ORIGINAL ARTICLE |
https://doi.org/10.5005/jp-journals-10063-0153 |
Assessment of Dental Myths in Beliefs among Medical Undergraduates: A Cross-sectional Survey
1,2Department of Public Health Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
Corresponding Author: Akhila Vanga, Department of Public Health Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India, Phone: +91 9492558965, e-mail: akhi.v2000@gmail.com
Received: 25 March 2024; Accepted: 16 April 2024; Published on: 17 May 2024
ABSTRACT
Background: Myths are used to convey beliefs and establish patterns of behavior. People have misconceptions about dentistry due to a lack of knowledge about oral health. Although dentistry has developed a lot today, myths and misconceptions about dentistry still exist, making it difficult to receive advanced and preventive treatment. Medical students are the backbone of the medical profession and can play an important role in combating misinformation by disseminating accurate information and awareness to the people of society. Therefore, it is important to assess their knowledge and understanding of dental myths.
Aim: The study aims to determine the prevalence of dentistry-related myths among medical students in Nellore city.
Materials and methods: A cross-sectional survey was conducted among medical undergraduates consisting of a self-designed and prevalidated questionnaire regarding the myths related to dental decay, teething, pregnancy, dental treatment, and miscellaneous topics. The collected data were statistically analyzed using the Chi-squared test.
Results: Almost half of the students in the 3rd year (49.70%) disagree that applying clove to a decayed tooth always relieves pain compared with other year students. The majority (48.31%) of 2nd-year students did not agree with the idea that extraction of teeth in the upper jaw causes loss of vision compared to other year students.
Conclusion: Most of the participants in our study were found to have misconceptions and myths related to oral health.
How to cite this article: Vanga A, Gomasani S. Assessment of Dental Myths in Beliefs among Medical Undergraduates: A Cross-sectional Survey. CODS J Dent 2023;15(2):35–41.
Source of support: Nil
Conflict of interest: None
Keywords: Medical students, Misconceptions, Myths
INTRODUCTION
The diverse cultural, ethnic, geographical, and religious landscape of India plays a crucial role in modeling the belief systems of its individuals. The word “myth” has its origins in the Greek term “Mythos.”1 The word myth is defined as the stories told by a group of people that are deeply imprinted in the minds of future generations over a period of time.2 Myths are regarded false perspectives that emerge and are usually passed on from one generation to the next.3 Factors that lead to the evolution of dental myths are sociocultural, blind traditional beliefs, and a lack of basic education, awareness, and nonscientific knowledge.4 In Indian society, there is a prevalence of common myths surrounding medical practices.
The major impact of these myths has been on oral habits. It caused an increase in the use of home remedies. Ultimately, people worsen their conditions instead of visiting dentists; instead, they seek alternatives, such as visiting hermits and monks. The traditional treatments that people achieve are not scientifically proven and can be hazardous to life. Faith in myths should be eradicated because one’s strong belief in myths can turn a simple problem into a chronic disease that may end in high financial cost treatment because of the lack of knowledge to treat it at an initial stage by providing proper education and healthcare awareness.
In India, most people with oral misconceptions visit primary healthcare centers, as medical practitioners or healthcare workers are the backbone of the medical community, and they must be aware of these myths to provide accurate knowledge to patients. Oral health directly influences overall well-being. It is included in the study of anatomy in the 1st year of medical academics. However, there is still a lack of knowledge about oral health. In this study, I would like to evaluate whether medical students are aware of these dental-related myths to provide accurate knowledge and care to their patients. The study aimed to assess the prevalence of knowledge of dental myths and beliefs among medical undergraduates.
MATERIALS AND METHODS
A cross-sectional study was conducted through a questionnaire survey (Google Forms) among all the medical undergraduates in Nellore city. The sample size is estimated to be 1,600 based on the annual distribution of medical colleges.
This survey was designed to measure the prevalence of dental myths and beliefs among undergraduate medical students. A pretested and validated questionnaire on the prevalence of dental myths was developed using an online Google Form. The link was later shared with medical graduates through their respective college WhatsApp groups. All the questions are in a closed-ended format, and participants are asked to evaluate the given options using a Likert scale. The survey consists of 22 questions divided into five sections. The first section consists of a consent form stating the purpose of the research, the necessity, and the willingness to participate in the study. Participants who agreed to the consent form were included in the study, and they will switch to the next section. Those who decline the consent form will be excluded from the study and are set to receive the submitted form. The second section consists of demographic data like age, gender, and year of education. The third section consists of eight questions regarding myths related to dental decay. The fourth section consists of five questions regarding myths related to teething and pregnancy. In the last section, there are nine questions regarding myths related to dental treatments and miscellaneous.
