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Authors : Dr. Krutika M Gaitonde, Dr. Ankita A Sawant, Dr.Shubhangi A. Mani.

Abstract:

Objective: To assess the awareness about hygiene and safety measures by assessing parent’s and children’s preference for different types of safety equipment while operating and it’s consideration to improve patient’s compliances as well as the hygiene levels between the patient and dentist towards dental treatment.

Material and methods: A total of 100 parents of age group 25-55 years and their children of age 10 to 16 years who are seeking dental treatment were made to look at pictures showing male and female dental resident wearing different safety measures. Data was collected using questionnaires accompanied by the same.

Result: A very high percentage of the parents irrespective of gender, while operating prefer to make the use of gloves along with a facemask and protective eyewear to maintain proper safety measure.

Conclusion: The awareness about hygiene and safety among parents and children is significant. The result obtained from this study can help dentist decide what is appropriate to wear when dealing with patients while operating so as to improve their compliance and hygiene between them also creating a better first impression and interpersonal relationship.

Introduction

These days due to the increase knowledge in advance technology, the general awareness regarding hygiene and information regarding various diseases that can occur if proper hygiene is not maintained has increased amongst the masses . In our field of dentistry we treat patients of all age groups. Not only is there a risk of transmitting various trans-mucosal infective diseases to the patient, but now a days various studies say that dentist are more prone to such diseases. Hence due to the increased awareness, it is very important for a dentist to maintain proper hygiene while operating on their patients. Also for us to carry out our treatment without any hindrance, compliance of patient as well as of their parents is very important.1, 2Creating a strong rapport & establishing a friendly relation with the child and with his parents help to create a comfortable atmosphere. On first visit to orthodontist, prior to verbal communication, impression about an orthodontist is developed based on clothing, grooming and cleanliness.3 Psychologists also highlight the importance of appearance & its effect upon first impressions and interpersonal relationship.4,5

Health professionals attire while operating /working has changed over the years although the use of gloves, facemask, protective eyewear is now considered as a standard practice in the modern dentistry.6 However fashion recently has played an influential role, giving rise to a medical workforce with a negligible attitude towards maintaining proper hygiene amongst the masses.7

Many studies have looked into patient’s attitude towards professional attire8,9;however literature lacks reports to determine awareness or their knowledge regarding this safety measures. So, this study is conducted to have an idea of patient’s attitude towards professional attire during working ,and is conducted among parents and children attending our dental department , Rural Dental College, PIMS who are seeking dental treatment.

Materials and Methods:

Study group: A cross sectional sample was used of all patients and their parents attending the rural dental college for treatment over a period of 1 month in October 2014. An information letter explaining the purpose of the research along with the consent form is given to all participants. Questionnaires were completed in waiting area during their appointment.

Clinical attire depiction: photographs of male and female dental residents in different safety measures while operating on the patient were taken as mentioned in table no. Color complexion, Facial expression kept constant as far as possible. The results obtained from six pictures, which are mentioned in table.Codes were given to each picture for ease of reference as shown in figures.

Questionnaire: this is formulated in English. The demographic information collected from the questionnaire including parent’s age, sex and occupation. The questionnaire comprise of questions along with photographs related to the dentist’ attire wearing different safety measure gears. They were asked to select one appropriate option for each question. A short discussion is done before the completion of questionnaire to encourage parents to comment on each question.

Inclusion criteria: parents of child who are able to understand and to communicate in English were selected.

Table 1.

 

Q 1

Q 2

Q 3

Q 4

Q 5

Q 6

 

0

1

0

1

0

1

0

1

0

1

0

1

Parents

3

97

97

3

77

23

88

12

92

8

43

57

17.6%

53.0%

53.0%

17.6%

48.7%

54.8%

59.9%

22.6%

49.7%

53.3%

39.1%

63.3%

Children

14

86

86

14

81

19

59

41

93

7

67

33

82.4%

47.0%

47.0%

82.4%

51.3%

45.2%

40.1%

77.4%

50.3%

46.7%

60.9%

36.7%

Total

17

183

183

17

158

42

147

53

185

15

110

90

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

X2

7.79

7.79

0.48

21.58

0.72

11.36

P value

<0.001 (S)

<0.001 (S)

>0.05 (NS)

<0.001 (S)

>0.05 (NS)

<0.001 (S)


Table 2.

