifies as major public health problems owing to their higher prevalence and significant social Impact 13. The later seems to be a personification leading to exaggerated poor oral health. Oral health is considered as fundamental to general health and well-being. A healthy mouth enables an individual to speak, eat and socialize without experiencing any active disease, discomfort or embarrassment 14. Oral health knowledge is considered to be an essential prerequisite for health related behavior 15. Numbers of features namely- diet, smoking, alcohol, hygiene, stress and exercise are linked to a wide range of important diseases forming the fundamental basis of common risk factor approach (WHO 2000) to prevent a range of conditions including oral diseases 16. Dentistry. Informed consent was also obtained from the study participants. The questionnaire was distributed in person to drivers belonging to various categories. All the drivers available at that time were included, the drivers not available during the survey were excluded. The survey was conducted in the month of May 2011. Data are collected and entered into spread sheets. Data are analyzed by software (SPSS) version 15.0. Frequencies descriptive were used. A chi-square statistic was computed to find the association of knowledge, attitude and practice on oral hygiene across various zones in Chennai and among various types of vehicle drivers. RESULTS: FIGURE I SHOWS KNOWLEDGE ABOUT THE DENTAL PROBLEMS AMONG STUDY PARTICIPANTS MATERIALS AND METHODS: The study was conducted to assess the knowledge about oral health, oral health practice and management of oral disease and health education among 160 drivers in Chennai. A cluster sample was used. The Chennai corporation area was divided into four zones namely north, east, south and central Chennai. In each zone 40 drivers of various categories were selected. The total sample size constituted of 160 drivers. Data on oral health was collected by means of self-administrated close ended questionnaire. The questionnaire were in English,was divided into three units as knowledge, attitude and practice. The questions and included details about socio demographic variables, dietary pattern, knowledge regarding oral health, oral practice, management of oral practices, management of oral disease and health education. Ethical clearance was obtained from the ethical committee of Department of Public Health Figure 1 : Shows that a majority of the study participants have not underwent any dental treatment (50%) while 18.75% of subjects have underwent removal of teeth. 11.25% of subjects have underwent cleaning of teeth, 13.13% of subjects have underwent restoration of teeth. Figure 2 : Shows that a majority of the participants have the habit of smoking 34.38%.while 2.50% of subjects have underwent chewing of tobacco. 5.63% of subjects have underwent alcohol, 0% of subjects have underwent smoking and chewing of tobacco, 1.25% of subjects [International Journal of Advanced Research on Oral Science 1:1 [2012] : 1-7 ] Page 2
Table 1 : KNOWLEDGE REGARDING ORAL HEALTH: RESPONDENT % S.No QUESTION ZONE I ZONE II ZONE III ZONE IV P value 1. Do you suffer from any dental problem? 23(57.5%) 15(37.5%) 18(45%) 11(27.5%).048 S 2 Are you aware of dental disease? 30(75%) 28(70%) 26(65%) 17(42.5%).014 S 3 Frequent eating meals and improper oral 30(75%) 22(55%) 24(60%) 28(70%).22 NS hygiene leads to caries? 4. Crocked teeth can lead to unesthetic smile? 22(55%) 21(52.5%) 11(27.5%) 15(37.5%).041 S 5 Lack of proper cleaning of the teeth can cause 34(85%) 20(50%) 21(52.5%) 21(52.5%).003 S week gums? 6 Cancer can be seen in oral cavity? 35(87.5%) 30(75%) 21(52.5%) 14(35%).000 S 7 Aware of causative factor for oral cancer? 34(85%) 26(65%) 21(52.5%) 14(35%).000 S 8 Nutrition is important for oral cavity? 28(70%) 13(32.5%) 19(47.5%) 28(70%).001 S 9 Consequence of tobacco, smoke, drinking? 37(92.5%) 28(70%) 24(60%) 19(47.5%).00 S 10 Eating refined food lead to dental disease? 26(65%) 10(25%) 15(37.5%) 18(45%).003 S 11 Oral health can affect general health? 28(70%) 12(30%) 18(45%) 26(65%).001S 12 Seen or heard any dental awareness 10(25%) 0(0%) 5(12.5%) 2(5%).002 S programme? [International Journal of Advanced Research on Oral Science 1:1 [2012] : 1-7 ] Page 3
Table 2 : ATTITUDE REGARDING ORAL HEALTH: RESPONDENT % S.No QUESTION ZONE I ZONE II ZONE III ZONE IV P value 1 Tobacco cessation advice is given by dentist? 33(32.5%) 14(35%) 15(37.5%) 10(25%).003 S 2 Stress during time you drive? 30(75%) 35(87.5%) 32(80%) 28(70%).271NS 3 Dental pain can be alleviated by dentist? 39(97.5%) 26(65%) 31(77.5%) 34(85%).002 S Table 3 : PRACTICES REGARDING ORAL HEALTH: RESPONDENT % S.No QUESTION ZONE I ZONE II ZONE III ZONE IV P value 1 Do you use tooth pick/pin? 30(75%) 22(55%) 29(72.5%) 26(65%).224 NS 2 Undergone any dental treatment? 25(62.5%) 16(40%) 19(47.5%) 19(47.5%).233 NS 3 Frequently consume tea, coffee? 18(45%) 21(52.5%) 18(45%) 30(75%).021 S 4 Able to have nutritious meal all three times a day? 21(52.5%) 21(52.5%) 23(57.5%) 28(70%).339 NS 5 Periodically go to the dentist for check-up? 8(20%) 0(0%) 6(15%) 1(2.5%).004 S 6 Have you tried ways of tobacco cessation? 13(32.5%) 7(17.5%) 11(27.5%) 3(7.5%).032 S 7 Inappropriate timings of work hinders consuming proper timing nutrition? 34(85%) 20(50%) 27(67.5%) 28(70%).010 S [International Journal of Advanced Research on Oral Science 1:1 [2012] : 1-7 ] Page 4
