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Year : 2020  |  Volume : 18  |  Issue : 3  |  Page : 232-235

Oral health status and treatment needs among multiple factory workers, Tumkur City – A cross sectional study

Department of Public Health Dentistry, Sri Siddhartha Dental College, Sri Siddhartha Academy of Higher Education University, Tumkur, Karnataka, India

Date of Submission26-Jan-2020
Date of Decision10-Jul-2020
Date of Acceptance24-Sep-2020
Date of Web Publication24-Oct-2020

Correspondence Address:
Mythri Halappa
Department of Public Health Dentistry, Sri Siddhartha Dental College, SSAHE University, Tumkur, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jiaphd.jiaphd_10_20

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Background: The oral cavity is a port for entry of many diseases and presents several unique features which make it especially prone to occupational disease. Aim: To describe the oral health problems among multiple factory workers of Tumkur city. Methodology: A cross-sectional, observational study was designed to include multiple (garment, leather, cement, and food) factories. A total of 3551 workers who voluntarily gave consent to participate were included and the data were recorded using modified WHO proforma - 2013. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS 19.0, IBM, Armonk, NY, USA). Descriptive statistics and Spearmen's correlation were applied and the P < 0.05 were considered as significant. Results: The mean age of the study participants was 32.12 ± 2.02 years. Oro mucosal lesions were found among 15.8% of people and 1.6% of subjects had leukoplakia. Alveolar ridge/gingiva (28%) was the most common site of occurrence for oro-mucosal lesions. The mean Decay, Missing, Filled Teeth (DMFT) was 3.11 ± 1.72. There was a positive correlation with age and all other parameters such as oro-mucosal lesions, decayed status, treatment needs, periodontal conditions and prosthetic status (P < 0.001). Conclusions: Oral health among multiple factory workers was poor. There was a trend of increase in DMFT, prosthetic need, oro-mucosal lesion along with the age of the factory workers which was statistically highly significant.

Keywords: Dental caries, factory workers, occupational hazards, oro-mucosal lesions, quality of life

How to cite this article:
Halappa M. Oral health status and treatment needs among multiple factory workers, Tumkur City – A cross sectional study. J Indian Assoc Public Health Dent 2020;18:232-5

How to cite this URL:
Halappa M. Oral health status and treatment needs among multiple factory workers, Tumkur City – A cross sectional study. J Indian Assoc Public Health Dent [serial online] 2020 [cited 2022 Dec 3];18:232-5. Available from: https://www.jiaphd.org/text.asp?2020/18/3/232/298992

  Introduction Top

Oral health is a vital part of general health and is a valuable asset of every individual.[1] Because of its effects on daily living; oral health is considered a determinant of quality of life. Impact of environmental change on the lives of natives of a particular geographical region influences the overall health status of an individual.[2] Environmental pollution is now recognized as a global threat and actions of humankind are largely accountable for this.[3] The industrial revolution has made rapid strides in expanding industrial activity worldwide, proving scope in employment for many and thus improving the standard of living of people, but at the same time majority of people employed in various industries are exposed to the hazardous environment.[4]

An occupational hazard is a hazard experienced in the workplace and it can encompass many types of hazards, including chemical hazards, air pollution hazards.[5] It is been known that the teeth of industrial workers exposed to inorganic acids are affected in varying degrees.[6] Exposure like solvents and possibly to pesticides, fertilizers, engine exhaust, textile dust, and leather dust also increase the risk of oral cancer.[4] Other commonly reported ill effects on oral health among these workers are gingivitis, periodontal diseases, dental caries, and tooth wear.[5],[6],[7],[8],[9] Estimated exposures to wood smoke and biomass smoke released from cooking in food factories and households in developing countries have led to an increased risk of oral cancer.[4] Today, because of the improvements in plant design and factory methods, many hazardous processes are eliminated.[6] But, the medical care is a priority for the factory workers to maintain a high number of work hours and production leaving little room for absence from work, whereas oral health is neglected due to overwork, minimal priority, multiple visits, limited availability of dental services and financial constraints in developing countries.[3]

Oral health maintenance is not considered mandatory, although dental or oral problems also lead to loss of man-hours. In addition, the health of industrial workers often goes uncared due to their stressful working conditions, busy schedules, and poor economic conditions. Until now, there are many studies among individual factories such as chemical, cement, and battery factory workers but very limited data on food, garment and leather industries and among multiple factory workers. Hence the present study was conducted to include multiple factory workers of Tumkur city to assess their oral health status and treatment needs.

  Methodology Top

Tumkur is one of the industrial hubs of Karnataka with its close proximity to Bangalore and an attractive location for industrial development. It has 22 large scale, 8 medium and many small scale industries.[10] A cross-sectional study was conducted to include all medium and small scale industries which were present in and around 5 km from the college. This comprised to fifteen different industries (three garments, three leather, two Food and Agro, two cement, three rice and two coconuts) present in the proximity which were selected for the study during March to October 2019. This survey was done on different days in different industries with prior permission from respective managements. After obtaining ethical clearance from the institutional ethical committee (IEC-07/2019) and permission from CEO/Director Human Resources Department of the respective factories, oral health screening was done on prescheduled dates.

