IP Indian Journal of Orthodontics and Dentofacial Research 2023;9(3):168–174

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IP Indian Journal of Orthodontics and Dentofacial Research

Journal homepage: https://www.ijodr.com/

Original Research Article

Do medical and paramedical students have a better awareness regarding oral
health practices and orthodontic treatment? A KAP study
Rudragoni Saikiran Gowd 1 , Navya Mudunuri 1 , Vasudevan S.D 1 ,
Ekavenika Kovelakar 1 , Ravali Tankala 1 , Sri Harsha Yelchuru 1, *
1 Dept. of Orthodontics and Dentofacial Orthopedics, KIMS Dental College and Hospital, Amalapuram, Andhra Pradesh, India

ARTICLE INFO ABSTRACT

Article history: Background: oral health is the most important for the wellbeing of the patient. But it is being neglected
Received 04-05-2023 in the developing and the underdeveloped countries and malocclusion being the third most commonly
Accepted 14-06-2023 occurring dental anomaly. Medical and paramedical students have been found to be the point of contact the
Available online 08-09-2023 community on a large scale. Hence, the present study was carried out to evaluate the awareness regarding
oral health and orthodontic treratment in KIMS College.
Materials and Methods: A validated self-administered questionnaire, pertaining to demographic data,
Keywords:
awareness of oral health knowledge regarding orthodontics as a specialty were included. A total of 42
Oral Hygiene questions included in the study. The answers from the students were recorded as Yes or No on a 2-point
Orthodontic treatment Likert scale.
Braces
Results: Significantly higher proportions (70.7%) of the dental students were aware of the oral health
Brushing habits
practices, Orthodontic treatment and the purpose of orthodontic treatment followed by the, medical
awareness students. Female students opined with a greater frequency (70.8%) that irregular teeth have a negative
impact on self-esteem and quality of life compared to male students.
Conclusion: The Dental students have more knowledge than the health care workers on awareness of
oral health practices regarding the use of mouthwashes, flossing technique etc. and also regarding the
orthodontic treatment and its importance.

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1. Introduction health awareness program as they are in frequent contact

with the general population.
Oral health is an essential requisite for general health and
well-being of an individual throughout the life. Poor oral Malocclusion is a commonly seen dental anomaly among
health and dental problems like caries and periodontal large number of populations. It is considered third most
disease can have a significant effect on quality of life as frequently occurring oral pathology next to dental caries
they might affect the patient’s eating, drinking, swallowing, and periodontal diseases. One will undergo orthodontic
smiling and communication. 1 Though oral health has treatment if he/she has knowledge and awareness regarding
always been neglected in the developing or underdeveloped orthodontics and that orthodontic treatment will improve
countries, 2 in order to maintain a good oral health, functioning and aesthetics and functioning in the perioral
proper and effective preventive measures must be practiced. region. This becomes even more important for the medical
Medical and paramedical students act as a guide for oral and paramedical students as they have to recognise the
* Corresponding author. orthodontic problems early and should be able to refer to an
E-mail address: [email protected] (S. H. Yelchuru). orthodontic specialist at the correct time for either initiating

https://doi.org/10.18231/j.ijodr.2023.031
2581-9356/© 2023 Innovative Publication, All rights reserved. 168
 Gowd et al. / IP Indian Journal of Orthodontics and Dentofacial Research 2023;9(3):168–174 169

