|Year : 2019 | Volume
| Issue : 2 | Page : 103-107
Knowledge, attitude, and practice regarding preventive dentistry among dental students in Tamil Nadu, India
Sangeeta Chavan, S Lavanya Rahavi, K Umesh, Muthu Karuppaiah, Palanivel Pandian
Department of Public Health Dentistry, Best Dental Science College, Madurai, Tamil Nadu, India
|Date of Web Publication||5-Nov-2019|
Dr. Sangeeta Chavan
Best Dental Science College, Ultra Nagar, Madurai-Chennai Highway, Madurai - 625 104, Tamil Nadu
Source of Support: None, Conflict of Interest: None
Purpose: This study aimed to assess the knowledge, attitude, and practice of preventive dentistry among dental students. Materials and Methods: It is a cross-sectional study conducted among dental students in Tamil Nadu, India. Seven dental colleges were randomly selected. Final-year students, interns, and postgraduates were selected at random. The survey was conducted in the month of July–September 2018. A 17-item, structured, self-administered questionnaire consisting of demographic information and questions which were based on the knowledge, attitude, and practices of preventive dentistry was used to collect data from the study participants. Ethical clearance and informed consent were obtained. Results: Nearly 93.1% of final-year students, 98.4% of interns, and 45.7% of postgraduates were knowledgeable of preventive dentistry. Majority of the dental students responded that regular dental checkup is important in preventing oral diseases and nearly 67% of final-year students, 62.9% of interns, and 80.2% of postgraduates reported that they feel competent in performing preventive dental procedures. More than 50% of the respondents expressed a need for some changes in the dental curriculum. Conclusion: Results indicate that even though students have knowledge regarding preventive dentistry, the emphasis on practicing it is not adequate. Hence, there is a need a need for change to improve to improve knowledge, attitude, and practice regarding preventive dentistry in undergraduate students.
Keywords: Dental students, preventive dentistry, Tamil Nadu
|How to cite this article:|
Chavan S, Rahavi S L, Umesh K, Karuppaiah M, Pandian P. Knowledge, attitude, and practice regarding preventive dentistry among dental students in Tamil Nadu, India. Educ Health Prof 2019;2:103-7
|How to cite this URL:|
Chavan S, Rahavi S L, Umesh K, Karuppaiah M, Pandian P. Knowledge, attitude, and practice regarding preventive dentistry among dental students in Tamil Nadu, India. Educ Health Prof [serial online] 2019 [cited 2020 May 27];2:103-7. Available from: http://www.ehpjournal.com/text.asp?2019/2/2/103/270282
| Introduction|| |
“An Ounce of Prevention is worth a Pound of Cure.”
This quote made famous by Benjamin Franklin acknowledges the importance of preventative solutions in medicine. Prevention of disease is one of the most essential and affordable affordable means to health promotion. Oral health also touches every aspect of life but is often taken for granted. Over the past few decades, in India, when compared to health, oral health is seeking priority, but still remains a burden. Miserably, these diseases affect children, adults, and families across the world every day, although they are nearly 100% preventable.
The reorientation of oral health services toward prevention and health promotion is one of the World Health Organization's (WHO) priority action areas for the continuous improvement of oral health. Despite this, prevention of oral diseases poses considerable challenge for many countries, particularly developing countries, because of inaccessibility of services, financial constraints, and stagnation of public dental health-care services.
In the present scenario, dentists come across a large number of patients of different age groups from different backgrounds in their day-to-day practice or course of study. They prefer to adopt more curative approaches than preventative approaches. The rationale is a preventative approach is considered too simple, often ineffective and less economical than curative approaches. In addition, dental students, the upcoming peer group, group, also tend to preconceive this idea of preventative dentistry given their curriculum focuses primarily on curative approaches.
