|Year : 2016 | Volume
| Issue : 2 | Page : 62-68
Awareness of dental implant treatment in an Indian metropolitan population
Amit S Gharpure1, Prasad D Bhange1, Arti S Gharpure2
1 Department of Dentistry, King Edward Memorial Hospital, Acharya Donde Marg, Mumbai, Maharashtra, India
2 Private Practice, Mumbai, Maharashtra, India
|Date of Web Publication||15-Mar-2017|
Amit S Gharpure
Department of Dentistry, King Edward Memorial Hospital, Acharya Donde Marg, Mumbai, Maharashtra
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Introduction: As implant dentistry becomes popular with each passing, need to understand its awareness in the general population exists. The aim of this study was to assess the public awareness of dental implants as a treatment option and its demographic distribution in the Indian Metropolitan City of Mumbai.
Materials and Methods: A questionnaire-based survey consisting of 12 questions on implant treatment awareness was conducted on randomly selected 1000 individuals attending eight dental clinics in the city of Mumbai, India. Distribution for each question was assessed using frequencies and percentages for various sociodemographic groups.
Results: 32.30% of the participants were aware of dental implants as an option to replace missing teeth, without significant variance in gender and age groups ranging from 18 to 70 years. Awareness of dental implant treatment increased with the increase in socioeconomic status. Dentists were the main source of information on implants, followed by the internet. 46.8% of the participants wanted additional information on dental implants. Among those aware of implants, 62.85% of the participants regarded high cost of the treatment as the biggest disadvantage, 31.89% of the participants blamed their dental professional for the failure of implants, 48.92% of the participants thought implants would last a lifetime, and 85.45% of the participants were ready to restore their missing teeth with implant-based treatment options.
Conclusion: This study reveals that there is a lack of awareness of dental implants and implant-based treatment in the population, especially in those with a low socioeconomic status. However, a significant portion of the population wanted to have more information on dental implants. Special efforts to improve doctor-patient communications will be needed to bridge the information gap.
Keywords: Awareness, implant dentistry, India, Mumbai, patient knowledge, survey
|How to cite this article:|
Gharpure AS, Bhange PD, Gharpure AS. Awareness of dental implant treatment in an Indian metropolitan population. J Dent Implant 2016;6:62-8
|How to cite this URL:|
Gharpure AS, Bhange PD, Gharpure AS. Awareness of dental implant treatment in an Indian metropolitan population. J Dent Implant [serial online] 2016 [cited 2021 Nov 29];6:62-8. Available from: https://www.jdionline.org/text.asp?2016/6/2/62/202156
| Introduction|| |
Since the intraoral use of titanium implants was first suggested in the 1950s, the practice of implant dentistry has become progressively more popular for the restoration of missing teeth. Dental implants have revolutionized the practice of restorative dentistry and have provided multiple benefits to patients. A majority of partially dentate and edentulous patients can be now be offered implant-related treatment options with a good prognosis even in cases of compromised local host hard and soft tissues.,,,,, With the turn of the century, the number of implants inserted worldwide annually is estimated to be close to 1 million. There is an increase in both the implant manufacturers as well as the number of dentists trained in implant therapy over the past decade.
The literature on implant dentistry has numerous publications which focus on quality assurance based on extensive basic research, but few shed light on the opinions of the public. Even though there has been a breakthrough in the evidence-based literature on implant dentistry, only 2% of the publications deal with patient-centered issues. The necessity for patient-centered outcomes in implant treatment has already been discussed in the 4th European Workshop on Periodontology. Studies which deal with information on the patient opinion of the treatment and the psychological impact following implant treatment are extremely limited., It is, therefore, necessary to conduct a survey to assess public opinion and awareness of dental implants.
Various sources of information regarding oral implants are available to the public. A study conducted in the United States showed that even though 77% of those questioned knew about dental implants, their main source of information was from the media and not dentists. In another survey conducted by Berge in Norway, mass media such as TV broadcasts and periodicals provided mostly negative information on dental implants. Patients are often confused with the information provided by the media, which may not be as accurate as evidence-based data provided by more suitable sources of information. Hence, it is necessary to provide patients with accurate information of the cost, longevity, and possible risk involved in implant treatment.
