ijlpr 2020; doi 10.22376/ijpbs/lpr.2020.10.1.P57-62
International Journal of Lifescience and Pharma Research
Prosthodontics for Dental Health
Research Article
Knowledge Awareness and Perception towards Prosthodontics Treatment and Services
among Medical Students in Jeddah City, Saudi Arabia- A Cross Sectional Pilot Study
Dr Karunakar Shetty* BDS, MDS (Prosthodontics), FICOI; Fatima Alzahra Ansari, BDS; Nada Ibrahim Alzurqi, BDS; Arwa
Ahmed Althagafi, BDS and Raniyah Abualnour BDS
* Associate Professor, Dentistry Program, IBN Sina National College of Medical Sciences, Jeddah, Kingdom of Saudi Arabia
Abstract: Prosthodontics is concerned with the design, manufacture and fitting of artificial replacements for teeth and other parts of the mouth.
Prosthodontic treatment involves the replacement of missing teeth by means of removable or fixed partial denture, implants, complete dentures,
or over dentures. The aim of this study was to evaluate the level of knowledge, perception, awareness and attitude of the medical students
towards Prosthodontic treatment. A cross-sectional, Questionnaire based study was conducted among Medical students, covering various Medical
colleges in Jeddah city. The study population was selected using cluster random sampling. Altogether 151 undergraduate medical students
throughout Jeddah city participated in this study. The data was collected, compiled, and statistically analyzed using SPSS software version 21 and
Chi-square test, t-test, and ANOVA. was performed A total of 151 participants, out of which there were 88 female participants (58.3%) and 63
male participants (41.7%), completed and returned the questionnaire. 134 participants (88.7%) were aware that missing teeth could be replaced
and 17 participants (11.3%) were unaware. 93 participants (61.6%) felt implant Supported Prosthesis is a better Option for replacement of missing
teeth and 58 participants (38.4%) did not feel so. 75 participants (49.7%) chose fixed partial denture as an option for replacement of missing teeth
whereas 76 participants (50.3%) opted for removable partial denture. 64 participants (42.4%) had fear of prosthodontic replacement and 87
participants (57.6%) had no fear. Within the limitations of this study, following conclusions were drawn: Majority of the medical students was
aware that missing teeth could be replaced. Most of them thought Implant supported prosthesis would be a better option for replacing missing
teeth. Equal number of participants opted for fixed prosthesis. The most important finding of this study was that majority of the participants
showed a lack of knowledge regarding oral hygiene measures with dental prosthesis.
Keywords: knowledge, awareness, prosthodontics, dental implants, Oral health.
*Corresponding Author
Recieved On 08 November 2019
Dr Karunakar Shetty* , Associate Professor, Dentistry
Program, IBN Sina National College of Medical Sciences,
Jeddah, Kingdom of Saudi Arabia
Revised On
06 December 2019
Accepted On 28 December 2019
Published On 06 January 2020
Funding
This research did not receive any specific grant from any funding agencies in the public, commercial or not for profit sectors.
Citation
Dr Karunakar Shetty*, Ficoi; Fatima Alzahra Ansari,Nada Ibrahim Alzurqi, Arwa Ahmed Althagafi,Raniyah Abualnour , Knowledge,
Awareness, and Perception towards Prosthodontic Treatment and Services among Medical Students in Jeddah City, Saudi ArabiaA Cross Sectional Pilot Study.(2020).Int. J. Life Sci. Pharma Res.10(1), P57-62 http://dx.doi.org/10.22376/ijpbs/lpr.2020.10.1.P57-62
This article is under the CC BY- NC-ND Licence (https://creativecommons.org/licenses/by-nc-nd/4.0)
Copyright @ International Journal of Life Science and Pharma Research, available at www.ijlpr.com
Int J Life Sci Pharma Res., Volume10., No 1 (Jauary) 2020, pp P57-62
P-57
ijlpr 2020; doi 10.22376/ijpbs/lpr.2020.10.1.P57-62
1.
