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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 10  |  Issue : 3  |  Page : 70-75

Assessment of the oral health status and OHRQoL among beggars in Jodhpur, India: A cross-sectional study


Department of Public Health Dentistry, Vyas Dental College, Jodhpur, Rajasthan, India

Date of Submission28-Aug-2022
Date of Acceptance03-Sep-2022
Date of Web Publication29-Sep-2022

Correspondence Address:
Mr. Rajendra Singh Bhati
Department of Public Health Dentistry, Vyas Dental College, Jodhpur, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INJO.INJO_20_22

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  Abstract 

Introduction: In India, charity is the noblest cause of human virtues and due to these religious myths, begging became the traditional profession. Beggars are the people “asking passerby for money for themselves without offering anything in return.” They are always undermined, humiliated and neglected in society. Hence, an attempt was made to assess the oral health status of beggars Jodhupur region. Aim: The aim of this study was to assess the oral health status and oral health related quality of life (OHRQoL) among Beggars (homeless) of Jodhpur Region, Rajasthan, India. Materials and Methods: A cross-sectional study was conducted among 113 beggars (homeless) to assess the oral health status and OHRQoL in Jodhpur Region, which was done by WHO Oral Health Assessment Form (1997) and oral health impact profile-14 (OHIP-14). The collected data were statistically analyzed by using descriptive statistics as well as Pearson’s correlation. Results: It was found that caries prevalence was 63.7%, and 43.2% of population were having gingival bleeding as well as periodontal pockets with 4–5 mm depth. The highest mean score was seen for the psychological disability; 3.226 ± 0.453 followed by handicap; 3.03 ± 0.16 and least was for physical disability; 2.33 ± 0.569. Conclusion: Mostly dental problems and poor oral health status were due to high level of unmet needs in the study population which highlights the need for a comprehensive dental care program. This study has utility for policymakers and other stakeholders to improve the oral health as well as knowledge of this population.

Keywords: Dental caries, gingivitis, oral health, periodontitis, quality of life


How to cite this article:
Bhati RS, Garla BK, Dagli R, Khan M, Shaketawat N, Dar AA. Assessment of the oral health status and OHRQoL among beggars in Jodhpur, India: A cross-sectional study. Int J Oral Care Res 2022;10:70-5

How to cite this URL:
Bhati RS, Garla BK, Dagli R, Khan M, Shaketawat N, Dar AA. Assessment of the oral health status and OHRQoL among beggars in Jodhpur, India: A cross-sectional study. Int J Oral Care Res [serial online] 2022 [cited 2022 Dec 6];10:70-5. Available from: https://www.ijocr.org/text.asp?2022/10/3/70/357315




  Introduction Top


Poverty and begging are still the biggest social issues despite of so much advancement in India which is difficult for government to tackle. India has uneven distribution of wealth because of one sided rapid economic growth.[1],[2] There are around 500,000, that is, half million beggars in India and among them all are not real.[2] Some people are begging as a profession to earn the money, whereas some are having no choice except begging. Begging has created its own grave since its inception and imposes a larger burden on growing society.[3]

In India, charity is the noblest cause of human virtues and due to these religious myths, begging became the traditional profession. Therefore, mostly beggars are found at religious and spiritual sites, important monuments, railway stations, and shopping districts.[4] The Census of India (2011) defined beggars as vagrants, prostitutes, and person having unidentified source ofincome and those with unspecified period called beggars.[5] Latest Census of Government of India (2011) said that majority of the beggars are in West Bengal and Uttar Pradesh. Not only in these two states even the Andhra Pradesh, Bihar, Madhya Pradesh, Rajasthan, Maharashtra, Assam, and Orissa have also higher rate.

The rate at which people are becoming involved in begging is increasing day by day. Therefore, there is need to control this menace of society through some legal efforts. Despite of anti-begging laws in 22 states of India still there is no central law which penalizes begging because Supreme Court has not yet decided constitution of anti-begging legislations.[6],[7] The only petition filed before the Court challenging the constitutionality of the Bombay (Prevention of Begging) Act, 1959 was also withdrawn by the petitioner.[6] Till now various measures have been taken by the governmental as well as non-governmental agencies to abolish begging. Most of the beggars are depriving from all the civil facilities from the country and categorized as stumpy people in the society.[6],[8],[9] As they are not in affordable situation to receive the health care facilities.[8],[10] Therefore, regular and proper monitoring is required. Hence, an attempt was done to assess the dental caries experience, periodontal status and oral health-related quality of life (OHRQoL) among Beggars in Jodhpur,India

Aim

The aim of this study was to assess the dental caries experience, periodontal status, and oral health-related quality of life (OHRQoL) among Beggars in Jodhpur, India.

Objectives

  1. To assess the dental caries experience using WHO Dentition status index as prescribed in WHO Basic Oral Health Survey 2013 and its impact on oral health related quality of life among beggars of Jodhpur city.


  2. To assess the periodontal status with the help of WHO Basic Oral Health Survey 2013 and its impact on oral health related quality of life among beggars of Jodhpur city.


  3. To make possible suggestion and recommendations for improving the oral health of beggars in order to improve their quality of life.



  Materials and Methods Top


Study setting

A cross-sectional study was conducted to assess the Dental caries experience, periodontal status, and OHRQoL among 113 beggars in Jodhpur, India at various religious places, Railway station, Bus stand and other public places were visited for the data collection.

Data collection

Ethical approval was obtained from the Institutional Ethical Committee and Review board, Vyas Dental College, Jodhpur, India and the informed consent was taken from all the study participants prior to the study. Data were collected by a trained assistant using a structured Performa and the data were collected over a period of 2 months from January 2022 to February 2022.

