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ORIGINAL ARTICLE
Year : 2022  |  Volume : 20  |  Issue : 3  |  Page : 230-233

Knowledge, attitude, and practice of probiotics for oral health among dental students: A cross-sectional study


1 Department of Engineering Design, Indian Institute of Technology Madras, Chennai, Tamil Nadu, India
2 Department of Conservative and Endodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University; Department of Conservative Dentistry and Endodontics, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
3 Department of Conservative and Endodontics, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
4 Department of Conservative Dentistry and Endodontics, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India

Date of Submission28-Jan-2022
Date of Decision04-Mar-2022
Date of Acceptance05-Mar-2022
Date of Web Publication17-Jun-2022

Correspondence Address:
Saravanan Poorni
Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu; Department of Conservative Dentistry and Endodontics, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaphd.jiaphd_23_22

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  Abstract 


Background: Over the years, probiotics have emerged as successful supplements for oral care management. Despite their extensive benefits and uses, their application in dental care is less due to limited knowledge about them among dentists. Aim: This study aimed to assess the knowledge, attitude, and practice in using probiotics for oral health among dental students of Chennai city. Materials and Methods: A cross-sectional online survey was conducted among 209 dental students through Google Forms. Pretested questionnaire with 14 close-ended questions was used. Ethical clearance and consent were obtained before the study. Statistical test was computed using SPSS version 20, and P value was kept at < 0.05 for significance. Results: Majority of the participants (86%) were aware of the probiotics and its use, but hardly 19% of them had put their knowledge into practice. A statistically significant difference was obtained between the male and female participants with the knowledge domain of the questionnaire (P = 0.021*, 0.006*, 0.048*). Conclusion: From the present study, we can conclude that the participants were well aware of the term probiotics but hesitated to prescribe it to their patients as their awareness of the availability of probiotics was less.

Keywords: Dental caries, dental students, oral health, probiotics


How to cite this article:
Krishnan L, Poorni S, Nivedhitha M S, Srinivasan MR. Knowledge, attitude, and practice of probiotics for oral health among dental students: A cross-sectional study. J Indian Assoc Public Health Dent 2022;20:230-3

How to cite this URL:
Krishnan L, Poorni S, Nivedhitha M S, Srinivasan MR. Knowledge, attitude, and practice of probiotics for oral health among dental students: A cross-sectional study. J Indian Assoc Public Health Dent [serial online] 2022 [cited 2022 Sep 26];20:230-3. Available from: https://www.jiaphd.org/text.asp?2022/20/3/230/347732




  Introduction Top


Dental caries is still a major public health problem owing to its high prevalence and incidence in several regions of developing countries.[1] In India, a recent report on the dental caries trend suggests a pooled caries prevalence of 50.6% among the population.[2] An increase in the prevalence of dental caries in developing countries, including India, places a bigger burden on the limited resources available for oral health.[3]

Conventionally, dental caries management and prevention involves the use of various restorative materials along or with remineralization agents. However, this traditional approach has the twin disadvantage of loss of tooth materials and the absence of patient compliance in dental caries prevention. Literature has shown the vicious cycle of restorative care leading to tertiary care and ultimate loss of the tooth.[4] The increasing cost of dental caries and its associated comorbidities has propelled the research to look for cost-effective alternatives for dental caries prevention rather than management. Although various remineralization agents have been proposed for this purpose, these agents need a professional application which increases the cost.[5] In this context, probiotics have emerged as an alternative for caries prevention and management, as the former can be self-applied and can also provide numerous health benefits along with the prevention of dental caries.[6]

The World Health Organization has defined probiotics as “Live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.”[7] These microorganisms belong to the natural human flora to survive in the acid environment during transit to the intestines.

These are dietary supplements advocated for the prevention and treatment of a wide range of diseases. They are products consisting of beneficial microorganisms that stimulate health-promoting microflora and suppress colonization of pathologic microbes, thus preventing disease spread.[8] Past literature highlights the extensive use of probiotics stains in various dental specialties for the reduction in caries development, in achieving periodontal health, reducing oral malodor, etc.,[9],[10],[11] despite its increase in use, there are not a lot of studies that shed light on the awareness, knowledge, and practice of these probiotics on oral health among dental students. It is important that the knowledge about these is imparted onto this population, as they are the practitioners of tomorrow. Furthermore, the findings of this study would help to assess if the curriculum is up to date. Thus, leading to the need of the hour where a thorough awareness and knowledge about the same is warranted among the dental students, which would pave a good platform to carry forward their future good dental practice.

