adya Sultan Ali1 , Mahjabeen Khan2 , Mashal Butt3 , Samreen Riaz4
1 Assistant Professor, Periodontology, DIKIOHS, DUHS,Karachi
2 Assistant Professor, Clinical Trial Unit, DUHS, Karachi
3 Lecturer ,Department of Periodontology,DIKIOHS,DUHS, Karachi
4 Lecturer, Department of Periodontology, , Karachi DIKIOHS, DUHS
Correspondence: Mahjabeen Khan 1 Assistant Professor, Periodontology, DIKIOHS, DUHS, Karachi
How to CITE:
AliNS, KhanM, ButtM, Riaz S. Implications of practices and perception on oral hygiene in patients attending a tertiary care hospital. J Pak DentAssoc. 2012 (1): 20-23
The objective of the present studywere to determine the oral hygiene practices and perceptions of patients attending Dr. Ishrat-ul- abad Institute of Oral health Sciences,Dow University Health Sciences,Karachi
Across-sectional questionnaire based survey was conducted during January to June 2011.A total of 1059 patientswere interviewed from a structured questionnaire at PeriodontologyDepartment of Dr. Ishratul-Ebad Institute of Oral Health Sciences, DUHS, Karachi. All patients seeking dental care at Outpatients Department were examined and interviewed by Dentists and Periodontist. The dental examinations were conducted focusing the oral hygiene as per standard oral hygiene practices.The study participantswere recruited by non probability convenience sampling. A structured questionnaire was used to collect information regarding practices and perception on oral hygiene.Datawas recorded and analyzed using SPSS version 16.
1059 respondents consented for interview regarding oral hygiene practices and perception.Most of the patients 694 (65.5%) belonged to 18-25 years of age.Most of the patients seeking dental care were female 684(64.6 %). The optimum oral hygiene practices and ideal perceptions 694 (65.5%)were found in age group 18-25 and were higher in females 684(64.9%) at significant level of 5%.
Oral health practices and perception vary based on age group and gender. The poor resources for dental care, common malpractices and the nonavailability of professional care were the main barriers in seeking optimumdental care.
Practices, Perception, oral hygiene,Oral health, ral hygiene,Bad oralHygiene
he understanding of actual practices in keeping the oral heath at standard based on patients’ perceptions of oral health care is vital.Oral hygiene is intimated in the health of all parts of the body. Oral health is generally a neglected aspect of health in developing countries. Oral health is about more than shining white teeth and sweet breath. The practices and perceived access barriers have been related to oral health. Several studies have been conducted, which were questionnaire based exploring different aspects of oral health. Some studies have shown that the gender differences were pronounced in female being more concerned about oral hygiene and their practices were optimum compared to men.Asurvey from Steele showed that 19-28% of all subjects were dental non-attendees. A perception that no need toclinical seek dental care was the commonest reason given by non-attendees. Patients’ perception of the quality of oral hygiene depends on their regular practices. Garbin proved that Ninety-eight percent (98%) Pateints knew about educative and preventive practices regarding oral health. However in developing countries this knowledge, practice and perceptions have been very poor Themajor perceived barriers were willingness to visit general and specialty dentists for treatment. The financial concerns of the patients and/or family were main reasons for not caring about oral hygiene. As low resources were available in urban facilities, but substantial barriers to care were uniformly perceived. Dental involvements in policy development from schools, provision of consultation and service have been limited in Pakistan. Priority given to oral health has been low because of lowfinances allocated and preferences in dealing with the multitude of other health problems. The failure to provide quality oral health care has been further aggregated by lack of or limited access to oral health care to the public by public sector hospitals.
Therefore a cross sectional hospital based study was conducted to determine the implications and the association between Practices and perception of oral hygiene and status of oral health in patients attending Dr. Ishrat-ul-Ebad Institute of Oral Health Sciences, DUHS, Karachi.
A cross-sectional questionnaire survey was conducted during January to June 2011. A total of 1059 patientswere interviewed from a structured questionnaire at Periodontology Department of Dr. Ishrat-ul-Ebad Institute of Oral Health Sciences, DUHS, Karachi. All patients seeking dental care at Outpatients Department were examined and interviewed by dentists and Periodontist.
All patients were included unless they refused to participate in the study.The dental examinations were conducted focusing the oral hygiene as per standard oral hygiene indicators. The study participants were recruited by non probability convenience sampling. A structured questionnaire was used to collect information regarding practices and perception on oral hygiene. A face to face interview was conducted to collect data regarding practices and perceptions regarding oralHygiene in urban population of Karachi. Data was recorded and analyzed using SPSS version 16. Descriptive statistics were calculated for response items and chi-square was implied for association of oral health and Practices and perception of oral hygiene among patients seeking care at public sector institute.
