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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 6-8

Knowledge, attitude, and practice of dental students regarding treatment of pregnant women in Daman


1 Department of Public Health Dentistry, Vaidik Dental College and Research Centre, Daman, Daman and Diu, India
2 Vaidik Dental College and Research Centre, Daman, Daman and Diu, India

Date of Submission04-Mar-2022
Date of Acceptance07-Mar-2022
Date of Web Publication25-Mar-2022

Correspondence Address:
Dr. Nilima Vaghela
Department of Public Health Dentistry, Vaidik Dental College and Research Centre, Daman, Daman and Diu.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INJO.INJO_7_22

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  Abstract 

Introduction: The role of oral health professionals includes providing preventive services and restorative treatment along with anticipatory guidance for pregnant women and their children. Aim: The objective of the study was to assess the knowledge, attitude, and practice among dental interns and final-year students in treating pregnant women. Materials and Methods: A questionnaire study was conducted in a private dental college in Daman city which included 100 students. A study-specific questionnaire was prepared to collect the data. Descriptive analysis was done. Statistical analysis was done with the help of Statistical Package for Social Sciences version 17 (SPSS Inc., IBM, Chicago, IL, USA). Results: On average, there was enough knowledge among students regarding oral health. Nearly 39.3% of students had sufficient knowledge regarding management of pregnant women in a dental chair, and the students considered textbooks (39%) and lectures (40%) as their prime source of knowledge. About 43% of the clinical students educated pregnant patients regarding their oral health and its influence on the fetus. Regarding the antibiotic and analgesic of choice for pregnant women, very few had other options other than amoxicillin (32%) and paracetamol (68%). Conclusion: The finding underscores the knowledge and information of dental students in the fundamentals of dental management of pregnant women to be satisfactory. Improvement is needed to increase the awareness of clinical students toward different types of critical treatment.

Keywords: Awareness, oral health, pregnancy


How to cite this article:
Vaghela N, Lajpatrai A, Dixit A. Knowledge, attitude, and practice of dental students regarding treatment of pregnant women in Daman. Int J Oral Care Res 2022;10:6-8

How to cite this URL:
Vaghela N, Lajpatrai A, Dixit A. Knowledge, attitude, and practice of dental students regarding treatment of pregnant women in Daman. Int J Oral Care Res [serial online] 2022 [cited 2022 May 25];10:6-8. Available from: https://www.ijocr.org/text.asp?2022/10/1/6/340921




  Introduction Top


Pregnancy increases women’s risk for oral infections, and proper perinatal caring reduces child’s susceptibility to possible risks in future. Researchers provide some association between periodontal diseases and birth outcome. Despite this, an overwhelming number of pregnant women refuse seeking dental care. Pregnancy is not a reason to defer routine dental care or treatment. However, this kind of outlook may be either due to decreased interest or lack of communication between the obstetrician and the patient or due to dentists’ disbeliefs to some misconceptions or lack of knowledge regarding the safety procedures during dental treatment. Delay in necessary treatment could cause unforeseen harm to the mother and possibly to the fetus. The role of oral health professionals includes providing preventive services and restorative treatment along with anticipatory guidance for pregnant women and their children.[1],[2],[3],[4] According to various studies, nearly 35–44% of women do not receive oral health care while pregnant. Less than one-third (30%) of women visited dentist during pregnancy and even after the birth of the child. Among pregnant women who report having oral problems, only about half seek oral health care. Low level of dental awareness in different socioeconomic groups may arise due to the lack of dental programs addressed to people at different ages.[5],[6],[7],[8],[9],[10],[11],[12] It is the duty of dental students and dentists to break the taboo of wrong belief that dental treatment should not be undertaken during pregnancy. Pregnant women should be advised that the prevention, diagnosis, and treatment of oral diseases are highly beneficial. For that, we should be aware of pregnancy-associated lesions and the treatment available. Thus, the present study was planned to assess the awareness among dental interns and final-year students in managing dental cases of pregnant women in Daman.