Preventive dentistry is a specialized branch of dentistry which deals with the prevention and interception of the progress of all dental and oral diseases. It includes two aspects of dental care, both of which are performed to help patients to avoid dental disease or to target them in their early more treatable stages. It averts initiation of dental diseases, intercepts their progress, controls their spread, limits their complication, and provides rehabilitation.
Thus, focusing on dental academics regarding preventive dentistry, certain queries arise such as “where the present dental academics lie either on preventive aspect or curative aspect?” In case of preventive aspect, “To what extent is prevention addressed in dental education?” and “do dental students prefer preventive or curative dentistry?” In order to unravel this, an attempt was made to assess information based on knowledge, attitude, and practice regarding preventive dentistry.
As preventive approaches can reduce the burden of oral health problems, it serves as a predominant part of dental service. Many oral diseases can be prevented if proper education and awareness are provided. In order to improve clinical practice with the advancing dental sciences, skills of practitioners toward preventive care options need to be improved. Dental students are the one who have a unique potential of preparing a future generation to accept preventive services.
| Materials and Methods|| |
A cross-sectional study was conducted among dental students to assess the knowledge, attitude, and practice regarding preventive dentistry in Tamil Nadu. The research was conducted among dental students of seven dental colleges of Tamil Nadu (equal representation from South and North Tamil Nadu) which were selected randomly. The pilot study was conducted for a period of 2 weeks in the month of June 2018, and the sample size was calculated based on the data obtained from the pilot study. The final sample size calculated after adjusting for finite population was 548. Final-year students, interns, and postgraduates were included in the study by employing random sampling techniques. A total of 100 students were selected from each of the seven dental colleges, and hence, a total of 700 students were selected to participate in the study. All student participation was purely voluntary.
The duration of the study was 4 months, which was conducted in June–September 2018. Ethical approval was obtained from the Institutional Ethical Review Board, and permission to conduct the study in the dental colleges was obtained from the respective higher authorities. Written informed consent was obtained from the participants before the start of the study. The participants were granted confidentiality of their responses.
A 17-item, close-ended, structured, self-administered questionnaire was used to collect data from the study participants. The first part of the questionnaire consisted of demographic information which included name, age, gender, qualification, and specialty. It consisted of 17 questions which were framed to assess the knowledge, attitude, and practice toward preventive dentistry.
The content of the questionnaire included nine questions framed to assess the knowledge of the participants regarding various aspects of preventive procedures such as pit-and-fissure sealant, remineralization of carious lesion, early diagnosis and risk factors of oral cancer, malocclusion, healthy dietary practice, and counseling. Five questions were formulated to assess students' attitudes toward preventive dentistry. The execution of preventive dentistry in their daily practice was evaluated by employing three questions. All the participants were asked to assemble in the auditorium during their free period, and 20 min was provided to complete the questionnaire in their colleges. Nine questions had “Yes” or “No” options, whereas eight questions had options in a Likert scale.
| Results|| |
The information collected was recorded in a Master Chart. The incomplete questionnaires were excluded and treated as missing. The total number of students participated in the study was 647 which includes final-year students (276), interns (245), and postgraduates (126) [Graph 1]. Data analysis was done with the help of computer using the Statistical Package for Social Sciences version 22.0 for Windows (SPSS Inc., Chicago, IL, USA). Kruskal–Wallis test was used to test the significance of difference between quantitative variables, and P < 0.05 was used to denote statistically significant relationship. [Table 1] shows the level of knowledge toward preventive dentistry among the three different groups in which the interns and postgraduates equally knew about preventive dentistry than the final-year students. [Table 2] indicates the attitude where nearly >60% of students felt a need in change in dental curriculum toward preventive dentistry. [Table 3] summarizes the practice of preventive dentistry among the three groups specifying that approximately 60% of students have never placed pit-and-fissure sealant.
| Discussion|| |
Most oral diseases remain untreated in low-income or developed countries due to various reasons. Most people will feel that regular dental treatments will be too expensive, and access to dental services is centralized only in cities which are less affordable in rural areas. Even though many of the oral diseases are preventable it still exists, as our primary concern is conservative treatment. It is, therefore, important that emphasis should be given to prevention rather than treatment of oral diseases to enhance oral health promotion. In relation to this, the present study was conducted to assess the knowledge, attitude, and practice regarding preventive dentistry among dental students in Tamil Nadu. Many studies regarding preventive dentistry have been done, but this study was considered to be the first one which was conducted among dental students in Tamil Nadu.
