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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 1  |  Page : 12-15

Self-medication practices and ignorance to seek treatment for oral health problems amongst adult dental patients: A cross-sectional survey


Department of Oral Medicine and Radiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Puducherry, India

Date of Submission29-Jun-2020
Date of Decision26-Jun-2021
Date of Acceptance02-Jul-2021
Date of Web Publication25-Feb-2021

Correspondence Address:
Mouttoukichenin Surenthar
Department of Oral Medicine and Radiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdrr.jdrr_67_20

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  Abstract 


Background: Self-medication is one of the major health concerns worldwide, and the World Health Organization has laid emphasis on correctly investigating and controlling it. Self-medication turns public and professional concern regarding imprudent practices, which has dramatically increased during the past few decades, especially in the developing countries. Aim and Objective: The aim of this study was to assess the self-medication practice for oral and dental health problems among adult dental patients in a teaching hospital, and the objective was to find the association between self-medication and ignorance in seeking dental treatment among those patients. Materials and Methods: This study was conducted among 100 participants with 50 males and 50 females from outpatient block, with various oral health problems. Results: The prevalence of practice of self-medication was 87% among dental patients irrespective of their oral health problem and was 70.1%, which was exclusively for oral health problems among those 87%. About 44.2% of the respondents answered that the professional operative procedures weaken the teeth, and about 24.5% of the respondents fear that dentists prescribed drugs would cause side effects, and this might be the reason behind these patients undertaking self-medication which was highlighted in this study. Conclusion: The increased prevalence of self-medication in this study was alarming with analgesics being the most commonly used drug without even considering the toxic effects of it. This study emphasized that there is a paramount need for educational programs on the public associated with indiscriminate usage of drugs in which all health-care providers including pharmacists should play a vital role, and the government should also emphasize on formulating new techniques on the sale of drugs which could reach both literate and illiterate individuals.

Keywords: Ignorance, oral health problems, self-medication


How to cite this article:
Surenthar M, Kumaran JV, Srinivasan SV, Daniel MJ. Self-medication practices and ignorance to seek treatment for oral health problems amongst adult dental patients: A cross-sectional survey. J Dent Res Rev 2021;8:12-5

How to cite this URL:
Surenthar M, Kumaran JV, Srinivasan SV, Daniel MJ. Self-medication practices and ignorance to seek treatment for oral health problems amongst adult dental patients: A cross-sectional survey. J Dent Res Rev [serial online] 2021 [cited 2021 May 5];8:12-5. Available from: https://www.jdrr.org/text.asp?2021/8/1/12/310191




  Introduction Top


The World Health Organization has defined self-medication as “use of pharmaceutical or medicinal products by the consumer to treat self-recognized disorders or symptoms, the intermittent or continued use of a medication previously prescribed by a physician for chronic or recurring disease or symptom, or the use of medication recommended by lay sources or health workers not entitled to prescribe medicine.”[1],[2] A systematic review report indicates that the prevalence of self-medication practices was high globally and varies from 32.5% to 81.5%. Studies have reported wide variations in its prevalence in India increasing from 31% in 1997 to 71% in 2011.[3] Self-medication is associated with risks such as misdiagnosis, use of excessive drug dosage, prolonged duration of use, masking of symptoms, and increased resistance to pathogens. Nevertheless, self-medication is an important component of primary health care, thereby decreasing the burden on delivering health care. Ignorance to seek treatment for oral health problem is the unawareness of the patients toward the treatment regimens and also the fear and myths associated with the dental treatment which would serve as a predisposing factor to indulge in self-medication practices. This study highlights on the association between the self-medication practices and the ignorance in seeking dental treatment among dental patients.


