Knowledge and Practice about Self-Medication for Oral Health Problems among Population in Riyadh Region, Saudi Arabia.

AIM: The aim of this study was to know self-medication practices among the population of Riyadh region for oral health issues.
METHODOLOGY: A questionnaire consisting of demographic self-practice of medication for oral health problems and knowledge about self-medication practices was sent through Google forms and it was in Arabic and English languages. The link of the questionnaire was sent through social and requested to send the link to their friends and relatives.
RESULTS: About 50.4% of study participants were having self-practice of medication for oral health problems. Self-practice of medication for oral health issues was statistically significant according to age gender and education (P < 0.05). Toothache (62.4%) is the main problem triggering self-medication and lack of time (44.6%) is the main reason for self-medication. Pain killer (68.8%) was the main medication and antibiotics were used by 2.2% of subjects.
CONCLUSION: Self-medication practice is prevalent in the world and hence, education regarding its consequences and adverse effects for the general public is mandatory. Copyright:

INTRODUCTION

The practice of diagnosing the disease by self and taking a prescription without professional health-care workers' advice is known as self-medication.[12] Over-the-counter and dietary supplements are the most widely self-medicated substances to treat common health issues at home. In few countries, these drugs are obtained without the prescription of a doctor and are easily available in supermarkets and convenience stores.[3]

These medicines include analgesics, antimalarials, antibiotics, and cough syrups, and a range of alternative medicines such as herbal remedies and traditional products. The WHO reported antibiotic resistance as an attention call due to self-medication with antibiotics.[45] Irrational use of these drugs have caused doctors as well as people concerns about the use of these drugs over the years as it developed more serious side effect frequently than the original disease itself.[5]

Many factors have been correlated to self-medications such as education, easy availability of drugs, and exposure to advertisements and media, society, laws, and legislation are some among other factors.[6] Many studies from both developed and developing countries reported self-medication as a common behavior.[7]

Patients often use over-the-counter drugs for oral health-related problems to reduce acute or chronic pain.[8] Many were not aware of its contraindications and side effects.[9] The injudicious self-practice of taking medicines results in wastage of resource, increase resistance to microbes, and pose a serious health hazard like adverse drug reactions and drug dependence. As health care professionals, it is our responsibility to create awareness among the public about the serious health hazards that can develop due to self-medication. The search of the literature revealed limited studies and data available related to this subject in the Kingdom of Saudi Arabia. Hence, the study was designed to assess the knowledge and practice of self-medication for oral health issues among people in Riyadh region of Saudi Arabia and to compare demographic factors with self-medication practices for oral diseases.

METHODOLOGY

A descriptive, cross-sectional study was designed to assess the self-medication practices, its awareness for oral health problems among the general public in Riyadh region of Saudi Arabia. Ethical clearance was obtained from the Institutional review board, College of Dentistry, Prince Sattam Bin Abdulaziz University. Participants who voluntarily gave Informed consent were included and those participants who denied were excluded.

To obtain the information regarding the practice of self-medication, a specially designed questionnaire was developed consisting of three parts. The first part consisted of demographic details. Second part practices of self-medication for oral disease. Third part about knowledge of self-medication practices.

The sample size is calculated using the relation n = z2PQ/d2

Where the level of precision is d = 3%,

Prevalence of practice of self-medication among people to be at 25% from previous studies = 1.96 × 1.96 × 25 × 75/3 × 3

n = 7203/9

= 800

Substituting the values in the above-mentioned formula, the sample size was 800.

The collected data were statistically analyzed using IBM SPSS Statistics for Windows, version 23 (IBM Corp., Armonk, N.Y., USA). Descriptive statistics and Chi-square test was used to check the association between the variables.

The questionnaire was distributed through Google forms and it was in Arabic and English languages. The link of the questionnaire was sent through social media, i.e., WhatsApp, snap chat and people are requested to send the link to their friends and relatives a total of 802 questionnaires were considered for statistical analysis.

Statistical analysis

All data were analyzed at 95% confidence interval Chi-square test was used to check statistical significance difference. SPSS version 23 was used for statistical analysis.

