|Year : 2018 | Volume
| Issue : 1 | Page : 39-43
Assessment of periodontal knowledge among residents of West Godavari District of Andhra Pradesh, India: A descriptive epidemiological survey
Gautami S Penmetsa1, Praveen Gadde2, Zabirunnisa Begum2, Narendra Mandalapu1, AV Ramaraju3
1 Department of Periodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
2 Department of Public Health Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
3 Department of Prosthodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
|Date of Web Publication||22-Mar-2018|
Dr. Praveen Gadde
Department of Public Health Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh
Source of Support: None, Conflict of Interest: None
Aim: To assess the periodontal knowledge among 18–50-year-old adult population living in the West Godavari state of Andhra Pradesh.
Materials and Methods: We conducted a cross-sectional face-to-face interview survey from July 2014 to June 2015 among individuals between ages 18 and 50 years living in the West Godavari district of Andhra Pradesh using a stratified multistage sampling method. For data collection, a specially designed pretested proforma was used. The proforma consisted of demographic details such as name, age, sex, income, education, occupation, personal habits, and systemic diseases, if any. The proforma also included a structured, 14-item questionnaire to assess the knowledge levels of participants regarding periodontal health and diseases. t-test and analysis of variance were used to analyze the collected data. P value less than 0.05 was considered statistically significant for all comparisons.
Results: The lowest percentage of correct answers was related to gum care during pregnancy (11.6%) and the effect of systemic diseases on periodontium (30%). A majority of the participants had higher level of knowledge scores related to the use of toothpaste (95.2%) and food accumulation leads to gum diseases (80.8%). There was no significant difference in mean knowledge score among different gender and occupation groups (P > 0.05). Participants with high economic status had the highest periodontal disease knowledge (P = 0.015).
Conclusion: Knowledge concerning periodontal health and disease is still poor in West Godavari; therefore, more dental health education is needed to improve oral health. In this study, positive attitudes toward prevention were related to better knowledge.
Keywords: Health education, knowledge, oral hygiene practices, periodontitis, prevention
|How to cite this article:|
Penmetsa GS, Gadde P, Begum Z, Mandalapu N, Ramaraju A V. Assessment of periodontal knowledge among residents of West Godavari District of Andhra Pradesh, India: A descriptive epidemiological survey. J NTR Univ Health Sci 2018;7:39-43
|How to cite this URL:|
Penmetsa GS, Gadde P, Begum Z, Mandalapu N, Ramaraju A V. Assessment of periodontal knowledge among residents of West Godavari District of Andhra Pradesh, India: A descriptive epidemiological survey. J NTR Univ Health Sci [serial online] 2018 [cited 2020 Mar 29];7:39-43. Available from: http://www.jdrntruhs.org/text.asp?2018/7/1/39/228159
| Introduction|| |
Periodontal disease, including gingivitis and periodontitis, is considered to be one of the most common diseases among population and, if left untreated, can lead to tooth loss. The main cause of periodontal disease is bacterial plaque although many other factors such as hormonal changes, diabetes, poor nutrition, smoking, and stress can affect the initiation and progression of gingival and periodontal diseases. The development of common periodontal diseases depends mainly on human behavior, and the control of these diseases is greatly supported by the fact that etiological factors are well documented.
Effective plaque control is an essential part in the treatment of inflammatory periodontal diseases. Many studies showed that effective plaque control for each person cannot be achieved without interactive motivation that includes educational and informative knowledge for the patient about periodontal diseases, their initiating factors, and the major role of dental plaque as the initiating cause for inflammatory periodontal changes. Nettleton emphasized the need for offering patients accurate information so that they can make an educated decision about their own behavior and actions.
Epidemiological data concerning periodontal health is available from over 100 countries in the world. Routine patient education concerning periodontal disease is recommended as a means of improving oral health. Former studies on adults have shown that their level of knowledge and attitudes toward dental health might be a barrier to effective oral preventive efforts. Therefore, maintenance of periodontal health and prevention of the disease requires informed public and patients who can differentiate between periodontal health and disease.
Little published data is available on the level of periodontal knowledge and periodontal disease from southern India.,, Therefore, the aim of this study was to assess the periodontal knowledge of adult population living in the West Godavari state of Andhra Pradesh.
| Materials and Methods|| |
This study used a cross-sectional, population-based survey from July 2014 to June 2015 among individuals between ages 18 and 50 years living in the West Godavari district of Andhra Pradesh. To select a representative sample, we applied stratified, multistage, random-area sampling. Individuals willing to participate and who agreed to give informed consent were included. A sample size of 1300 was estimated using a sample size calculation for estimating a single proportion using findings from the pilot study. For sample selection, West Godavari district was divided into three zones. From each zone two mandals and from each mandal two villages were randomly selected.
For data collection, a specially designed pretested proforma was used. The proforma consisted of demographic details such as name, age, sex, income, education, occupation and personal habits, and systemic diseases, if any. The proforma also included a structured, 14-item questionnaire designed from previous studies to assess the knowledge level of participants regarding periodontal health and diseases. In the knowledge section, few items focused on gingival appearance, some items addressed causes and outcomes of periodontal disease, and few items were related to the impact of systemic disease on the progression of periodontal conditions and prevention. All participants were provided with full explanation of the study objectives and the questionnaire was in their native language. The participants were forbidden to discuss their completed questionnaire with others. Each question was given one correct statement and the other statements were wrong, and the participant responded to the statement by selecting one of three responses, namely yes, no, or I don't know. The responses to the questions about periodontal knowledge were scored as true (score 1) and false (score 0), and a sum score derived from 14 questions (range: 0–14) was calculated for each participant. Once completed, each questionnaire was double checked to ensure that all the items were answered, and participants were requested to complete any missing data. The data were processed by a computer after auditing, reviewing, and coding the completed questionnaires for data processing and analysis.