 

Q 1

Q 2

Q 3

Q 4

Q 5

Q 6

 

0

1

0

1

0

1

0

1

0

1

0

1

Parents

3

97

97

3

77

23

88

12

92

8

43

57

17.6%

53.0%

53.0%

17.6%

48.7%

54.8%

59.9%

22.6%

49.7%

53.3%

39.1%

63.3%

Children

14

86

86

14

81

19

59

41

93

7

67

33

82.4%

47.0%

47.0%

82.4%

51.3%

45.2%

40.1%

77.4%

50.3%

46.7%

60.9%

36.7%

Total

17

183

183

17

158

42

147

53

185

15

110

90

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

100.0%

X2

7.79

7.79

0.48

21.58

0.72

11.36

P value

<0.001 (S)

<0.001 (S)

>0.05 (NS)

<0.001 (S)

>0.05 (NS)

<0.001 (S)

Test applied: Chi-square test.

group * VAR00002 Crosstabulation

 

 

 

VAR00002

Total

 

 

 

0

1

group

Parents

Count

77

38

115

% within VAR00002

85.6%

34.5%

57.5%

Children

Count

13

72

85

% within VAR00002

14.4%

65.5%

42.5%

Total

Count

90

110

200

% within VAR00002

100.0%

100.0%

100.0%

SR NO.

SAFETY MEASURES

CODES

1

Dentist With GLOVES

DG

2

Dentist without GLOVES

DWG

3

Headcap+Facemask+Eye protector

HFE

4

Headcap+Facemask

HF

5

Headcap+Eye protector

HE

6

Facemask+Eye protector

FE

 

RESULT:

A total of 112 parents (63 males, 37 females) between ages 25- 55 years, mean age was 41± 0.8 years and 100 children (52 males, 48 females) between ages 10-16 years, mean age was 14.12 ± 1.05 completed and gave back the questionnaire. Of these 6 parents declined to participate in the study, 4 refused due to time restraints, 2 were not able to communicate in any appropriate language. So, total sample size was 100 for parents as well as for their children.

All data is collected and chi-squared test is performed to find significant values. And graphs are made which shows positive or yes values of result.

 

  1. While operating, a large number of children irrespective of the gender or age preferred the dentist to wear gloves. 53.0% parents preferred dentist to wear gloves whereas 47.0% children preferred dentist to wear gloves while operating on the patient (graph 1).
  2. The results obtained regarding the use of protective eyewear, facemask and headcap, (graph 1) showed that not a very high percentage of children 45.2% prefer the use of protective eyewear, facemask and headcap, whereas 54.8% of parents prefer the use of protective eyewear, facemask and headcap. 22.2% of parents and 77.4% of children prefer dentist wearing headcap and facemask (P>0.05 S). 53.3% of parents and 46.7% of children prefer dentist wearing headcap and protective eyewear (P>0.05 NS). 63.3% of parents and 36.7% of children prefer dentist wearing facemask and protective eyewear that is statistically significant (P<0.001).

Gender-based analysis (graph 2) is found to be non-significant that is 52.4% of males prefer dentist wearing headcaps, facemask and protective eyewear, whereas 47.6% of females prefer the same. 60.4% of male and 39.4% of female prefer dentist wearing headcap and facemask, 46.7% of male around 53.3% of female prefer dentist wearing headcap and protective eyewear, 60.0% of male and 40.0% of female prefer dentist wearing facemask and protective eyewear.

   

GRAPH 1: Description of parents and children in form of different safety measures (Chi-squared Test performed)

GRAPH 2: Description of males and females in form of different safety measures.(Chi-squared Test performed)

Discussion:

The study revealed that not only did the parent have a very strong opinion regarding the attire of dentist while operating, surprisingly so did the children. Non-verbal communication in the form of a clinician’s appearances while operating can play a major role in any attitude formed in the relationships between patients and practitioner 10. Professionalism can be portrayed through proper appearance based on dress codes, can increase a patients feelings of comfort and confidences, thus leading to an improved dental experience11.

In the dental profession, there is a high risk of transmission of infections between dentist and patients.12 Now a days it is considered as a standard practice, in modern dental surgery/office and practice that the dentist not only for the safety of the dentist but also for the safety of the patient should make use of gloves, a facemask, protective eyewear as well as headcap as and when required.13

In our study, a majority of parents encourage the use of gloves along with facemask and protective eyewear.

