among seafarers visiting the Krishnapatnam port, Nellore, Andhra Pradesh. Methodology: Cross ..... hp/pdf/activities/statutory/ism/flag/uk/MSN_1768.pdf.
ORIGINAL RESEARCH
Srikanth Eet al.: Dental Emergencies among Seafarers
Awareness and Practices on Dental Emergencies among Seafarers visiting Krishnapatnam Port, Andhra Pradesh, India Embeti Srikanth1, Sudhir K.M2, Chandra sekahara Reddy.V3, R.L Manogna Vangala4, Krishna Kumar R.V.S5, Srinivasulu Gomasani6, Deepthi Athuluru7 1-Post-Graduate Collge, Narayana Dental college and hospital, Nellore. 2-Professor, Narayana Dental college and hospital, Nellore. 3-Professor and Hod, Narayana Dental college and hospital, Nellore. 4-Dental Surgeon, Narayana Dental college and hospital, Nellore. 5-Associate Professor, Narayana Dental college and hospital, Nellore. 6-Reader, Narayana Dental college and hospital, Nellore. 7- Senior Lecturer, Narayana Dental college and hospital, Nellore.
Correspondence to: Dr. Embeti Srikanth, -Post-Graduate Collge, Narayana Dental college and hospital, Nellore Contact Us: www.ijohmr.com
ABSTRACT Aim: To assess the Knowledge and practices towards management of dental emergencies and dental traumatic injuries among seafarers visiting the Krishnapatnam port, Nellore, Andhra Pradesh. Methodology: Cross sectional descriptive study was conducted on Merchant marine cargo vessels seafarers visiting Krishnapatnam port Muthukur, Nellore form various countries during the period of May - Aug 2017. Verbal consent was obtained from the study participants after explaining the aim and objectives of the study. Data were collected using self-administered validated questionnaire consisting of two parts. The first part consisted of socio-demographic details; second part consisted of assessment of knowledge and attitude towards dental emergencies and management of dental traumatic injuries. Results: 30.3% of the respondents reported that they encountered dental emergencies on the sea while sailing. Tooth pain was reported as the commonest dental emergency on board (63.9%). Just 43.5% of seafarers were aware of the availability of emergency medical kit.23%, and 20.5% of the seafarers used salt water rinsing and clove oil to relieve tooth pain respectively. Mouth ulcers were managed by the majority of them using B-complex tablets (36.1%) and glycerin. Interestingly 81.1% of the seafarers were not aware of the method of management of traumatic dental injuries. Majority of the respondents in the cadre of Engineer (75%) Second/third mate (63.15%) Captain, chief mate, chief training officer(67.40%) oiler (91.66%) reported that they had first aid training for the management of dental emergencies and traumatic injuries during the training period. Conclusion: Majority of the respondents/seafarers had adequate knowledge and practices in management of dental emergencies and dental traumatic injuries. KEYWORDS: Oral health, Traumatic injuries, Emergencies, Sailors
AINTRODUCTION ASSSAAsasasss Working conditions are one the factor affecting oral health. During long working hours encourage unhealthy lifestyles, lack of physical exercise, and social isolation with oral health becoming a low priority. 1 Dental problems and oral pathologies are not infrequent among seafarers, and these workers represent a group of special needs as they are isolated during long sea voyages. On the other hand, provision of health care (including dental care) to sailors is a problematic task, as a large majority of merchant ships do not carry health professionals and are at sea for days or weeks and months before they reach the port. For centuries, the captain of the ship has been in charge of the treatment of diseases and the health protection of the crew, while at sea.2 The Poor oral health of seafarers is considered as the main cause of their dental problems that can result in complications for shipping companies during voyages. Another reason for frequent oral pathologies encountered in sailors is the use of excessive amounts of snacks. They also consume a large quantity of tea, coffee, and
beverages because of their odd working hours and unique lifestyle. Most of the dietary substances mentioned above contain fermentable carbohydrates and sugars, which are considered to be prime risk factors of dental caries and associated dental diseases.2 Danish Radio medical Service in its 2010 annual report, which covered about 1300 consultations, stated that dental problems (8.1 %) were among the four most frequent concerns and followed after skin-symptoms (11.2 %), injuries (11.1 %) and symptoms from muscles and nerves (10.5 %).3 Dental problems are often a major cause for concern amongst seafarers. It has been reported that at the UK P&I Club, claims often arise from dental problems that require urgent medical treatment and even repatriation of the crew. Seafarers are often at sea for long periods of time and unable to attend regular dental check-ups ashore, which may lead to dental problems developing unchecked. Long working hours and minimal physical exercise can result in the excessive consumption of highly caffeinated and very sugary drinks, unhealthy snacking and high levels of nicotine inhalation. In these
How to cite this article: Srikanth E, Sudhir K.M, Reddy CSV, Vangala RLM, Krishna Kumar RVS, Gomasani S, Athuluru D. Awareness and Practices on Dental Emergencies among Seafarers visiting Krishnapatnam Port, Andhra Pradesh, India. Int J Oral Health Med Res 2018;5(3):14-19.