With dental implant treatment become popular by the day, it is necessary to ascertain public notions on implant treatment in the urban Indian population. Thus, it is essential to conduct a survey to determine patients' perceived level of awareness, sources of information, and their acceptance and satisfaction on implant treatment by analyzing feedback. The aim of this study was to assess the public awareness of dental implants as a treatment option in the Indian Metropolitan City of Mumbai and its demographic distribution based on age, gender, education levels, profession, and net family income.
| Materials and Methods|| |
This was a questionnaire-based cross-sectional study. The questionnaire included twelve questions related to the awareness of dental implants of the participants and their knowledge about implant treatment. The questions and the distribution of the responses of the participants can be seen in [Table 1].
|Table 1: Distribution of responses of the participants to various questions related to their information on dental implants|
Click here to view
The locality of Dadar is situated in the center of the city and has a diverse population. Due to its central location and accessibility, patients from all over the city visit multiple private dental clinics in Dadar. Similarly, the dental surgery department clinic at King Edward Memorial Hospital, Mumbai, also sees diverse patients from all across the city for dental treatment. For this reason, a sample size of 1000 individuals was collected by randomly selecting individuals visiting seven dental clinics in Dadar along with the Dental Surgery Department at King Edward Memorial Hospital to represent the metropolitan population of Mumbai. At each center, patients willing to participate in the study were asked to fill in the questionnaire. A written informed consent was obtained and the investigators directly distributed and collected the questionnaires. Before submission of the questionnaire, the investigators checked for completeness and invalid entries. The questionnaire was translated and printed in local languages to improve the understanding of the respondents. The duration of the study was from March 15, 2016, to July 15, 2016.
Inclusion criteria were healthy adults and participants who were over 18 years of age. Exclusion criteria were individuals below 18 years of age and those were seriously ill/terminally ill, mentally challenged, physically handicapped, and pregnant females.
To obtained detailed demographic information, the participants were allocated to several subgroups according to age (18–30, 31–50, 51–70, 71 and above), education (not completed primary school, studied up to primary school, studied up to high school, graduates and postgraduates/professionals), and profession (self-employed/freelancers/own business, white-collar workers/civil servants/professionals, blue-collar workers/manual laborers, persons engaged in agriculture, students, homemakers, retirees, and unemployed). Further, the participants were classified according to net family income per month into five subgroups, less than ₹10,000, ₹10,001–₹25,000, ₹25,001–₹50,000, ₹50,001–₹150,000, and finally ₹150,001 and above.
Completed questionnaires were coded, and data were tabulated before analysis. Distribution of responses was examined using frequencies and percentages. Descriptive statistics were presented for the scores of questionnaire domains in the groups based on age, gender, education, profession, and family income.
The ethical clearance was obtained from the Institutional Ethical Committee. A written informed consent was obtained from all the participants by the investigators. This study was conducted in adherence to relevant national and international laws and followed the GCP guidelines and was in accordance with the STROBE statement for cross-sectional studies.
| Results|| |
The demographic distribution of the sample is described in [Table 2]. A total of 32.3% (n = 323) participants reported that they were aware of dental implants as an option to replace missing teeth. 30.17% (n = 156) males and 34.58% (n = 167) of females reported that they were aware of dental implants. Awareness of dental implants in the various categories based on age, gender, level of education, profession, and net monthly family income is described in [Table 2].
|Table 2: Demographic distribution of the participants on the basis of awareness of dental implants|
Click here to view
For those patients who were aware of dental implant treatment, the various sources of information on dental implants are mentioned in [Table 1] and [Figure 1]. When asked if they wanted more information on dental implants, 46.8% of all participants reported that they wanted more information. 77.71% of those who were aware of dental implants wanted more information on implants as seen in [Figure 2]. In those participants who did not know about dental implants, only 34.61% of the participants wanted more information whereas 73.37% of the participants did not want more information on implants. When asked which source they wanted additional information from, most of the participants (92.31%) reported their dentist followed by other sources as seen in [Table 1].
|Figure 1: Percentage distribution of the source of information on dental implants for those participants who were aware of dental implants as an option to replace missing teeth (n = 323)|
Click here to view
|Figure 2: Percentage distribution of participants based on awareness of dental implants as an option to replace missing teeth (n = 1000). Furthermore, percentage distribution of participants who were aware of dental implants (n = 323) based on whether they wanted additional information and whether they were ready to replace their missing teeth with dental implants|
Click here to view
Distribution of responses of the participants to questions based on their knowledge of dental implants such as the location of anchorage, longevity, maintenance, and reasons for failure/loss can be seen in [Figure 3] and [Table 1]. Most participants (62.95%) reported high cost of treatment as the biggest disadvantage followed by invasive nature of surgery (19.20%), and finally, a long period for treatment completion (17.96%) as seen in [Figure 4]. A large number of participants (85.45%) reported that they would go ahead and restore their missing teeth with dental implants [Figure 2]. When the participants who were aware of dental implants were asked if they specifically knew anyone else who had undergone dental implant treatment, 16.72% of them reported that they themselves had implant-based treatment, 55.11% of them knew of acquaintances who had implant-based treatment, and only 28.17% of them did not know anyone with dental implant treatment. Satisfaction with implant-based treatment was reported by 92.24% of the participants [Table 1].