INTRODUCTION
Health is no longer seen solely as the absence of illness and
disease. Rather it is the complete physiological, psychological
and social well-being of a person1Health related quality of life
is an emerging subject of importance during recent years.
This is based on the realization that the effects of a disease
or condition cannot be fully determined by using solely
clinical measures; since these do not take into consideration,
the subjective experiences that individuals have concerning
their health 2 Oral health is an essential element of health
throughout life. Poor oral care and oral health problems can
have a significant impact on quality of life. However, oral
problems are affecting the human race since ancient times,
and they are considered as one of the problems for health
issues. Tooth loss can have a negative impact on facial
appearance, speech, and mastication. The replacement of
missing teeth by appropriately designed prostheses is in
demand, and is required to maintain a good health status and
normal life3 Medical practitioners should play an active role in
oral health promotion4 Proper knowledge of oral diseases is
crucial in medical practice due to the following reasons: (a)
Periodontal diseases are associated with multiple systemic
conditions of medical interest, (b) A large number of
systemic diseases have oral manifestations, (c) Many drugs
are associated with oral adverse drug reactions5,6 and (d) the
majority of the population approach medical practitioners for
their oral health problems. Hence, early screening and
proper referral by these professionals may benefit to
improve the access to oral health problems and to reduce
the associated morbidity and mortality. The need of the hour
is for general practitioners to have adequate knowledge
about oral health as they are the one to whom the majority
of the population approach. The prevention of oral disease is
the most acknowledged and efficient method of ensuring oral
health 6. Oral health is now known to be equally important in
relation to general health7.
Written and visual media and
dentists are the most common sources of receiving oral
health information8 To redirect the focus of oral-health
professionals toward effective preventive interventions and
to enable them to motivate their parents to adopt healthy
behaviors, special educational programs need to be
integrated into undergraduate training and made available to
established clinicians as required9,10. Though oral health has
an important role in systemic health, it is often neglected11,12.
The awareness and knowledge of dentistry is still grossly
inadequate among many patients and health care workers
.The implication of this is that the vast majority of patients
who should benefit from dental services or be referred for
their various dental ailments would be unable to assess the
services due to the poor awareness and knowledge of
dentistry by the attending health care providers13. Medical
doctors are the primary caregivers for the vast majority of
health related complaints and they are also expected to play
active roles in oral health promotion3. As such, family
physicians and pediatricians have much more important roles
to play and when their knowledge of dentistry and oral
health care practices are low or poor, inappropriate dental
management and advice or referrals of patients will be the
likely outcome. Similar trends were found among medical
students in the study by Adeghe et al in which their
knowledge of oral health was described as suboptimal since
only 2.8% of the 279 medical students had good knowledge
of dental specialties13 Nurses also play vital roles in the
health care of patients along with medical doctors14.They
represent one of the first groups of health care providers
drkarun16@gmail.com
fatima_1117@hotmail.com,na
Dentistry (prosthodontics)
that give primary care to patients before referral to specialist
doctors15. It has been observed that medical doctors do not
know much about various common dental problems,
consequences of not treating dental patients at appropriate
times, various specialists dental branches etc., although they
have a dental posting of 2 weeks during their MBBS
curriculum 16. Today’s students are tomorrow’s doctors and
the knowledge they are going to acquire at present will be
reflected in the future during their practice. Exploration of
literature reveals that only few studies have assessed oral
health awareness among undergraduate medical students. So,
the present study was conducted with an aim to assess oral
health awareness among undergraduate medical students in
Jeddah city .
2
MATERIALS AND METHODS
A cross-sectional, questionnaire based study was conducted
among medical students, covering various medical colleges in
Jeddah city. This study was conducted to assess the
knowledge,
awareness,
and
perception
towards
prosthodontic treatment and services among medical
students in Jeddah city. Ethical clearance was obtained from
the Institutional Ethical committee with approval number H18-11072019. A specially designed questionnaire consisting of
close ended questions was used. The questionnaire was pilot
tested for validation on a small group of ten medical
students, who were requested to complete it and to indicate
any question that they found unclear. The necessary
modifications were made in the final questionnaire, which
was divided into 2 parts based on knowledge and attitude.
