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 Table of Contents  
Year : 2021  |  Volume : 2  |  Issue : 2  |  Page : 40-43

Basic oral health knowledge and awareness among rural adults: A Cross-Sectional Study

1 Department of Orthodontics, Dr. B Smiles (Dental Surgery), Wappingers Falls, NY, USA
2 Department of Conservative Dentistry and Endodontics, SKSS Dental College and Hospital, Ludhiana, Punjab, India
3 Department of Orthodontics and Dentofacial Orthopaedics, Bahra Dental College and Hospital, Mohali, Punjab, India
4 Department of Prosthodontics, Crown and Bridge, Bahra Dental College and Hospital, Mohali, Punjab, India
5 Department of Public Health Dentistry, Karnavati School of Dentistry, Gandhinagar, Gujarat, India
6 Department of Public Health Dentistry, Rayat and Bahra Dental College and Hospital, Mohali, Punjab, India

Date of Submission01-Mar-2021
Date of Decision29-Mar-2021
Date of Acceptance04-Apr-2021
Date of Web Publication24-Jun-2021

Correspondence Address:
Ramandeep Singh Gambhir
Department of Public Health Dentistry, Rayat and Bahra Dental College and Hospital, Mohali, Punjab
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpcdoh.jpcdoh_12_21

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Background: It is very important to identify common oral health problems particularly in rural areas and create awareness for the same so that people can make informed choices. This study was conducted among the adult population residing in rural areas to assess their oral health knowledge and awareness. Materials and Methods: A descriptive cross-sectional study was conducted among adult population residing in rural areas around the dental clinic. A total of 662 participants constituted the final sample size after making necessary exclusions. A self-designed close-ended questionnaire written in English and Punjabi (local language) was constructed specifically for the study. The questionnaire was split into two sections. Analysis of variance and t-test were used in statistical analysis. Results: Majority of the participants (450, 68%) were male and 42.6% (282) of participants were in the age group of 41–50 years. Only 38% (251) of participants gave a positive response when asked about the importance of good oral health. About 40.2% (264) of participants believed that dental problems get cured solely by medicines. Low knowledge scores were recorded in 38.2% (252) of participants. Mean knowledge scores of the study participants were significantly associated with education (0.016) and occupation (0.027). Conclusion: Oral health knowledge and awareness among majority of study participants were not satisfactory. Therefore, the study emphasizes an urgent need for dental awareness and education programs targeting the rural masses.

Keywords: Adult, awareness, India, oral health, oral hygiene

How to cite this article:
Bhangu AK, Dhillon M, Ghuman KS, Kumar M, Goel R, Gambhir RS. Basic oral health knowledge and awareness among rural adults: A Cross-Sectional Study. J Prim Care Dent Oral Health 2021;2:40-3

How to cite this URL:
Bhangu AK, Dhillon M, Ghuman KS, Kumar M, Goel R, Gambhir RS. Basic oral health knowledge and awareness among rural adults: A Cross-Sectional Study. J Prim Care Dent Oral Health [serial online] 2021 [cited 2021 Dec 3];2:40-3. Available from: http://www.jpcdoh.org/text.asp?2021/2/2/40/319192

  Introduction Top

Oral diseases can cause disability to perform daily functions if they remain hidden and are not treated in the initial stages. Maintaining a good oral profile requires joint efforts from the dental health professional as well as the patient himself.[1] No perceived need and having no serious dental problems were among the two most commonly cited reasons by participants for not visiting a dentist according to some study reports.[2] One of the most important factors that contribute toward good oral health of a population is the outlook of its people toward their dentition.[3]

India, a developing country, faces numerous hurdles in delivering oral care to the needy population due to the unequal distribution of dental health professionals in urban and rural areas. Moreover, overall health is directly influenced by an individual's knowledge regarding oral health.[4] A study was conducted among some participants aged 50 years or above in a rural part of India.[5] Certain myths that prevailed in the study population were tooth loss is an extension of old age, dental caries can be prevented by chewing tobacco, oral diseases can be cured by taking medicines only, loss of vision can occur due to tooth extraction, and oral prophylaxis causes loosening of teeth.[5] These myths proved to be a hurdle in the utilization of dental services by the people. Due to this, impending dental problems of people, later on, multiply and affect the overall health.[6]