interceptive procedures or for correction. 3 they were divided into three categories 1) Knowledge about
The Medical, Paramedical students after their graduation irregular teeth and smile (7 questions), 2) Knowledge about
become the point of contact with the community at orthodontic treatment (4 questions), and 3) Awareness about
large through camps and in college. Their awareness orthodontist and orthodontic treatment (11 questions). A
regarding oral health practices in general and orthodontics pilot study was carried out to evaluate and compare the
in particular can influence the oral health practices of the knowledge and awareness regarding Orthodontic treatment
community among 10 dental and 10 paramedical undergraduate
It is stated that the main reasons for the malocclusion students of different campus. Concern of each student has
being left untreated are the lack of information about been taken before collecting the responses. Once the pilot
the malocclusion, lack of resources, literacy rate, and study was approved the questionnaire study was conducted
socioeconomic status. Awaisi et al 4 evaluated the social among medical, dental and paramedical undergraduate
barriers affecting demand for orthodontic treatment, students of our campus.
concluded that the majority of individuals who chose The answers from the students were recorded as Yes or
treatment had high socioeconomic status and the majority No on a 2-point Likert scale. There were several options
of those who had low socioeconomic status did not prefer for some questions. After the survey application to raise
treatment. awareness of Oral health and orthodontic treatment, a
Although there are studies in the literature that evaluate presentation was given about oral and dental health and
orthodontic knowledge and awareness among school orthodontic treatment to all students in dental and medical
children in different societies, not many studies are available and paramedical colleges.
comparing the awareness regarding oral and orthodontics All the undergraduate students in the different courses
among the medical, dental and paramedical courses such who were willing to participate in the study were included
as nursing, physiotherapy etc., Hence this study was in the study.
carried out to assess the awareness regarding relationship The data were entered using Microsoft Excel and
of orthodontic knowledge and awareness among different analysed with SPSS software.
dental, medical and paramedical fraternity. Our null
hypothesis is that there is difference regarding awareness
2.3. Statistical analysis
and knowledge regarding oral health and orthodontics
among the students of medical, dental and paramedical Data were analyzed using IBM SPSS version 20 software
branches. (IBM SPSS, IBM Corp., Armonk, NY, USA). Descriptive
The aim of the present study is to evaluate and compare statistics and Chi square tests were done to analyze the study
the knowledge and awareness regarding Orthodontic data.
treatment among dental and medical and paramedical
undergraduate students of the campus. 3. Results

2. Material and Methods Majority of the study subjects were medical students (39%),
females (75.6%), belonged to the 20-25 years age group
2.1. Study location and duration (53.8%) and upper middle socioeconomic status (63%).
The research was carried out in 2021 (October to December) Nearly 95% of the study subjects opined that oral health is
among dental, medical and paramedical undergraduate an integral part of general health. 96.3% preferred normal
students of our campus. The research was started after tooth brush. 43% of the study participants reported using
obtaining approval from the Ethical Committee of our such amounts of tooth paste which covers the full length of
college. The students were given detailed information the brush. 3 months is the most frequent response (52.6%)
regarding the purpose of the study and their informed from the participants for the question on frequency of
consent was included in the study. changing tooth brush. 78.7% had the habit of rinsing their
oral cavity every time they eat. 73% reported that they
did not know oil pulling as an alternative for commercial
2.2. Questionnaire
mouth wash. Listerine and Colgate were the frequently
A validated self-administered questionnaire, was used mouth washes reported by the participants. 88.1%
specifically designed and utilized in the study. Questions reported tongue cleaning habit and only slightly more than
pertaining to demographic data, awareness of oral health 50% of the study sample knew what flossing is. Regarding
knowledge regarding orthodontics as a specialty were orthodontic questions, nearly 91% responded that smile
included. A total of 42 questions included in the study. is very important for facial beauty. 40.2% of the study
Demographic date includes 5 questions. Awareness of subjects reported never observing in the mirror for irregular
Oral health consists of 15 questions and awareness of teeth. 56.1% were aware that orthodontic treatment can
orthodontic treatment consists of a total of 22 questions and resolve certain breathing issues. 46.6% felt that braces are
170 Gowd et al. / IP Indian Journal of Orthodontics and Dentofacial Research 2023;9(3):168–174

