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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 16  |  Issue : 2  |  Page : 121-126

Oral hygiene status and dental awareness of non – dental health professionals in Aminu Kano Teaching Hospital, Kano State, Nigeria


1 Department of Preventive Dentistry, Faculty of Dentistry, College of Health Sciences, Bayero University Kano and Aminu Kano Teaching Hospital, Kano, Nigeria
2 Department of Periodontology and Community Dentistry, University College Hospital, University of Ibadan, Ibadan, Oyo State, Nigeria
3 Department of Child Dental Health, Faculty of Dentistry, College of Health Sciences, Bayero University Kano and Aminu Kano Teaching Hospital, Kano, Nigeria

Date of Submission28-Jan-2019
Date of Decision02-Jun-2019
Date of Acceptance29-Aug-2019
Date of Web Publication19-Nov-2019

Correspondence Address:
Dr. Olohigbe O Alufohai
Department of Preventive Dentistry, Faculty of Dentistry, 5College of Health Sciences, Bayero University Kano, Aminu Kano Teaching Hospital, Kano
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njbcs.njbcs_3_19

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  Abstract 


Background and Aims: The oral hygiene status of individuals may be a strong indication of the extent of their dental awareness. The level of awareness can make a great difference in the quality of oral health care that can be rendered to patients. The aim of this study is to evaluate the oral hygiene status and dental awareness of non-dental health professionals in Aminu Kano Teaching Hospital, Kano State, Nigeria. Methodology: A total of 425 participants selected by multistage sampling technique fulfilled the inclusion criteria for this study. They included 238 males and 187 females. Each respondent completed an informed consent sheet and a modified questionnaire on dental awareness. They were examined immediately after to assess oral hygiene status using the Simplified Oral Hygiene index by Greene and Vermillion (1964). Results: Majority of study participants displayed moderate dental awareness. Dental awareness was categorized as poor, low, moderate, high and excellent using a researcher's analysis index. 56.5% displayed moderate awareness. Using the simplified oral hygiene index by Greene and Vermillion (1964), 60.94% were found to have fair oral hygiene. A strong statistically significant difference was observed in dental awareness among the professional specialties and ethnic groups. A very strong statistically significant difference was seen in the oral hygiene status. Conclusion: The dental awareness of the cadre of health professionals included in this research is considered unsatisfactory while the oral hygiene status of majority of the respondents needs improvement. These findings will therefore necessitate interventions to upgrade their awareness level and oral hygiene.

Keywords: Dental awareness, non-dental health professionals, oral hygiene


How to cite this article:
Alufohai OO, Taiwo JO, Sani B. Oral hygiene status and dental awareness of non – dental health professionals in Aminu Kano Teaching Hospital, Kano State, Nigeria. Niger J Basic Clin Sci 2019;16:121-6

How to cite this URL:
Alufohai OO, Taiwo JO, Sani B. Oral hygiene status and dental awareness of non – dental health professionals in Aminu Kano Teaching Hospital, Kano State, Nigeria. Niger J Basic Clin Sci [serial online] 2019 [cited 2019 Dec 9];16:121-6. Available from: http://www.njbcs.net/text.asp?2019/16/2/121/271000




  Introduction Top


Oral Health can be defined as a state of being free from chronic mouth and facial pain, oral and throat cancers, oral sores, birth defects such as cleft lip and palate, periodontal disease, tooth decay and tooth loss and other diseases and disorders that affect the oral cavity.[1]

Oral health is an integral component of general health.[1] Oral diseases have been described as a universal health condition in both third world and developed nations.[1] Some oral diseases though not life threatening have also been seen to have significant impact on the quality of life especially as a result of their psycho-social effects.[2],[3] Others have been shown to restrict domestic, school and office activities, thereby causing millions of productive hours to be lost yearly, affecting the global economy.[4],[5]

The association between oral health and some systemic diseases have been reported in the literature. Conditions like cardiovascular diseases, bacterial pneumonia, extremes of birth weight, diabetic complications and osteoporosis have been linked with poor oral conditions.[5],[6],[7],[8]

Oral diseases are largely preventable[9] and several aetiological factors which have been identified including lack of oral health awareness, traditional and cultural beliefs, low level of education and poverty, habits like smoking and tobacco chewing, and more importantly, poor oral hygiene.

