|Year : 2015 | Volume
| Issue : 1 | Page : 9-14
Myths regarding oral health among patients visiting a dental school in North India: A cross-sectional survey
Ramandeep Singh Gambhir1, Ashotosh Nirola2, Samir Anand3, Tarun Gupta4
1 Department of Public Health Dentistry, Rayat and Bahra Dental College and Hospital, Mohali, Punjab, India
2 Department of Periodontics, Laxmi Bai Institute of Dental Sciences and Hospital, Patiala, Punjab, India
3 Department of Periodontics, Rayat and Bahra Dental College and Hospital, Mohali, Punjab, India
4 Department of Public Health Dentistry, MM University, Mullana, Ambala, Haryana, India
|Date of Web Publication||7-Dec-2015|
Ramandeep Singh Gambhir
Department of Public Health Dentistry, Rayat and Bahra Dental College and Hospital, Mohali - 140 104, Punjab
Source of Support: None, Conflict of Interest: None
Background: In the field of dentistry, various myths and misconceptions prevail among patients that hamper them from availing proper treatment from a dental professional. Therefore, this study was conducted to assess the prevalence of myths regarding oral health and hygiene among out-patients visiting a dental school in North India and suggest possible remedial measures. Materials and Methods: A cross-sectional survey was conducted utilizing a convenience sample of 552 participants. A self-designed pretested questionnaire containing 15 questions on myths regarding oral health and hygiene was distributed among the study participants. Demographic details of the subjects were also recorded. Results were statistically analyzed using Chi-square test. Results: More than half (58.7%) of the participants thought that there is a worm inside a decayed tooth, and this was significantly associated with age, gender, and educational status of participants. Three-fourth (75%) of the participants were of the opinion that decay is caused by eating sweets, and more than 70% of males believed this and this was significantly associated with age and educational status of study participants (P < 0.05). Conclusion: Myths and misconceptions regarding oral health prevailed among majority of the participants in this study. There is an urgent need to educate the public regarding various oral health issues.
Keywords: Decay, myths, oral health, patients, tooth loss
|How to cite this article:|
Gambhir RS, Nirola A, Anand S, Gupta T. Myths regarding oral health among patients visiting a dental school in North India: A cross-sectional survey. Int J Oral Health Sci 2015;5:9-14
|How to cite this URL:|
Gambhir RS, Nirola A, Anand S, Gupta T. Myths regarding oral health among patients visiting a dental school in North India: A cross-sectional survey. Int J Oral Health Sci [serial online] 2015 [cited 2019 Nov 20];5:9-14. Available from: http://www.ijohsjournal.org/text.asp?2015/5/1/9/171158
| Introduction|| |
Health continues to be a neglected entity despite continuous efforts for health promotion, worldwide. Oral health is an integral part of general health and factors such as diet, oral hygiene practices, literacy, socio-economic status, etc., influence oral health to a great extent. Poor oral health resulting from untreated dental ailments can have a significant impact on the quality of life which may lead to deterioration of general health. The attitude of people toward their own teeth, and the attitude of dentist professionals who provide dental care play an important role in determining the oral health condition of the population. As a result of advancement in medical technology, the life expectancy has increased and now patients tend to retain their teeth for a longer time.
Oral health knowledge is considered to be an essential prerequisite for health-related behavior. The health care industry, including dentistry, has evolved from a traditional practice based on folk cures to a structured medical discipline that relies on science and technology. Although modern dentistry has come a long way, there are still many dental myths that are passed on by word of mouth through many generations. In most cases, such myths are attempts to explain a variety of phenomena for which there are no available supporting data. These myths have become too deeply-rooted in our culture, and we sometimes find it difficult to differentiate between fact and fiction. However, they are considered truthful and often shared by the societies that told them earlier. These dental perpetuated myths act as a barrier and prevent us from availing proper dental care.
