Oral Health Myths among General Population at Riyadh Region, Saudi Arabia.

BACKGROUND: Taboos or myths have got a connection from the history where there was no scientific understanding about the concepts of health they are part of culture and information shared or communicated by a number of people. Understanding myths and misbelieves are important to provide good oral care with health education to the people. AIM: The aim of this study is to assess the prevalence of oral health myths and to find its association between the demographic factors of general public in the Riyadh region of Saudi Arabia.
METHODOLOGY: Questionnaire consisting of demographic details and myths about oral health problems was sent through Google forms. The link of questionnaire was sent through social media and requested to send the link to their friends and relatives.
RESULTS: About 50.71% of the study participants were against to myths and 23.48% of study participants were toward myths. The response in terms of agreement, disagreement or do not know was statistically not significant according to age, gender, or education.
CONCLUSION: The prevalence of myths about dental treatment is almost 50%. This population needs to be educated to know the fact and to take action to rectify them about dental treatments. Copyright:

INTRODUCTION

World health has defined health under three dimensions that is the physical, mental, and social dimensions. This social dimension has deep roots from the society and has a role in influencing the health. From the time immemorial the early man correlated diseases to the wrath of god and invasion of the human body by evil spirits.[1]

Taboos or myths have got a connection from the history where there was no scientific understanding about the concepts of health. Similarly during the development of dentistry taboos also developed which became imprinted in minds of people.

General health is linked to oral health[2] with the social and economic burdens in many countries oral diseases remain a neglected area of international health.[3] Most of the beliefs are acquired through communication. In fact, most of our misbelieves are transmitted culturally.[4] Myths are considered to be part of culture and information shared or communicated by a number of people.

Myths can be present due to a variety of reasons such as poor education, cultural beliefs, and social misconceptions. In general, myths are usually transferred from one generation to the other.[5] Myths are deep-rooted in society, so difficult to break the chain.[6] Hence, there is a need to educate individuals to change the mindset and the behavior in order to eliminate these myths, as earlier literature showed a lack of awareness was the main reason for myths.[7]

Myth can be harmful, helpful, or neutral. In every community, it takes a very natural unknown origin based on past events.[6]

Hence, its important to know these myths and misconceptions in the population to provide good care and health education to the people. Literature revealed limited studies and data related to this subject in the kingdom of Saudi Arabia. Hence, the study was designed to assess myths related to oral health and to evaluate its association between demographic variables among participants in the Riyadh region of Saudi Arabia.”

Objectives

To assess dental myths prevalent among general public in the Riyadh region of Saudi Arabia

To correlate between the demographic variables and dental myths.

METHODOLOGY

The present cross-sectional study was conducted after obtaining ethical approval from the Institutional Review Board of College of Dentistry, Prince Sattam Bin Abdulaziz University Al-kharj. Informed consent was asked from the participants before study. Those participants denying giving consent were excluded from the study.

The questionnaire was distributed through Google form and it was in Arabic and English. It was sent through social media, i.e., WhatsApp, snap chat, and was asked people to send link to their friends and family after answering the questions.

Sample size was calculated using the relation n = z2 PQ/d2

Level of precision is d = 4%,

Prevalence of dental myths to be at 40% from previous studies = 1.96 × 1.96 × 30 × 70/5 × 5.

Total number of new participants attending CIDS in 2 months = 9600/16

=8067.36/16 = 504.21

The sample size for the study was 504.

Data collection

Demographic information about age (years), gender, and education was collected. Questionnaire had 15 close-ended questions related to myths in oral health. The responses for the questions were either the participant agrees, disagrees, or do not know was recorded [Table 1].

Table 1

Study population according to gender, educational status, and age

	Frequency (%)
Age group (years)
23-30	412 (61.3)
31-40	138 (20.5)
41-50	90 (13.4)
Above 50	32 (4.8)
Gender
Male	482 (71.7)
Female	190 (28.3)
Education
Not educated	10 (1.5)
Up to secondary	215 (32)
Bachelor	410 (61)
Masters	30 (4.5)
PhD	7 (1.0)

Validity and reliability of the questionnaire

The validity of the questionnaire was measured on thirty participants who were excluded from the main analysis. Resulted kappa value was 0.87. The questionnaire was translated to Arabic and used. The translation was done according to the WHO process of translation and adaptation of instrument. The reliability of the questionnaire was measured using test–retest method.

