FIELD OF THE INVENTION
[001] The present invention relates to the field of medical science, and more particularly, the present invention relates to the cross-sectional study on oral health knowledge and beliefs assessment in the adult population.

BACKGROUND FOR THE INVENTION:
[002] The following discussion of the background to the invention is intended to facilitate an understanding of the present invention. However, it should be appreciated that the discussion is not an acknowledgment or admission that any of the material referred to is published, known, or part of the common general knowledge in any jurisdiction as of the priority date of the application. The details provided herein the background if belongs to any publication is taken only as a reference for describing the problems, in general terminologies or principles or both of science and technology in the associated prior art.
[003] Approximately 4 billion individuals across the globe are affected by dental disease. Oral hygiene is essential for good systemic health. In India oral health is not considered as an essential care. The dental disease prevalence and incidence is not properly documented and reported in India. Oral health is one of the most neglected parts of community health globally and more in developing countries like India. The reason for poor oral hygiene is multifactorial, including poor awareness, accessibility to health care and economic constraints. There is lack of dental and oral health awareness in our population. Due to Lack of economic resources majority of individuals resorts to dental extractions as compared to getting restoration of tooth. Loss of dentition at an early age result in poor quality of life for these individuals. The need of hour is to focus on preventive care to reduce dental disease burden. World health organization also emphasizes in its various programs on preventive community aspect of Oral health. It is economically sound when preventive dental interventions are employed in time. Many prevalent community knowledge and belief are harmful to the oral health. These should be identified and community awareness and education should be employed to modify them. Knowledge and beliefs analysis are important in policy formulation and designing behavioral modifications strategies. Basic dental care and hygiene is an inexpensive tool for building healthy community. Present study is a part of oral hygiene project which focuses on knowledge and belief aspect of oral and dental health in our population.
[004] In light of the foregoing, there is a need for the cross-sectional study on oral health knowledge and beliefs assessment in the adult population that overcomes problems prevalent in the prior art.

OBJECTS OF THE INVENTION:
[005] Some of the objects of the present disclosure, which at least one embodiment herein satisfies, are as follows.
[006] The principal object of the present invention is to overcome the disadvantages of the prior art by providing aCross-sectional study on oral health knowledge and beliefs assessment in the adult population.
[007] An object of the present invention is to provide across-sectional study on oral health knowledge and beliefs assessment in the adult population, wherein the study aims to access oral health-related knowledge and belief at three health centers in relation to socioeconomic and education status.
[008] Another object of the present invention is to provide across-sectional study on oral health knowledge and beliefs assessment in the adult population, wherein the study provides important information for the formulation of oral health care policies for education and awareness in the study population.
[009] Other objects and advantages of the present disclosure will be more apparent from the following description, which is not intended to limit the scope of the present disclosure.

SUMMARY OF THE INVENTION:
[010] The present invention provides a cross-sectional study on oral health knowledge and beliefs assessment in the adult population.
[011] In one aspect of the present invention the cross-sectional study comprises a total of 600 individuals, 200 each from three healthcare centers enrolled.
[012] In another aspect of the present invention, a closed-ended questionnaire is used for accessing knowledge and belief aspects.
[013] In another aspect of the present invention, 83.67 % had good knowledge and 16.5 % has adequate belief for the combined population.
[014] In another aspect of the present invention, the mean ± standard deviation for center 1, center 2, and center 3 are; 0.67±0.47, 0.92±0.27, and 0.92±0.26 respectively.
[015] In another aspect of the present invention, the mean ± standard deviation for center 1, center 2, and center 3 are; 0.67±0.47, 0.92±0.27, and 0.92±0.26 respectively.
[016] In another aspect of the present invention, the mean ± standard deviation for center 1, center 2, and center 3 are; 0.67±0.47, 0.92±0.27, and 0.92±0.26 respectively.
[017] In another aspect of the present invention, for adequate belief, the Mean ± standard deviation for center 1, center 2, and center 3 are 0.07±0.25, 0.18±0.38 and 0.24±0.42 respectively.
[018] In another aspect of the present invention, higher Education and income are statistically significant for all the parameters (P< 0.05) for the overall population.
[019] In another aspect of the present invention, the majority of the population had good knowledge, while the beliefs are poor.
[020] In another aspect of the present invention, the present study shows that despite good knowledge beliefs are very inadequate and wrong which might result in a significant dental disease burden.