Questionnaire

A self-administered questionnaire was used in this study which consisted of two parts. The first part included the participants’ demographic data and the second part had 14 questions related to oral health related quality of life (OHRQoL) and the study participants were requested to complete the questionnaire. 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.

Training and calibration

The standardization and calibration of the data collection method were done through a two-day training sessions which was organized in the Department of Public Health Dentistry. The training session consisted of a revaluation of the criteria outlined, followed by an examination of adult patients based on simulation of field technique for reliability.

Statistical analysis

Data were analyzed using Statistical Package for Social Sciences (SPSS) 22.0 (SPSS Inc., Chicago, Illinois). Descriptive statistics such as mean and standard deviation were used. The Spearman correlation coefficient was used to measure the correlation between components of DMFT, gingival bleeding and pocket with depth of more than 4–5 mm with OHIP-14.


  Results Top


This cross-sectional study was carried out among 113 beggars to assess the dental caries experience, periodontal status and OHRQoLin Jodhpur region, Rajasthan,India

[Table 1] shows the sociodemographic characteristics of the studied population. Among 113 beggars, 71(62.8%) were males and 42(37.2%) were females with mean age of 1.74 ± 0.75 years.
Table 1: Demographic characteristics of studying individuals

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[Table 2] shows that 63.7% of studied population had dental caries experience with 60.2% were having missing teeth. It was found that only 10.6% of population had filled teeth. However, it was clearly seen that most of the participants, that is, 42.5% were having periodontal disease and 69% of individuals were having LOA score 1.
Table 2: Dental caries experience and periodontal status of studied individuals

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[Table 3] shows oral health-related quality of life which was measured by OHIP-14. The highest mean score, that is, 3.226 ± 0.453 was seen for the dimension psychological disabilityfollowed by handicap i.e. 3.03 ± 0.16 and least was for physical disability i.e.2.33 ± 0.569.
Table 3: Distribution of responses and mean scores for the OHIP-14

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[Table 4] shows correlation between the variables of oral health status and OHIP-14. DT was found to be significantly correlated with the functional limitation and physical pain with P = 0.01 and .005, respectively, and MT was also significant with the physically handicapped with P = 0.007. FT was significant with Psychological disability having P = 0.02. Gingival bleeding and loss of attachment was not significant with the any of the dimensions of OHIP-14. The highest correlation was found between physical pain and DT.
Table 4: Correlation between the dental caries experience and periodontal status and OHIP-14

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  Discussion Top


Oral health is an important constituent of general health and quality of life. However, poor oral health affects one’s physical, psychological, and social well-being, as well as one’s quality of life.[11] Beggars is often forced to live the life of destitute and despair due to lack of access to resources essentially housing, education, health care services and employment opportunities. This often predisposes this vulnerable section of society to increased health risks and poor oral health.[12],[13]

As such there is no published literature available on the beggars regardingoral health related quality of life. So this study was undertaken with initiative to assess the dental caries experience and periodontal status and OHRQoL among the beggars of Jodhpur region, Rajasthan India. In our work it was found that 63.7 of dental caries were seen among the studied population which may be due to their poor oral hygiene habits.[14],[15],[16],[17],[18],[19],[20],[21]

In this study 42.5% subjects were having gingival bleeding with the pocket depth of 4–5 mm (CPI score 3). It was also seen that 69% of individuals were having LOA 01 score (loss of attachment). This may be due to their low level of awareness regarding oral hygiene practices. Their low socioeconomic status with less or no utilization of dental health services is another factor to be considered for pitiable oral health status.[22],[23],[24],[25],[26],[27],[28],[29],[30],[31]

OHRQoL was also assessed by using OHIP-14 domains and correlated withcomponents of DMFT, gingival bleeding and pocket with depth of more than 4-5 mm. A statistically significant correlation was found between the domains of the OHIP-14 such as functional limitation, physical pain and psychological discomfort with the components of DMFT.[32],[33],[34],[35] This might be due to the fact that decayed teeth leads to pain, food lodgment, interference with mastication and the daily routine activity, which is perceived by the patient as functional limitation, physical pain and psychological discomfort.

The painful aching was reported among 97.4% of the studied population which leads to limited food choices, trouble in biting and chewing food with speech problems. This may be due to their negative attitude of living with the pain and accepting it at greater level with dysfunction.

Overall we can say that lack of proper knowledge with negative attitude and negligence towards oral health has a negative impact on the quality of life which will further lead to functional as well as physical disability. Therefore, it is equally essential to lay stress upon improving their attitude so that they could reduce the negative impact on their quality of life.[36],[37],[38],[39]

Limitations

Till date very few of the studies have been carried out among the homeless individuals and none of them were on beggars. Therefore, there was not much literature available for comparison of this study which proved a major limitation. Hence, it is suggested that further studies should be undertaken.

Recommendations

  1. Government of India should come up with certain laws which should be legislated with immediate action to vanish this social issue.


  2. India has various religious myths regarding the charity which makes this begging a more powerful. There is need to educate those people so that they should not give them money as charity is just a little single time help to them.


  3. Government has to build work-houses along with training sessions in order to keep these people busy with work.


  4. Increase in the political commitment and financial allocations in support for effective health care facilities with emphasis on oral care.


  5. Providing supportive environment for improving their quality of life by the establishment of schools especially for the deaf, dumb and blind people. Instead of individual charity and donation, people should collectively raise the funds on large and organized scale.



  Conclusion Top


Among manifold evils of India begging is the one of the most critical and social issue. The study highlighted the high dental caries experience and periodontal diseaseamong the beggars with negative attitude towards their oral health. Though India is democratic country and promising a bright future. But still the problem of beggars has not been solved. Hence, Indian government has to take the valiant and vigorous steps to eradicate the beggary by the provision of food, shelter, and health care facilities.

Financial support and sponsorship

Not applicable.

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

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



 

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