Rural people make up for >70% of the Indian population, therefore carefully executed community outreach programs targeting oral health can bring a positive change in oral health behavior of this population.[7] Although many studies have been done to assess knowledge and awareness of people in the recent past, data regarding the majority of the Indian rural population are still lacking. Therefore, the aim of this particular study was to assess oral health knowledge and awareness in an adult population residing in a rural area of Punjab, India.

  Materials and Methods Top

Ethical clearance

Ethical clearance to conduct the present study was obtained from the Institutional Ethics Committee and concerned health authorities. Participation in the study was voluntary and informed consent was obtained from those study participants who were willing to participate. Moreover, any type of information disclosing the identity of the patient was not collected.

Study population and study sample

A descriptive cross-sectional study was conducted among adults residing in villages (rural area) around the dental clinic (Amloh, Punjab, India). Adult population comprised patients who visited the dental clinic for their treatment for a period of 2 months. The following formula was used to calculate the required sample size:

where Z is the standard normal score with 95% confidence interval (α = 0.05), S is the standard deviation of the variable, and d is the maximum acceptable error. After applying the formula, 662 participants constituted the final sample size. These were enrolled in the study using systematic random sampling methodology. Participants who were systemically ill and unwilling to participate were excluded from the study. All the participants were asked to fill the questionnaire according to the response format provided in the questionnaire.

Questionnaire/research instrument

A self-designed close-ended questionnaire written in English and Punjabi (local language) was constructed specifically for the study. The content of the questionnaire was verified by oral health specialists and it was pretested for validity and reliability. The reliability of the questionnaire was good (0.84). The participants were made fill the questionnaire while they were seated in the waiting area of the clinic. During this time, one of the investigators made sure that concerned participants fully understood the questions. The questionnaire was split into two sections-A “General Section” (Section A) which was made to collect sociodemographic details of the participants (age, gender, occupation, education, etc.). Section B (Knowledge section) which comprised 12 questions on oral health such as number of primary and permanent teeth, smoking and chewing tobacco, and gathering oral health information. Total score was calculated on the basis of each participant's response. Score of “1” was given to each positive response and score of “0” was awarded to each negative response. The total score was calculated by adding the sum of responses (from 1 to 12), on a Likert Scale. Categorization of final score was done at three levels-low (0–4), medium (5–8), and high (9–12).

Statistical analysis

Categorical measurements were done using number and percentages. SPSS package version 19.0 (SPSS, Chicago, IL, USA) was used for statistical analysis. Analysis of variance test was used and Student's t-test was used to find significance between different groups. The significance level was set at < 0.05.

  Results Top

Demographic profile of participants

A total of 662 participants were included in the present study. Majority of the participants (450, 68%) were males and 42.6% (282) of participants were in the age group of 41–50 years. Educational background of the participants revealed that 63.1% (418) of participants had level of education between the 6th and 12th class. Occupational profile of participants depicted that 62.2% (412) were self-employed and 17.2% (114) were engaged in government job [Table 1].
Table 1: Distribution of study participants according to sociodemographic characteristics

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Response to questionnaire/research instrument

Participants' response toward questionnaire regarding oral health is depicted in [Figure 1]. More than one-third of participants (38%, 251) gave a negative response when asked about the importance of good oral health. Majority of the participants (77.5%, 513) used to clean their teeth at least once a day. More than 50% (366) of participants were of the opinion that loss of teeth with age is normal. Around 22% (144) of participant still believed that smoking and chewing tobacco is not harmful for oral and general health. A positive response was given by only 31.5% (208) of participants when they were asked whether oral health can affect general health. More than one-third of the participants (40.2%, 264) believed that dental problems get cured solely by medicines. Interest in gathering oral health information was shown by only 44% (291) of participants.
Figure 1: Subjects' response on various questions regarding oral health

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Knowledge/awareness level of participants

