| Abstract|| |
Aim: This study aims to evaluate the knowledge and awareness of periodontal disease, its etiology and management among medical professionals.
Materials and Methods: The 300 medical professionals included in this questionnaire-based survey comprised of doctors from government medical colleges and consultants in various specialties in private hospitals and clinics. The participants comprised of equal numbers of subjects in the medical profession including interns, postgraduates, and consultants.
Results: The results from the questionnaire-based survey indicated that knowledge about periodontal terminologies was high among medical professionals. However, mixed response was elicited regarding the etiology, treatment, and current trends in periodontal practice.
Conclusion: Awareness and knowledge of periodontal terminologies, the etiopathogenesis, treatment options and the current therapeutic trends amongst medical professionals can greatly contribute towards motivating patients for treatment and also provide necessary referrals.
Keywords: Awareness, medical personnel, periodontics
|How to cite this article:|
Sivaram G, Kumar D, Hariepriya P, Jeyaruby J. Periodontal knowledge and awareness among South Indian medical professionals: A questionnaire-based survey. J Educ Ethics Dent 2016;6:85-8
|How to cite this URL:|
Sivaram G, Kumar D, Hariepriya P, Jeyaruby J. Periodontal knowledge and awareness among South Indian medical professionals: A questionnaire-based survey. J Educ Ethics Dent [serial online] 2016 [cited 2020 Apr 7];6:85-8. Available from: http://www.jeed.in/text.asp?2016/6/2/85/223006
| Introduction|| |
Complete or partial edentulism is a common problem affecting the majority of the population worldwide. Periodontal disease is one of the common causes for tooth loss in the urban and suburban population. The Asian population, in particular, has been reported to have the third highest prevalence of periodontitis. India with its vast and diverse population has a 100% prevalence of periodontal disease. Advanced periodontal disease marked by pocket formation and bone loss that finally results in tooth loss may affect 40%–45% of the population of India. The loss of dentition can have an overall effect on an individual's well-being. In developing countries such as India, awareness among the population is limited in terms of identifying the signs and symptoms of periodontal disease, its progression and long-term effects. Most of the people seek periodontal treatment at an advanced stage of disease  in which salvaging the natural tooth often proves to be difficult. To prevent unnecessary tooth loss and create an awareness among the general population, it is imperative for medical professionals to possess awareness and knowledge  about the etiopathogenesis of Periodontal disease and the available treatment options. This questionnaire-based survey aims at evaluating periodontal awareness among medical professionals.
| Materials and Methods|| |
Three hundred medical professionals comprising of interns, postgraduates, and consultants were included in the survey. These medical professionals were randomly selected from various government medical colleges and private hospitals in Chennai.
The survey was conducted through a questionnaire-based response and to avoid bias in sample size, equal number of subjects was sampled. The subjects included 100 interns, 100 postgraduates, and 100 consultants. Informed consent was obtained from the respective colleges and hospitals before distribution of the questionnaires to the respondents at their place of work.
The questionnaire was broadly categorized into four major subsects:
- Knowledge and awareness about periodontal terminologies (Question 1–3)
- Role of multifactorial etiology in periodontal disease (Question 4–12)
- Concepts about treatment (Question 13–17)
- Current trends in periodontal practice (Question 18–26).
The obtained samples were pooled together and categorized into four groups, and statistical analysis was performed using Pearson's Chi-square test.
The questionnaire used for the survey is given in [Table 1].
| Results and Discussion|| |
The questionnaire used in the present survey was broadly grouped into four categories comprising of periodontal terminologies, etiology of periodontal disease, treatment concepts, and current trends in periodontal treatment modalities.
The knowledge of periodontal terminologies  among medical professionals was found to be outstanding in the present survey. Majority of the participants were able to recognize the various periodontal terminologies, and the results were found to be statistically significant (P ≤ 0.05). The medical professionals were aware of commonly used periodontal terminologies such as gingival recession, halitosis, and epulis [Table 2].
|Table 2: Knowledge and awareness about periodontal terminologies among medical professionals|
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Periodontal disease is found to be multifactorial in nature. In terms of the etiology and pathogenesis ,, of periodontal disease, majority of health-care professionals (275 participants) believed calculus to be the main etiological agent for initiating periodontal disease. Around 253 respondents believed that genetic factors also contribute to the periodontal disease process. Genes play a role in the predisposition and progression of periodontal diseases. These results were found to be statistically significant as well (P ≤ 0.05) [Table 3].
In terms of risk modifiers and risk indicators, majority believed that smoking had deleterious effects on periodontal tissues and can contribute to early tooth loss. This result was found to be statistically significant (P ≤ 0.05). Smoking interacts and compounds effects of various systemic conditions, resulting in greater disease severity [Table 3].
Periodontal disease has a two-way relationship as far as systemic health  is concerned. Periodontal disease is considered to be the 6th major complication of diabetes mellitus and constitutes an important risk factor as well. However, other systemic diseases when considered to be risk factors of periodontal disease were not found to be statistically significant (P > 0.05) [Table 3].
Most of the medical professionals in this study believed that gingival hyperplasia was drug induced and did not consider other contributing factors [Table 3]. Very few individuals believed that factors such as hormonal changes and deposits also contribute to gingival hyperplasia. This result was found to be statistically significant (P ≤ 0.05).
Awareness is also high about occurrence of dentinal hypersensitivity  to hot and cold foods in case of root exposure as 235 participants were aware of dentinal hypersensitivity and its causes [Table 3].