|Figure 3: Percentage distribution of the factor which the participants, who were aware of dental implants, would blame in case of implant failure/loss (n = 323)|
Click here to view
|Figure 4: Percentage distribution of the biggest disadvantage of implant dentistry as recorded by participants who were aware of dental implants (n = 323)|
Click here to view
| Discussion|| |
In this study, the total awareness of dental implants was 32.3% which is much higher than 23.24% reported in previous studies conducted in urban Indian populations by Chowdhary et al. However, it is much lower as compared to 72% reported by Tepper et al., 79% reported by Pommer et al., 70.1% reported by Berge, and 77% reported by Zimmer et al. in European and North American populations.,,, This is probably because implant treatment is yet to become as popular in the Indian subcontinent as it is in the European and North American populations. This study demonstrated that awareness in females is marginally greater than males and that all the age groups showed almost similar levels of awareness except the 71 years and above group, which had a lower level of awareness [Table 2]. This is in contrast to the findings of Chowdhary et al. in which a higher number of males were aware of dental implants as compared to females. In this study, awareness of dental implants increased as we moved from a lower to a higher level of education and family income [Table 2]. This can probably be explained by the fact that people with a higher education level and net monthly family income have better access to advanced oral health care and thus are more concerned about their oral health. In the various professions, highest levels of awareness were noted in students, followed by white-collar employees, homemakers/retired citizens, and the self-employed. The lowest awareness was seen in participants engaged in agriculture probably because they come from poor socioeconomic backgrounds and usually reside in underdeveloped areas with limited oral health awareness.
Although a number of participants (67.49%) reported that they got information on dental implants from their dentist, a significant number (20.43%) also reported various media sources such as the internet, magazines, newspapers, and the TV [Table 1] and [Figure 1]. These findings are similar to studies by Pommer et al. and Tepper et al., However, findings of studies by Berge and Best reported that media was the main source., Findings reported by Akagawa et al. show that dentists provided not more than 20% of the information on dental implants, whereas the study by Al-Johany et al. in a Saudi Arabian population showed that family, friends, and acquaintances were the most important source.,
A high percentage of the participants reported that they wanted more information on dental implants [Figure 2], especially from their dentist (92.31%) which is similar to the findings of earlier studies., Most of the participants clearly demonstrated a lack of knowledge on implant-based treatment. About two-thirds of the participants, who knew about dental implants, correctly answered that the jawbone was where implants are anchored whereas 15.17% marked gums and 17.96% were not sure. On being questioned how long implants would last, almost half the participants picked “a lifetime.” Most of the participants reported that they would blame incompatibilities/allergies for implant failure/loss with dentists being a close second choice [Figure 3]. Few participants blamed the patient or poor maintenance for the failure/loss [Figure 3] and when asked if implants needed special care and oral hygiene, only 42.72% felt that implants need more care than natural teeth whereas 55.11% reported the same as that of natural teeth. These findings are similar to previous studies and highlight the fact that the current information on longevity, complications, and maintenance of implants provided by dentists is insufficient.,
Almost two-thirds of the participants picked high cost as the single biggest disadvantage of implant treatment followed by invasive nature of the surgery and a long period for treatment completion [Figure 4]. These findings are similar to previous studies., Some earlier studies also reported that there was significant fear of surgery which deterred patients from implant treatment. The cost price of most reputed implants is high and this price has to be borne by the patients. More patients will opt for implant-based treatment options once their health insurance policies include coverage for such treatments. Similarly, the government should implement schemes to provide cheaper dental implant-based treatment options to patients with lower socioeconomic status.
71.83% of the participants who were aware of dental implants either had implant-based treatment themselves or knew of an acquaintance that had this treatment and 92.24% were satisfied with the treatment. Furthermore, on being asked if they would restore their missing teeth with implants, 85.45% of those aware of dental implants agreed to undergo implant-based treatment [Figure 2]. This clearly indicates that participants, once familiar with implant-based treatments, would select such treatment options to replace their missing teeth and would generally be satisfied with the treatment provided.
The findings of this study clearly point out that there is a general lack of awareness on implant-based treatment in the Indian metropolitan population. However, a large number of participants are interested in obtaining additional information on implant-based treatment options from their dental practitioner. It can be seen that a majority of patients, from among those aware of dental implants, wanted to opt for implant-based treatments. Thus, dental professionals need to spend more time on consulting patients to make them aware of the advantages of implant-based treatment options and provide them with accurate information.
| Conclusion|| |
This study clearly demonstrated that only one-third of the population is aware of dental implants as an option to replace missing teeth. Those aware of implants were inadequately informed about the location of implant placement, their maintenance, and their durability. Participants with a better socioeconomic status such as good education and family income were more likely to be aware of implants as compared to their counterparts with a lower socioeconomic status. Although a majority of participants got information on implants from their dentists, they still wanted additional information. Thus, it is important for dental professionals to educate their patients on the merits of implant-based treatment options and improve their understanding of implant therapy at the time of the consultation.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Lindh T, Gunne J, Tillberg A, Molin M. A meta-analysis of implants in partial edentulism. Clin Oral Implants Res 1998;9:80-90.