With this background, the current study was conducted with an aim to assess the knowledge, attitude, and practice in using probiotics for oral health among dental students of Chennai city.


  Materials and Methods Top


A cross-sectional study was conducted among 209 dental students of Chennai city. Ethical clearance for the study was obtained from the institutional review board of our college (dated February 2021; ref no;-SVDC/IRB/13E/2019). The study participants included were dental students above 20 years and those who gave consent to participate in the study. Due to the current pandemic situation, the entire study was conducted on an online platform from March 2021 to May 2021. A self-administered questionnaire designed in the English language using previous literature evidence was made using Google Forms. The link regarding the same was shared to participants using convenience sampling who filled it anonymously. They were asked to fill it in only once. The internal consistency and reliability of the questionnaire were tested in a pilot study which yielded a value of 0.85 and 0.82, indicating good reliability and consistency. The comprehensiveness of the questionnaire was optimized using content and face validity with the help of a team of dental experts from the department of endodontics and conservative dentistry before the main study.

The questionnaire consisted of 14 closed-ended questions, including demographic details, knowledge, attitude, and practice questions of using probiotics in oral health.

Data obtained were entered into Microsoft Excel 2010 and analyzed using IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY. Descriptive statistical analysis was done for all variables. Percentage scores and frequency distribution were calculated for knowledge, attitudes, and practices related to the use of probiotics for caries prevention. Chi-square test was computed to assess the associations between gender and questionnaire. P value was kept at 0.05 for statistical significance.


  Results Top


Among the 209 study participants who completed the study, 20.6% were male and 79.4% were female. The study revealed that 86.6% of them were aware of the term probiotics, 64.1% reported natural foods as the source of probiotics, and 40% stated academics as their source of knowledge. Majority of the participants (66.5%) had knowledge about the advantages of probiotics and 71.3% of them knew its use on oral health, but only 19.1% of them had put it into practice.

Among these, most of them (27.8%) had used milk product probiotics for better intestinal health (24.9%), whereas about 8% had used probiotics to improve oral health. Twenty-three percent of the participants were aware that Lactobacillus is a strain for probiotics, but <4% were aware of Streptococcus and Bifidobacterium strains.

Sixty-one percent of the participants agreed on the wide use of probiotics for oral problems.

Among the nonusers of probiotics, majority (94%) of them did not use probiotics as they were not aware of its use and about 5%–6% felt that these probiotics were either expensive or were present in the food which they did not like.

Eighty-four of the study participants were willing to use probiotics if recommended by health practitioners.

The association between gender and knowledge, attitude, and practice of probiotic use in oral health is shown in [Table 1]. A significant difference was seen in knowledge domain between the genders.
Table 1: The association between the gender and knowledge, attitude, and practice levels

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  Discussion Top


Probiotics are live microbes available commonly in the form of food supplements that benefit the host defense of the body by improving its intestinal balance. Recently, numerous research papers and studies focusing on the effect of probiotics for oral health are being published.[12] Unfortunately, these are not adequately utilized to combat oral problems due to a lack of proper knowledge and low awareness about the benefits of probiotic products among the dental fraternity.[13] Hence, data on the knowledge, attitudes, and practices related to the use and benefits of different strains in probiotic products for oral health among the dental fraternity are important. Therefore, the current study is the first step in exploring the knowledge, attitude, and practice trends of using probiotics for oral health prevention among the dental fraternity and also provides a pathway for further research in understanding the novel technologies applied on probiotics for treating and preventing dental caries, periodontitis, halitosis, and various oral pathologies.

The results showed that the maximum number of participants (86%) were aware of the term probiotics through the academic curriculum (40%), which were in terms with the study conducted among the dental students of Chennai where 80.5% were aware.[13] The participants were also well aware of the advantages (66%) and uses of probiotics in oral health (71%). This indicated that the participants have a clear basic knowledge on probiotics. But when the same knowledge was put to practice, majority (80%) of them failed as an in-depth knowledge on applications of probiotics with respect to frequency of usage, and dosages were not present among the participants (45%). On the other hand, those who had prescribed probiotics to their patients had used milk products (27%) as their source and Lactobacillus strain (23%) probiotics for improving intestinal health (24%). This is in contrast to another study reported by Krishnan et al., where about 40% of the participants had used milk as a source of probiotics for oral problems (32%).[14]

In the present study, 84% of the study participants were willing to use probiotics if prescribed by a practitioner which was in similar lines with the study done by Sunayana et al. in 2013.[15]

This reinforces the positive attitude the dental fraternity has toward the use of probiotics for oral health. With increasing public awareness of the importance of nutrition, it is important as health-care professionals to provide them with the best nutritional supplements as curative or preventive agents for their oral problems. The current study findings can be used as a base platform to create awareness programs for the dentists so that the use of probiotics can be widened among this fraternity.