Sample selection

The sample for the study was collected from an online survey by distributing the questionnaire link general public at the Riyadh region of Saudi Arabia. The questionnaire was distributed through Google forms and it was in the Arabic and English Language. The link of the questionnaire was sent through social media, i.e., WhatsApp, snap chat and people were requested to send the link to their friends and relatives. Questionnaires were sent to a total of 800 participants out of 672 questionnaires were received with complete information giving a response rate of 84%. These 672 participants were used for the analysis. The received responses were converted into percentage of participants providing response as agree, disagree, and do not know according to the demographic factors. Mean for converted percentages were taken and compared according to demographic variables.

Statistical analysis

All data were analyzed at 95% confidence interval independent sample t-test and one way ANOVA were used to check statistical significance difference. SPSS version 23 was used for the statistical analysis (IBM SPSS Statistics for Windows, IBM Corp., Armonk, N.Y., USA).

RESULTS

A total of 800 questionnaires were sent through Google forms out of which 672 giving a response rate of 84%.

Table 1 shows the study population according to gender, educational status, and age. Majority of the particpants were belonging to 20–30 years of age. About 71.1% were male and 28.9% of the population were females. Sixty-one percent of the study participants were holding a bachelor degree. Moreover, only 1% of the participants were having PhD.

Table 2 shows comparison of study participants to responses according to age group. There was no statistically significant difference among different age groups. Percentage of disagreement was more according to the age group (51.60 ± 18.05). Followed by do not know (26.22 ± 17.91).

Table 2

Comparison of responses of study participants according to age group

Response	Age group	Mean±SD	F	P and significance
Agree (years)	20-30	20.64±14.89	0.082	0.970 (NS)
	31-40	22.02±19.04
	41-50	22.08±19.01
	Above 50	23.96±20.30
	Total	22.17±17.99
Disagree (years)	20-30	51.42±16.60	0.377	0.770 (NS)
	31-40	50.57±17.72
	41-50	55.63±19.55
	Above 50	48.76±19.33
	Total	51.60±18.05
Do not know (years)	20-30	27.94±19.07	0.314	0.815 (NS)
	31-40	27.38±16.75
	41-50	22.29±18.74
	Above 50	27.29±18.27
	Total	26.22±17.91

SD: Standard deviation, NS: Not significant

Table 3 shows comparison of study participants to responses according to gender. There was no statistically significant difference among gender. The percentage of disagreement was slightly more among females (53.56 ± 17.09). Followed by do not know (26.22 ± 17.91).

Table 3

Comparison of responses of study participants according to gender

Response	Gender	Mean±SD	t	P and significance
Agree	Male	21.55±16.65	0.169	0.867 (NS)
	Female	20.53±16.48
Disagree	Male	50.94±17.18	0.418	0.679 (NS)
	Female	53.56±17.09
Do not know	Male	27.48±18.59	0.237	0.815 (NS)
	Female	25.90±17.97

SD: Standard deviation, NS: Not significant

Table 4 shows comparison of study participants to responses according to education. There was a statistical significant difference for the response of agree according to age group. Percentage of agreement was more with not educated (38 ± 15.67) than compared to others. Percentage of disagree was more with masters (56.88 ± 21.69) than compared to other groups.

Table 4

Comparison of responses of study participants according to education

Response	Education	Mean±SD	F	P and significance
Agree	Not educated	38.00±15.67	3.061	0.022
	Up to secondary	22.54±18.52
	Bachelor	20.36±15.43
	Maters	17.10±18.39
	PhD	29.53±23.19
	Total	25.50±19.45
Disagree	Not educated	44.00±18.04	1.346	0.262
	Up to secondary	47.68±17.14
	Bachelor	53.70±17.09
	Maters	56.88±21.69
	PhD	44.76±20.08
	Total	49.40±19.07
Don’t know	Not educated	18.00±17.80	0.724	0.579
	Up to secondary	29.77±18.24
	Bachelor	25.94±18.36
	Maters	26.00±21.49
	PhD	25.72±21.72
	Total	25.09±19.45

SD: Standard deviation

Table 5 shows overall response to various questions by the study participants. The agreement of myths varied from 4.5% to 56.3% for the various questions asked. About 50.71% of the study participants were against to myths and 23.48% of study participants were toward myths and 25.79% of study participants were neutral.