The data collected underwent analysis through the Chi-squared test. All responses were entered into an electronic database and analyzed using Statistical Package for the Social Sciences-27 (IRMI Inc., Armonk, New York, United States of America). Responses to the survey are scored as “1” means strongly agreed, “2” means agreed, “3” means neutral, “4“ means disagree, and “5” means strongly disagree. Calculate the mean, standard deviation, and percentage of the frequency distribution. For evaluation and further assessment, the five-point Likert scale was condensed and scored as follows—“1” indicates both strongly agree and agree, “2” indicates neutral, and “3” indicates both disagree and strongly disagree.
RESULTS
A cross-sectional study was conducted to assess the prevalence of dental myths among medical undergraduates in Nellore, Andhra Pradesh, India. The total number of students who participated in our study was 1,171. Out of the active participants who had completed the online survey questionnaire, there were 1,104 students included in the study. A total of 67 students who had partially filled out or declined the questionnaire were excluded from the study. The demographic data are shown in Figure 1 and Table 1 as follows.
| Male | Female | ||
|---|---|---|---|
| Age | 19–22 years | 26.17% | 24.92% |
| 23–27 years | 23.21% | 25.70% | |
| Year of study | 1st year | 46.66% | 53.33% |
| 2nd year | 51.61% | 48.38% | |
| 3rd year | 51.92% | 48.07% | |
| 4th year | 49.43% | 53.84% | |
| CRRI | 39.10% | 60.89% | |
CRRI, Compulsory Rotatory Residential Internship
Fig. 1: Details of the age and year of study of both male and female medical students
Table 1 shows the demographic details of undergraduate medical students who actively participated in the study. Out of which, 19–22-year-old male students actively participated in the study. A majority of 60.89% of females in the Compulsory Rotatory Residential Internship (CRRI) batch had active participation in comparison with other batch students.
Table 2 shows the responses of the participants to the myths related to dental decay, of which 41.10% of students from the 2nd year agree with the myth that decay occurs because the teeth are soft. A majority of 43.30% of students in the 3rd year disagreed that decay in teeth is a hereditary process. Almost 45.30% of 2nd-year students disagreed that worms are present inside tooth decay.
| Agree | Neutral | Disagree | |
|---|---|---|---|
| Q1. Decay occurs because my teeth are soft | |||
| 1st year | 37.50% | 21.40% | 41% |
| 2nd year | 41.10% | 13.80% | 45.30% |
| 3rd year | 38.39% | 21.20% | 40.19% |
| Final year | 38.29% | 17.44% | 40.41% |
| CRRI | 40.90% | 18.59% | 40.48% |
| Q2. Placing a clove in a decayed tooth always relieves pain | |||
| 1st year | 42.30% | 24.20% | 33.30% |
| 2nd year | 39.10% | 22.40% | 38.20% |
| 3rd year | 33.40% | 16.70% | 49.70% |
| Final year | 36.58% | 20.85% | 42.54% |
| CRRI | 41.32% | 19.00% | 39.66% |
| Q3. Calcium tablets should be taken to prevent cavities in the teeth | |||
| 1st year | 39.40% | 13.80% | 46.60% |
| 2nd year | 38.60% | 22.40% | 38.70% |
| 3rd year | 36.10% | 21.70% | 42.00% |
| Final year | 39.14% | 21.70% | 39.14% |
| CRRI | 38.83% | 17.35% | 43.79% |
| Q4. Decay in teeth is a hereditary process | |||
| 1st year | 43.30% | 18.50% | 38.00% |
| 2nd year | 39.60% | 22.40% | 37.70% |