In the current study, regarding knowledge, students consider tobacco and alcohol consumption and lower consumption of fruits and vegetables as risk factors of cancer, and they prefer early diagnosis of cancer and health education to be the best ways to improve recovery so that patients can be treated without any major surgical intervention. All three groups (final-year students, interns, and postgraduates) have almost equivalent proficiency with respect to preventive dentistry. The present study shows that 86.9% of the interns were aware of sealant placement in preventing pit-and-fissure caries and 34.7% of the interns consider that fluoridated toothpaste usage is more important than brushing. The results of a study conducted by Thakur et al. are in contrast to the results obtained in the present study where 100% of interns were aware of sealant placement. In the same study, 36.7% of the interns understood the importance of fluoridated toothpaste usage. Another study performed by Nilchian et al. regarding awareness on preventive dentistry among Isfahan dental students showed that 62.9% and 69.9% of students have moderate knowledge regarding fluoridated toothpaste usage and oral hygiene, respectively.
Focusing on the attitude of dental students, regular dental checkups were considered important for preventing disease by interns, final-year students, and postgraduates. On average, 70% of participants felt competent in performing preventive procedures. Regarding integration of preventive procedures into routine practice, our study shows a positive attitude in >90% of the students. A study conducted by Sushanth et al. showed that 85% of the participants felt that such practice gives morally sound satisfaction, which is similar to our study, and dissimilarly, it shows that nearly 60% of the participants were not willing to integrate preventive procedure into routine practice. Interns and final-year students think that there is a need of change in dental curriculum toward preventive dentistry so that they get exposure about preventive procedure and promote oral health. Alsadhan et al. manifested that almost 88% of research participants agreed upon their need for more dental health educational programs.
Regarding practice, a higher percentage of postgraduates placed more pit-and-fissure sealants when compared to interns and final-year students, may be due to their experience. All three groups have an opinion that practicing preventive dentistry is helpful for patients. Sushanth et al. performed a study, which is in line with the current study, stating that 90% of the respondents felt the same. The habit of counseling in our study is high among final-year students and interns, the probable reason of which could be compulsion from faculties.
A study conducted by Thakur et al. regarding preventive dental care among dental interns in Kanpur showed that colleges do not adequately prepare dentists to fulfill their role in providing prevention-oriented dental service. The findings of this study are in accordance with a study conducted by Al-Wesabi and Isa  among students of Yemen regarding the role of dental education in preventive dentistry, all of which have blamed undergraduate curricula for inadequate preparation of dentists. Proper dental education should emphasize the overall aspects of preventive dentistry with early exposure of preventive dental training in order to improve students' knowledge, attitude, and practice on preventive care.
A similar study done by Khairnar et al. on preventive dentistry among health-care students in Dhule city showed that health-care professional students are generally aware of preventive measures for oral diseases, with dental students showing highly positive knowledge and attitude but lacking behavior. Hence, there is a need to include a syllabus about the importance of preventive dentistry in their curriculum.
Premnath and John conducted a study on preventive dental care among dental professionals in Chennai and reported that dentists' knowledge of and attitudes toward prevention should be improved and updated to enable and encourage them to provide their patients with preventive care. Greater effort should be made by professional organizations and governmental agencies to inform patients of the benefits of sealants.
