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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 7  |  Issue : 2  |  Page : 73-77

Oral health status, awareness, attitude, practices, and level of nicotine dependence among Tamil Nadu Electricity Board workers in North Chennai, Tamil Nadu


Department of Public Health Dentistry, Priyadarshini Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Web Publication19-May-2016

Correspondence Address:
T C Bharathi
D. No. 1A, Lalitha Garden, Madhavaram, Chennai - 600 060, Tamil Nadu
India
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DOI: 10.4103/0976-433X.182673

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  Abstract 

Aim: To assess the oral health status, awareness, attitude, practices, and level of nicotine dependence among electricity board workers in North Chennai, Tamil Nadu. Subjects and Methods: A cross-sectional study was conducted among the electricity board workers in North Chennai. About 285 electricity board workers answered the questionnaire regarding the oral health awareness, attitude, practices, and also Fagerstrom nicotine dependence questionnaire was used to record the tobacco usage. After answering the questionnaire, the subjects were examined using the mouth mirrors and probe under natural light for recording the oral health status using oral hygiene index-simplified index and decayed, missing, and filled teeth (DMFT) index. Statistical Analysis Used: SPSS version 21. Results: The mean DMFT of electricity board workers was 4.168 ± 2.766. About 91.6% of electricity board workers were with fair oral hygiene status. Prevalence of smoking among the study subjects was 26.7% and smokeless tobacco was 9.1%. Conclusions: The finding of the study provides the insight into the oral health status and awareness among electricity board workers in North Chennai. The oral health status of the electricity board workers is in a fair state. Steps should be taken so as to provide basic dental care facilities for the workers.

Keywords: Electricity board workers, nicotine dependence, oral health


How to cite this article:
Bharathi T C, Kavitha K, Ganesh R. Oral health status, awareness, attitude, practices, and level of nicotine dependence among Tamil Nadu Electricity Board workers in North Chennai, Tamil Nadu. SRM J Res Dent Sci 2016;7:73-7

How to cite this URL:
Bharathi T C, Kavitha K, Ganesh R. Oral health status, awareness, attitude, practices, and level of nicotine dependence among Tamil Nadu Electricity Board workers in North Chennai, Tamil Nadu. SRM J Res Dent Sci [serial online] 2016 [cited 2020 Oct 22];7:73-7. Available from: https://www.srmjrds.in/text.asp?2016/7/2/73/182673


  Introduction Top


Oral hygiene is the practice of keeping the mouth healthy and clean by brushing and flossing to prevent tooth decay and gum disease. The World Health Organization has a definition of good oral health: “Oral health means being free of chronic mouth and facial pain, oral and throat cancer, oral sores, birth defects such as cleft lip and palate, periodontal (gum) disease, tooth decay and tooth loss, and other diseases and disorders that affect the mouth oral cavity.”[1]

Oral health is often taken for granted, and its value is not fully understood, until it is lost. Oral health continues to be a neglected entity despite continuous efforts for oral health promotion, worldwide.[2] According to the general dentistry, there is a relationship between gum disease and health complications such as stroke and heart disease. Other research shows that more than 90% of all systemic diseases have oral manifestations including swollen gums, mouth ulcers, dry mouth, and excessive gum problems.[3]

The occupational environment is one of the major determinants for oral health. Every occupation is associated with one or other ill effects on health. Studies have shown the associations between occupational exposure and greater incidence of oral diseases. Hence, it is necessary to consider the ignorance of employees about their real oral condition, and there is an urgent need of an efficient policy for workers' health. It was observed that the risk factors for oral diseases in workers are age, educational level, smoking, and general health status.[4]

Tobacco use has been directly implicated in numerous oral morbidities including oral cancer, stomatitis nicotina, oral leukoplakia, periodontitis, gingival recession, and soft tissue changes. Hence, we are in a unique position to provide salient, proximal information about tobacco use and oral health, which can motivate tobacco users to quit.[5]

Tamil Nadu Electricity Board (TNEB) was formed in 1957, and it was divided into nine regions all over Tamil Nadu. Chennai is a cosmopolitan city in which TNEB is divided into two regions such as Chennai North and Chennai South region. TNEB workers are a group of people who are separated into four grades. These people spend most of their times in their tiring work, without regular food, rest, and recreation. In particular, the 3rd and 4th grade workers work in their day and night shifts leading to a change in their schedules of their lifestyles. Their socio-economic conditions adversely influence oral health status of individuals by indirectly lowering, preventing, or postponing their use of appropriate self-care or professional services. One such condition is financial loss of hourly wages for workers who take off to visit the dentist, a general inability to pay for dental care, poor access to dental care, lack of insurance, and lack of regular source of dental care. Their work stress has an adverse effect on physical and psychological well-being of workers and can induce several unhealthy behaviors such as smoking and excessive alcohol use.