  Conclusion Top


Probiotics are considered as an emerging supplementary field in health care. They play an important role in improving the microbiota of the general as well as oral health. From the present study, we can conclude that the participants were well aware of the term probiotics but hesitated to prescribe it to their patients as their awareness of the availability of probiotics was less. Further awareness programs on probiotics use and its benefit are warranted to combat the situation, also studies are needed to be carried out regarding the barriers of usage of probiotics in their daily practice.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ndagire B, Mwesigwa CL, Ntuulo JM, Mayanja-Kizza H, Nakanjako D, Rwenyonyi CM. Dental caries pattern and treatment needs among Ugandan adolescent students: A cross-sectional study. Int J Dent 2020;2020:8135865.  Back to cited text no. 1
    
2.
Mehta A. Trends in dental caries in Indian children for the past 25 years. Indian J Dent Res 2018;29:323-8.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Kassebaum NJ, Smith AG, Bernabé E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990-2015: A systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res 2017;96:380-7.  Back to cited text no. 3
    
4.
Sicca C, Bobbio E, Quartuccio N, Nicolò G, Cistaro A. Prevention of dental caries: A review of effective treatments. J Clin Exp Dent 2016;8:e604-10.  Back to cited text no. 4
    
5.
Doshi A, Asawa K, Bhat N, Tak M, Dutta P, Bansal TK, et al. Knowledge and practices of Indian dental students regarding the prescription of antibiotics and analgesics. Clujul Med 2017;90:431-7.  Back to cited text no. 5
    
6.
Aha S, Tomaro-Duchesneau C, Tabrizian M, Prakash S. Probiotics as oral health biotherapeutics. Expert Opin Biol Ther 2012;12:1207-20.  Back to cited text no. 6
    
7.
World Health Organization. Available from: https://www.who.int/foodsafety/fs_management/en/probiotic_guidelines.pdf. [Last accessed on 2021 May 24].  Back to cited text no. 7
    
8.
Anuradha S, Rajeshwari K. Probiotics in health and disease. J Indian Acad Clin Med 2005;6:67-72.  Back to cited text no. 8
    
9.
Kumar VN, Krishnamurthy M, Poorni S, Patil S, Raj AT. Probiotics in caries prevention. J Contemp Dent Pract 2018;19:123-4.  Back to cited text no. 9
    
10.
Poorni S, Srinivasan MR, Nivedhitha MS. Probiotic Streptococcus strains in caries prevention: A systematic review. J Conserv Dent 2019;22:123-8.  Back to cited text no. 10
[PUBMED]  [Full text]  
11.
Lin YJ, Chou CC, Hsu CS. Effects of Lactobacillus casei Shirota intake on caries risk in children. J Dent Sci 2017;12:179-84.  Back to cited text no. 11
    
12.
Bridgman SL, Azad MB, Field CJ, Letourneau N, Johnston DW, Kaplan BJ, et al. Maternal perspectives on the use of probiotics in infants: A cross-sectional survey. BMC Complement Altern Med 2014;14:366.  Back to cited text no. 12
    
13.
Prasad S, Rukmani R. Probiotic awareness among general dentists in Chennai. J Oral Med Oral Surg Oral Pathol Oral Radiol 2017;3:45-7.  Back to cited text no. 13
    
14.
Krishnan HK, Moses J, Ravindran S,Namalwar BR,Velchamy S. Awaereness, knowledge and attitude about probiotics among pediatricdentist in Chennai. Int J Curr Res 2020;1:11893-6.  Back to cited text no. 14
    
15.
Sunayana M, Alekhiya K, Preethi A, Kumar S, Prabu D. Awareness about probiotics in dental, medical professionals and health care providers. UJMDS 2013;01:36-40.  Back to cited text no. 15
    



 
 
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