  Materials and Methods Top


A questionnaire study was conducted in a private dental college in Daman. Dental interns and final-year clinical students who were present in the college were included in the study. One hundred and forty students were present on the day and participated in this study. A convenience sampling was done. All procedures performed in the study were conducted in accordance with the ethics standards given in 1964 Declaration of Helsinki, as revised in 2013.The study proposal was submitted for approval and clearance was obtained from the ethical committee, of our institution. A written informed consent was obtained from each participant. A study-specific questionnaire was prepared to collect the data. Demographic details were included in the questionnaire along with the questions pertaining to dental awareness, attitudes, practices, and how to deal with them. The questionnaire was designed to contain 20 questions in 2 pages. It contained questions regarding knowledge, attitude, and practices. Content validity was checked by a subject expert, and reliability of the questionnaire is 0.8. The participants were administered the questions in the college premises, and a filled questionnaire was collected from the students in a week’s time. After collecting the questionnaire, each student was briefed about the important aspects of oral hygiene and its relation to systemic health. Descriptive analysis was done. Statistical analysis was done with the help of Statistical Package for Social Sciences version 17 (SPSS Inc., IBM, Chicago, IL, USA).


  Results Top


Only proportions were considered and no comparison was done in this study. Out of the 100 clinical students who took part in the study, 50 were interns and 50 were final-year students. When considering practice-related questions, in order to understand their outlook toward the management of pregnant women, a question was put up “have you ever neglected treating pregnant women due to lack of knowledge?” Fortunately, most of the study participants said no (63.5%), few hesitated to answer (can’t say, 23.6%), and a very few (12.9%) answered yes. About 39.3% of the clinical students educate pregnant patients regarding their oral health and its influence on the fetus. About 42.1% educated occasionally and 18.6% never took pain to bring awareness among pregnant ladies. Out of 100 students, 17.1% have treated between 6 and 20 pregnant patients, 81.4% have treated <5 patients, and just 1.4% of clinical students have treated more than 20 gravid women. When we questioned them about their knowledge regarding managing pregnant women in a dental chair was sufficient, 39.3% answered yes, 20% said no, and 40.7% replied very little. The students considered textbooks (39%) and lectures (40%) as their prime source of knowledge about dental management of pregnant women. Nearly 17% depended on internet, whereas very few (4%) thought that brochure videos would be useful [Figure 1]. Regarding their knowledge about the suitable period for treating dental problems in pregnant women, about 79% of the students answered as the second trimester, and among them, 69% replied the reason as the first trimester is the period of organogenesis and high chances of abortion occur during that period and the third trimester can lead to preterm birth, which points out the second trimester to be the best period for treatment. Regarding the antibiotic and analgesic of choice for pregnant women, very few had other options than amoxicillin (32%) and paracetamol (68%). About 84% of the clinical students prefer treating a pregnant patient in the left lateral decubitus position, whereas very few (5.0%) considered 90° the right position and few (12.9%) answered supine as the correct treatment position. Most of the clinical students have encountered gingival diseases (76.4%) as the most common oral disease in pregnant women. Few thought periodontitis (12.1%) and dental caries (10.7%) as the most prevalent oral disease. Only very few (0.7%) said erosion. When asked about naming any two antibiotics contraindicated during pregnancy, more than half the percentage (70%) came forward with tetracycline and thalidomide. Chloramphenicol, ciprofloxacin, erythromycin, aminoglycosides, sulfonamides, and cephalosporins are the other drug names that contributed.
Figure 1: Attitude of participants on where they gain knowledge on pregnant patients