better used during 15-30 years of age. Nearly 70% knew Table 1: Descriptive statistics for background characteristics of
that it might be necessary for some teeth to be extracted the study sample
as part of orthodontic care. Only 65.2% of the study Variable Category Frequency Percent
sample visited dentist at some point in time. 73.5% were 17-20 394 42.0
aware that adults can wear braces. 71.2% had demonstrated 20-25 505 53.8
Age
knowledge of different types of braces and 54.9% knew 25-30 26 2.8
that there are invisible braces available in orthodontic >30 13 1.4
Male 229 24.4
care. No significant differences were noted between males Gender
Female 708 75.6
and females in their oral hygiene habits. Students from
Medical 366 39.0
paramedical courses had significantly lesser knowledge on Course Dental 246 26.2
the nature of oral health as an integral part of general health. Paramedical 326 34.8
Significantly higher percentage of paramedical students I year 273 29.1
(46.6%) reported brushing twice a day compared to medical II year 241 25.7
and dental students. Paramedical students were significantly Year of
III year 194 20.7
study
more aware of the benefits of oil pulling in reducing oral IV year 180 19.2
bacteria and promoting oral hygiene. Significantly higher Internship 50 5.3
proportion (70.7%) of dental students knew what flossing Upper 79 8.4
means as compared to medical and paramedical students. Upper middle 591 63.0
Socioeconomic
There were no significant differences in oral hygiene habits status Lower middle 244 26.0
based on socioeconomic status. Female students opined Lower 24 2.6
with a greater frequency (70.8%) that irregular teeth have a
negative impact on self-esteem and quality of life compared
to male students. Female students were more aware of any active disease, discomfort or embarrassment. 7 Oral
the availability of various types of braces compared to health knowledge is considered to be an essential
male students, the difference of which was statistically prerequisite for health related behaviour. 8,9
significant. Also, females were more knowledgeable on Orthodontic treatment not only improves quality of
the availability of invisible braces than males, which was life through the correction of aesthetic component,
a statistically significant difference. Based on the course but it also enhances the individual’s self-esteem, most
of study, significantly lesser percentage of dental students important motivation for orthodontic treatment is usually
reported observing in the mirror for jaw discrepancies. an improvement in appearance by not only improving the
Paramedical students were significantly less aware than appearance of teeth but overall face. There is a scarcity of
medical and dental students that orthodontic treatment can data about the awareness of orthodontic treatment and oral
resolve certain breathing problems. Dental students had health in this region. 10
significantly higher awareness of the possible necessity to This study assessed attitudes, knowledge and practice of
extract some teeth as a part of orthodontic care, availability dental students, medical students and paramedical students
of various types of braces along with the existence of on oral health and orthodontic treatment. The sample taken
invisible braces. There were no significant differences based was convenience and sample was evaluated by giving self-
on socioeconomic status in the participants’ responses to administered structured questionnaire. In this study it was
orthodontic questions. found that most of the responses were highly significant.
In the current study, it was found that the awareness of
4. Discussion dental students was better than the medical and paramedical
students but still dental students should have more
The word Hygiene (from Greek hygienos) is a science efficient knowledge in order to promote good oral health.
concerned with the investigations of environmental factors The awareness in the medical and paramedical students
that affect human health and how the human body responds regarding the oral hygiene practices and orthodontic
to them. The primary factor in the prevention of dental treatment was less and the findings were statistically
caries and periodontal diseases is by obeying the rules of significant. Only less than 40% of the nursing students
proper oral hygiene. Health education is very important in were aware of practices like flossing, mouth wash etc.
dentistry and basic of modern prevention programs should whereas 70% of dental students were aware of the same.
be included in all curricula of medical courses. 5 As compared to various studies 1,11–14 it was found that
Oral disease qualifies as major public health problems regarding orthodontic treatment, 98% of the dental students
owing to their higher prevalence and significant social were aware that orthodontic appliance can correct the
impact?. 6 Oral health is considered as fundamental to position of teeth whereas only 38% of then nursing students
general health and well-being. A healthy mouth enables an had a knowledge of orthodontic therapy. Students belonging
individual to eat, speak and socialize without experiencing to other professions apart from dentistry like engineering
 Gowd et al. / IP Indian Journal of Orthodontics and Dentofacial Research 2023;9(3):168–174 171