  Materials and Methods Top


This study was conducted among randomly selected sample of 100 participants with 50 males and 50 females from the outpatient block, with various oral health problems. Participants with age 18 years and above, who visited outpatient block of a teaching dental hospital, were included in the study. Participants who were mentally debilitated to give a valid response to question and those who were not willing to participate were excluded from the study. The participants were clearly explained about the study, and informed consent was obtained. They were interviewed, and the information obtained was entered in a 22-point, closed-ended question-based, semi-structured questionnaire [Table 1] with three sections, namely, Part A with sociodemographic profile, Part B relating to the practice of self-medications, and Part C with questions to ignorance in dental treatment. The reliability of the questionnaire was established using a pilot study by collecting data from ten participants, not included in the sample.[4]
Table 1: A 22-point, closed-ended question-based, semi-structured questionnaire

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Statistical analysis

The statistical analysis was done using IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.. Chi-square test was used for comparison.


  Results Top


The mean age of distribution of participants is 39.1 (±12). Gender distribution of our study participants is equally distributed [Table 2]. The majority of the study participants are from an urban area (74%) [Table 3]. Almost 60% of the study participants had education up to at least the primary level [Table 4]. The prevalence of self-medication among the study respondents was 87%. The associations between gender and drug users were statistically significant with P < 0.045 [Table 5], whereas the place of residence [Table 6] and the level of education [Table 7] were not significantly associated.
Table 2: Gender distribution of study participants (n=100)

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Table 3: Place of residence of the participants (n=100)

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Table 4: Education distribution of the study participants (n=100)

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Table 5: Association between gender and drug users

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Table 6: Association between the place of residence and drug users

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Table 7: Association between education and drug users

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  Discussion Top


The present study was an attempt to study the prevalence, pattern, and awareness of self-medication practices. Probably, this would be the first study to highlight on the association of ignorance to dental treatment on patients who self-medicate regularly. The prevalence of self-medication among the study respondents, irrespective of dental or oral health problem, is 87% which means more than three-fourth of the study population are indulging in self-medication practices for symptoms such as headache, fever, toothache, body ache, and common cold. Among the 87% of the study respondents, the prevalence of self-medication among the study respondents for oral health problem is 70.1%. The age group in our survey ranged from 18 to 70 years, and the mean age group of the participants was 39.1 years, indicating that middle-aged group participants were majorly involved in the practice of self-medication. This finding was in compliance with the study conducted by Shankar et al.,[5] in 2002 and Ritu et al.,[6] in 2011. This study detected an association with gender and self-medication, where females were more likely to indulge which is consistent with the previous studies by Afolabi et al.,[7],[8] in 2008. Probably, this is because females are more anxious and have a lower threshold to pain and greater fear. There was no significant association between the place of respondents and self-medication practice as our study comprised majority of the respondents from the urban regions, whereas previous studies have reported a positive association between the level of education and self-medication, which was not observed in our study.

Pain (88.6%) was the most common cause for self-medication without the prescription of the dentist among our respondents. Pain killers were the most commonly used drug (88.6%) among the study respondents, and both pain killers and antibiotics are used by 11.5% of respondents. Idiosyncratic drug reactions are hypersensitivity adverse drug reactions that do not occur in most patients at any dose and do not involve the known pharmacological properties of the drugs. A single dose of analgesics such as ibuprofen is quite sufficient to cause idiosyncratic reactions such as acute nephritis,[9] and antibiotic resistance is one of the most challenging issues with indiscriminate use of antibiotics without any guidelines.

Pharmacists (91.4%) were the most common source for self-medication among the respondents. Severe urticaria had developed in one of the study respondents who got the drugs prescribed by a pharmacist for dental pain; this necessitates the need for strict law imposition so as to curtail the purchase of drugs without a prescription. In our study, 16.4% of the study respondents used topical medicaments (pain killers such as Amrutanjan) intraorally for dental pain. This question was particularly added to assess their awareness on chemical burns following such practices. It is quite alarming that 16.3% of the respondents answered that the self-medication practices are not hazardous and safe. However, 65.6% of the respondents knew that regular self-medication practices would cause damage to body organs. It is satisfactory from the above study that 77% of the respondents agreed to discontinue the practice though 3.3% of the respondents were not willing to quit. About 44.2% of the respondents answered that the professional operative procedures weaken the teeth and about 24.5% of the respondents fear that dentists prescribed drugs would cause side effects, and this might be the reason behind these patients undertaking self-medication which was highlighted in this study.