Moberg LE, Köndell PA, Sagulin GB, Bolin A, Heimdahl A, Gynther GW. Brånemark System and ITI Dental Implant System for treatment of mandibular edentulism. A comparative randomized study: 3-year follow-up. Clin Oral Implants Res 2001;12:450-61.
Aglietta M, Siciliano VI, Zwahlen M, Brägger U, Pjetursson BE, Lang NP, et al.
A systematic review of the survival and complication rates of implant supported fixed dental prostheses with cantilever extensions after an observation period of at least 5 years. Clin Oral Implants Res 2009;20:441-51.
Adell R, Eriksson B, Lekholm U, Brånemark PI, Jemt T. Long-term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990;5:347-59.
Bergendal T, Engquist B. Implant-supported overdentures: A longitudinal prospective study. Int J Oral Maxillofac Implants 1998;13:253-62.
Friberg B, Gröndahl K, Lekholm U, Brånemark PI. Long-term follow-up of severely atrophic edentulous mandibles reconstructed with short Brånemark implants. Clin Implant Dent Relat Res 2000;2:184-9.
van Steenberghe D, Quirynen M, Naert I, Maffei G, Jacobs R. Marginal bone loss around implants retaining hinging mandibular overdentures, at 4-, 8- and 12-years follow-up. J Clin Periodontol 2001;28:628-33.
Brunski JB.In vivo
bone response to biomechanical loading at the bone/dental-implant interface. Adv Dent Res 1999;13:99-119.
Vasak C, Fiederer R, Watzek G. Current state of training for implant dentistry in Europe: A questionnaire-based survey. Clin Oral Implants Res 2007;18:668.
Strassburger C, Heydecke G, Kerschbaum T. Influence of prosthetic and implant therapy on satisfaction and quality of life: A systematic literature review. Part 1 – Characteristics of the studies. Int J Prosthodont 2004;17:83-93.
Pjetursson BE, Karoussis I, Bürgin W, Brägger U, Lang NP. Patients' satisfaction following implant therapy. A 10-year prospective cohort study. Clin Oral Implants Res 2005;16:185-93.
Lang NP, Karring T, Meredith N. Group E summary. J Clin Periodontol 2002;29:232-4.
Abu Hantash RO, Al-Omiri MK, Al-Wahadni AM. Psychological impact on implant patients' oral health-related quality of life. Clin Oral Implants Res 2006;17:116-23.
Vermylen K, Collaert B, Lindén U, Björn AL, De Bruyn H. Patient satisfaction and quality of single-tooth restorations. Clin Oral Implants Res 2003;14:119-24.
Zimmer CM, Zimmer WM, Williams J, Liesener J. Public awareness and acceptance of dental implants. Int J Oral Maxillofac Implants 1992;7:228-32.
Berge TI. Public awareness, information sources and evaluation of oral implant treatment in Norway. Clin Oral Implants Res 2000;11:401-8.
Tepper G, Haas R, Mailath G, Teller C, Zechner W, Watzak G, et al.
Representative marketing-oriented study on implants in the Austrian population. I. Level of information, sources of information and need for patient information. Clin Oral Implants Res 2003;14:621-33.
Brägger U, Krenander P, Lang NP. Economic aspects of single-tooth replacement. Clin Oral Implants Res 2005;16:335-41.
Chowdhary R, Mankani N, Chandraker NK. Awareness of dental implants as a treatment choice in urban Indian populations. Int J Oral Maxillofac Implants 2010;25:305-8.
Pommer B, Zechner W, Watzak G, Ulm C, Watzek G, Tepper G. Progress and trends in patients' mindset on dental implants. I: Level of information, sources of information and need for patient information. Clin Oral Implants Res 2011;22:223-9.
Best HA. Awareness and needs of dental implants by patients in New South Wales. Aust Prosthodont J 1993;7:9-12.
Al-Johany S, Al Zoman HA, Al Juhaini M, Al Refeai M. Dental patients' awareness and knowledge in using dental implants as an option in replacing missing teeth: A survey in Riyadh, Saudi Arabia. Saudi Dent J 2010;22:183-8.
Akagawa Y, Rachi Y, Matsumoto T, Tsuru H. Attitudes of removable denture patients toward dental implants. J Prosthet Dent 1988;60:362-4.
Kent G. Effects of osseointegrated implants on psychological and social well-being: A literature review. J Prosthet Dent 1992;68:515-8.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1], [Table 2]