The questionnaire items were initially revised by an expert panel. The face validity of the questionnaire was subsequently assessed with the aid of lay people's opinions. Content validity was then evaluated by the expert panel regarding the relevancy, clarity, simplicity and necessity of the questionnaire's items. The items were corrected, substituted, or deleted, if necessary. To test its reliability, the questionnaire was distributed to 30 participants. They completed the test twice on two occasions separated by 10 days, and the reproducibility of the answers was found to be 85% indicating adequate reliability and stability of the questionnaire. To assess internal consistency, Cronbach's alpha was calculated and found to be 77%.
Six trained interviewers carried out data collection. To ensure uniformity in data collection and avoid interinterviewer variability, detailed information regarding the process of interviewing and ethical considerations were delivered by the main researcher in which interviewers received relevant guidelines on the ethical issues, questionnaire, and interview. Ethical clearance was obtained from the institutional review board, Vishnu Dental College. The data collected were analyzed using SPSS, version 21.0. Frequency tables, percentages, and cross-tables were generated. For comparison of knowledge with socio demographic variables, a t-test and one-way analysis of variance (ANOVA) were employed. Significance level was set at P < 0.05.
| Results|| |
The background characteristics of the 1300 participants are presented in [Table 1]. The mean age was 42.3 years, and 53.3% of the participants were males. Majority of the study population had education level up to high school level and were employed. Only 11.4% of the study population had a habit of smoking and 3.8% had a habit of alcohol consumption.
[Table 2] represents the responses of study population to the 14-item questionnaire revealing the knowledge scores. The lowest level of knowledge was related to Q9 (26.5%), Q10 (30%), and Q3 (42.3%). A majority of the participants had higher level of knowledge scores related to Q6 (95.2%) and Q11 (80.8%).
|Table 2: Distribution of respondents' answers to questions on periodontal disease knowledge|
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[Table 3] presents the mean periodontal disease knowledge scores in relation to the sociodemographic background variables. There was no significant difference in mean knowledge score among different gender and occupation groups (P > 0.05), and more highly educated respondents had higher knowledge and attitude scores than those of less educated (P < 0.001). Participants with high economic status had the highest periodontal disease knowledge (P = 0.015).
|Table 3: Distribution of scores for periodontal disease knowledge according to socio demographic background variables|
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| Discussion|| |
The belief and knowledge of people about periodontal health and disease is important in establishing preventive practice. The present study happens to be first of its kind to assess periodontal knowledge among adults of the West Godavari district in Andhra Pradesh. As per the recent scenario, the life span of individuals has increased who want to enjoy a healthy and long lifestyle in which a healthy smile plays a vital role. However, unfortunately, its importance is often underestimated, and the need for regular dental care cannot be underrated. The progression of periodontal disease usually remains unnoticed and goes on unrecognized until it reaches its advanced stage. Hence, this study presented a comprehensive view of awareness towards gingival and periodontal disease of adult population representative of district of the West Godavari district in Andhra Pradesh.
In our study, the periodontal knowledge score was significantly higher among 18–24 years age group when compared to other age groups, a finding also reported among Jordan and Sweden.,, On the other hand, no clear relationship between the periodontal knowledge score and gender was evident, which is in contrast with the findings of a study among Japanese young adults. In our study, people with higher income and higher educational status were related to a higher knowledge score; a similar finding emerged in a Swedish study among adults.
The questionnaire consisted of questions related to gum disease as periodontal knowledge is essential in maintaining good periodontal health. Around 52.8% of the population had knowledge concerned to caries or gum problems. In the present study, 42.3% reported that they tended to visit the dentist more often only in pain, which is in agreement with the study conducted by Taani DQ et al. The findings are similar with the reported findings of Savage et al., Almas et al., and Taani et al. The delay in visiting a dentist until the toothache is manifested attributes to the cost of dental treatment an easy go attitude of “treatment not necessary.”,,
Around 70.7% of the population agreed that regular toothbrushing is definitely necessary for the maintenance of periodontal health which is in agreement with the studies conducted by Vidya et al., Nyandindi et al., and Khan et al. 95.2% of the population used toothpaste for brushing the teeth and 4% used toothpowder; 0.8% were not aware of particular using of dentifrice.
Despite growing evidence regarding the bidirectional relationship between periodontitis and diabetes, most of the population in the study, accounting to about 70%, had no idea that diabetic condition had relationship with the periodontal disease which is in agreement with the study of Farah et al. When questioned further regarding the effect of systematic disease on periodontal health, 49.8% of population was not aware of the fact.
| Conclusion|| |
Our results showed poor periodontal knowledge among West Godavari population. Health education programs should place more emphasis on the causes and manifestations of periodontal disease. Appropriate interventions and strategies must be initiated for the prevention and control of periodontal diseases. Such programs may promote periodontal health and possibly decrease the need for future complex treatment and tooth loss.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3]