The study was conducted mainly in the day shift, as it was more convenient to the working units. All the employees present at the time of examination without any systemic diseases aged 20–60 years and who wished to participate voluntarily were included in the study. Information regarding demographic details, deleterious habits, and data on oral health status was examined by recording dental caries, gingival status, and oral mucosal lesions (2013 WHO Performa).[11] Type IV examination was carried out. The examiner and the recorders were trained and calibrated to record the details under staff supervision to prevent any diagnostic variability during the oral examination. The intra examiner variability was found to be more than 0.82 by kappa statistics. The information was recorded by a recorder in the proforma who was sitting close to the examiner and data were further subjected to descriptive statistical analysis and Spearman's correlation tests using SPSS 19.0 (IBM, Armonk, NY, USA). P < 0.01 was considered statistically significant.

  Results Top

A total of 3551 subjects were examined from 15 various food, garment, cement, and leather factories in and around the Tumkur city with an age range of 20–60 years.

Majority belonged to 30–40 years of age, with the mean age of the workers being 32.1 ± 2.02 years. Of which, 52.5% (1864) were males and 47.5% (1687) were females in the study. Socioeconomic status revealed that the majority of the workers belong to lower middle class according to BG Prasad's classification. Educational qualification revealed that 52% had at least cleared high school education. 71% of the people had one or the other deleterious habits and this increased with age. Chewing tobacco (32.1%) was more than smoking (19%) and 10% had both habits [Table 1].
Table 1: Demographic details of the subjects

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Oro-mucosal lesions were found among 15.8% of people, and among them, 4.1% had ulcers (aphthous and traumatic), 1.6% had leukoplakia [Table 2]. Alveolar ridge/gingiva (28%) was more common location of the oro-mucosal lesion, followed by Sulci (23%), buccal mucosa (18%) and floor of the mouth (15%) [Table 3].
Table 2: Distribution of oro-mucosal lesions among the subjects

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Table 3: Location of the oro-mucosal lesions

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Mean decayed teeth, filled teeth, missing due to caries and missing due to other reasons were 2.33 ± 1.49, 0.23 ± 0.03, 0.54 ± 0.91, and 0.31 ± 0.10, respectively. Mean Decay, Missing, Filled Teeth was 3.12 ± 1.72. The present study showed, 51% required one surface filling, 12% need two surfaces filling, 18% need pulpal care and restoration, and 34% required extraction, while 22% required the need for removable partial denture. The most required treatment was one surface filling followed by the extraction of the teeth [Table 4].
Table 4: Dentition status and treatment required among factory workers

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Community periodontal index score 2 - calculus (29%) and loss of attachment of 4–5 mm (23%) was found more among the study subjects [Table 5].
Table 5: Periodontal condition among factory workers

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None of the workers had prosthesis in the upper and lower jaw. In upper jaw, 72% workers required no prosthetic need, 28% needed prosthesis. In that, 54% required one-unit prosthesis, 33% required multi-unit prosthesis, and 13% required full prosthesis. In lower jaw, 63% workers required no prosthetic need, 37% needed prosthesis. In that, 55% required one-unit prosthesis, 20% required multi-unit prosthesis, and 24% required full prosthesis [Table 6].
Table 6: Prosthetic status and need among factory workers

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Prosthetic need increased with increasing age and all the other parameters when compared with age using Spearman's correlation test showed a positive correlation [Table 7].
Table 7: Correlation of age with other parameters

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  Discussion Top

In India, there is no national oral health service as there are in other developed countries.

[12] Health promotion among the industrial workers requires coordinated action by all concerned, including the dental profession, local factory authorities, social and economic sectors, and voluntary organizations. Factory authorities should establish regular oral health care services to provide necessary health education, preventive, and curative dental care services.

In this study, 45% study population belonged to 30–40 years, which is in contrast to the study conducted by Bansal and Veeresha,[1] in which 42.8% belonged to 25–34 years of age group. Females were less compared to males in the present study, but overall, there was no much difference between both. This is in contrast with other studies as they were conducted on laborious factories,[5],[13],[14] and the present study included various food, garment, cement and leather factory where the females outweighed the males. Chewing tobacco was more than smoking this was in accordance with Bansal and Veeresha,[1] Akman et al.[15]

In this study, 42% of workers had dental caries, which is in contrast to a study done by Grover and Grover, in which 60.0% of subjects had decayed teeth.[1] Around 15.8% of workers had oral mucosal lesions, which was similar to Bansal and Veeresha [1] and Malaovalla et al.[16] The most common oro-mucosal lesions in the present study was traumatic ulcers, ANUG followed by candidiasis and leukoplakia. This was in contrast to many studies where leukoplakia was more.[1],[17] The most common site affected was sulci followed by alveolar ridge and buccal mucosa, which was in contrast with Bansal and Veeresha [1] and Ikeda et al.,[18] this may be due to the type of lesions.