| 3rd year | 36.64% | 21.20% | 41.98% |
| Final year | 40.34% | 17.44% | 42.11% |
| CRRI | 40.90% | 18.59% | 40.48% |
| Q5. Worms are present in the tooth decay | |||
| 1st year | 37.00% | 22.30% | 40.40% |
| 2nd year | 41.10% | 13.80% | 45.30% |
| 3rd year | 38.45% | 21.20% | 40.26% |
| Final year | 42.12% | 17.44% | 40.41% |
| CRRI | 40.90% | 18.59% | 40.48% |
| Q6. Powdered salt cleans the teeth much better than toothpaste | |||
| 1st year | 39.90% | 24.20% | 35.60% |
| 2nd year | 39.20% | 16.70% | 43.90% |
| 3rd year | 36.60% | 22.17% | 41.16% |
| Final year | 42.12% | 18.29% | 39.57% |
| CRRI | 40.90% | 19.42% | 39.66% |
| Q7. Flossing can harm the gums | |||
| 1st year | 43.20% | 15.20% | 41.30% |
| 2nd year | 41.10% | 20.00% | 38.60% |
| 3rd year | 36.64% | 23.07% | 40.26% |
| Final year | 37.44% | 20.85% | 41.69% |
| CRRI | 39.66% | 20.66% | 39.66% |
| Q8. The longer you brush, the cleaner your teeth get | |||
| 1st year | 38.54% | 20.40% | 40.80% |
| 2nd year | 41.50% | 20.09% | 38.21% |
| 3rd year | 39.36% | 23.07% | 37.54% |
| Final year | 37.86% | 20.85% | 41.26% |
| CRRI | 37.60% | 19.42% | 42.97% |
CRRI, Compulsory Rotatory Residential Internship
Table 3 indicates the responses of the participants to the myths related to teething and pregnancy. Around 41.62% of 3rd-year students agreed with the statement that “baby teeth are unimportant because they fall away later.” About 45.45% of 2nd-year students disagreed that the removal of teeth during pregnancy leads to the miscarriage of a baby.
| Agree | Neutral | Disagree | |
|---|---|---|---|
| Q1. Baby teeth are unimportant because they fall away later | |||
| 1st year | 39.50% | 20% | 40.46% |
| 2nd year | 38.75% | 16.74% | 44.49% |
| 3rd year | 41.62% | 20.36% | 38.00% |
| Final year | 40.42% | 18.29% | 41.27% |
| CRRI | 38.83% | 19.42% | 42% |
| Q2. No dental treatment should be done during pregnancy | |||
| 1st year | 39.99% | 24.28% | 35.71% |
| 2nd year | 42.10% | 15.31% | 42.57% |
| 3rd year | 40.30% | 21.71% | 37.99% |
| Final year | 41.27% | 18.29% | 40.42% |
| CRRI | 36.77% | 23.55% | 39.66% |
| Q3. Removal of teeth during pregnancy causes miscarriage of baby | |||
| 1st year | 37.61% | 21.42% | 41% |
| 2nd year | 41.14% | 13.87% | 45.45% |
| 3rd year | 38.45% | 21.26% | 40.26% |
| Final year | 42.12% | 17.44% | 40.41% |
| CRRI | 40.90% | 18.59% | 40.48% |
| Q4. There will be a loss of teeth after giving birth to a baby | |||
| 1st year | 42.37% | 20% | 37.58% |
| 2nd year | 41.14% | 16.26% | 42.57% |
| 3d year | 41.62% | 19.00% | 39.36% |
| Final year | 41.27% | 18.29% | 40% |
| CRRI | 39.66% | 19% | 41.31% |
| Q5. Scaling at the time of pregnancy causes miscarriage of the baby | |||
| 1st year | 49.03% | 14.76% | 36.18% |
| 2nd year | 40.18% | 20.57% | 39.23% |
| 3rd year | 39.36% | 17.19% | 43.43% |
| Final year | 41.26% | 17.44% | 41.26% |
| CRRI | 37.18% | 19.83% | 43% |
CRRI, Compulsory Rotatory Residential Internship
Table 4 shows the responses of the participants to the myths related to dental treatment and miscellaneous. A majority of 48.31% of the 2nd-year medical students disagreed that the extraction of upper teeth leads to loss of vision. At the same time, 46.66% of 1st-year students agreed that frequent cleaning of the teeth removes the layer of enamel. About 43.42% of 3rd-year students believed that wisdom teeth indicated intelligence.