Work stress makes them to consider oral health as a low priority, and the knowledge about the tobacco addiction is not well known among the workers. Hence, the objective of our study was to determine their oral health status, attitude, awareness, practice, and the knowledge about the ill effects of tobacco, which has an adverse effect on their systemic health among TNEB workers in Chennai North.


  Subjects and Methods Top


A descriptive cross-sectional study was conducted among electricity board workers in Perambur division, Chennai North, during the period of August 2015. The study was approved by the Institutional Review Board and the permission to conduct the study was obtained from the Ethical Committee of Priyadarshini Dental College and Hospital, Pandur, Thiruvallur district. Prior permission was obtained by Divisional Officer of TNEB in Perambur division to conduct the study.

Chennai Electricity Board is divided into North Chennai and South Chennai. We selected North Chennai which again consists of three circles such as Chennai North circle, Chennai South circle, and Chennai West circle. Chennai North circle is again divided into four divisions such as Perambur, Ponneri, Tandaiyarpet, Vyasarpadi, in which we randomly selected Perambur division.

The estimated sample size for the study was 285 determined by “G” power statistical software based on 90% power with an alpha error of 0.05. The study population was the workers who were present on the day of the study and those who were willing to participate in the study.

For clinical examination, the examiners were trained and calibrated by an experienced examiner for reliability and reproducibility with a kappa statistic value of 0.80–0.85. The clinical examination was conducted using a structured predefined pro forma which included oral hygiene index-simplified (OHI-S) and decayed, missing, and filled teeth (DMFT) index to record the oral health status of the subjects.

A structured closed-ended questionnaire was used to collect the data about their oral hygiene awareness, practices, and Fagerstrom test of nicotine dependence for both smokers and tobacco chewers among electricity board workers.

After answering the questionnaire, the subjects were examined using mouth mirror, probe under natural light for recording the oral health status using OHI-S index and DMFT index. After oral examination, oral hygiene instructions and tobacco cessation counseling were given to the workers.

The collected data were entered into Microsoft Excel sheets and analyzed using Statistical Package for the Social Sciences software, version 21, acquired by IBM in 2009. The current versions (2015) are officially named IBM SPSS Statistics which was used for survey authoring and deployment (IBM SPSS Data Collection), data mining (IBM SPSS Modeler), text analytics, and collaboration and deployment (batch and automated scoring services). Proportions were compared by the use of Chi-square test. P < 0.05 was selected to denote statistical significance.


  Results Top


A total of 285 electricity board workers participated in the study. Out of 285 participants in the study, 240 (84.2%) were males and 45 (15.8%) were females. The age group of the participants ranged from 25 to 58 years. The mean DMFT of electricity board workers was 4.168 ± 2.766. The mean number of decayed teeth was 2.547 ± 2.192. The mean number of missing teeth was 1.098 ± 1.200. The mean number of filled teeth was 0.523 ± 0.894. [Figure 1] shows the brushing technique practiced by study subjects. [Figure 2] shows the duration of brushing among electricity board workers. [Table 1] shows oral health awareness and attitude among electricity board workers. [Figure 3] shows the oral health status among electricity among workers. [Table 2] shows the DMFT status among electricity board workers. [Figure 4] shows the level of nicotine dependence among smokers. [Figure 5] shows the level of nicotine dependence among tobacco chewers.
Figure 1: Brushing technique practiced by study subjects

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Figure 2: Duration of brushing among electricity board workers

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Table 1: Awareness and attitude toward oral health among electricity board workers

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Figure 3: Oral health status among electricity board workers

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Table 2: DMFT status among electricity board workers

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Figure 4: Level of nicotine dependence among smokers

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Figure 5: Level of nicotine dependence among tobacco chewers

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  Discussion Top


The present study was conducted among electricity board workers to assess the status, awareness, attitude, and practices of oral health and level of nicotine dependence. Moreover, a comparable prevalence data have not been recorded previously worldwide. Association of dental caries status, oral hygiene status with age, their grade, brushing habit, frequency of brushing, and tobacco use was assessed.