Medical professionals believed that the long-term periodontal health was achieved by periodic recall and maintenance. However, there was a difference in opinion regarding the frequency of dental visits, but majority of the respondents (192 participants) firmly advocated dental visits once in 6 months. This response was statistically significant too (P ≤ 0.05) [Table 4].
Advanced periodontal care for periodontally compromised patients seemed to be a mandatory treatment protocol. One hundred and eighty-four medical professionals from the present survey indicated that surgical approach  was a better treatment option to effectively remove subgingival deposits. Among the present subject group, there was a misconception that routine scaling could cause removal of tooth substance with 158 professionals replying in the affirmative. In tooth mobility due to periodontal disease, most of the practitioners (219 participants) believed that extraction  is the best-treatment option.
Two hundred professionals agreed that acute gingival and periodontal disease called for additional treatment apart from systemic antibiotic intake. Only 133 of the professionals surveyed were aware about local delivery of systemic antibiotics; hence, it is statistically insignificant (P > 0.05) [Table 4].
Smile designing is not restricted to an esthetic makeover alone but involves the development of a stable masticatory system, wherein the teeth, tissues, muscles, skeletal structures, and joints all function in harmony. It requires comprehensive treatment planning to achieve successful restoration of a smile that is functionally sound and esthetically pleasing. An understanding of the interrelationship among the various components of the oral masticatory system including the teeth, muscles, bones, joints, gingival tissues, and occlusion is essential. Knowledge of smile designing by means of dental treatment to achieve an esthetic smile was statistically insignificant among medical professionals (P > 0.05) [Table 5].
The overall awareness among medical professionals about the current trends in periodontal practice was higher regarding various treatment modalities. When questioned about plastic surgery, microsurgery, and LASER's  in dentistry, 136 professionals were aware that these treatment modalities could be used in dentistry [Table 5].
The reconstruction of osseous defects caused by inflammatory periodontal disease is a continuing challenge in periodontal therapy. Periodontal regeneration refers to the complete restoration of functional supporting tissue, including alveolar bone, cementum, and the periodontal ligament. Regeneration of the periodontal attachment apparatus is the ultimate goal of periodontal therapy. Awareness about regenerative periodontal therapy aided by bone grafts and biological mediators  was comparatively low among the interns with only 46 participants replying in the affirmative [Table 5].
One hundred and thirty-seven of the professionals were aware that host modulation therapy  can be used as an adjunct in preventing the progression of periodontal disease. Awareness about stem cells used to regenerate lost periodontal tissue was higher among consultants with 83 participants replying positively [Table 5].
Dental implants used for replacement of lost teeth were well accepted as a treatment modality among the health-care professional groups as 234 participants responded in the affirmative. This result was found to be statistically significant (P ≤ 0.05) [Table 5].
The disadvantages of this questionnaire-based study would be the presence of a certain degree of subjectivity that is not acknowledged. Differences in understanding and interpretation of the questions by the respondents as opposed to the original purpose of the study can cause a miscommunication leading to skewed results. Lack of conscientious responses can affect the validity of the study. Researcher imposition can lead to missing other important aspects. A larger sample size and including rural centers may provide better insight and help create awareness.
| Conclusion|| |
Within the present scope of study, the results indicated that there was good amount of knowledge and awareness among health-care professional groups. This should be utilized in counseling, educating, and motivating patients to maintain a good oral health status and also provide referrals to specialized dental facilities for further treatment when required.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Albandar JM, Rams TE. Global epidemiology of periodontal diseases: An overview. Periodontol 2000 2002;29:7-10.
Ramfjord SP, Emslie RD, Greene JC, Held AJ, Waerhaug J. Epidemiological studies of periodontal diseases. Am J Public Health Nations Health 1968;58:1713-22.
Shah N. Oral and Dental Diseases: Causes, Prevention and Treatment Strategies. NCMH Background Papers-Burden of Disease in India (New Delhi, India). New Delhi: Government of India, National Commission on Macroeconomics and Health, Ministry of Health and Family Welfare; 2005. p. 275-98.
Madhankumar S, Singarampillay V, Natarajan S. Oral hygiene awareness among 2 non-professionals college students in Chennai. Int J Sci Res Public 2012;2:2250-31.
Pralhad S, Thomas B. Periodontal awareness in different health care professionals: A questionnaire survey. J Educ Ethics Dent 2011;1:64-7. [Full text]
American academy of Periodontology, Gloss of periodontal terms 4th
Newman M, Takei H, Klokkevold P, Carranza F. Etiology of periodontal diseases. Carranza's Clinical Periodontology. 10th
Edition, Saunders Co., Lindo,2006; 1: 133-275.
Srinidhi S, Ingle NA, Chaly PE, Reddy C. Dental awareness and attitudes among medical practitioners in Chennai. J Oral Health Comm Dent 2011;5:73-8.
Gur A, Majra J. Awareness regarding the systemic effects of periodontal disease among medical interns in India. J Glob Infect Dis 2011;3:123-7.
Newman M, Takei H, Klokkevold P, Carranza F. Periodontal pathology. Carranza's Clinical Periodontology. 10th Edition, Saunders Co., Lindo,2006; 1: 373-391.
Subhashraj K, Subramaniam B. Awareness of the specialty of oral and maxillofacial surgery among health care professionals in Pondicherry, India. J Oral Maxillofac Surg 2008;66:2330-4.
Subhashraj K. Awareness of management of dental trauma among medical professionals in Pondicherry, India. Dent Traumatol 2009;25:92-4.
Dr. G Sivaram
Department of periodontics, Ragas Dental College and Hospital, Uthandi, Chennai - 600 119, Tamil Nadu
Source of Support: None, Conflict of Interest: None
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]