| Agree | Neutral | Disagree | |
|---|---|---|---|
| Q1. If I’m not in pain, I need not visit a dentist | |||
| 1st year | 49.04% | 23.80% | 27.13% |
| 2nd year | 41.14% | 18.66% | 40.18% |
| 3rd year | 38.45% | 21.26% | 40.26% |
| Final year | 42.12% | 17.44% | 40.41% |
| CRRI | 40.90% | 18.59% | 40.48% |
| Q2. Extraction of teeth in the upper jaw causes loss of vision | |||
| 1st year | 39.99% | 18.57% | 41.42% |
| 2nd year | 33.97% | 18.19% | 48.31% |
| 3rd year | 39.36% | 22.17% | 38.45% |
| Final year | 40.42% | 19.14% | 40.42% |
| CRRI | 38.83% | 18.18% | 42.96% |
| Q3. Cleaning of teeth causes the loosening of teeth | |||
| 1st year | 335.23% | 20% | 44.75% |
| 2nd year | 39.22% | 21.53% | 39.22% |
| 3rd year | 38.90% | 21.26% | 39.81% |
| Final year | 37.43% | 18.72% | 43.82% |
| CRRI | 38.83% | 21.07% | 40.07% |
| Q4. Frequent cleaning of teeth removes the layer of enamel | |||
| 1st year | 46.66% | 23.80% | 29.51% |
| 2nd year | 41.14% | 22.00% | 36.83% |
| 3rd year | 38.00% | 21.71% | 40.26% |
| Final year | 37.86% | 19.57% | 42.54% |
| CRRI | 38.01% | 20.24% | 41.73% |
| Q5. The bleaching process causes the pores on teeth surfaces, it eats away the teeth surface | |||
| 1st year | 40.94% | 18.57% | 40.47% |
| 2nd year | 42.10% | 22.48% | 35.40% |
| 3rd year | 39.81% | 22.62% | 37.55% |
| Final year | 40.84% | 21.70% | 37.44% |
| CRRI | 40.07% | 21.07% | 38.83% |
| Q6. Local anesthesia given during the extraction causes loss of sight and sensation forever | |||
| 1st year | 40.46% | 22.38% | 37.13% |
| 2nd year | 44.01% | 24.88% | 31.09% |
| 3rd year | 45.24% | 21.26% | 33.47% |
| Final year | 41.69% | 20.85% | 37.44% |
| CRRI | 41.72% | 19.00% | 39.25% |
| Q7. Bleeding from the mouth is a sign of cancer | |||
| 1st year | 40.47% | 17.61% | 41.90% |
| 2nd year | 44.49% | 22.48% | 33.00% |
| 3rd year | 40.26% | 19.45% | 40.26% |
| Final year | 35.73% | 21.70% | 42.54% |
| CRRI | 38.42% | 21.07% | 40.48% |
| Q8. Any growth in the mouth is a sign of cancer | |||
| 1st year | 37.61% | 21.42% | 41% |
| 2nd year | 43.53% | 22.00% | 34.44% |
| 3rd year | 40.71% | 17.64% | 41.61% |
| Final year | 40.00% | 17.87% | 41.69% |
| CRRI | 37% | 21.07% | 42.14% |
| Q9. The wisdom tooth is related to intelligence | |||
| 1st year | 39.52% | 19.04% | 41% |
| 2nd year | 42.57% | 26.31% | 31.09% |
| 3rd year | 43.42% | 14.93% | 41.62% |
| Final year | 37.01% | 20.85% | 42.12% |
| CRRI | 40.07% | 21.48% | 38.42% |
CRRI, Compulsory Rotatory Residential Internship
DISCUSSION
The cross-sectional survey was conducted among medical undergraduates to assess the beliefs and myths about oral health in Nellore city. There are many reasons why myths exist among people, such as low education and a lack of proper awareness of oral health. As medical practitioners, it’s their responsibility to guide patients and clarify their misconceptions. In this present study, out of 1,171 participants, the active participants who completed the questionnaire were 1,104.
This unique study stands out by involving every medical undergraduate in Nellore city, compared to most of the studies6,7 so far involving general people as their study participants. In this current study, 2nd-year students (45.30%) stated that they don’t agree that decay occurs because their teeth are soft compared with the other year students. This is because they were aware of enamel, which is the hardest substance in our body, and taught it to us in childhood. With that knowledge, most 2nd-year students (38.70%) disagreed with the usage of calcium tablets to prevent caries. Almost half of the students in the 3rd year (49.70%) disagreed that applying clove to decayed teeth always relieves pain, as its active ingredient, eugenol, contributes to numbering and alleviating toothache pain by serving as a temporary rather than a permanent solution. This is in contrast with the study conducted by Sharma et al.8 and Raina et al.9 where 49.4% of their participants believed in the pain-relieving properties of cloves in decayed teeth. Approximately, 43.30% of 1st-year students believe that decay in teeth is a hereditary process compared to other-year students. A majority of 45.30% of 2nd-year students don’t accept that there are worms present inside tooth decay in comparison with other-year students because they are aware of the knowledge that bacteria cause tooth decay. This contrasted with comparisons with some other study reports conducted by Tewari et al.10 where >90% of subjects believed in this myth. Compared to other year students, 43.90% of 2nd-year students disagreed that powdered salt cleans the teeth much better than toothpaste. This may be because powered salt doesn’t contain any other agents or disinfectants that remove bacteria from the tooth surface. Approximately, 43.20% of 1st-year students believed that flossing could harm the gums compared with other-year students. Approximately, 41.50% of 2nd-year students believe that the longer they brush their teeth, the better clean teeth they get compared to other-year students. This may be because children were taught to brush longer, which removes the bacteria, and to get a clean, better tooth by their parents.