The association between ignorance in dental treatment and self-medication though positive, was compared with respect to frequency since the number of sample was not statistically significant which would be the limitation of the study. Hence, in further studies, a large sample size would be recommended.


  Conclusion Top


The worldwide practice of self-medication is hiking steadily which increases the intricacies in the medical and dental treatments. The high prevalence of self-medication in our study was alarming, with analgesics being the most commonly used drug without even considering the toxic effects of it. This study emphasized that there is a paramount need for educational awareness programs on the public associated with hazardous use of drugs, in which all health-care providers including pharmacists should play a vital role.[10] Awareness programs on myths about the routine basic dental treatment should be inculcated for all patients seeking it. We recommend that the government should also emphasize to control the retail sale of Schedule H drugs to be used as over-the-counter (OTC) drugs and thereby bringing new amendments in the Drug and Cosmetics Act[11] to formulate new techniques such as different color-coded prescriptions to be prescribed by every doctor to differentiate OTC drugs from others to minimize the ill effects of the latter, which could even reach the illiterate.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
WHO Guidelines for the Regulatory Assessment of Medicinal Products for Use in Self-Medication; 2000. Available from: www.who.int/medicines/library/qsm/whoedm-qsm-2000-1/who-edm-qsm-00_1.htm. [Last accessed on 2019 Aug 21].  Back to cited text no. 1
    
2.
Guidelines for the Regulatory Assessment of Medicinal Products for use in Self-Medication. Europe: World Health Organization; 2000. (WHO/EDM/QSM/00.1). Available from: https://apps.who.int/ir/is/handle/10665/66154. [Last accessed on 2019 Aug 21].  Back to cited text no. 2
    
3.
Kumar V, Mangal A, Yadav G, Raut D, Singh S, et al. Prevalence and pattern of self-medication practices in an urban area of Delhi, India. Med J Dr. D.Y. Patil University 2015;8:16-20.  Back to cited text no. 3
    
4.
Gandhi S, Gandhi RA, Nayyar AS, et al. Assessment of abuse of self-medication for oral and dental problems among 21–60 years aged populace residing in the rural areas of Belgaum Taluk, Karnataka, India: A questionnaire study. Arch Med Health Sci 2016;4:180-4.  Back to cited text no. 4
  [Full text]  
5.
Shankar PR, Partha P, Shenoy N. Self-medication and non-doctor prescription practices in Pokhara valley, Western Nepal: A questionnaire-based study. BMC Fam Pract 2002;3:17.  Back to cited text no. 5
    
6.
Ritu P, Himmat S, Manisha R, Gaurav G. An online exploratory study of self-medication among pharmacy graduates in India. Int J Drug Dev Res 2011;3:200-7.  Back to cited text no. 6
    
7.
Afolabi AO. Factors influencing the pattern of self-medication in an adult Nigerian population. Ann Afr Med 2008;7:120-7:  Back to cited text no. 7
    
8.
Afolabi AO, Akinmoladun VI, Adebose IJ, Elekwachi G. Self-medication profile of dental patients in Ondo State, Nigeria. Niger J Med 2010;19:96-103.  Back to cited text no. 8
  [Full text]  
9.
Nanau RM, Neuman MG. Ibuprofen-induced hypersensitivity syndrome. Transl Res 2010;155:275-93.  Back to cited text no. 9
    
10.
KomalRaj MR, Bhat PK, Aruna CN. Self medication practices for oral health problems among dental patients in Bangalore: A cross sectional study. IOSR J Pharmacy 2015;5:68-75.  Back to cited text no. 10
    
11.
Drugs and Cosmetics Rules-Schedule H & Schedule H1 Drugs; 2017. Available from: https://www.medindia.net/patien/tinfo/drugs-and-cosmetics-rules-sch/edule-h-schedule-h1-drugs.htm. [Last accessed on 2019 Aug 21].  Back to cited text no. 11
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

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