Interestingly, several studies[10],[11],[12] amongst various groups of individuals have shown a low level of dental awareness among them. This was seen to be true even among literates and healthcare professionals, and in many cases, concluded to be the result of inappropriate oral health education.

In healthcare circles, it is imperative to have a healthcare team that have an appreciable knowledge of proper oral hygiene because oral health cannot be divorced from general health.

Optimally, total health requires the combined efforts of the medical and dental professions.[10],[11],[12] The objective of this study is therefore to evaluate the oral hygiene status and dental awareness of nondental health professionals in AKTH, Kano.


  Methodology Top


The study design was a descriptive cross-sectional type. First, Ethical approval was obtained from the Research and Ethics committee of the AKTH, Kano. Sample size was determined using the Fischer's formula and a prevalence of value obtained from Sofola et al., 2009.[13] Non-dental health professionals were then classified into 14 professional groups using the International Standard Classification of Occupation (ISCO, 2008 revision). A comprehensive register of the various numbers of these health workers was obtained from the Administrative department and a non-proportionate stratified sampling technique was used to select a specific number from each professional strata. The particular staff to be included in the study from each group was then selected by a simple random sampling method using ballots. A total of 425 participants fulfilled the inclusion criteria for this study. They included 238 males and 187 females. Respondents were approached during break period in the study area. The objectives and methodology was explained to them in detail and their consent obtained. Each respondent completed an informed consent sheet afterwards and the modified questionnaire on dental awareness. They were examined immediately after to assess their oral hygiene status using the Simplified Oral Hygiene index by Greene and Vermillion (1964). The oral hygiene index was categorized as poor, fair and good using the Simplified Oral Hygiene Index by Greene and Vermillion (1964), while dental awareness was categorized as poor, low, moderate, high and excellent using a researcher's index.

Data analysis

The data was recorded on the proforma designed for the purpose of this study. These results were analyzed using statistical package for social sciences (SPSS) version 20.0 (SPSS Inc, Chicago, IL). Data was summarized with descriptive statistics such as frequency and analysis index. Percentage, means and standard deviation and illustrated using tables and charts. The chi square test was used to assess the significance of associations between categorical groups. Spearman's Rank analysis was used to assess the correlation between dental awareness [Table 4] and oral hygiene. A P value of 0.05 or less was considered statistically significant. Respondents were rewarded with an oral health education with emphasis on good oral hygiene practices as well as verbal advice and motivation for further clinical consultations at the AKTH dental clinic.
Table 4: Correlation between oral hygiene status and dental awareness

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  Results Top


The mean age of the participants was 36 ± 7.18 years with a range of 25-59 years. Male to female ratio was 1:0.48. Respondents were largely of Hausa tribe and belonged to the Islamic religion. The married group comprised the largest number of the study population. Nurses constituted the highest percentage of health professionals studied while the Audiologists/speech therapists and Optometrists were the least in number [Table 1].
Table 1: Sociodemographic characteristics of participants

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Most ofthe study participants were found to display moderate dental awareness. 56.5% displayed moderate awareness while 60.94% [Figure 1] and [Figure 2] were found to have fair oral hygiene, using the simplified oral hygiene index by Greene and Vermillion (1964). Quite a small fraction of the subjects had a good oral hygiene status while less than a tenth of the entire study population showed excellent dental awareness.
Figure 1: Percentage distribution of oral hygiene status of participants

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Figure 2: Level of dental awareness of participants