Only 30.5% (203) of participants reported high knowledge scores and 38.2% (252) of participants were having low scores [Table 2]. There was a statistically significant association of mean knowledge scores with education level (P = 0.016) and occupational profile (P = 0.027) of the participants [Table 3].
Table 2: Oral health knowledge scores of study participants on the basis of Likert Scale

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Table 3: Mean knowledge scores of participants according to different sociodemographic variables

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  Discussion Top

Oral hygiene plays a very crucial role in the prevention and treatment of many diseases, especially dental caries and periodontal disease. Not maintaining good oral health can lead to bigger problems which later on become difficult to treat. The present study engaged rural-based population as target because such population groups neglect their oral health, as they focus mainly on pain relief and emergency dental care.[8] Awareness regarding oral health was not satisfactory in the study participants as less than one-third of participants presented with high knowledge scores.

More than one-third of participants in the present study did not consider it necessary to keep good oral health. Similar findings were observed in some other studies conducted on another rural population.[9] This emphasizes the need for oral health awareness programs targeting this vulnerable population.

In the present study, 77.5% of participants cleaned their teeth daily, which is lower as compared to the study findings of Salunke et al.[7] Some other studies also reported that awareness of oral health practices was low, especially in rural communities in India.[10] More than 50% of participants in the study believed that tooth loss is a natural squeal of aging process which is more as compared to some other study reports.[11] These beliefs can prevent participants from consulting a dentist during certain times when teeth can be saved.

More than two-third of the study participants believed that oral health problems have nothing to do with general health and well-being. This finding is in congruence with the findings of some other study conducted by Singh et al.[11] However, this finding was in contrast to results of another study.[12] It is an established fact that four most prominent noncommunicable diseases-cardiovascular diseases, diabetes, cancer, and chronic obstructive pulmonary diseases, also share common risk factors with oral diseases.[13] Therefore, awareness can be created regarding all these facts so that people can lead a healthy and longer life.

Dental problems cannot be cured solely by taking medicines; a visit to a dental professional is necessary. More than one-third of participants in the study (38.2%) thought that taking medicines alone can cure dental problems and majority of times resort to self-medication as reported by a study conducted in Uttar Pradesh, India.[14] This shows that their knowledge and awareness regarding oral health are poor.

Only 44% of participants showed interest in gathering oral health information. Oral health promotion strategies need to be implemented among the rural masses in order to educate, motivate and spread the awareness regarding oral health in order to maintain good oral hygiene.

Awareness regarding oro-dental health highly depends on one's educational level and occupation (socioeconomic status indicators). This fact is supported by the results of the present study as mean knowledge scores were significantly associated with education level and type of occupation of study participants (P < 0.05). Similar findings were observed in some other studies also.[11],[15],[16]

The present study had some limitations as well. Due to limited time and resources, detailed data on oral hygiene practices and the presence of deleterious habits was not obtained from study participants. This could have impacted the results to some extent. Moreover, the study sample comprised participants who were residing in villages situated within 10–15 km of the dental clinic. Therefore, the results of the study should be interpreted with caution. Similar studies engaging a larger sample and including other valuable information should be conducted in future.

  Conclusion and Key Recommendations Top

Oral health knowledge and awareness among the majority of study participants were not satisfactory as depicted from their knowledge scores. Therefore, there is an urgent need for dental awareness and education programs, especially targeting the rural population.

  1. Primary health centers and community health workers do not address the topic of oral health, and there is scarcity of dental health professionals in rural areas of India, where majority of population resides.[17]
  2. There is an utmost need for comprehensive oral health education programs among the rural masses.
  3. Setting up subsidized dental care facilities close to rural populations along with mobile dental clinics and dental screening and treatment camps can surely reduce oral health disparities between rural and urban population.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

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Varghese CM, Jesija JS, Prasad JH, Pricilla RA. Prevalence of oral diseases and risks to oral health in an urban community aged above 14 years. Indian J Dent Res 2019;30:844-50.  Back to cited text no. 2
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  [Table 1], [Table 2], [Table 3]


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