The prevalence of dental caries was more, which was similar to Hayashi et al.[18] Prevalence of edentulousness and the prosthetic need was high compared to Helöe et al.[19] Poor economic status, lack of knowledge may be contributing factors for poor oral health.

  Conclusions Top

The industrial sector plays an important role in national development. And the present study showed dental caries and need for prosthesis was more compare to other problems. Despite the significant amount of exposure to risk factors, only a few reported with oro-mucosal lesions. Hence, oral health screening and health education at regular intervals should be made mandatory, which helps to prevent the accumulation of healthcare demands among the factory employees.

Limitation and recommendation

The present study used convenient sampling and did not include a detailed history of habits to correlate with the lesions. Information regarding utilization of dental services is also missing in the study. Hence, the information obtained can be used as baseline data to conduct further in-depth study to know the correlation between their work pattern and habits and oral health problems in future.


I would like to acknowledge all the interns for helping during the study and all the department staff for supporting the study.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

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;4:105-10.  Back to cited text no. 1
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Gambhir RS, Sohi RK, Singh G, Brar R, Singh H, Kakar H. Oral hygiene practices and dentition status of public transport workers of India-a cross-sectional study. J Clin Diagn Res 2014;8:ZC33-6.  Back to cited text no. 2
Nagarajappa R, Sanadhya S, Sharda AJ, Asawa K, Tak M, Batra M, et al. Assessment of the periodontal status among Kota Stone workers in Jhalawar, India. J Clin Diagn Res 2013;7:1498-503.  Back to cited text no. 3
Patil VV, Shigli K, Hebbal M, Agrawal N. Tooth loss, prosthetic status and treatment needs among industrial workers in Belgaum, Karnataka, India. J Oral Sci 2012;54:285-92.  Back to cited text no. 4
Sharma A, Thomas S, Dagli JR, Solanki J, Arora G, Singh A. Oral health status of cement factory workers, Sirohi, Rajasthan, India. J Heal Res Rev 2014;1:15-9.  Back to cited text no. 5
Suchi K, Jyothi C, Dileep CL, Jayaprakash K. Oral health status of battery factory workers in Kanpur city: A cross-sectional study. J Indian Assoc Public Health Dent 2014;12:80-7.  Back to cited text no. 6
Bozyk A, Owezarek B. Incidence of parodontal diseases in workers of the Chelm cement plant exposed to cement dust. Czas Stomatol 1990;43:375-80.  Back to cited text no. 7
Shaikh H, Shankar S, Vinay S. Assessment of periodontal status and treatment needs among beedi factory workers, Haranpanahalli town, Davangere district, Karnataka. J Indian Acad Dent Spec 2011;2:13-7.  Back to cited text no. 8
Peterson PE, Henmar P. Oral conditions among workers in the Danish granite industry. Scand J Work Environ Health 1988;14:328-31.  Back to cited text no. 9
List of Various Industries in Tumkur; 2020. Available from: https://www.tumkuronline.in/industries. [Last accessed on 2020 Feb 03].  Back to cited text no. 10
World Health Organisation. Oral Health Surveys: Basic Methods. 5th ed.. Geneva: World Health Organisation; 2013.  Back to cited text no. 11
Gambhir RS, Gupta T. Need for oral health policy in India. Ann Med Health Sci Res 2016;6:50-5.  Back to cited text no. 12
[PUBMED]  [Full text]  
Tuominen M, Tuominen R. Tooth surface loss and associated factors among factory workers in Finland and Tanzania. Community Dent Health 1992;9:143-50.  Back to cited text no. 13
Peterson PE, Gormsen C. Oral conditions among German battery factory workers. Community Dent Oral Epidemiol 1991;19:104-6.  Back to cited text no. 14
Akman H, Akal KU, Redzep E, Delilbasi C. Prevalence of oral lesions in a selected Turkish population. Turk J Med Sci 2003;33:39-42.  Back to cited text no. 15
Malaovalla AM, Silverman S, Mani NJ, Bilimoria KF, Smith LW. Oral cancer in 57, 518 industrial workers of Gujarat, India: A prevalence and follow-up study. Cancer 1976;37:1882-6.  Back to cited text no. 16
Ikeda N, Handa Y, Khim SP, Durward C, Axéll T, Mizuno T, et al. Prevalence study of oral mucosal lesions in a selected Cambodian population. Community Dent Oral Epidemiol 1995;23:49-54.  Back to cited text no. 17
Hayashi N, Tamagawa H, Tanakai M, Haniokai T, Maruyama N, Takeshita T, et al. Association of tooth loss with psychosocial factors in male Japanese employees. J Occup Health 2001;43:351-5.  Back to cited text no. 18
Helöe LA, Kolberg JE. Dental status and treatment pattern in a group of commuting laborers in Norway. Community Dent Oral Epidemiol 1974;2:203-7.  Back to cited text no. 19


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


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