1) Gloves: In Dentistry, we tend to use a lot of different and sharp instruments during our procedures. A lot of study have reported cases of dentist being pricked by an infected needles and so and have been contacted with various diseases such has hepatitis B, HIV and many more.14

Our study says that almost all the parent preferred the use to gloves and encouraged the dentist to use a fresh pair for very patient. Even children have preferred the use of gloves. This could be due to the reason that they had experienced their dentists using only gloves in the past and their mind is conditioned to their use.15

2) Facemask: There are a lot of instances when patients are not completely honest about their health diseases due to various reasons and many of the time they are not even aware of it. Various studies have proven that the oral cavity is the house of the largest number of micro-flora and transmission of various diseases can occur very fast through this media.16

Our Study says that majority of the parents and the older age group of children prefers the use of the facemask supporting the findings of Shulman and Brehem20 as well as McKenna et al19, as they are aware that there can be instances that even a doctor can be reason to get infected. Whereas, the younger group of children does tend to get intimidated by the same but somehow if various soft skills used to explain the importance, they do get cooperative.

3) Headcap: our study says that there are some mixed views regarding the use of a headcap. Some parents prefer the use, whereas majority of the parents do mind the dentist not using the headcap as long as their hair are neatly tied up and do not intervene their dental procedure.However, children on the other hand lack this awareness.

4) Eyewear: Eyewear is often considered as one of the least important safety measures during practice. However apart from our hands playing a major role in the filed of dentistry our eyes seems to play a bigger role at times. Often while operating unintentionally there can be instances when few particles such as contaminated water, saliva, blood, debris, calculus, cement, acrylic particles could come in contact with the eyes, which could be indeed very harmful for them.17 Few studies reveal that it is important especially for children to maintain a good amount of eye contact during the treatment with the dentist, whereas on the other hand it is a myth that children are intimidated by the use of such safety equipment18 and also at the same time may be unaware of the protective purposes they serve.

However this can be explained to them in a more calmed way to increase their knowledge regarding this awareness. Hence, our study revealed that an older group of children prefer the use of safety equipment as they understood the importance of it and as they were familiar with the dentist wearing such safety equipment. On the other hand a younger group of children did not much prefer the use of the same.

This has a very important effect on the first impression of the dentist towards their patients and in future helps in the interpersonal relationship between both of them. Hence making small improvements while operating on the patient can not only have an important impact on increasing as well as decreasing the level of anxiety and comfort level of the patient with their dentist19,20 but also improve the hygiene levels between them which is not only important for the patient, but now a days seems to be more important for the dentist. Perhaps this fact this often neglected by many dental practitioners, which should be avoided.

CONCLUSION:

Parents significantly favor the use of various safety equipment for an air of professionalism and a good level of hygiene, whereas children significantly prefer dentist to use gloves along with facemask and eyeware.

It is important to note that although patient’s preferences in this study did indicate certain opinion regarding their dentist appearances while operating, these preferences carry little weight as compared to personal soft skills such as kindness, patience and their clinical competences.

However to conclude our study, bringing about certain changes in one’s style especially while working and operating can make a remarkable change towards the attitude of the parents and children towards the dentist in terms of their comfort and anxiety levels and can increase the chances of the child accepting the treatment readily, thus increasing patient compliances and awareness along with maintaining improved levels of hygiene and preventing transmission of various diseases.

References:

  1. Bhavna shroff GRKL. aparent's preferences regarding the attire of othodontist. angle's orthodontics. 2014 may; 84(3).
  2. WM s. our relation to children. dental review. 1891; 5(534-537).
  3. bersheid E GS. The social psychological implications of facial physical attractiveness. clinical plastic surgery. 1982 july; 9(3).
  4. S.U. R. what to wear today?effect of doctor's attire on the trust and confidence of patients. american journal of medicine. 2005 Nov; 118(11).
  5. Townend E DGFD. A clinical study of child dental anxiety. Behaviour research theraphy. 2000 Jan; 38(1): p. 31-46.
  6. L B. On the value of an old dress code in the new millenium. Arch Intern Med. 2003 Jun; 163(11): p. 1277-81.
  7. Lil M.M WTJ. Judging a book by its cover:discriptive survey of patient's preferances for doctor's appearance and mode of address. British Medical Journal. 2005 Dec; 331: p. 1524-7.
  8. Keenum A WLSAR. Patient's attitudes regarding physical characteristics of family practice physicians. south medical journal. 2003 Dec; 96(12): p. 1190-4.
  9. Nair B.R AJR,SRHKI. Evidence-based physician's dressing: a cross-over trial. Medical journal of Australia. 2002 Nov; 177: p. 681-682.
  10. Brosky M.E KOPJSPIJCG. Patient perception of professionalism in dentistry. Jornal of Dental Education. 2003; 67: p. 909-915.

More references are availabe on request.

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