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  Discussion Top


The present study was conducted to assess awareness among dental interns and final-year students in managing dental cases of pregnant women in Daman. When asked about the knowledge provided in the BDS curriculum in treating pregnant women on a dental chair, majority felt as very little, which has to be seriously taken into account. This parallels with the study conducted by Aljulayfi et al. in Saudi Arabia.[10],[11],[12] The gaps in knowledge and practice of oral and dental health care among the dental students should require more intense classes and instructions. Moreover, the students considered textbooks and lectures as their prime source of knowledge about dental management of pregnant women, which highlights the necessity of creating awareness among clinical students in their academic syllabus itself. Regarding most common oral disease, our study shows that about 76% of the participants agreed that gingivitis is the most common oral manifestation in pregnant women. Another study had registered that about 81% of the participants agreed that pregnancy increases the tendency to have gingival inflammation.[1],[2],[3] At least half of the respondents reported not being completely comfortable treating pregnant patients. Further, many dentists appear to not follow medication prescribing guidelines for this population.[10],[11],[12] When compared with other similar studies, knowledge of clinical students seems to be satisfied. Women should be highly advised and motivated by the dentist to implement recommended health practices but need information in a timely, accessible, consistent manner. Oral health professionals should render all needed dental services to pregnant women. It is also important that dental clinicians need to remain vigilant in recognizing and preferably preventing adverse drug interactions in their patients. Dentists who perceived higher levels of barriers are likely to have incorrect assumptions about the appropriateness of routine and emergency oral health care during pregnancy. The scope of future research is higher in this field, especially when there is still no evidence that the mercury released from the existing amalgam fillings harms the fetus or not and the role of fluoride on water and pros and cons of dietary supplements during pregnancy, which is also a pressing issue.


  Conclusion Top


This study has provided valuable insight into the current scenario among budding dental practitioners and their awareness in treating pregnant patients. Reviewing their awareness, an acceptable knowledge in some areas is observed, but they still need to have more training and education during their under- and postgraduate life to improve their knowledge of how to handle pregnant dental patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ngeow WC, Chai WL. Understanding the dental need and care during pregnancy: A review. Med J Malaysia 1999;54:146-50.  Back to cited text no. 1
    
2.
Gaszyńska E, Klepacz-Szewczyk J, Trafalska E, Garus-Pakowska A, Szatko F. Dental awareness and oral health of pregnant women in Poland. Int J Occup Med Environ Health 2015;28:603-11.  Back to cited text no. 2
    
3.
California Dental Association Foundation, American College of Obstetricians and Gynecologists, District IX. Oral health during pregnancy and early childhood: Evidence-based guidelines for health professionals. J Calif Dent Assoc 2010;38:391-403, 405-40.  Back to cited text no. 3
    
4.
May L, Suminski RR, Yeung AY, Linklater ER, Christensen C, Jahnke S. Pregnant patient knowledge of and obstetric provider advice on oral health. J Dent Oral Disord Ther 2014;2:1-6.  Back to cited text no. 4
    
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Bamanikar S, Kee LK. Knowledge, attitude and practice of oral and dental healthcare in pregnant women. Oman Med J 2013;28:288-91.  Back to cited text no. 5
    
6.
Soysa N, Alles N. A pilot study on attitudes, knowledge and behaviour towards dental diseases among grade medical officers in the Kandy district, Sri Lanka. J Dent 2016;4:9-16.  Back to cited text no. 6
    
7.
Irvine J, Holve S, Krol D, Schroth R. Early childhood caries in indigenous communities: A joint statement with the American Academy of Pediatrics. Paediatr Child Health 2011;16:351-64.  Back to cited text no. 7
    
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Alves RT, Ribeiro RA, Costa LR, Leles CR, Freire Mdo C, Paiva SM. Oral care during pregnancy: Attitudes of Brazilian public health professionals. Int J Environ Res Public Health 2012;9:3454-64.  Back to cited text no. 8
    
9.
Boggess KA, Edelstein BL. Oral health in women during preconception and pregnancy: Implications for birth outcomes and infant oral health. Matern Child Health J 2006;10:S169-74.  Back to cited text no. 9
    
10.
Aljulayfi I, Alrusayni A, Alqahtani S, Hamam MK. Awareness of dental interns in managing cases of pregnant women in Saudi Arabia. Saudi J Dent Res 2015;6:26-9.  Back to cited text no. 10
    
11.
Pina PM, Douglass J. Practices and opinions of Connecticut general dentists regarding dental treatment during pregnancy. Gen Dent 2011;59:e25-31.  Back to cited text no. 11
    
12.
Lee RS, Milgrom P, Huebner CE, Conrad DA. Dentists’ perceptions of barriers to providing dental care to pregnant women. Women’s Health Issues 2010;20:359-65.  Back to cited text no. 12
    


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