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Within the professional groups, the environmental and occupational health hygiene professionals presented the highest mean OHI-S score of 3.01 ± 1.08, while the optometrists/ophthalmic physicians as well as the audiologists/speech therapists had the least mean OHI-S scores of 1.52 ± 0.40 and 1.50 ± 1.02 respectively [Table 2]. This again, had a strong statistical significance of P = 0.030.
Table 2: Oral hygiene status of the various professional groups

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In studying the dental awareness from the professional groups, a single respondent each from the specialist medical doctors, audiologist/speech therapists as well as respondents not classified, displayed an excellent dental awareness. This constituted about 0.71% of the entire study population. The specialist medical doctors were seen to have the highest percentage of respondents with a high dental awareness (8.71%) [Table 3]. The nursing staff/midwives had 8% of their respondents exhibiting a high dental awareness as well. On the other extreme, the Nursing staff/midwives, the paramedical practitioners and environmental/occupational health hygiene professionals had the highest number of respondents showing poor dental awareness in decreasing percentages (2.82%, 0.24% and 0.47%, respectively). This was observed to have a strong statistical significance with P value = 0.00.
Table 3: Dental awareness among professional groups

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A strong statistically significant difference was observed in the levels of dental awareness among the professional specialties and ethnic groups of the participants. A very strong statistical significant difference was seen in the oral hygiene status among all the variables of the study population including the age categories, the sexes, ethnic groups, religion and professional specialties of the respondents.


  Discussion Top


The oral health of individuals can have significant impact on the quality of life of such persons and by extension, their general health and hence, the economic wellbeing of a nation.[2],[5] On another hand, the dental awareness and oral hygiene status of individuals may be indications of their oral health status. Several concerns are therefore fundamental for health professionals managing the teaming population of persons affected with oral health conditions,[14] for example, what is their level of dental awareness and what is their oral hygiene status like? The answers to these questions will not only provide an indication to their overall well-being, but will also help in extrapolating the level and quality of oral health care they are delivering to patients with oral and dental conditions who may come in contact with them before reaching the dentist or dental professional.

In the light of the above, this study was aimed at evaluating the oral hygiene status and dental awareness of non-dental health professionals in Aminu Kano Teaching Hospital, with a view to providing answers to the aforementioned questions as well as producing a baseline data for future references as such a study has never been carried out in this centre.

Oral hygiene can be defined as the practice of keeping the mouth clean[9] Dental awareness can be described as the public or common knowledge or understanding of the essentials of dental components as well as their relevance and importance.[13] In this study, the oral hygiene status of the participants was assessed using the simplified oral hygiene index of Greene and Vermillion (1964),[15] while the dental awareness was evaluated using a modified version of a questionnaire derived from structured questions designed by the World Health Organization (WHO) collaborating centre for commercial oral health programmes and research, Department of Community Dentistry, Faculty of Health Sciences, University of Copenhagen, Denmark.[16]

Due to the proportionate nature of the stratified sampling technique, Nurses and Midwives constituted the greatest percentage of health workers. This is closely followed by Specialist Medical doctors with the Audiologists and speech therapists along with the optometrists that constitute the least number of health professionals. Baseer et al., Pralhad et al. and Nasiru et al. in their studies among health professionals also had respondents from the Nursing specialty presenting the greatest number of respondents.[14],[17] Nasiru et al. in their study in Lagos Nigeria had a ratio of Nurses: Doctors: Allied health specialties of 7:2:[17] The high ratio of nurses and medical doctors as against other health professionals can be readily due to the fact that this study centre is a tertiary health facility that is also responsible for the training of post graduate doctors and nurses/midwives alongside it's other primary objectives of service and research.[18] Medicine and Surgery as well as Nursing and Midwifery are also known to be the bedrock of Medical practice and have for ages had the more dominant number of practitioners in the Medical profession.[19] The bulk of the respondents had a university degree. Other tertiary institutions that produced professionals in this study are Nursing/Midwifery School, Health Technology/Sciences Schools, Polytechnics and Colleges of Education. Similarly, the universities are the peak of the citadels of learning and are responsible for producing professionals in every cadre of human endeavour.[20] This is probably the readily obvious reasons why most of the participants had university degrees.