The knowledge questions help to know about the awareness
and relevant information whereas the attitude questions give
us information about their attitude towards prosthodontic
treatment and no prior knowledge is assumed. The study
population was selected using cluster random sampling.
Altogether 151 medical students throughout Jeddah city
participated in this study, their name was not recorded to
ensure anonymity. Medical students not willing to participate
in this study were not included. The students were
approached through the medical colleges in which they were
studying and each medical college formed a cluster. The
required permission for data collection was obtained from
the heads of the institutions through proper channel and
following the necessary protocol. The participants were
randomly selected and the purpose of the study was
explained to them. The questionnaire was distributed to
them by the investigator, and all the questions were
explained to avoid any ambiguity. They were assured of the
confidentiality of their responses and were requested to give
appropriate answers. The filled questionnaire was collected
on the same day and the study was completed by 2 months.
3
STATISTICAL ANALYSIS
The data were tabulated and analyzed using the Statistical
Package for the Social Sciences (SPSS) version 21 (SPSS Inc,
Chicago, IL). Chi-square test was used to compare the
knowledge, awareness and perception of the medical
students towards prosthodontic treatment. P-value of less
than 0.05 was considered statistically significant, and a p-value
of less than 0.001 was considered strongly significant.
4
RESULTS
A total of 151 students, consisting of 88 female participants
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(58.3%) and 63 male participants (41.7%) completed and
returned the questionnaire. (Table1). Based on the
knowledge questions(TABLE 2),134 participants (88.7%)
were aware that missing teeth could be replaced and 17
participants (11.3%) were unaware. 93 participants (61.6%)
felt implant supported prosthesis is a better Option for
replacement of missing teeth and 58 participants (38.4%) did
not feel so.87 participants (57.6%) were aware that
replacement of missing teeth could be done in a dental
college in the vicinity and 64 participants (42.4%) were
unaware. 64 participants (42.4%) felt that the quality of their
life improves after prosthetic treatment and 87 participants
(57.6%) did not feel so. 77 participants (51%) of them felt
masticatory ability improves after prosthetic treatment and
74participants (49%) felt it does not have any effect.
31participants (20.5%) felt that prosthesis needs oral hygiene
maintenance as natural teeth and 120participants (79.5%) did
not feel so. Based on the attitude questions (table 3), 75
participants (49.7%) chose fixed partial denture as an option
for replacement of missing teeth whereas 76 participants
(50.3%) opted for removable partial denture. 64 participants
(42.4%) had fear for the prosthodontic replacement and 87
participants (57.6%) had no fear. 100 participants (66.2%)
were content with dental prosthesis and 51 participants
(33.8%) were not. 68 participants (45%) would allow dentists
Dentistry (prosthodontics)
to decide prosthetic treatment for them and 83 participants
(55%) would decide on their own. 82 participants (37%) were
willing to discuss prosthetic treatment options with their
family members and 69 participants (45.5%) did not wish to.
37(24.5%) of them felt prosthodontic treatment would be
very expensive and 114 participants (75.5%) did not feel so.
Spearman’s correlation between knowledge and attitude
score was 0.234 (0.004%) which was statistically significant.
(Table 4). Regarding gender wise comparison of knowledge
and attitude based on Spearman’s correlation, female score
was -0.198 (0.065%) and male score was -0.134 (0.293)
(Table 5). Regarding gender wise comparison of the
knowledge scores, a good score for females was 51 (58%)
and for males it was 42 (66.7). Poor score for females was 37
(42%) and for males it was 21 (33.3%). The total good score
was 93 (61.6%) and poor score was 58 (38.4%) and Chisquare value was 1.17 with p value 0.27, which was
statistically not significant (Table 6). Regarding gender wise
comparison of the attitude scores, negative score for females
was 52 (59.1%) and for males it was 35 (55.5%) with total
negative score being 87 (57.6%). The positive score for
females was 36 (40.9%) and for males it was 28 (44.4%) with
total positives core being 64 (42.4%). Chi-square value was
0.188 and p value was 0.66, which was statistically not
significant. (Table 7)
Table 1. Distribution of the subjects based on gender
Frequency
Percent
Females
88
58.3
Males
63
41.7
Total
151
100.0
Table 2. Knowledge Based Questions
K1: Are You Aware That Missing Teeth Can Be Replaced?