A study conducted by Ahuja et al. on dental faculties in Bengaluru city stated that dental faculty in Bengaluru had good knowledge of preventive dental care, which was significantly different with respect to oral diseases, and had positive attitudes toward preventive dentistry. As dental faculty are the one involved in training the future dental professionals to achieve preventive practice, they should be involved in continuing education activities and placing emphasis and support on prevention-related research.
Pratiwi et al. executed a study on the knowledge and self-perception of preventive dentistry among Indonesian dental students indicating that the perceptions of clinical students participating in the study have high competence (94%–99%) in providing education and preventive care to their patients, but there is still a lack of preventive knowledge.
According to the results of the present study, even though the students have knowledge and a positive attitude about preventative dentistry, they lack in practice. Hence, there is a need of change in dental curriculum toward preventive care and inclusion of syllabus on oral health in health-care professionals' curriculum.
Further studies should be performed exploring the barriers of training in the preventative field not only in dentistry but also in other health professional areas. A qualitative approach using observation of clinical training as well as content analysis of health curriculum and its goals can help develop appropriate action plans to implement preventive strategies.
| Conclusion|| |
Today's students will be future practitioners. Health beliefs and attitudes of dental students, as future dental health professionals, not only affect their oral self-care habits but also potentially influence their patient's ability to take care of their teeth and shape the public's oral health education level. Thus, the positive attitudes toward preventive dentistry need to be developed during student training rather than in practice. In order to create more positive attitudes for future dental professionals, there should be an early and sufficient exposure to the preventive aspects of dentistry in the dental curriculum. Therefore, dental curriculum needs to be changed by incorporating preventive dental science curriculum into their academics, and coordinated efforts from all specialties of dentistry is vital to change the attitude of our booming dentists toward preventive dentistry, thereby promoting oral health.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Gambhir RS, Kaur A, Singh A, Sandhu AR, Dhaliwal AP. Dental public health in India: An insight. J Family Med Prim Care 2016;5:747-51.
] [Full text]
Premnath P, John J. Knowledge attitude and practice toward preventive dental care among dental professionals in Chennai. J Educ Ethics Dent 2015;5:20. [Full text]
Ahuja N, Pramila M, Krishnamurthy A, Umashankar GK, Sharma N. Knowledge and attitude towards preventive dental care among dental faculties in Bangalore city. J Indian Assoc Public Health Dent 2014;12:93. [Full text]
Pratiwi R, Akbar FH, Abdullah A, Mareta YA. Knowledge and self perception about preventive dentistry among Indonesian dental students. Pesqui Bras Odontopediatr Clin Integr 2018;18:3860.
Thakur P, Awasthi A, Shavi GR. Knowledge, attitude and practices towards preventive dental care among dental interns in Kanpur, India. Natl J Integr Res Med 2016;7:92-96.
Nilchian F, Kazemi S, Abbasi M, Ghoreishian F, Kowkabi M. Evaluation of Isfahan's dental students' awareness about preventive dentistry. J Dent (Shiraz) 2014;15:1-5.
Sushanth VH, Kalra DD, Kumar NP, Prashant GM, Bhate P, Imranulla M. Assessment of knowledge, attitude, and practice regarding preventive options in oral care among dentists in Davangere city, Karnataka: A cross-sectional study. Dent Med Res 2015;3:20. [Full text]
Alsadhan SA, Darwish AG, Al-Harbi N, Al-Azman A, Al-Anazi H. Cross-sectional study of preventive dental knowledge among adult patients seeking dental care in Riyadh, Saudi Arabia. Saudi J Dent Res 2017;8:52-7.
Al-Wesabi MA, Isa ZM. Knowledge, attitude and practice on preventive dentistry among senior dental students in Yemen. Int J Public Health Res 2015;5:560-8.
Khairnar MR, Dodamani AS, Karibasappa GN, Naik RG, Deshmukh MA. Knowledge, attitude and behavior towards preventive dentistry among health care students in Dhule city. Nurs 2015;25:1.
[Table 1], [Table 2], [Table 3]