Around 44.49% of 2nd-year students disagreed that baby teeth are unimportant because they fall away later compared to other-year students. This may be because baby teeth finally shed off over some time, and then later, the permanent dentition develops. In a study conducted by Yadav et al.,11 46% of their participants thought that treatment of milk teeth was not necessary as they would be replaced by permanent teeth. Most students in the 2nd year (45.45%) disagreed that the removal of teeth during pregnancy causes a miscarriage of the baby. Maybe with that opinion, 42.57% of 2nd-year students disagreed that no dental treatment should be performed during pregnancy in comparison with other-year students in the study conducted by Vignesh and Priyadarshni.12
Approximately, 55.8% of the respondents believe that it’s preferable to refrain from dental treatment during pregnancy. Compared to other-year students, 42.57% of 2nd-year students disagreed that there would be a loss of teeth after giving birth to a baby. Almost 43.43% of the 3rd-year students disagreed that scaling at the time of pregnancy causes miscarriage compared to other-year students. This may be because they are not well-versed in gynecology conditions that will be taught to them in further academic years.
A little over 49.04% of the 1st-year students think that if there is no pain, there is no need to visit the dentist compared to other-year students. This may be because they are not aware of the problems that occur when further treatment measures are taken for the decayed tooth. The majority (40.42%) of final year students agreed with the idea that extraction of teeth in the upper jaw causes loss of vision compared to other year students. Maybe with that assumption (451.69%) of final-year students thought that the use of local anesthesia during the extraction causes loss of eyesight. This has been a common myth that has spread for generations. Perhaps this is why this myth was passed down from generation to generation and was deeply imprinted in people’s minds. This myth was found to be supported by 20% of respondents, according to the study conducted by Saravanan and Thiruneervannan.13 However, there is much more in the study conducted by Gambhir et al.,14 where 72.8% of participants agreed that extraction of upper teeth leads to vision loss. Approximately, 46.66% of 1st-year students agreed that frequent cleaning of teeth removes the layer of enamel compared to other year students. Maybe with that knowledge, 1st-year students (44.75%) disagreed that cleaning teeth causes the loosening of teeth compared to other-year students. This may be because the scaling removes the enamel surface, causing sensitivity. This is like the survey conducted by Kiran et al.5 where 24.6% of their participants perceived similar misconceptions about scaling. Approximately, 42.10% of 2nd-year students agreed that the bleaching process causes the pores of the teeth to eat away the teeth’ surface in comparison with other year students. With the lack of awareness of oral cancers, (44.49%) and (43.53%) of 2nd-year students agreed with both statements that bleeding from the mouth is a sign or indicator of cancer and any growth in the mouth is a sign of cancer, respectively. About 43.42% of 3rd-year students believe that wisdom teeth are related to intelligence in comparison with other-year students.
Limitations
The scope of our study was limited to Nellore, Andhra Pradesh, India, which may not represent the diversity of dental myths across India due to varying religious and cultural practices. In addition, there are other factors such as socioeconomic status, educational background, and access to healthcare services can also influence the prevalence and persistence of dental myths within different regions of India. Expanding research nationwide would provide a comprehensive understanding of the prevalent myths despite advancements in technology.
Future Prospects
Enhancing awareness of dental myths and beliefs among medical students during their foundational education holds promise for the future. By integrating accurate dental information into basic medical curricula, we can ensure that every medical student receives comprehensive training to debunk misconceptions and embrace evidence-based practices in oral health. This proactive approach not only fosters better understanding but also equips future healthcare professionals to deliver holistic care, ultimately improving patient outcomes and public health.
CONCLUSION
A significant number of participants in the study were found to be influenced by prevailing myths and misconceptions concerning oral health. It is important to encourage medical students to gain timely knowledge about various oral health issues.
ORCID
Akhila Vanga https://orcid.org/0009-0002-4273-3221
Srinivasulu Gomasani https://orcid.org/0000-0001-6716-7823
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