Very limited research has been conducted related to myths in dentistry among dental patients in India. Therefore, the present survey was conducted to assess the prevalence of myths related to oral health among patients visiting a Dental College and Hospital in North India and suggest possible measures to raise awareness regarding oral health.
| Materials and Methods|| |
Ethics and informed consent
Ethical clearance for the survey was obtained by the Institutional Ethics Committee. The patients were fully informed about the study undertaken and written informed consent was obtained. They were also assured that their unwillingness to participate in the survey would not affect their treatment.
Study setting and study population
A cross-sectional survey was conducted on the patients visiting the outpatient department (OPD) of the dental college. The survey was conducted for a period of 2 months inside the Department of Oral Medicine and Radiology where all the patients report after making the OPD card from the reception desk. Participants were chosen for inclusion in the survey using the criteria of being at least 18 years of age, without cognitive, hearing or vision impairment, and having either limited or no difficulty in understanding the questionnaire given by the principal investigator in English.
Study sample and sampling technique
A 15-item self-structured questionnaire was used to assess the prevalence of dental myths in a sample of patients (n = 552) seeking dental care at the OPD of the dental college. A convenient sampling technique was adopted in this study. The sample size was estimated by use of a sample size calculation for estimating a single proportion (α = 0.05, prevalence of dental myths obtained from previous literature-81%).
The formula used was n = 4 pq/L2 where, P = 81% (prevalence obtained from the literature available).
q = (1 − P) = (1 − 81%) =19%, L = allowable error which is kept at 3.5.
The minimum sample size calculated was 502, but it was decided to include 50 more participants in case there are nonresponders. Only new patients who were visiting the dental college during the study period and agreed to participate were included in the survey until the estimated sample size was reached. A total of 552 patients participated in the current survey. A pilot survey was conducted on 10% of the study population to assess the feasibility of the survey.
Research instrument and data collection
The instrument for the survey was a self-designed questionnaire written in English language that was handed over to each of the study participants. The questionnaire was also translated to Hindi language in case the patients are not able to understand English. The questionnaire was pretested on 20 participants from the survey sample for content validation before it was administered. Mean content validity ratio was calculated as 0.87 based on the opinions expressed by a panel of academicians. The reliability of the questionnaire was good (0.82). The questionnaire included two sections - Section A was "general section" containing sociodemographic details of the participants. Section B was "dental myths" section that comprised of 15 close-ended questions assessing the prevalence of dental myths. The questions on myths were collected from a sample of oral health pamphlets and brochures and common myths related to oral health, oral hygiene, diet, etc. The questionnaire was distributed to the patients while they were sitting in the OPD. One of the investigators was present with the participant while the questionnaire was being filled to make sure that participants fully understood the questions and respond accordingly.
Results were statistically analyzed using SPSS package version 15.0 (SPSS, Chicago, IL, USA). Descriptive statistical analysis was carried out in this study. Chi-square test was used to determine if there were any associations found between demographics and the myths and perceptions among the community. A 'P' < 0.05 was considered statistically significant.
| Results|| |
The present survey was conducted among 552 patients who visited dental college and hospital for their routine dental check-up and necessary treatment.
The age of the survey participants ranged from a minimum of 18 to more than 45 years with majority of the participants belonging to 36–45 years (34.7%). There were 296 males (56.8%) and 256 females (46.3%) in the study population [Table 1]. Educational status of the survey participants revealed that 27% of the survey participants were educated until high school and majority of the participants (44.5%) completed graduation. Regarding employment status, 77% (425) of the participants were employed.
Response toward dental myths and association with demographic variables
[Table 2] depicts the responses of the survey participants toward various dental myths. More than half (58.7%) of the participants thought that there is a worm inside a decayed tooth and it was significantly associated with age, gender, and educational status of participants (P < 0.05) [Table 3]. Decay was thought to be a heredity process by 62.7% (346) of the survey participants that was significantly associated with education level. Gender-wise distribution of positive response toward a myth by the survey participants is depicted in [Figure 1]. More than half of the participants believed that cleaning makes the tooth loose and out of this more than 60% were males [Figure 1]. This finding was significantly associated with age, gender and educational level of participants (P < 0.05). Three-fourths (414) of the participants were of the opinion that decay is caused by eating sweets and more than 70% of males believed this. This was significantly associated with age and gender of the study participants. More than 70% (392) of participants believed in the myth that no dental treatment should be done during pregnancy, and surprisingly more than 75% of females believed in this. Around 40% of the respondents thought that throwing the exfoliated tooth on the top of the roof can lead to the eruption of permanent teeth. Both of these findings were significantly related to age, gender, and educational status of participants (P < 0.05). Moreover, health of the teeth is not related to general health was thought only by 20.6% (114) of the participants and this finding was more prevalent in older and less educated participants [Table 3].