Table 2: Association between participants’ course of study and oral hygiene habits
Question Gender Category Frequency Percent P value
Yes 354 96.7
Medical No 1 0.3
Don’t know 11 3
Do you think that Yes 240 97.6
Oral health is a part
Dental No 5 2 <0.001*
of your general
health? Don’t know 1 0.4
Yes 295 90.5
Paramedical No 21 6.4
Don’t know 10 3.1
Once a day 274 74.9
Medical
Twice a day 92 25.1
Frequency of Once a day 150 61
Dental <0.001*
brushing Twice a day 96 39
Once a day 174 53.4
Paramedical
Twice a day 152 46.6
Every month 93 25.4
Every 3 months 198 54.1
Medical
Every 6 months 63 17.2
Less than 6 months 12 3.3
Every month 85 34.6
How often do you
Every 3 months 136 55.3
change your Dental <0.001*
toothbrush? Every 6 months 22 8.9
Less than 6 months 3 1.2
Every month 129 39.6
Every 3 months 159 48.8
Paramedical
Every 6 months 33 10.1
Less than 6 months 5 1.5
Yes 95 26
Do you know about Medical
No 271 74
oil pulling is
Yes 66 26.8
alternative for Dental 0.798
commercial No 180 73.2
mouthwash? Yes 92 28.2
Paramedical
No 234 71.8
Yes 115 31.4
Do you know that Medical
No 251 68.6
oil pulling helps to
Yes 86 35
remove bacteria and Dental 0.001*
promote oral No 160 65
hygiene? Yes 148 45.4
Paramedical
No 178 54.6
Yes 178 48.6
Medical
No 188 51.4
Do you know what
Yes 174 70.7
is meant by Dental <0.001*
flossing? No 72 29.3
Yes 128 39.3
Paramedical
No 198 60.7
Yes 135 36.9
Medical No 190 51.9
Don’t know 41 11.2
Have you noticed Yes 61 24.8
bleeding from gums Dental No 155 63 0.021*
while brushing? Don’t know 30 12.2
Yes 113 34.7
Paramedical No 170 52.1
Don’t know 43 13.2
Chi square test; * denotes statistical significance
172 Gowd et al. / IP Indian Journal of Orthodontics and Dentofacial Research 2023;9(3):168–174

Table 3: Association between participants’ course of study and response to orthodontic questions
Question Course of study Category Frequency Percentage P value
Yes 334 91.3
Medical No 17 4.6
Are you aware that May be 15 4.1
teeth alignment Yes 230 93.5
plays an important Dental No 11 4.5 <0.001*
role for a better May be 5 2
smile? Yes 225 69
Paramedical No 53 16.3
May be 48 14.7
Yes 193 52.7
Have you ever Medical No 143 39.1
observed any May be 30 8.2
crookedness or Yes 125 50.8
irregularities of Dental No 94 38.2 0.092
your teeth while May be 27 11
brushing or looking Yes 143 43.9
into mirror? Paramedical No 140 42.9
May be 43 13.2
Yes 164 44.8
Medical No 195 53.3
May be 7 1.9
Have you observed Yes 68 27.6
any jaw differences Dental No 175 71.1 <0.001*
in your face? May be 3 1.2
Yes 101 31
Paramedical No 216 66.3
May be 9 2.8
Yes 245 66.9
Do you think Medical
No 121 33.1
irregular teeth can
Yes 173 70.3
affect your Dental 0.676
Self-esteem and No 73 29.7
quality of life? Yes 222 68.1
Paramedical
No 104 31.9
Yes 214 58.5
Do you know that Medical No 103 28.1
parafunctional May be 49 13.4
habits (thumb Yes 202 82.1
sucking, mouth Dental No 27 11 <0.001*
breathing, lip May be 17 6.9
biting) can cause Yes 122 37.4
irregular teeth? Paramedical No 126 38.7
May be 78 23.9
Yes 234 63.9
Do you know that Medical
No 132 36.1
orthodontic
Yes 157 63.8
treatment relieves Dental <0.001*
certain breathing No 89 36.2
problems? Yes 135 41.4
Paramedical
No 191 58.6
What age do you <15 134 36.6
feel better for Medical 15-30 174 47.5 0.062
braces? >30 15 4.1
 Gowd et al. / IP Indian Journal of Orthodontics and Dentofacial Research 2023;9(3):168–174 173

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Author biography
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A cross-sectional epidemiological school study. APOS Trends Orthod. Rudragoni Saikiran Gowd, Post Graduate Student
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174 Gowd et al. / IP Indian Journal of Orthodontics and Dentofacial Research 2023;9(3):168–174

Navya Mudunuri, Post Graduate Student https://orcid.org/0009-0000- Sri Harsha Yelchuru, Reader https://orcid.org/0009-0000-2309-3359
8936-7500

Vasudevan S.D, Professor and Head https://orcid.org/0000-0002-8764-

1374 Cite this article: Gowd RS, Mudunuri N, Vasudevan S.D, Kovelakar E,
Tankala R, Yelchuru SH. Do medical and paramedical students have a
Ekavenika Kovelakar, Senior Lecturer https://orcid.org/0009-0001- better awareness regarding oral health practices and orthodontic
7157-3127 treatment? A KAP study. IP Indian J Orthod Dentofacial Res
2023;9(3):168-174.
Ravali Tankala, Senior Lecturer https://orcid.org/0000-0002-9783-
7768