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Original Article
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A descriptive study on the perception of health care workers to dental treatment at a tertiary hospital in Lagos, Nigeria | ||||||
Oyapero Afolabi1, Ogunbanjo VO2 | ||||||
1Department of Preventive Dentistry, Lagos State University Teaching Hospital, Ikeja, Lagos.
2Department of Oral and Maxillofacial Surgery, Lagos State University Teaching Hospital, Ikeja, Lagos Nigeria. | ||||||
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Oyapero A, Ogunbanjo VO. A descriptive study on the perception of health care workers to dental treatment at a tertiary hospital in Lagos, Nigeria. Edorium J Dent 2016;3:30–39. |
Abstract
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Aims:
Many oral diseases have a strong connection with systemic conditions while effective delivery of health care often requires the combined efforts of all health professionals. Due to the problems of access to dental care, patients may consult other primary health care providers for their oral health needs. This study was undertaken to assess the oral health knowledge, attitude and practices among various health professionals working in Lagos State University Teaching Hospital, (LASUTH).
Methods: This cross-sectional study was conducted at the LASUTH Ikeja, Lagos, Nigeria. A stratified probability sampling method was used to categorize the different health professionals in LASUTH and about 20% of the health workers in each category were enlisted using the nominal roll as a sampling frame. A total of 148 questionnaires were administered during the study on subjects who met the inclusion criteria and gave their informed consent. Results: Females and younger respondents were more likely to visit the dentist than males for routine dental check-up even though the association was not significant. The oral health knowledge and attitude among the various health professionals surveyed in LASUTH was found to be inadequate even though Medical doctors had the overall best responses. There was a significant difference between the attitude of the Medical Doctors and other health professionals on questions about extractions (p = 0.024); dental treatments (p = 0.008); dental fillings (p = 0.000); artificial teeth (p = 0.013); bleeding gums (p = 0.002) and replacement of lost teeth (p = 0.004). Conclusion: All health professionals can promote oral health by disseminating accurate oral health messages, being appropriate role models by paying attention to their own oral health, encouraging appropriate dental visits and participating in oral health promotion within their scope of duties. It is also recommended that dental items feature more frequently in hospital ground rounds and clinical meetings of to address this deficit. | |
Keywords:
Attitude to dentistry, Dental treatment, Health care workers, Oral disease, Oral health knowledge
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Introduction
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Oral health may be defined as a state of health of oral and related tissues that enables an individual to eat, speak and socialize without active disease, discomfort or embarrassment and which contributes to general well-being. Oral diseases may be associated with considerable pain, anxiety, and impaired social functioning. Although most dental diseases are not life-threatening, they are detrimental to the quality of life and can have an impact upon the self-esteem, nutrition and health of an individual [1] [2]. Many oral diseases have a strong connection with systemic conditions while effective delivery of health care often requires the combined efforts of all health professionals [3]. Due to the difficulties of access to dental care, patients may consult other primary health care providers for their oral health needs. Hence, medical practitioners and other health care workers frequently encounter patients with oral and dental problems [4]. All health professionals can promote oral health by disseminating accurate oral health messages, being appropriate role models by paying attention to their own oral health, encouraging appropriate dental visits and participating in oral health promotion within their scope of duties [5]. With proper knowledge, medical professionals could guide patients, friends, families and the community at large on appropriate steps to take to address oral health conditions [6]. They could, however, dismiss a patient's symptoms or wrongly prescribe medication based on inaccurate knowledge or prejudices to dentistry. Oral health care has usually been excluded from general health care. Some researchers [7][8][9] have observed that nurses, physicians, and other health care professionals have not been adequately trained to provide oral health advice or screening. In a study by Applebaum et al. [10], only 9% of primary care physicians could identify the high risk sites in the oral cavity for oral cancers, while only 24% knew the most common signs and symptoms of potentially malignant disorders. Similarly, a survey of nurses showed that only 35% identified sun exposure as a risk for lip cancer while only 19% felt that their knowledge of oral cancers was adequate [11]. A survey of nursing assistants in nursing homes also found that they erroneously regarded tooth loss as a natural consequence of aging [12]. These surveys underline the need to bridge the knowledge and attitude gap if non-dental health professionals are to contribute towards the reduction of the burden of oral diseases. Very few surveys have been done in this Nigeria to determine the perception of medical health workers to dental treatment. The present study was undertaken to assess the oral health knowledge, attitude and practices among various health professionals working in LASUTH. | ||||||
Materials and Methods
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This cross-sectional study was conducted at the Lagos State University Teaching Hospital, (LASUTH) Ikeja, Lagos, Nigeria. Sample size Sample selection Study setting and location Inclusion and exclusion criteria Data collection Data analysis | ||||||
Results | ||||||
One hundred and fifty questionnaires were distributed to the health professionals during the study period. The completed questionnaires were checked for completeness and consistency. A total of 148 respondents who were eligible by set inclusion and exclusion criteria and who completed all the aspects of the questionnaire properly were included in the final analysis. Socio-demographic and diabetic characteristics of the study population Association between the socio-demographic characteristics of respondents and dental check-up History of dental treatment in the study population A comparison of health workers responses to questions on knowledge about dental treatment A comparison of health workers responses to questions on attitude to dental treatment | ||||||
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Discussion