A total of 1059 respondents consented for interview regarding oral hygiene practices and perceptions.Most of the patients 694 (65.5%) belonged to 18-25 years of age. Most of the patients seeking dental care were female 684 (64.6%). There were 356 (33.6%) respondents with primary education as shown in Table I. Patients response ratewas 95.8%(n = 1059).
Majority of patients 868 (81.96%) were aware that oral hygiene play a pivotal role in over health of humans. The major bulk of patients 882 (83.2%) clean their teeth regularly and 510 (48.1%) clean their teeth once daily.
Mostly 932(88%) prefer teeth cleaning by tooth paste as shown inTable II.
Thirty-eight per cent stated an examination by a dentist in last year.Only 28%received emergent care. The optimum oral hygiene practices and ideal perceptions 694 (65.5%) were found in age group 18-25 and were higher in females 684 (64.9%) at significant level of 5%shown in Table III.
Patients had more expectations and practices were based on the preservation of natural teeth.The level of oral hygiene was measured based on health of soft and hard tissues of mouth. Currently global dental caries and periodontal disease comprise a considerable public health problem in the majority of countries. There have been wide disparities among developed and developing countries observed in epidemiologic indicators of oral disease. The prevalence rates of tooth loss and experience of oral problems vary according to income. The present study showed that 868(81%) respondents believe that oral hygiene has the mandatory role in over all body health and keeps them away from illness. Since this was an institutional based study in a major urban city of Karachi, therefore the awareness and practices were high among younger age group (153=67.1% and P value= .517). The good standard oral hygiene practices and perception were found in females (153=67.1%) compared to male (75=32.9%). There was no significant association of education levels overall. Patients with 14 years of education have shown that they (95=41.7%) had good practices and perception of oral hygiene compared to 85(34.3%) bad practices.
Experience of oral problems was high in low income countries and access to health carewas poor in rural areas. The study reported that (222=20.9%) had poor hygiene and they never visited anyDentist for any dental problem.
Tooth brushing is the most popular oral hygiene practice across the world, In our survey 932(88.0%) had preferred practices of using tooth paste, tooth powder (61=5.76%) and miswak (28=2.64%) respectively.
Although use of tooth paste have been extremely infrequent in most developing countries. Regular tooth brushing appears less common110 (10.4%) among patients at or more than 40 years of age. This finding has been consistent with several studies in developing countries. The traditional oral self-care is prevalent in several countries of Africa and Asia. While fluoridated toothpaste is widely used in developed countries Oral health services are available in developed countries; however, the use of such services is low among the older people.
According to the country reports, health promotion programmes reflects the lack of oral health policies. Worldwide there are few population-oriented preventive or curative activities currently implemented in developed high income countries. Therefore in developing countries like Pakistan lack of financial support from government rendered oral health services unaffordable to patients. In this current study reasons for avoiding dental examination were cost (487=45.9%), time (457=43.15%) and fear (115=10.8%) respectively. Other barriers were weak national health policy, the impact of poor oral health, and lack of trained dentist and institutes in oral health. An integration of oral health into national health programmes and availability of standard oral health services needs to be addressed on priority basis starting from school based service. The National Health Programmes for diabetes, hypertension and liver diseases should be integrated with oral health to be effective to improve the oral hygiene in our population.
Forty three percent of the subjectsweremale and 57% were female. Forty four percent of themale and54% of the female revealed self-perception malodor and rated their oral health as poor, 46% reported a dental visit within the previous year and68%felt they needed dental treatment.A lack of perceived need (88%) was the primary reason why dental care was not sought more frequently. Brushing was prevalent among 81% of male and 99% of female students. Both miswak (chewing sticks) and tooth brushing were used by 53% male and 83% female students.
Frazo conducted an interventional study through health care workers counseling to patients in the community and reported that health care worker can play a pivotal role in modifying practices and perceptions for oral hygiene.
Shah reported from Dehli India that dental caries were more in rural compared to urban communities. This was based on oral hygiene practices and perception. We also found the similar results from this study Good oral health outcomes for patients are defined as the primary purpose of dental practice and, therefore, an essential dimension of success. The link between positive patient perceptions of general care and his/her own oral health to practice success is explored. ,Current evidence highlights the importance of maintaining good oral health during pregnancy. Most women were unaware of link between oral health and maternal child health. This finding has been consistent with the other studies.
The determinant of the oral hygiene practices and perceptions of patients attending Dr. Ishrat-ul- abad Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi showed association among the dental hygiene and their poor practices and perception. Therefore programmes for further care and research in the urban population are needed on priority.
Oral health practices and perception vary based on age group and gender. The poor resources for dental care, common malpractices and the nonavailability of professional care were the main barriers in seeking optimumcare.
Conflict of Interest:
The authors declared no conflict of interest for this study
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