Studying the number of years of practice of the participants revealed that most of them had been working for between 1-10 years. Adebimpe et al. in their study on health workers in a teaching hospital in South-western Nigeria had 35.2% of their respondents working between 1-5 years and 64.8% working above 5 years, respectively.[21] Being a tertiary health institution, most of the working population would include young aspiring persons in pursuit of specializations in their various fields. They also include trainee personnel like house officers and interns in different specialties. This set of respondents were also made up of consultants from several medical and para medical specialties as well as post basic Nursing and Midwifery personnel.

As for the oral hygiene of the professional groups, the Audiologist/Speech therapists and the Optometrists/ophthalmic physicians had the lowest mean oral hygiene score while the Environmental health hygiene professionals were found with the highest mean oral hygiene score. Baseer et al. in their study reported that nurses and technicians significantly more likely visited the dentist than doctors, pharmacists and medical students.[14] In this study, the two specialities with the lowest oral hygiene indices indicating a better oral hygiene are head and neck related specialities similar to the dental professional. In AKTH particularly, the speech therapists co-manage cleft lip and palate cases alongside the oral and maxillofacial surgeons. The Ophthalmology and Otolaryngology departments are closely situated to the Dental clinics. Over time, they have had good interactive associations with the dental health professionals and this may have contributed to the outcome picture seen. On the other hand, the environmental and health hygiene professionals who are supposed to have first-hand knowledge of the importance and relevance of health hygiene interestingly had the poorest oral hygiene status among the study population. This was contrary to expectation and is a pointer to the need for better oral health care awareness in the health sector at large.

The dental awareness of about half the entire number of health professionals in this study was assessed as moderate using modified analysis scale designed from poor to excellent. Baseer et al. in their study of oral health knowledge, attitude and practices among health professionals in King Fahad Medical City, Riyadh concluded that oral health knowledge among the study subjects was lower than what would be expected of that group, which had higher literacy levels in health care.[14] Habib et al. also concluded that medical doctors had inadequate information about periodontal disease after their research on the knowledge, awareness and attitude of medical doctors towards periodontal disease in Dar es Salaam, Tanzania.[22] In their own conclusion on the knowledge of periodontal diseases among group of healthcare professionals in Yenepoya University, Mangalore, India, Rajesh et al. stated that severe knowledge deficit was seen in risks associated with periodontitis and risk factors for periodontitis.[23] Sofola and Ayankogbe found out that though 61.7% of Nigerian family physicians claimed to know about periodontal diseases, only 45.7% were able to give correct answers to a questions in a study carried out to examine their knowledge of oral health.[13]

The dental awareness level seen among the various healthcare personnel in AKTH may be partially attributable to periodic joint hospital seminars which affords various specialities opportunities to educate the staff community on relevant areas of public interest in their fields. There may also be the possibility of exposure to Dentistry via upgraded school curriculums, social media interactions as well as dental sensitization measures offered the general public through certain oral health care programmes like the World Oral Health Day by the Faculty of Dentistry, Bayero University, Kano.

Having being carried out in a major referral health facility practically serving an entire geopolitical zone in Nigeria, this study can be said to represent the level of care that can be served to a large populace. The results obtained were however based mostly on subjective assessment because of ethical reasons and being a cross sectional study may have revealed the respondent's perception at the time of study only.


  Conclusion Top


The outcome of this study reveals a knowledge gap in dental awareness which has a direct relationship with the oral hygiene status of the study population.


  Recommendations Top


There is a strong need for further interprofessional education to increase the overall awareness of oral health among workers in healthcare circles. These findings will therefore necessitate relevant interventions to help improve on their oral hygiene and upgrade their dental awareness. It is expected that this outcome will in turn impact on the quality of oral healthcare they can deliver to patients, thereby enhancing their overall quality of life.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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