|Table 2: Response of participants on various myths related to oral health|
Click here to view
|Table 3: Association of dental myths with different sociodemographic variables|
Click here to view
| Discussion|| |
The present survey focusses on the common myths regarding oral health among patients attending an OPD of a Dental College and Hospital in North India. There are variety of reasons due to which myths can be prevalent in a population like poor education, cultural beliefs and social misconceptions and are passed on from one generation to the next. It is important to understand these kinds of myths as these can have a significant impact on the general health of people.,
More than 50% of participants in the present survey were males. This finding is similar to another study conducted among dental patients in South India. This could be due to the reason that women are busy doing household chores in the day time and, therefore, find it difficult to visit the dental college during the working hours to avail necessary dental treatment.
More than 60% of the participants in the present survey believed that there is a worm inside a decayed tooth, and this finding was significantly related to age, gender and educational status of participants. This figure is less as compared to some other study reports conducted in Bareilly District where more than 90% of subjects believed in this myth. This could be due to the reason that majority of people do not know about initiation and progression of dental caries. To explain them about dental caries, most of the dentists relate dental caries to a "worm" in the native language that needs to be taken out to save the tooth. About 75% of participants thought that decay is caused by eating sweets and more of the older and less educated participants believed in this myth. This can be because from olden days, health professionals have been stressing on avoiding sweets rather than educating them that dental caries belongs to the group of common diseases considered as "complex" or "multi-factorial."
Majority of the participants thought that decaying of teeth is a hereditary process, and more of less educated participants believed in this myth. This shows that their knowledge and awareness regarding oral health is poor and is associated with their literacy level that predisposes them to false beliefs. Furthermore, 40% of participants were of the opinion that throwing the exfoliated milk tooth of the child on the roof of a house in the presence of squirrel can lead to the eruption of the healthy permanent tooth, and the statistically significant relationship of this myth was noted with age, gender, and education level of participants. It is believed that squirrel takes the old tooth and returns it for a new one. This kind of behavior can be attributed from the family members, especially grandparents, who exerted a considerable influence on the family especially the younger generation. Moreover, a certain number of participants believed that cleaning of teeth by a dentist makes the teeth loose. This kind of misconception is inherited due to falsely exaggerated information promulgated by those who had previous personal negative dental experiences with the use of ultrasonic scaler for cleaning. A certain number of participants also believed that when gums bleed, it is better not to brush the teeth and extraction of upper teeth lead to loss of vision. This belief is because brushing provokes bleeding, but they are unaware that it is not the cause.
A vast majority of female participants believed in the myth that no dental treatment should be done during pregnancy also showing a significant association with age and educational level. This could be due to the reason that undergoing dental treatment during pregnancy would hamper the development of the fetus. However, they are unaware of the fact that treatment has to be done when in emergency and other procedures can be done during 2nd trimester when organogenesis is complete. One of the positive findings of the survey was that a high percentage of participants agreed to the fact that dental health is related to general health. This shows that they are aware of the complexity of dental problems and their detrimental effect on overall and general health.
The findings of this study revealed that younger individuals tend to have a more positive perception as compared to older individuals toward majority of the myths which shows that they are better informed about oral health issues. Correspondingly, more educated participants responded more positively toward the perception in question as compared to less educated ones. A survey conducted in Pakistan reported similar findings in which higher percentage of illiterates and older persons had beliefs in one or more dental myths. To overcome this problem, education should be imparted in all age-groups that help to raise the internal consciousness, empowerment and also alters unhealthy behavior and practices.