K2- Do You Think Implant Supported Prosthesis Is A Better Option
K3: Are you aware that there is a Dental college where replacement of missing teeth is
done in your district?
K4: Will quality of your life improve after prosthetic treatment
K5: Will your masticatory ability improve after prosthetic treatment
K6: Do you think that prosthesis needs oral hygiene maintenance as natural teeth?
Yes
No
Total
Yes
No
Total
Yes
No
Total
Yes
No
Total
Yes
No
Total
Yes
No
Total
Frequency
134
17
151
93
58
151
87
64
151
64
87
151
77
74
151
31
120
151
Percent
88.7
11.3
100.0
61.6
38.4
100.0
57.6
42.4
100.0
42.4
57.6
100.0
51.0
49.0
100.0
20.5
79.5
100.0
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Dentistry (prosthodontics)
Table 3 Distribution Of The Subjects Based On Knowledge
Frequency
Yes
75
A1: What would you choose between fixed & removable
No
76
Total
151
Yes
64
A2: Do you have any fear related to prosthetic treatment
No
87
Total
151
Yes
100
A3: Are you content with your oral prosthesis?
No
51
Total
151
Yes
68
A4: Do you let your dentist decide with regard to your prosthetic treatment? No
83
Total
151
Yes
82
A5: Do you talk to your family about prosthetic treatment options
No
69
Total
151
Yes
37
A6: Do you consider dental prosthetic treatment is too expensive?
No
114
Total
151
Percent
49.7
50.3
100.0
42.4
57.6
100.0
66.2
33.8
100.0
45.0
55.0
100.0
54.3
45.7
100.0
24.5
75.5
100.0
Table 4 Spearman’s Correlation Between Knowledge And Attitude
r value
P value
Attitude v/s knowledge
-0.234
0.004*
*significant; n= 151
Table 5 Spearman’s Correlation Between Knowledge And Attitude (Gender-Wise)
r value
P value
Females
-0.198
0.065
Males
-0.134
0.293
N= 151
Table 6 Gender wise Comparison Of the Knowledge Scores
Gender
Total
Female
Males
Good
Count
51
42
93
Percent
58.0%
66.7%
61.6%
Poor
Count
37
21
58
Percent
42.0%
33.3%
38.4%
Total
Count
88
63
151
Percent
100.0%
100.0%
100.0%
Chi-square value-1.17
p value-0.27; n=151
Table 7 Gender wise Comparison Of The Attitude Scores
Gender
Total
Female
Males
Negative
Count
52
35
87
Percent
59.1%
55.6%
57.6%
Positive
Count
36
28
64
Percent
40.9%
44.4%
42.4%
Total
Count
88
63
151
Percent
100.0%
100.0%
100.0%
Chi-square value-0.188
p value - 0.66; n=151
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5.
DISCUSSION
Oral health means much more than just healthy teeth. Good
oral health is a major resource for social, economic and
personal development of individuals. Teeth are required for
mastication, phonetics, aesthetics, and structural balance and
for the comfort of an individual. With the loss of teeth, the
above functions are impaired resulting in physical,
physiological and psychological trauma to the individual.
Preventive dental care is almost non-existent in rural areas17
The importance of teeth for general health and well-being of
an individual has already been discussed. So an appreciation
of the need for replacement of lost teeth which depend upon
knowledge and attitude of the individual about types and
modes of artificial teeth replacement is required to be
known18 Therefore an attempt was made to survey the
medical students of Jeddah city who were studying at various
medical colleges to evaluate their knowledge, awareness and
perception towards prosthodontic treatment and services.