RESULTS

Table 1 shows the study subjects according to age group, gender, and educational status. There were a total of 802 subjects out of which 37.7% belonging to above 40 years of age 52.6% were females and majority (72.3%) were holding a degree graduation.

Table 1

Study population according to age group, gender, and educational status

	Frequency (%)
Age group (years)
18-22	155 (19.3)
23-30	187 (23.3)
31-40	158 (19.7)
Above 40	302 (37.7)
Gender
Male	380 (47.4)
Female	422 (52.6)
Education
School	152 (19.0)
Degree	580 (72.3)
Postgraduate	70 (8.7)

Figure 1 shows that 50.4% of study participants had practice of self-medication for oral health problems.

Figure 1

Percentage of study subjects having self-medication practices

Table 2 shows a comparison of self-medication practices among study subjects. The practice of self-medication practice was more among females (57.7%) than males which was statistically significant (P < 0.05). According to the age group, 42.1% aged above 40 years were having self-medication practices and only 15.1% of study subjects belonging to 18–22 years were having self-medication practices the result was statistically significant (P < 0.05). According to educational qualification, there was a statistically significant difference among self-medication practice which was more prevalent with subjects holding graduation degree (67.8%) followed by those having education up to secondary school (23.3%) and least among subjects having a postgraduation (8.9%).

Table 2

Comparison of self-medication practices according to demographic factors

	Self-medication practices		Total (%)	Statistics χ2, P
	Yes (%)	No (%)
Gender
Male	171 (42.3)	209 (52.5)	380 (47.4)	8.34, 0.005 (S)
Female	233 (57.7)	189 (47.5)	422 (52.6)
Age group (years)
18-22	61 (15.1)	94 (23.6)	155 (19.3)	21.957, <0.001 (HS)
23-30	79 (19.6)	108 (27.1)	187 (23.3)
31-40	94 (23.3)	64 (16.1)	158 (19.7)
Above 40	170 (42.1)	132 (33.2)	302 (37.7)
Education
Up to secondary school	94 (23.3)	58 (14.6)	152 (19.0)	10.305, 0.006 (HS)
Degree	274 (67.8)	306 (76.9)	580 (72.3)
Postgraduate	36 (8.9)	34 (8.5)	70 (8.7)
Regular dental visits
Yes	92 (22.8)	88 (22.1)	180 (22.4)	10.305, 0.006 (HS)
No	312 (77.2)	310 (77.9)	622 (77.6)

HS: Highly significant, S: Significant

Table 3 shows responses to various questions related to self-medication among study participants. 47% of the study participants have answered that they use the same medicines as other members of the family. 81.7% of the study participants have told they will continue the medication till the condition subsides. Among the oral health-related problems triggering self-medication, it is the toothache (62.4%) for which majority of the participants practice self-medication and the least being the loose tooth (2.2%). The main reason for this was lack of time (44.6%) and least as traditional belief (9.2%). Majority of study participants (64.6%) are of the view that they have got temporary relief from the problem after self-medication. 17.1% of the study subjects are unsure about their effects after self-medication.

Table 3

Responses to various questions related to self-medication among study participants

Questions	Responses	Frequency (%)
Same medicines as family members	Yes	190 (47.0)
	No	214 (53.0)
	Total	404 (100.0)
Self-medication till condition subsides	Yes	330 (81.7)
	No	68 (16.8)
Oral health-related problems triggering self-medication	Toothache	252 (62.4)
	Bleeding gums	71 (17.6)
	Bad breath	57 (14.1)
	Swelling	11 (2.7)
	Loose tooth	9 (2.2)
	Others	4 (1.0)
Reasons for self-medication	Lack of time	180 (44.6)
	Lack of money	100 (24.8)
	Not so important	87 (21.5)
	Traditional/religious relief	37 (9.2)
Response after self-medication	Temporary relief from the problem	261 (64.6)
	Effective	74 (18.3)
	Unsure about effects	69 (17.1)

Table 4 shows knowledge on self-medication practices among study participants. 68.8% of study participants responded as pain killer as the type of self-medication used most commonly followed by homemade remedies (17.6%) and only 2.2% of subjects have told as antibiotics. The major source of getting medication being the pharmacy (67.3%). Majority of subjects 87.6% do check the expiry before using the self-medication. Relatives being a major source for self-medication (42.6%), almost 52.2% of study participants were aware of its harmful effects.