The present survey had one limitation as well. Some of the myths included in the survey did not have any scientific basis and were based on beliefs on oral health and hygiene commonly encountered in day-to-day practice. However, an attempt was made by the authors to assess the prevalence of various myths in the absence of adequate supporting literature. Therefore, a more extensive study covering a vast geographical area is needed focusing on the basic concepts of oral health, disease, and hygiene.
| Conclusion|| |
Majority of participants in the present survey believed in myths and misconceptions associated with oral health and hygiene and these were significantly higher among less educated and older age-groups. This acts as an access barrier in the utilization of dental services. It is the responsibility of the dental public health professionals, government and nongovernment health organizations to educate the public in order to clear misconceptions towards various oral health issues and strive for the following: (1) Dental awareness programs especially targeting the rural aged vis a vis their relative lack of mobility and mental rigidity; (2) setting up subsidized dental care facilities close to rural populations; (3) mobile dental clinics and dental camps. Surveys with larger samples at multi-centric levels, which investigate the factors making dental education infusion difficult in rural areas are imperative in any country like India with large rural populace, to decrease disparities between rural and urban areas.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Randhawa AK, Veeresha KL, Gambhir RS, Sohi RK, Bansal V, Dodamani A. Assessment of oral health status, treatment needs, coverage and access barriers of patients reporting to a rural dental college in Northern India. J Indian Assoc Public Health Dent 2011;18:899-904.
Petersen PE. The World Oral Health Report 2003. Continuous Improvement of Oral Health in the 21st
Century – The Approach of the WHO Global Oral Health Programme. Geneva, Switzerland: WHO; 2003. Available from: http://www.who.int/oral_health/media/en/orh_report03_en.pdf
. [Last cited on 2015 Mar 15].
Gholami M, Pakdaman A, Montazeri A, Jafari A, Virtanen JI. Assessment of periodontal knowledge following a mass media oral health promotion campaign: A population-based study. BMC Oral Health 2014;14:31.
Sherman P, Moscou S, Dang-Vu C. The primary care crisis and health care reform. J Health Care Poor Underserved 2009;20:944-50.
Ashley FP. Role of dental health education in preventive dentistry. In: Murray JJ, editor. Prevention of Dental Disease. 3rd
ed. Oxford: Oxford University Press; 1996. p. 406-14.
Mason RM. Myths that persist about orofacial myology. Int J Orofacial Myology 2011;37:26-38.
Singh SV, Akbar Z, Tripathi A, Chandra S, Tripathi A. Dental myths, oral hygiene methods and nicotine habits in an aging rural population: An Indian study. J Dent Res 2013;24:242-4.
Rai M, Kishore J. Myths about diabetes and its treatment in North Indian population. Int J Diabetes Dev Ctries 2009;29:129-32.
Adler E, Paauw D. Medical myths involving diabetes. Prim Care 2003;30:607-18.
Vignesh R, Priyadarshni I. Assessment of the prevalence of myths regarding oral health among general population in Maduravoyal, Chennai. J Educ Ethics Dent 2012;2:85-91.
Tewari D, Nagesh L, Kumar M. Myths related to dentistry in the rural population of Bareilly district: A cross-sectional survey. J Dent Sci Oral Rehabil 2014;5:58-64.
Fejerskov O. Changing paradigms in concepts on dental caries: Consequences for oral health care. Caries Res 2004;38:182-91.
Nagaraj A, Ganta S, Yousuf A, Pareek S. Enculturation, myths and misconceptions regarding oral health care practices among rural female folk of Rajasthan. Ethno Med 2014;8:157-64.
Chhabra N, Chhabra A. Parental knowledge, attitudes and cultural beliefs regarding oral health and dental care of preschool children in an Indian population: A quantitative study. Eur Arch Paediatr Dent 2012;13:76-82.
Silk H, Douglass AB, Douglass JM, Silk L. Oral health during pregnancy. Am Fam Physician 2008;77:1139-44.
Khan SA, Dawani N, Bilal S. Perceptions and myths regarding oral health care amongst strata of low socio economic community in Karachi, Pakistan. J Pak Med Assoc 2012;62:1198-203.
[Table 1], [Table 2], [Table 3]