Journal of Dental Research and Review

ORIGINAL ARTICLE
Year
: 2020  |  Volume : 7  |  Issue : 4  |  Page : 171--176

Assessment of awareness of periodontal disease among dental undergraduates: A questionnaire study


Shruti S Ligade, Shretika Pandya 
 Department of Periodontology, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India

Correspondence Address:
Shruti S Ligade
Department of Periodontology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune - 411 018
India

Abstract

Background: Periodontal disease has become a major public health problem in India with a high prevalence. Conventionally, it is believed that regular dental prophylaxis and maintenance of oral hygiene is sufficient for the prevention or control of gingival diseases, and yet there are patients undergoing various periodontal surgeries in everyday life. Periodontology treats the body as one unit, and hence, there should be in-depth knowledge of systematic diseases and their relation with the oral cavity. The awareness about the scope of periodontology and the major as well as minor surgeries is very low among the population as among the undergraduate students. This questionnaire survey was undertaken to judge the same and subsequently, if required, provide awareness. Methodology: The blinded questionnaire survey was undertaken among all the dental colleges from Pune, namely, Dr. D. Y. Patil Dental college (Pimpri), Sinhgad Dental College (Pune), Rangoonwala Dental College (Pune), and Bharti Vidyapeeth Dental College (Pune). A total of 150 students from the final year of all colleges voluntarily participated in the study. As it was a triple blinded study, no gender bias was obtained in the result. Results: On getting the results and statistical analysis using SPSS Version 11.5 software, it was found that dental undergraduate students (Bachelor of Dental Surgery) had superficial knowledge about maintenance of periodontal health, namely the students could tell the importance of chlorhexidine mouth wash but were unable to tell the appropriate method of use. Many students were not able to differentiate between the symptoms of the periodontal abscess and periapical abscess. The importance of implant landmarks and basic knowledge about the pull of frenal attachment was lacking among the majority of the participants among all the three colleges. Conclusion: It can be stated that periodontal awareness among dental undergraduates was lacking in regard to its application toward the surgeries and its importance with systemic diseases as diabetes and hypertension. This bridge of ignorance must be crossed so that patients can be rightly educated by in earliest stage, and the importance of the branch of periodontology can be duly given. Note: Please note source file has more reviewer queries found, please check and confirm



How to cite this article:
Ligade SS, Pandya S. Assessment of awareness of periodontal disease among dental undergraduates: A questionnaire study.J Dent Res Rev 2020;7:171-176


How to cite this URL:
Ligade SS, Pandya S. Assessment of awareness of periodontal disease among dental undergraduates: A questionnaire study. J Dent Res Rev [serial online] 2020 [cited 2021 Jan 24 ];7:171-176
Available from: https://www.jdrr.org/text.asp?2020/7/4/171/302057


Full Text



 Introduction



Periodontal diseases are among the major chronic infections afflicting mankind at present.[1] Even though these are preventable diseases, their prevalence is increasing in the world.[1] The burden of periodontal diseases is comparatively higher in developing countries. Periodontal disease has become a major public health problem in India, and the prevalence ranges from 50% to 100% in various parts of the Indian subcontinent and hence, is a matter of deep concern.[2]

Periodontal health is not restricted to the maintenance of an infection-free periodontal tissue. It also encourages to manage the balanced integrity in tooth and supporting structures. In addition, there exists esthetic disharmony, which can be managed with periodontal plastic surgery. Periodontal procedures as frenectomy, crown lengthening, root coverage procedure, and smile designing consider the function and cosmetic value of the tooth as well as the tissue.

In recent times, there has been a resurgence of interest in the interaction between oral conditions and a number of prevalent systemic diseases.[3]

The possibility that periodontal diseases might influence the morbidity and mortality of systemic diseases has led to new dimensions of research in periodontal medicine. Evidence for a link between periodontal disease and several systemic diseases is growing rapidly.[3] The inflammatory burden of chronic periodontitis is thought to have an important systemic impact. Among these interactions is that between oral infections such as periodontitis and systemic diseases such as cardiovascular disease, cerebrovascular disease (stroke), peripheral vascular disease, diabetes mellitus, respiratory infections, and adverse pregnancy outcomes.[4],[5],[6],[7],[8] The severity also has considered periodontitis as the 6th complication of diabetes mellitus.[9]

The complaints about food lodgment may not be mere cavitation, and the involvement of the furcal area should be assessed. This involvement might have further lead to endodontic lesions. Such cases need the use of interdisciplinary dentistry.

The knowledge and practice of periodontology are not restricted to the maintenance of oral hygiene with scaling and curettage. This branch comprises a vast array of surgeries, from flap debridement to regeneration of bone volume for the placement of an implant.

The budding dentists need the knowledge of the specialty field to maximize its correct application, and a questionnaire survey can be the simplest and informative tool reflecting the awareness of the young dentists.

