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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 15  |  Issue : 1  |  Page : 38-42

Knowledge and awareness of prosthodontic treatment requirements among partially edentulous patients of the armed forces: An observational study


1 Air Force Dental Centre, Air Force Academy, Dundigal, Hyderabad, Telangana, India
2 CMDC (SC), Pune, Maharashtra, India

Date of Submission06-Oct-2020
Date of Acceptance27-Dec-2020
Date of Web Publication09-Mar-2021

Correspondence Address:
M P Shashidhar
18 Air Force Dental Centre, Air Force Academy, Dundigal, Hyderabad, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jodd.jodd_61_20

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  Abstract 


Background: Prosthodontic rehabilitation of the partially edentulous patients is one of the important treatment modalities carried out in outpatients departments of Armed Forces Dental Centers. Removable partial dentures, fixed dental prosthesis, and implant-supported prosthesis are the options available for the rehabilitation of the partially edentulous patients. Knowledge and awareness about the prosthetic rehabilitation varies between the individuals and has been largely unobserved and less reported in the literature. The aim of this study was to evaluate the knowledge and awareness of the partially edentulous patients of the armed forces about different options available for prosthetic rehabilitation in general and implant prosthesis in particular.
Subjects and Methods: The study included 546 partially edentulous participants who reported to one of the tertiary care dental centers of the armed forces requiring prosthodontic rehabilitation. A self-explanatory questionnaire containing the personal particulars, various options available for the replacement of the missing teeth, and advantages and disadvantages of all the options including dental implants were asked to all the participants. Data were fed into Microsoft Excel® sheet and analyzed using statistical software SPSS.
Results: More than half of the participants were unaware of their edentulous state, treatment options available for them, and advantages and disadvantages of available treatment modalities.
Conclusion: The results of the study bring about the further requirement of patient education in increasing their knowledge and awareness, which will enable them to make informed decision in choosing appropriate treatment modality in consultation with the treating prosthodontist.

Keywords: Knowledge and awareness of dental implants, knowledge and awareness of partially edentulous patients, knowledge and awareness of prosthodontic rehabilitation


How to cite this article:
Shashidhar M P, Gowda E M. Knowledge and awareness of prosthodontic treatment requirements among partially edentulous patients of the armed forces: An observational study. J Dent Def Sect. 2021;15:38-42

How to cite this URL:
Shashidhar M P, Gowda E M. Knowledge and awareness of prosthodontic treatment requirements among partially edentulous patients of the armed forces: An observational study. J Dent Def Sect. [serial online] 2021 [cited 2021 Apr 18];15:38-42. Available from: http://www.journaldds.org/text.asp?2021/15/1/38/310970




  Introduction Top


Prosthetic treatment of partially edentulous patients is one of the important treatment modalities carried out in armed forces dental centers. Knowledge and awareness of partially edentulous patients about the various treatment options available for prosthetic treatment is variable, largely unexplored and less reported in the literature. In conjunction with the advice given by the treating dentists, including prosthodontists, if the patients are aware of different kinds of prosthetic treatment, it enables them to choose most appropriate treatment modality.[1],[2] There are no existing data regarding knowledge and awareness of partially edentulous patients about various treatment modalities of prosthodontic treatment available. This study was conducted with an aim to evaluate extent of knowledge and awareness of the patients regarding various options to treat partially edentulous arches along with the advantages and disadvantages to the specific treatment.

Depending on the number of missing teeth, condition of teeth, and the surrounding structures, the options available for replacement of missing teeth in partially edentulous patients are removable partial dentures, teeth-supported fixed dental prosthesis, and implant-supported prosthesis. Removable partial dentures are cost effective, commonly undertaken, and possess further treatment options. It is associated with disadvantages of poor retention and stability during function, soreness of the supporting tissues, altered speech, and hassles of insertion and removal every day, leading to poor patient compliance.[3] Long-term use of removable partial dentures has disadvantages such as resorption of residual alveolar ridges and damage to adjacent teeth. Teeth-supported fixed dental prostheses are associated with advantages of better patient compliance, better function, esthetics, and phonetics but carries disadvantages of nonbiological essence of preparation of abutment teeth, postoperative sensitivity, and secondary caries of the abutments.[4] Implant prosthesis is associated with advantages of improved functions, speech, esthetics, preservation of abutment teeth, and alveolar bone. It is associated with disadvantages of high cost involved and technique sensitivity.[5]

In this cross-sectional observatory study, we aimed to investigate the level of knowledge and awareness of partially edentulous patients among armed forces clientele, about various options available for the prosthetic treatment with their advantages and disadvantages.