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This study assessed oral health knowledge and attitude of health care professionals in LASUTH. The study was descriptive and cross-sectional and was done using a self-administered questionnaire. It was observed that most of the respondents were medical doctors and nurses, while about 53% of the respondents were female with most of them in the 30–39 years age group. In the present study, 49.33% of the health professionals had previously visited the dentist for routine check-up. This was significant because visiting the dentist for routine check-up can be interpreted as accessing preventive care. The percentage of female health professionals visiting a dentist for routine check-up was higher than their male colleagues. One possible explanation for this tendency is that women care more about their health and their appearance and have greater aesthetic concerns than men. This was in agreement with work by previous researchers [14]. Among the health professionals surveyed in this study, medical doctors were more likely to have visited the dentist for a routine check-up than the other health workers. Similarly, respondents that had a postgraduate training or qualification were more likely to have attended the dental clinic for a routine check-up. This may be attributed to favorable conditions like the proximity of dental centre, rotations by medical doctors through the dental clinic during their specialist training as well as regular contact between dental residents on specialist training with their medical colleagues. It was also encouraging to note that the prevailing reason for dental attendance among the respondents was for scaling and polishing which is mainly a preventive procedure. This was in agreement with the findings of Kaur et al. but, however, in contrast to the work of previous researchers who observed that toothache was the main reason why health professionals visited the hospital [15] [16][17]. The majority of the respondents that had attended for dental treatment viewed the dental personnel as cordial and the procedure undergone as atraumatic. The attitude of dental personnel and the occasional trauma associated with some dental procedures may be a barrier to dental treatment for those who have had a negative experience. Some studies have shown that previous traumatic dental experiences are often correlated with a high level of dental anxiety [18][19][20]. There is also an association between dental fear and less frequent dental attendance, poorer oral health, and greater functional impairment. The positive attitude encountered in this group of respondents should be exploited to motivate them and their patients to seek preventive dental services routinely. This study addressed the knowledge and attitude of health workers regarding dental treatment and practice. There was a considerable lack of oral health knowledge among most of the health professionals on different aspects of dental treatment. This lack of knowledge may be a significant barrier to the prompt identification and referral of dental conditions as well as in the preventive advice that health workers should give to patients. The knowledge of medical doctors was generally higher than that of other health workers while nurses had the second best responses. Radiographers were observed to have the worst responses out of the health workers surveyed. It is significant to note that health workers that have a high level of interaction with patients in the clinics had better responses. Physicians, nurses and other health professionals that work directly with patients may gain information and experience in general dental health during their careers due to their constant clinical interaction with patients. In the developing nations, there is a high prevalence of oral disease while there is poor access to oral health services [15]. In many countries, young children are not examined by a dentist until they are three years old, but they see primary-care providers, including physicians very frequently for health screenings [21]. Physicians are often the primary source of preventive information for most patients since they establish a relationship with them from an early stage. Integration of oral health information into health education sessions can address the common determinants of health and improve the ability of the patients to take appropriate preventive actions [22]. There is thus a significant need to improve the knowledge of health workers on different aspects of dental treatment and this need is greatest among health workers that are not involved in clinical activities. Correspondingly, medical doctors had a more positive attitude on different aspects of dental treatment compared to other health workers. Less than 50% of the respondents had a positive attitude to different aspects of dental treatment. Majority of the health workers were scared of dental treatments, felt that dental treatments were usually painful and believed that dental fillings were unnecessary. Most of them also believed that extractions were the most important thing that dentists do and did not see a need to relate patients' systemic health with their oral health. Some chronic conditions as well as illnesses in immunocompromised patients have oral manifestations which could promptly alert health workers. Oral health care needs to be addressed by all health workers and should be integrated into comprehensive health-promoting strategies and practices [23]. The common risk factor approaches for chronic diseases require collaboration between health professionals [24]. Thus, oral health promotion is needed within health care practices of physicians and nurses [25]. Changes to attitudes, perceptions and knowledge are important precursors to changes in behavior. Medical professionals often are the first point of contact for patients with dental diseases, i.e., halitosis, bleeding gums, toothache and oral cancer. All members of the health profession have the potential to promote oral health by supporting accurate oral health messages, showing exemplary oral health related behaviors, encouraging appropriate dental visits and participating in explicit oral health promoting activities within their scope of duties. A limitation of the study was its descriptive nature and also that the data collection was limited to a Tertiary facility. Future studies could explore the knowledge and attitude of health workers in secondary and primary care facilities as well as rural health care workers who attend to a significant part of the population. Future studies could also explore the role of medical clinics as an avenue for screening for oral health conditions. | ||||||
Conclusion
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There was a moderate level of demand for preventive dental services among the respondents surveyed, while female health workers were more likely to access dental services. The oral health knowledge and attitude among the various health professionals surveyed in LASUTH was found to be inadequate even though medical doctors had the overall best responses. The knowledge of health workers on oral health and their attitude to dentistry must improve if a positive impact must be made on the oral health status of their patients. Continuing medical education for health professionals should include oral health topics to improve their knowledge of oral health. It is recommended that Dental items feature more frequently in hospital ground rounds and clinical meetings of to address this deficit. The general practice/ family medicine residency program should also consider the inclusion of a dental rotation in their training. | ||||||
References
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Author Contributions:
Oyapero Afolabi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Ogunbanjo V.O. – Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published |
Guarantor of submission
The corresponding author is the guarantor of submission. |
Source of support
None |
Conflict of interest
Authors declare no conflict of interest. |
Copyright
© 2016 Oyapero Afolabi et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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