The response rate of this study was high (80.8%) and in
accordance with the above previous study19. Based on gender
distribution, 58.3% of female participants and male
proportion was 41.7%. However, some studies have found a
slightly significant influence of gender, which was not revealed
in our study20 The majority of our participants were of the
opinion that missing teeth can be replaced (88.7%) and only a
few of them had an opinion that missing teeth could not be
replaced (11.3%). This finding is consistent with the previous
studies21Most of our participants thought that implant
supported prosthesis would be a better option (61.6%) and
quite a lot of participants thought that implant supported
prosthesis was not. This is in contrast with other studies20,22
which found that only 15.6% of the participants considered
implants as a better mode of replacement of teeth. This
disparity could be attributed to the higher standards of health
and education in the country compared to the neighboring
countries in the region22,23. Marcus et al. found that lack of
education is correlated to lack of awareness about the
importance of oral health and the consequences of neglect
appear to constitute a barrier in using dental health care
services. Most of the participants felt oral hygiene
maintenance is not required for prosthesis as natural teeth
(79.5%) and only a few of them felt prosthesis needs oral
hygiene maintenance as natural teeth (20.5%). The results of
the present study are in accordance with the study
conducted by Doshiet al.,24 where clinical medical and
paramedical students and medical, engineering students
showed poor oral health knowledge respectively, and it is
also in agreement with the study conducted by Baseer et
al.,25 where health professionals showed less knowledge
about oral health. The probable reasons could be less clinical
exposure of medical students to oral health problems as they
are pre occupied with their own curricular activities, and
also the attitude of the students toward oral health
considering it as least important. Among the participants, few
of them felt quality of life improves after prosthetic
treatment (42.4%) and most of them thought quality of life
will not change with the prosthetic treatment (57.6%). Half of
the participants chose fixed prosthesis as the option of
replacing missing teeth (49.7%) and the same number opted
for removable prosthesis (50.3%). This result is in accordance
Dentistry (prosthodontics)
with the previous studies which showed that 40.5% of
subjects showed positive attitude towards fixed prosthesis as
mode of replacement of teeth and only 20.1% felt removable
prosthesis as a better option. A study done by Al-Quran26
also confirms our results. Similar survey done in Saudi Arabia
highlighted that around 50% of the study sample preferred
removable partial denture while 25% preferred fixed partial
denture and this result was contrary to our findings.20 Most
of the participants did not show any fear related to
prosthetic treatment (57.6%) and few participants did
(42.4%). Lack of awareness of various prosthodontic
treatment options amongst participants prevented them from
utilizing treatment. Dental camps and prosthodontic
outreach programs are possible solutions to change the
attitude, spread awareness and provide knowledge about
ways and means of artificial teeth replacement as concluded
in a study by Menezes M. 27
5.1
1.
2.
3.
6.
Limitations of the study
Limited sample size as the study was performed only by
one group (medical students) and limited only to one
city (Jeddah).This limits the generalizability of the study
findings.
Screening of intraoral clinical status of the study
participants was not done.
The tendency toward socially desirable response cannot
be completely excluded, especially when using a selfassessment tool.
CONCLUSION
Majority of the medical students of this study were aware
that missing teeth could be replaced. Most of them thought
Implant supported prosthesis would be better option for
replacing missing teeth. The most important finding of this
study was that the majority of participants showed a lack of
knowledge regarding oral hygiene measures with dental
prosthesis. Equal number of participants opted for fixed
prosthesis. The present results may serve as a baseline for
the future evaluation of attitudes of medical students towards
replacement of teeth.
7.
AUTHORS CONTRIBUTION STATEMENT
Dr. Karunakar Shetty conceptualized the study, formulated
the study design with regard to this work and was also the
principal investigator and primary author of the manuscript.
He also analyzed the collected data and coordinated with the
statistician for the analysis of the data. Dr. Nada, Dr. Fatima,
Dr Arwa and Dr Raniyah gathered the data, helped in analysis
of these data and necessary inputs were given towards the
designing of manuscript. All authors discussed the
methodology and results and contributed to the final
manuscript.
8.
CONFLICT OF INTEREST
Conflict of interest declared none.
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9.
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