have underwent chewing of tobacco and alcohol, 28% of subjects have underwent smoking and alcohol, 5.63% of subjects have underwent smoking and alcohol, 22.50% of subjects have not underwent any habit. FIGURE II SHOWS PREVALENCE OF HABITS AMONG STUDY PARTICIPANTS DISCUSSION: The result of this study indicates the knowledge of drivers (car, lorry, auto, bus, and tempo) about oral health, attitude to oral health and oral health practice. The questionnaire was with questions about socio-demographic, personal history, knowledge regarding oral health, oral health practices, management of oral disease and health education. The investigator was always available during the filling of questionnaire to clarify any doubts regarding questions. Figure 3 : Shows that approximately 70% of the study participants have not undergone extraction. 9.38% of subjects have underwent extraction of one tooth, 18.13% of subjects have underwent extraction of two to five tooth, 2.50% of subjects have underwent extraction of tooth more than five. FIGURE III HEALTH DISEASE AMONG STUDY PARTICIPANTS Knowledge regarding oral health: Approximately 42% participants suffered from dental disease while 58% of subjects did not. Since majority of participants are not visiting for regular dental check-up, the exact estimation of dental diseases are not possible. Approximately 62.5% of subjects are aware that cancer can be seen in the oral cavity and 37.5% of subjects are aware of subject. Nearly 67.5% of subjects are aware of the consequence of chewing tobacco, smoking, alcohol and 32.5% of subjects do not know the consequences. Majority of the participants think that chewing tobacco, smoking can lead to oral cancer. Tobacco use results in a greater risk of cancer, lung disease, and cardiovascular diseases. The statistics are overwhelming almost 90% of lung cancer deaths are in men and almost 80% in women, as well as between 80% and 90% of chronic obstructive pulmonary disease (COPD) deaths are caused by smoking tobacco 18. Smokeless tobacco has also been found to be associated with pancreatic cancer 19. Smoking tobacco has been linked to Alzheimer s disease 20 and its use during pregnancy can result in complications that endanger the mother and fetus 21, 22. Other effects of tobacco use in participants think that tobacco smoking, intake of excessive sweets and not cleaning teeth regularly are the major harmful habits that affect teeth and gums. The awareness about [International Journal of Advanced Research on Oral Science 1:1 [2012] : 1-7 ] Page 5
the habit can be co-related with national oral survey and fluoride mapping 2002. 23 Attitude regarding oral health: Approximately 45% of subject thinks that tobacco cessation advice is given by dentist. Tobacco smoking is psychologically and physiologically addictive, while smokeless tobacco is physiologically addictive 24. Tobacco cessation requires that patients are motivated to fight their addiction. Methods include referral to counseling and quit lines, stand-alone pharmaco-therapeutic intervention, self-help materials (such as hand outs, pamphlets, videos, and computer programs) Oral health Practice: This survey found that only 9% of subject brushed their teeth twice daily. This finding indicates that oral health education is very poor among the drivers. In the present study 95% of subjects are using tooth paste, but in study by Zhu et al it was only 44.4% of study participants. In the study done by Harikiran et al, 38.5% of subjects brushed their teeth two or more times a day, 47% of subjects rinse their mouth after each meal. Another finding shows that 33% of subjects do not pick their teeth. This attributes the lack of knowledge regarding the harmful effect of pricking of teeth. Conclusion: Result of this study indicates that majority of the participants are non-vegetarians which is not good for oral health as well as general health. The findings suggest that oral health related knowledge, attitude and practice of the study participants are poor and needs to be improved. Systematic community oriented oral health promotion programs are needed to improve oral health knowledge, attitude and practice of drivers. REFERENCES: 1. Mwakatobe AJ, Mumghamba EGS, Oral health behaviour and prevalence of dental caries among 12- year-old schoolchildren in Dares Salaam, Tanzania. Tanz Dent J 2007;14(1):1-7 2. Sheiham A: Changing trends in dental caries. Int J Epidemiol 1984, 13:142-147. 3. Al-Mutawa S, Al-Duwairi Y, Honkala E, Honkala S, Shyama M: The trends of dental caries experience of children in Kuwait. Dent News 2002, 9:9-13. 4. Al-Tamini S, Petersen PE: Oral health situation of schoolchildren, mothers and schoolteachers in Saudi Arabia. Int Dent J 1998, 48:180-186 5. Bradnock G, White DA, Nuttall NM, Morris AJ, Treasure ET, Pine CM: Dental attitudes and behaviours in 1998 and implications for the future. Br Dent J 2001, 190:228-232 6. Rimondini L, Zolfanelli B, Bernardi F, Bez C: Selfpreventive oral behaviour in an Italian university student population. J Clin Periodontol 2001, 28:207-211.7. Stenberg P, Håkansson J, Åkerman S: Attitudes to dental health and care among 20 to 25- year-old Swedes: results from a questionnaire. Acta Odontol Scand 2000, 58:102-106 8. Åstrøm AN, Samdal O: Time trends in oral health behaviour s among Norwegia adolescents.acta Odontol Scand 2001, 59:193-200. 9.Kulak-Özkan Y, Ozkan Y, Kazazoglu E, Arikan A: Dental caries prevalence, tooth brushin and periodontal status in 150 young people in Istanbul: A pilot study Int Dent J 2001, 51:451-456 [International Journal of Advanced Research on Oral Science 1:1 [2012] : 1-7 ] Page 6
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