Oral health is a vital part of general health and is a valuable asset of every individual. Oral disease is an important public health problem owing to the prevalence, socio-economical aspect, expensive treatment, and lack of awareness.[6] Various factors such as environmental factors, occupational factors, dietary factors, pathologic factors, and oral hygiene practice affect the oral health of an individual.[7] It was, therefore, expected that differences in occupation, lifestyle, and health-care utilization would have an effect on dental health.[8] The awareness on the causative factors for oral diseases, the attitude, oral health-related habits, and behavior play a vital role in determining the oral health status of individuals.[9]

The scarce literature on dental health awareness, attitude, oral health-related habits, and behavior among the adult population in relation to socio-economic factors in India prompted us to take up this study on the TNEB workers of Chennai North that had all the classes of employees under one roof.

Our study reported a mean DMFT score of 4.168 ± 2.766 which is less than the study conducted by Dagli et al.[8] among green marble mine laborers, India, which showed a mean DMFT score of 2.79 ± 2.44, and another study result is also equivocal which is conducted by Bali et al.[9] that showed a mean DMFT score of 2.8 in rural and 2.9 in urban areas. Similarly, a study by Bansal and Veeresha [6] showed a mean DMFT score of 2.18 among factory workers in Himachal Pradesh, India. This might be attributed to the lack of proper oral hygiene maintenance which resulted in poor oral health status, so electricity board workers must improve their method of maintaining their oral hygiene and awareness toward regular dental treatments.

In the present study, 98.2% used tooth paste and tooth brush to clean their teeth, whereas a study conducted by Sharma et al.[7] showed that 86.7% cleaned their teeth with toothbrush and tooth paste, which is less than the present study, which shows that our study participants practice the basic oral hygiene properly.

Only 39.3% used soft tooth brush, 22.1% used medium toothbrush, 23.9% used hard toothbrush, and 14.7% had no idea about it, while in contrast, a study conducted by Umeizudike et al. showed increased awareness toward the type of tooth brush in which 68.8% used soft tooth brush, 30.2% used hard toothbrush, and 1.0% did not know about it,[10] which shows the lack of awareness about different types of tooth brush available nowadays.

About 21.8% believed that use of fluoride results in the reduction of dental cavities and 78.2% did not know about it, while a study conducted by Chanchal et al.[11] showed that 7.9% believed fluoride usage results in the reduction of dental cavities, 44.7% refused it, and 47.4% did not know about it, which shows the lack of awareness toward fluoride and its properties. Hence, awareness should be created by conducting more oral health education programs about the importance of fluoride.

The present study shows that 23.9% of the participants reported that they do not visit the dentist due to high cost of the dental treatment while 12% of the participants also reported that they do not visit the dentist due to the high expense of dental treatment in the study conducted by Al-Omiri et al.[12] Due to the high cost of the dental treatment, most of the people in the developing countries cannot afford the treatment cost, thus reluctant to seek the dental treatment.

The present study shows that around 81.8% of the participants visited the dentist only in problem, only 4.6% visited the dentist once in 3–6 months, and 4.9% visited the dentist once in a year, which is more than a study conducted by Jain et al.,[13] where 54% of the subjects visited the dentist when they were in pain. This is due to the lack of oral health knowledge, awareness, and neglect among the participants that caused the frequency of visit low; this also affects the participants' health-seeking behavior. Visiting a dentist is still not considered as preventive dental behavior, at present, it only depends on the treatment needs.

About 36.8% had adverse tobacco habit, in which 27.7% had smoking habit and 9.1% had tobacco chewing habit; in contrast, a study conducted by Sharma et al.[7] showed that 40% had tobacco consuming habit, around 9% had smoking habit, and 22.22% had chewing habit, which shows the lack of awareness toward tobacco and its ill effects.

As far as our knowledge is concerned, this study is the first of its kind in assessing the oral health awareness, knowledge, attitude, and practice of TNEB workers in Chennai North, and more such studies are needed across the country in the near future so that an amalgamation of the above literature could be used to plan out more oral health educational programs to improve more awareness toward oral health among the TNEB workers.