Table 5

Overall responses of study participants about various myths

Myths	Agree	Disagree	Don’t know
If there is no pain in the tooth no need of visiting a dentist	46.52	49.92	3.59
Dental infection will not spread among siblings	29.95	51.82	18.20
Not to worry about milk teeth as they will eventually fall out with time	56.30	33.31	10.37
Exfoliated tooth should be buried	16.03	63.8	20.172
A child born with a tooth is a sign of bad luck in the family	4.545	18.43	77.03
Scaling will weaken the tooth structure	35.27	39.22	25.51
Extraction of teeth will affect eye vision	6.47	66.2	27.33
Pregnant ladies were not supposed to take dental treatment until delivery	32.3	26.26	41.41
Extraction of upper teeth will affect the brain	5.545	61.00	33.43
Placing tobacco over painful tooth will reduce pain	10.63	67.8	21.57
Extracted teeth need no replacement with an artificial teeth	17.4	65.04	17.57
We should not eat anything when we are going for tooth extraction	37.93	46.26	15.8
Brushing your teeth using salt, whitens your teeth	20.12	39.89	39.98
More you brush using hard bristles, more whiter your teeth becomes	18.37	67.44	14.16
Eruption of the third molar will increase wisdom	14.83	64.39	20.76
Mean±SD	23.48±15.61	50.71±16.24	25.79±17.51

Graph 1 shows the mean percentage of responses by the study participants for various questions in terms of agree, disagree, and do not know according to age, gender, or education.

Graph 1

Overall responses about myths by the study participants

DISCUSSION

Oral health awareness and practices differ from country to country and among communities depending on traditional beliefs and socioeconomic development.[8] Each culture has its own system of health beliefs, perceptions, and ideas about health and illness, which is the underlying cause for their health-related behaviors.[9]

The present study was carried out on participants belonging to 20–50 years as they are good representatives of people from various regions. Education, culture, gender, and age are among the factors which play a role in the prevalence of myths. General health of the people is influenced by myths.[10]

About 46.52% of participants believe if there is no pain in the tooth no need of visiting a dentist. This is quite more as there is a need of routine dental checkups to find dental diseases, especially caries and periodontal diseases as they do not cause pain during the initial stages.

About 6.47% of the participants thought that extraction of the upper front tooth may cause impairment of patient's vision and 27.32% responded as do not know making it almost 34%. This finding is similar to the studies done by Saravanan and Thirineervannan[11] and Singh et al.[12] whereas many other studies have reported significantly more percentage (35%–70%) than compared to the present study.[1314151617] However, the fact is there is no relationship between extraction and eye vision which has been agreed by 66.2% of the participants. About 35.27% agreed that scaling would weaken the tooth structure, similar report was done by Saravanan and Thirineervannan[11] where 34% said that scaling would weaken the tooth structure. However, the result was in contrast (63.2%) with the studies by Vignesh and Priyadarshn.[6] 10% of the participants believed that placing of tobacco reduce tooth pain as such there is no such correlation for the myth. Five percent believed that the extraction of upper teeth affected the brain which is similar to the report of 7% by Saravanan and Thirineervannan.[11]

The results of the present study for many other myths such as eruption of the third molar increase wisdom (14.83%), pregnant ladies were not supposed to take dental treatment till delivery (32.3%), child born with teeth or whose upper front teeth erupted before the lower teeth was a sign of bad luck in the family (4.5%), no need to worry about milk teeth as they would eventually fall out with time (56%). These findings were similar with the study done by Vignesh and Priyadarshn.[6]

In general total, there were statistically significant differences according to age, gender, or education regarding agreement, disagreement among the study population. Overall 23.48 ± 15.61 of the study population are toward myths, 50.71 ± 16.24 of the study population are disagreeing these myths and 25.79 ± 17.51 of study participants are neither toward agreement or disagreement. These findings call a necessary of educating people regarding ignorance and misconception about myths and overcome them.

CONCLUSION

The results of the present study indicate almost 50% of the Saudi population was against myths in dentistry whereas 25% of the population are in agreement toward myths in oral health care. Whereas almost 25% of the population neither believes nor follow the myths about dental treatment hence the prevalence of myths toward dental treatment is almost 50% which needs to be corrected. Hence, its our duty to help people learn and know the scientific fact and take the necessary steps to rectify them.

Financial support and sponsorship

Self sponsored.

Conflicts of interest

There are no conflicts of interest.