  Subjects and Methods Top


After obtaining the clearance from the institutional ethical committee, all consecutive patients reporting to outpatient department of one of the tertiary care dental centers of the Armed Forces, during the period of the study were included. Only patients who were willing to participate in the study with fulfilling inclusion and exclusion criteria were taken up for the study after obtaining written informed consent. Data were collected for 6 months from February 2019 to July 2019 who met the following criteria. Inclusion criteria were participants above 18 years of age, should be partially edentulous, and not in possession of any prosthesis. Exclusion criteria were participants with severe periodontal disease, completely edentulous patients, children, and mentally challenged individuals.

All the participants selected for the study were given self-explanatory close-ended questionnaire before they were taken up for treatment. Questionnaire was prepared from the inputs received from subject experts in the field, draft questions were made, and the best suited questions were included in the questionnaire. Questionnaire was prepared bilingually in English and Hindi to correspond with the reading and comprehension levels of patients with different levels of education. The primary tool was in English language; back translation was done in Hindi and was validated by domain experts. Data collected from the questionnaire were cleaned, coded, and entered into master sheet and statistically analyzed using SPSS 25 .2018 IBM intl ®, statistical software. Since being observational qualitative study, all the dichotomous or the binary data were subjected to logistic regression analysis.


  Results Top


This study included 546 participants predominantly male consisting of 61.54% (336) and 38.46% were females (210). Eighty-four participants were below 30 years, 306 were between 30 and 50 years, and 156 were between 50 and 80 years. [Table 1] summarizes the demographic structure of the participants.
Table 1: Demographic detail of the participants

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First question recorded the demographic details of the participants. Second question investigated their awareness of the edentulous state. Out of 546 participants, 136 (24.91%) were not aware of their edentulous state and 410 (75.1%) were aware that they have missing teeth in their mouth. Third question investigated their knowledge about the sequelae of the edentulism. Nearly 43.96% of participants said difficulty in eating, 8.79% bad smile, 23.08% as drifting of the teeth, and 24.18% were not aware of the sequelae. [Table 2] summarizes these results.

Knowledge and awareness on prosthodontic treatment options available for the replacement of missing teeth was investigated through fourth question. Nearly 30.77% of the participants were not aware of the options available for prosthodontic treatment and those who were aware, had got the information mainly from the dentists. A detail of awareness on availability of options available for prosthetic treatment with results of logistic regression analysis is tabulated in [Table 3]. On further analysis of the data of serving personnel, it was found that 53.65% of the serving personnel participated was aware of prosthetic options and 46.34% were not aware.
Table 2: Knowledge and awareness on ill effects of tooth loss

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Table 3: Knowledge and awareness on prosthodontic options available for the replacement of the missing teeth in general population and serving personnel

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Question five investigated about awareness of different prosthodontic rehabilitative options available. Nearly 70% of participants were aware of the different options available to them. Nearly 27.47% were aware of removable partial dentures, 9.89% were aware of tooth-supported fixed dental prosthesis, and 31.87% were aware of implant-supported crowns and bridges [Table 4].
Table 4: Knowledge and awareness on different prosthodontic options

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[Table 5] demonstrates the source of information of different prosthetic options. Nearly 70% of the participants said that dentists were the primary source of information and 18.68% had information from print and social media.
Table 5: Source of information about the prosthodontic options

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Seventh question investigated the knowledge and awareness of disadvantages of removable partial dentures. Around 52.75% of participants were not aware of the disadvantages of the removable partial dentures. Nearly 26.37% of participants felt that difficulty in insertion and removal was main disadvantage of removable partial denture and 20.88% felt that pain and soreness while eating are the problem with removable prosthesis, which are tabulated in [Table 6]. The disadvantages of the tooth-supported fixed dental prosthesis were investigated in question eight, wherein 65.93% of the participants were not aware of the disadvantages, 26.37% of the participants said that grinding of the adjacent teeth, and 20.88% felt sensitivity and food lodgment were the disadvantages of the tooth-supported fixed dental prosthesis. These results are tabulated in [Table 7].
Table 6: Disadvantages of removable partial dentures

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Table 7: Disadvantages of a tooth supported fixed dental prosthesis

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[Table 8] elicits the advantages of implant-supported crowns and bridges. Around 47.25% of the participants were not aware of the advantages of the implant-supported prosthesis. Nearly 34.06% of the participants felt that nongrinding of sound teeth and fixed nature of the restoration (8.68%) are the advantages of implant-supported crowns and bridges.
Table 8: Advantages of an implant-supported crowns and bridges