International Journal of Oral Health and Medical Research | ISSN 2395-7387 | SEPTEMBER-OCTOBER 2018 | VOL 5 | ISSUE 3
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ORIGINAL RESEARCH
Srikanth Eet al.: Dental Emergencies among Seafarers
circumstances, if oral health is neglected, gum disease, tooth decay,and toothache can readily occur.4 Dental emergencies and accidents do happen at sea. Dental instruments are not available on aboard, and specific medications for oral emergencies in the medicine chest are limited. Majority of merchant ships do not carry health professionals and are at sea for days or weeks before they can reach a port, management of these emergencies is left to the crew and captain of the ship. So there is a need to conduct a study on Knowledge and practice towards the management of dental emergencies and dental traumatic injuries among seafarers. So this study was conducted with an aim to assess the Knowledge and practice towards the management of dental emergencies and dental traumatic injuries among seafarers visiting the krishnapatnam port, Nellore (D,t) Andhra Pradesh.
AMATERIALS AND METHODS Cross sectional descriptive study was conducted to assess the Knowledge and attitude towards management of dental emergencies and dental traumatic injuries among seafarers visiting Krishnapatnam port, Nellore (D,t) Andhra Pradesh. Ethical clearance will be obtained from IRB of the Narayana dental college and hospital Nellore; official permission will be obtained from Krishnapatnam port authorizes Muthukur,Nellore (d.t) prior to the start of the study. The source of data is primary in nature, for which a survey was conducted using a questionnaire. The present study was conducted among seafarers visiting Krishnapatnam port, Nellore Andhra Pradesh from various countries during the period of three months MAY-AUG 2017. Krishnapatnam port is one of the 14 notified nonmajor deepwater ports on the East cost of India. Seafarers working in the different ships visiting Krishnapatnam port who were willing to participate and gave informed consent were included in the study. Verbal consent was obtained from the participants after explaining the aim and objectives of the study. The data was collected using a self-administered questionnaire consisting of two parts. The first part consisted of socio-demographic details; second part consisted of questions on assessment of knowledge and attitude towards dental emergencies and management of dental traumatic injuries. The 14 item questionnaire which was designed for this study was validated by checking the content validity before the start of the study. Content validity was assessed using content validity index with Davis criteria 1992.5 It was given to two experts in the field of dental research and their response was recorded, item and scale content validity was checked and Item Content Validity Index score (Lynn 1986)6 was 1.0 and 0.9 for two experts respectively and Scale Content Validity Index score (Waltz & Bausell 1981) was 0.9 for both experts which were acceptable.7 On the day of investigation the investigator visited the ships in the krishnapatanam port after obtaining
permission from port authorities, Questionnaire was given to the captain of the ship ,and the captain was asked to distribute the questionnaire to the crew members and was collected back on the next day from the captain. Statistical Analysis: Data obtained was entered in SPSS software programme and was subjected to Statistical analysis. Chi-square test and Fisher’s exact test was used to finding out the statistical differences between awareness and practices of dental emergencies and management of dental traumatic injuries among seafarers. P value was kept at 0.05 with a confidence interval of 95%.