Table 4

Knowledge on self-medication practices among study participants

Questions	Responses	Frequency (%)
Type of self-medication used for oral health-related problem	Pain killers	278 (68.8)
	Homemade	71 (17.6)
	Antibiotics	9 (2.2)
	Salt and hot water	24 (10.4)
	Ice pack	2 (0.5)
	Others	2 (0.5)
Sources of getting medicine	Pharmacy	272 (67.3)
	Friends	25 (6.2)
	Present at home	77 (19.1)
	Traditional home	29 (7.2)
	Others	1 (0.2)
Checking expiry date of medicine	Yes	354 (87.6)
	No	48 (11.9)
Sources of knowledge about self-medication	Relatives	172 (42.6)
	Friends	35 (8.7)
	Personal knowledge	99 (24.5)
	Pharmacist	69 (17.1)
	Media	27 (6.7)
	Traditional healers	2 (0.5)
Are you aware about harmful effects associated with self-medication	Yes	211 (52.2)
	No	70 (17.3)
	Don’t know	123 (30.4)

DISCUSSION

In this present cross-sectional study, we investigated oral disease-related self-drug administration practices and knowledge among the general public in Riyadh region, Saudi Arabia. The prevalence of this practice was 50.4% in the present study. Data from Studies around the world report the prevalence range of 80%–90%,[1011121314] whereas in some studies, the prevalence rate of 30%[15] has been reported; the reasons for such differences could be the cultural belief, education status, socioeconomic conditions, etc.

In this study the prevalence rate was highest among subjects aged 40 years and above this result is in accordance with a Jordanian study where authors reported the highest prevalence among the 36–55 years age group.[16]

In the present study female subjects were having more self-medication practices than compared to male subjects similar to the study reported by Afolabi[17] and fear of dentistry could be a reason for this.

47% of subjects utilized the same medications as their family members, which is almost similar to the reports of other studies.[41718] easy availability in the house and prescriptions written for similar symptoms could be some of the reasons for utilizing the same kind of self medications.

Many authors have reported that toothache is the main reason[412151719] for people to take self-medication; this finding is similar in our study also where 62.4% of the study participants stated toothache as the reason. Tooth pain affects sleep impairs work performance, can be the reason for difficulty in eating, etc., so it ultimately calls for immediate remedies to achieve a temporary relief from pain.

Authors from various studies[34122021] have reported that painkillers were the drug used most frequently the second one being antibiotics; the use of painkillers was in agreement with the results of our study. Studies conducted by Agbor and Azodo,[19] Gutema et al.[22] and Sultane et al.[18] showed that the participants preferred antibiotics over other aids which is in contrast to the present study observation where only 2.2% of subjects practiced the use of antibiotics. The practice of consuming unprescribed antibiotics needs to be curbed as its consequence of antibiotic resistance is on a rise than other drugs.[21]

Pharmacy is the source of getting medicines without a certified doctor's prescription observed in this study (67.3%). This was in agreement with other studies.[41017181920] 87.6% of the study subjects had a habit of checking the expiry date of the medicines and this finding was similar to studies by Giriraju,[4] Komalraj et al.[17] The common guiding source of knowledge about self-medication for the participants was their relatives (42.6%) followed by having personal knowledge (24.5%). This was similar to the findings of Giriraju[4] and Agbor and Azodo.[19]

52.2% of the participants knew about harmful effects of self-medication 30.4% were not having any idea. Harmful effects of self-medication can be antibiotic resistance, skin problem, hypersensitivity, and allergy. It is the responsibility of pharmacists and the manufacturers of over-the-counter drugs to make people understand the side effects associated with medicating themselves and to take professional advice before the consumption of any drugs.

CONCLUSION

Self-medication practices are an alarming concept. 50.4% of people in Riyadh region had a practice of self-medication. Pain killer was the most common drug; toothache being the triggering factor, lack of time was the main reason for such practices. The pharmacy counter is the main source for self-medication. Hence, education is necessary for the general public regarding its consequences, adverse effects, and take professional advice before the consumption of any drug.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.