To date, very few studies have been assessed, which concludes the knowledge about the awareness of diseases in periodontology.[10],[11] Keeping this in view, the present survey has been designed to evaluate the acquaintance, orientation, and behavior of dental undergraduates towards periodontal disease.

Aim of the study

The aim of this questionnaire survey was to assess the awareness of periodontal Among Dental Undergraduates using a close-ended questionnaire.

 Methodology



Data for this questionnaire-based cross-sectional study were obtained after the approval of the institutional research ethics committee and the students' consent to participate.

The blinded questionnaire survey was undertaken among all the dental colleges from Pune, namely, Dr. D. Y. Patil Dental college (Pimpri), Sinhgad Dental College (Pune), Rangoonwala Dental College (Pune), and Bharti Vidyapeeth Dental College (Pune). A total of 150 students from the final year of all colleges voluntarily participated in the study. As it was a triple-blinded study, no gender bias was obtained in the result.

A self-constructed questionnaire was distributed to all subjects participating in the survey. After the distribution of the questionnaire, 10 minutes were allotted for completing the questionnaire. Each question of the questionnaire had three options of which only one was appropriate. The questionnaire consisted of varied levels of questions – a few pertaining to basic periodontology, while others saw relation with the specialty branch. The general basic questions were expected to be answered correctly by the dentists [Table 1]. Special emphasis was given to obtain the knowledge about the core subject, and the outcome was recorded accordingly.{Table 1}

The goal of categorization in survey research is to obtain a sufficient sample that is representative of the population of interest. It is often not feasible to collect data from an entire population of interest, and therefore, a subset of the population or sample is used to estimate the population responses. It is, therefore, necessary to correctly identify the population of interest.

This study thus prepares s criteria to include the final year undergraduate students studying course of Bachelor of Dental Surgery (BDS). To clarify the inclusion of population, it was critically checked to exclude the students studying in the first, second, and third year BDS, Interns, and students from any other professional course. A self-prepared close-ended questionnaire was prepared for the survey, which can be studied below, and it was anticipated to be answered in the stipulated time.

Statistical analysis

The sample size calculation was done considering the number of dental colleges in the city and specifically focused on the group, including the final year of dentistry. The total sample size was inflated to 150 students to accommodate errors and nonparticipation. The study got a complete response from 150 students.

Data were analyzed using SPSS version 11.5 software (Online version of the software from Chicago, IL, USA). Descriptive analysis was used for inferring the results of the survey.

Descriptive statistics

The descriptive analysis included the expression of students' responses to the study questionnaire using frequency and proportions.

 Results



The results obtained showed a wide range though specific questions were expected a straight forward and uncomplicated answer without much reasoning [Refer [Figure 1]a, [Figure 1]b, [Figure 1]c, [Figure 1]d, [Figure 1]e, [Figure 1]f, [Figure 1]g.{Figure 1}

Although all dentists commonly recommend the usage of mouthwash, it was found that only 74.6% of the students were able to answer the appropriate method of chlorhexidine mouthwash, and 19.4% participating dental students could not answer the question correctly. Students were aware of the detrimental effects of tobacco on the periodontium, and hence, 72% of students have answered the second question correctly. Although general dentists infrequently encounter halitosis patients, 89.3% of students answered “Yes” while 10.7% opted “No” for the third question in the survey. When questioned regarding Periodontal-medicine, 73.3% of students were able to answer the relation between periodontal disease and systemic disease, 9.3% of participants could not answer properly, while 17.4% were not aware of the dual relation. The awareness of periodontal health in pregnant ladies was seen with only 65.3%, while 32% of dentists assumed no additional gingival care was required in pregnancy.

When judged for periodontal care during human immunodeficiency virus (HIV), maximum 56% of students had knowledge regarding the same while only 2.7% of participants could not comment upon it. The questions regarding the sequela of food lodgment and pocket formation were answered correctly by 68.7% dental students, as also 84.7% of respondents had awareness regarding recessing gingival margin and its treatment from a periodontist.

When questioned about the importance of maintenance therapy in periodontology and prognosis of the deteriorating condition such as aggressive periodontitis, 86.7% and 84.7% of students were found to have knowledge regarding the same, though both questions were pertaining to the specialized branch of dentistry. They still seemed perplexed regarding knowledge of treatment of midline diastema, where 36.7% of students answered “Yes” while 49.3% checked “No.”

Maximum dental students showed awareness regarding difference in abscess found in periodontology against found in endodontics. Almost 89.3% were aware of the difference in swelling in relation to periodontitis and endodontics and have correctly scored. The majority, approximately 60.6% were found unaware about the periodontal defects and bone loss with the prognosis; this can be attributed to negligible encounters with chronic periodontitis patients during basic graduation. About 57.4% of dental students had knowledge regarding periodontal flaps and surgical intervention required, whereas 20.6% failed to answer it appropriately. The result saw confusion when Dental students were questioned regarding implant placement in resorbed ridges, and the answer given was 33.3%, 32%, and 34.7% with “Yes,” “No,” and “Don't No” respectively.