  Conclusion Top


The finding of the study provide insight into the oral health status, awareness, attitude, practices and level of nicotine dependence among electricity board workers in North Chennai. Primary oral health programs like dental screening and oral health education at regular interval should be made mandatory which will help to prevent accumulation of health care demands of electricity board workers. In phase of results obtained, it was concluded that electricity board workers present moderate caries prevalence. A lack of knowledge on good oral hygiene practices, lack of motivation, low priority which was given to the dental care in the society, lack of facilities for an early and a regular oral health check up, a prompt treatment and finally the cost of the treatment may be the reason for the accumulated treatment needs. Approximately 35.8% of all electricity board workers, predominantly males, reported currently using tobacco both smoking and smokeless. We found that it is important to change this attitude and behaviours early in the educational process because tobacco cessation is unfamiliar entity for most electricity board workers.

As dental professionals, we should take necessary steps to improve the oral health status and motivate the electricity board workers for regular dental check-ups in order to improve their oral health.

Recommendations

In view of the findings of the present study, it is recommended that:

  • A program should be planned, which includes oral health education and motivation, demonstration of correct tooth-brushing technique educating about the ill-effects of tobacco consumption for electricity board workers
  • Regular dental check-up of all the electricity board workers should be made every 6 months.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Kaur S, Kaur B, Ahluwalia SS. Oral health knowledge, attitude and practices amongst health professionals in Ludhiana, India. Dentistry 2015;5:315.  Back to cited text no. 1
    
2.
Gambhir RS, Sogi GM, Veeresha KL, Sohi RK, Randhawa A, Kakar H. Dental health status and treatment needs of transport workers of a Northern Indian city: A cross-sectional study. J Nat Sci Biol Med 2013;4:451-6.  Back to cited text no. 2
    
3.
Duraiswamy P, Kumar TS, Dagli RJ, Chandrakant, Kulkarni S. Dental caries experience and treatment needs of green marble mine laborers in Udaipur district, Rajasthan, India. Indian J Dent Res 2008;19:331-4.  Back to cited text no. 3
[PUBMED]  Medknow Journal  
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Schour L, Sarnat BG. Oral manifestations of occupational origin. JAMA 1942;12:1197-207.  Back to cited text no. 4
    
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Gordon JS, Severson HH. Tobacco cessation through dental office settings. J Dent Educ 2001;65:354-63.  Back to cited text no. 5
    
6.
Bansal M, Veeresha KL. Oral health status and treatment needs among factory employees in Baddi-Barotiwala-Nalagarh Industrial hub, Himachal Pradesh, India. Indian J Oral Sci 2013;4:105-9.  Back to cited text no. 6
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Sharma A, Thomas S, Dagli RJ, Solanki J, Arora G, Singh A. Oral health status of cement factory workers, Sirohi, Rajasthan, India. J Health Res Rev 2014;1:15-9.  Back to cited text no. 7
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Dagli RJ, Kumar S, Dhanni C, Prabu D, Suhas K. Dental health among green marble mine laborers, India. J Oral Health Community Dent 2008;2:1-7.  Back to cited text no. 8
    
9.
Bali, et al. National oral health survey and Fluoride Mapping. Dental council of India and Ministry of health and family welfare (Government of India), 2002-2003; p. 105.  Back to cited text no. 9
    
10.
Umeizudike KA, Onajole AT, Ayanbadejo PO. Periodontal health knowledge of nonmedical professionals and their oral hygiene behavior in a teaching hospital in Nigeria. European J Gen Dent 2015;4:48-54.  Back to cited text no. 10
    
11.
Chanchal G, Manish K, Nagesh L. KAP toward oral health, oral hygiene and dental caries status among anganwadi workers in Bareilly city, Uttar Pradesh. J Dent Sci Oral Rehabil 2014;5:53-7.  Back to cited text no. 11
    
12.
Al-Omiri MK, Al-Wahadni AM, Saeed KN. Oral health attitudes, knowledge, and behavior among school children in North Jordan. J Dent Educ 2006;70:179-87.  Back to cited text no. 12
    
13.
Jain N, Mitra D, Ashok KP, Dundappa J, Soni S, Ahmed S. Oral hygiene-awareness and practice among patients attending OPD at Vyas Dental College and Hospital, Jodhpur. J Indian Soc Periodontol 2012;16:524-8.  Back to cited text no. 13
[PUBMED]  Medknow Journal  


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]
 
 
    Tables

  [Table 1], [Table 2]



 

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Abstract
Introduction
Subjects and Methods
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