RESULTS Table 1: Shows the demographic characters of the study participants. Most of the respondents were in the age range of 20-29 (39.3%), and the majority of them were graduates (44.3%). 37.3% of the participants were in the cader of captain /chief metes followed by second & third mates (15.6%) the least representation was from bosun & mess boys (0.8%).45.9% of the subject had working experience for more than 10 years as a seafarer. Variables Age
Sex Education
Position
Years of Experience
20 – 29 30 – 39 40 – 49 50 – 59 60 and above Male Profession or Honours Graduate Intermediate or diploma High school certificate Engineer/engineering officer Second/third mate Captain, chief mate, chief training officer Ratings Able-bodied Seamen Bosun Oiler Ordinary seamen Fitter/mechanic Electrician Mess man, mess boy Chief cook Less than 6 6 – 10 11 - 15 16 – 20 More than 20
Frequency (n) 48 43 23 2 6 122 14 54 44 10 4
Percentage (%) 39.3 35.2 18.9 1.6 4.9 100.0 11.5 44.3 36.1 8.2 3.3
19 46
15.6 37.7
2 14 1 12 3 11 3 1 6 45 21 22 18 16
1.6 11.5 .8 9.8 2.5 9.0 2.5 .8 4.9 36.9 17.2 18.0 14.8 13.1
Table 1:-Demographic characteristics of the study population according to age, gender, education, cader, and years of experience
Table 2 & 3: Shows the responses to questions on awareness and practices related to dental emergencies among seafarers based on education and years of experience as seafarers. 30.3% of the respondents reported that they encountered dental emergencies once a while on the sea while sailing. Tooth pain was reported as the commonest dental emergency on board by (63.9%) majority of the seafarers. When a question was asked on the availability of medical
International Journal of Oral Health and Medical Research | ISSN 2395-7387 | SEPTEMBER-OCTOBER 2018 | VOL 5 | ISSUE 3
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Srikanth Eet al.: Dental Emergencies among Seafarers
Education
1
How often did you encounter dental emergencies on sea while sailing
2
Do you have medical or paramedical staff on board?
3
Which is the most common dental emergency you have faced while on board?
4
Do you carry emergency medicine kit for management of dental emergencies and traumatic injuries?
How do you manage Tooth pain? 5
6
How do you manage Oral swelling?
How do you manage Mouth ulcers? 7
8
Do you know how to manage traumatised tooth which is avulsed from the tooth socket?
Chi square test Total
Very Often Often Once a while
Below graduate 1(1.5%) 2(2.9%) 26(38.2%)
Above graduate 0 0 11(20.4%)
1(0.8%) 2(1.6%) 37(30.3%)
Never
39(57.4%)
43(79.6%)
82(67.2%)
Yes
17(25.0%)
1(1.9%)
18(14.8%)
No
49(72.1%)
52(96.3%)
101(82.8%)
Don’t know
2(3.0%)
1(1.8%)
3(2.5%)
Tooth Pain
45(66.2%)
33(61.1%)
78(63.9%)
Swelling Mouth Ulcer Any others Tooth pain+Mouth Ulcer Tooth pain+ Swelling Yes No Don’t know Clove oil Salt water rinse Painkillers Combination of Painkillers and Antibiotics Combination of all Clove oil Salt water rinse Hot fermentation Painkillers Antibiotics Combination of painkillers+antibiotics Combination of all Glycerin Topical Anesthesia B-complex tab Antibiotics+painkillers Glycerin+ B-complex Yes No
2(2.9%) 8(11.8%) 3(4.4%) 7(10.3%) 3(4.4%) 45(66.2%) 23(33.8%) 0 13(19.1%) 8(11.8%) 1(1.5%) 15(22.1%)
1(1.9%) 6(11.1%) 11(20.4%) 3(5.6%) 0 8(14.8%) 42(77.8%) 4(7.4%) 12(22.2%) 20(37.0%) 9(16.7%) 2(3.7%)
3(2.5%) 14(11.5%) 14(11.5%) 10(8.2%) 3(2.5%) 53(43.4%) 65(53.3%) 4(3.3%) 25(20.5%) 28(23.0%) 10(8.2%) 17(13.9%)
31(45.6%) 8(11.8%) 24(35.3%) 2(2.9%) 0 1(1.5%) 17(25.0%)
11(20.4%) 0 38(70.4%) 0 3(5.6%) 1(1.9%) 3(5.6%)
42(34.4%) 8(6.6%) 62(50.8%) 2(1.6%) 3(2.5%) 2(1.6%) 20(16.4%)
16(23.5%) 19(27.9%) 2(2.9%) 26(38.2%) 1(1.5%) 20(29.4%) 22(32.4%) 46(67.6%)
9(16.7%) 25(46.3%) 0 19(35.2%) 6(11.1%) 4(7.4%) 1(1.9%) 53(98.1%)
25(20.5%) 44(36.1%) 2(1.6%) 45(36.9%) 7(5.7%) 24(19.7%) 23(18.9%) 99(81.1%)
Chi square -
p-value 0.02*#