 Discussion



Few studies have evaluated the attitude and behavior of general medical practitioners toward periodontal diseases.[12],[13] Most of these studies showed that a very less number of dentists communicate with the physicians about their patients and vice-versa[14],[15] though this is not considered an ideal scenario. To the best of our knowledge, this is the first study of its type in this region that documents the acquaintance, awareness, and orientation of general dental practitioners toward periodontal disease. A significant amount of emphasis is now being given for the prevention of diseases rather than the treatment aspect. Hence, proper knowledge of preventive oral health and proper oral hygiene practice becomes an important way for maintaining good dentition. In our survey, we found that there is limited knowledge about periodontal health and disease among general dental practitioners.

Although all dentists commonly recommend the usage of mouthwash, it was found that only 74.6% of the students were able to answer the appropriate method of chlorhexidine mouthwash while 19.4% participating dentists could not answer the question correctly. The optimum action of chlorhexidine is found to be 30 min after tooth brushing, which can positively help decreasing the pocket depth.[16]

Tobacco and its detrimental effects are well acknowledged by the students. The direct and indirect consequences of tobacco on periodontium are deep-rooted in this society. Hence, 72% of participants could answer the second question correctly. Yet, 20.6% of dentists failed to have knowledge of tobacco abuse on periodontium.

Although general dentists infrequently encounter halitosis patients, 89.3% of students answered aptly about the treatment of the same by the periodontist. Similarly, if the etiology of bad-odor is not of dental origin, a general physician or psychiatrist must be consulted.

It was noteworthy to find that 73.3% of students were able to answer the relation between periodontal health and disease and systemic health and disease, 9.3% of students could not answer properly, while 17.4% were not aware of the dual relation. A study done by Kaur et al.[17] concluded that there is an underestimation of the extent, severity, and outcome of periodontal diseases and their effects on systemic health. Most of the respondents were aware of the signs and symptoms of periodontal disease and its strong association with diabetic mellitus and cardiac disorders, but they are less aware of the fact that periodontal disease has a potential effect on many organ systems of the body.

It is also noteworthy that 65.3% of the students are well aware of the association of periodontal disease and preterm low birthweight; however, on the other hand, 32% of the undergraduate students were not aware of this relation. This points out the lacking knowledge of the potential association of a diseased periodontium with a diseased systemic condition.

HIV is a crucial topic in virology and is of equal significance in the clinical and academic fields. The students are stressed upon to treat such patients and study the related clinical scenarios. Despite this fact, a mere 56% of students know about the relationship between HIV and periodontitis. A matter of concern is that 44% of the students are not aware of that dentists do play an important role in diagnosis of HIV and that the periodontium manifests the disease in a variety of ways.

About 50.6% of students are not aware that bleeding on probing is one of the first, most important and a subjective sign[18] of periodontal disease, while on the other hand, 86% and 89.3% of students, respectively, know that change of color in gingiva is pathogenic and the presence of inflammation during a diseased state.

Furthermore, 68.7% of students do know the relation of food lodgment and its role in periodontal disease, and 81.4% of students are aware of mobility being a sign of gradual bone loss and periodontal disease.

Among the undergraduate students, 50.6% of students were well aware of the signs and symptoms of periodontitis, including pus discharge and bone loss.

The awareness that the role of a periodontist is pivotal in the management of recession is 84.7% and also in smile designing, which was known by a comparatively less number of students with just 54% undergraduate students answering correctly, while the remaining 40% and 6% were not aware.

Students are quite knowledgeable about chronic periodontitis being a slow progressing disease while aggressive periodontitis a rapidly progressive and has a familial tendency with 84.7% and 86.7% of students answering correctly to the questions.

There seems to be a mixed reaction about the frenal attachment being one of the causes for diastema formation, with only 49.3% of students answering correctly while 36.7% were incorrect, and the remaining 14% were not aware and did not know the answer.

The requirement of periodontal surgery in all patients with periodontal disease is not a must is known by 57.4% of the undergraduate students, while 60.6% of the students felt that horizontal type of bony defects had a better prognosis.

The question regarding implants surgery got a mixed response from the students, with 33.3% of students answering correctly, while 34.7% did not attempt the question.

 Conclusion



To conclude the study, it can be stated that periodontal awareness among dental undergraduates was lacking in regard to its application toward the surgeries and its importance with systemic diseases as diabetes and hypertension. This bridge of ignorance must be crossed so that patients can be rightly educated by in earliest stage and the importance of the branch of periodontology can be duly given. A fair and due significance of the knowledge of periodontium should be seeded from the graduation stage. Multiple magazines and journal houses should be encouraged to throw light upon on the vast array of periodontal associations in dentistry as well as systemic pathology.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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