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  Discussion Top


Awareness of the patients about their edentulous state and various prosthetic treatment options available to them in consultation with the treating prosthodontist will enable them to appropriately decide the suitable treatment modality. This study was carried out to investigate the level of awareness and knowledge of partially edentulous patients requiring prosthodontic treatment. Results of the present study have shown that 51.65% of the participants have inadequate knowledge or information about their edentulous state, its sequelae, and treatment options available. Dentists were the biggest source of information (70.33%) regarding available prosthodontic options, wherein information from social and print media was only about 18.68%. According to the study by Zimmer et al., 77% of the participants got this information from the press with little contribution from their dentists,[6] and similar findings were reported by Akagawa et al., wherein they said only 20% of the participants obtained this information from the dentist.[7] This variation could be because of the low educational status of the subjects, wherein only 25.28% were graduates and 13.19% were postgraduates. The remaining 74.33% of participants were of matriculate and intermediate educational level. This indicates that educational status is one of the important factors in gathering information about the edentulous state and its treatment.[8],[9],[10],[11] The sample was nonspecific and randomly included all the patients attending outpatient department which involved the dependent family members. Their educational status and lack of availability of social and print media could also attribute to this finding. The service personnel awareness regarding availability of various prosthodontic treatment options were slightly high which could be due to compulsory yearly dental inspection and dental educational lectures after the dental inspection. The dissemination of the information from the serving personnel to the dependents could be the reason for dentist being the high percentage of source of information.[10] This also emphasizes the trust of the dependent clientele on the treating dentist of Armed Forces.

The prosthodontic treatment options considered in this study were removable partial dentures, tooth-supported fixed dental prosthesis, and implant-supported prosthesis. Removable partial dentures are most widely used treatment modality for treatment of partially edentulous patients.[12] One hundred and fifty participants (27.47%) in the study had opted for the option of removal partial denture. The majority of 52.75% participants had no idea about the drawbacks or disadvantages of removal partial denture. Around 26.37% were aware of the difficulty in insertion and removal and 20.88% about pain and soreness during mastication. This could be attributed for the fact about 71.42% were <50 years of age and were first timers seeking replacement of teeth and also due to poor awareness due to educational status of the participants.

Teeth-supported fixed dental prosthesis had been most sought after treatment modality by the patients.[13] In our study, only 9.89% of the participants were aware of the tooth-supported fixed partial denture which is on the lower side. However, the data showed that participants were aware of the disadvantages of fixed dental prosthesis, which were grinding (19.78%) and sensitivity and food lodgment (14.28%). This could be attributed toward the educational status of the participants and also the awareness of lesser value could be attributed to the fear factors of disadvantages.

Implant-supported prosthesis has been ideal and optimal treatment modality if all the conditions are favorable.[14] In our study, although 31.87% were aware of the implant treatment as an option, 47.25% were unaware of the advantages of implant-supported prosthesis. Around 34.06% were aware of the advantage that implant prosthesis is fixed and 18.06% attributed the advantage to nongrinding of adjacent teeth.

This study was conducted among the patients attending the outpatient department in one of the tertiary care dental centers of the armed forces. The results of this study indicate the low educational status and awareness of the available treatment options for the missing teeth. The role played by dentist and paradental staff of the armed forces in educating the patients about edentulousness and its sequelae is also highlighted. This information should be passed on to the serving personnel and their dependents by the dentists and paradental staff during dental inspections and community screening camps such as camps conducted by Army wives' welfare association (AWWA). Although the dental treatment in armed forces is free of cost, eliminating the cost barrier, the awareness regarding the availability of prosthodontic treatment is low. Access to the dental treatment, especially toward the specialty prosthodontic treatment and lack of specialized dental treatment in the given area can also be an important barrier.[8] This is very much a factor in armed forces considering the terrain and the provisioning of specialized dental treatment. Fear factor toward dental treatment, hierarchy in conducting the study and obligation to complete the survey might be a cause for bias. This bias could have been neutralized if the study had more specific target participants and also a drop box used to collect the data. When the same results are applied to the general population, their level of understanding and accessibility to dental treatment may vary significantly.


  Conclusion Top


This study was undertaken with the aim of investigating the level of knowledge and awareness of partially edentulous patients seeking prosthodontic treatment in one of the tertiary care dental centers of the armed forces. Within the limitations of the study, the awareness of the patient's edentulous state, treatment options available, and advantages and disadvantages of available treatment modalities were low. The results of the study emphasizes further requirement of patients education in increasing their knowledge and awareness, which will enable them to make informed decision in choosing appropriate treatment modality in consultation with treating prosthodontist. Further multicentric studies involving larger sample size may be required to authenticate and strengthen the evidences brought about in this study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Kumar A, Gupta R, Nagpa Al, Samra RK, Kaur J. Evaluation of awareness toward various treatment modalities for replacement of teeth in local population of Sundar Nagar, District Mandi, Himachal Pradesh. Indian J Dent Sci 2019:11;77-88.  Back to cited text no. 14
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8]



 

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