DETAILED DESCRIPTION OF DRAWINGS:
[021] While the present invention is described herein by way of example using embodiments and illustrative drawings, those skilled in the art will recognize that the invention is not limited to the embodiments of drawing or drawings described and are not intended to represent the scale of the various components. Further, some components that may form a part of the invention may not be illustrated in certain figures, for ease of illustration, and such omissions do not limit the embodiments outlined in any way. It should be understood that the drawings and the detailed description thereto are not intended to limit the invention to the particular form disclosed, but on the contrary, the invention is to cover all modifications, equivalents, and alternatives falling within the scope of the present invention as defined by the appended claim.
[022] As used throughout this description, the word "may" is used in a permissive sense (i.e. meaning having the potential to), rather than the mandatory sense, (i.e. meaning must). Further, the words "a" or "an" mean "at least one” and the word “plurality” means “one or more” unless otherwise mentioned. Furthermore, the terminology and phraseology used herein are solely used for descriptive purposes and should not be construed as limiting in scope. Language such as "including," "comprising," "having," "containing," or "involving," and variations thereof, is intended to be broad and encompass the subject matter listed thereafter, equivalents, and additional subject matter not recited, and is not intended to exclude other additives, components, integers, or steps. Likewise, the term "comprising" is considered synonymous with the terms "including" or "containing" for applicable legal purposes. Any discussion of documents, acts, materials, devices, articles, and the like are included in the specification solely for the purpose of providing a context for the present invention. It is not suggested or represented that any or all these matters form part of the prior art base or are common general knowledge in the field relevant to the present invention.
[023] In this disclosure, whenever a composition or an element or a group of elements is preceded with the transitional phrase “comprising”, it is understood that we also contemplate the same composition, element, or group of elements with transitional phrases “consisting of”, “consisting”, “selected from the group of consisting of, “including”, or “is” preceding the recitation of the composition, element or group of elements and vice versa.
[024] The present invention is described hereinafter by various embodiments with reference to the accompanying drawing, wherein reference numerals used in the accompanying drawing correspond to the like elements throughout the description. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiment set forth herein. Rather, the embodiment is provided so that this disclosure will be thorough and complete and will fully convey the scope of the invention to those skilled in the art. In the following detailed description, numeric values and ranges are provided for various aspects of the implementations described. These values and ranges are to be treated as examples only and are not intended to limit the scope of the claims. In addition, several materials are identified as suitable for various facets of the implementations. These materials are to be treated as exemplary and are not intended to limit the scope of the invention.
[025] The present invention provides Cross-sectional study on oral health knowledge and beliefs assessment in adult population.
[026] Present study is a part of ‘oral hygiene project’ cross-sectional survey, to assess and compare knowledge and beliefs of oral health. The study is conducted at three centers, Dental surgery department, Himalayan institute of medical science (center 1), community health center doiwala (center 2) and District hospital New Tehri (center 3). From every center 200 individuals are enrolled. A total of 600 individuals participated in the study. The study is conducted between November 2019 to march 2020 at the respective centers. The study is approved by the institutional ethical committee vide letter no SRHU/HIMS/ETHICS/2020/66. Sampling method and size calculation: Convenient sampling method is used to recruit the participants reporting to respective dental OPD at three centers. Sample size is calculated by standard formula of n= Z a/2 2 P Q / d 2; Here ‘n’ is number of samples, Z IS 1.96 at 0.05 p-value, P is unknown prevalence as there are no previous studies so it’s taken as 50%. Q is P-1 and d is relative precision which is 15% (i.e 15% of 50 %). Applying the above formulae, the total number for each center is calculated to be 171. We added a 15 % standard attrition and rounder it to 200 individuals from each center.
[027] Patient of age 18 year and above who provided written informed consent are included in the study. Patient who are not mentally sound, recent face trauma or major dental surgery in last 6 months and cancer of head and neck origin are excluded in the study.
[028] The questionnaire is developed by a systematic review of research papers. The questionnaire is finalized at the end of two interactive session in the peer review meeting. The panel for review consisted of 5 dental experts. A pilot study is done on 20 patients and further the questions are refined.
[029] Beliefs are defined as any action/ opinion which are not scientifically documented but are prevalent in masses as accepted opinion/ behavior. Knowledge is defined as any known actions/opinion, which are stated as facts and verified by scientific methodologies.
[030] In ‘oral hygiene project’; there are 11 questions on Knowledge and 6 questions on belief domain; all participants with ‘yes’ Reponses is given score 1. While ‘Do not know’and‘No’ response are given score 0. Individuals who scored 4 or more cumulative score are classified as having good knowledge and adequate belief respectively.
[031] A p value of 0.05 is considered significant at Confidence interval of 95% and 90% power. Chi square test is utilized to calculate significant difference with cross tabulation of various parameters in respect to education and income separately. Sperman’s correlation coefficient is used see correlation between knowledge and belief.
[032] 61.8% of the total population are female, 42.2 % are in age range 31-50 years, 51.5% with education of graduation and above and 44.2% with income in range of twenty to fifty thousand. While comparing between centers for various parameter center 2 had highest percentage population (67%) with graduate and above education followed by center 3 and center 1. While center 3 had highest percentage of population (53%) in income range of 21000-50,000 Rupees followed by center 1 and center 2 [Table 1].

[033] Calculation of the scores for knowledge and belief as mentioned in methodology, correlation is done using two tailed spearman’s correlation set at significant of 0.001. There is no correlation between knowledge and belief using Spearman correlation coefficient of 0.063 and p value of 0.12. Calculation of mean score for knowledge and belief: For overall population 83.6% of population had good knowledge, 16.3 % had adequate beliefs. Mean± standard deviation values for good knowledge are highest for center 2 (0.92±0.27) followed by center 3 (0.92±0.26) and center 1(0.67±0.47). For adequate belief center 3 had highest scores (0.24±0.42), followed by center 2 (0.18±0.38) and center 1 (0.07±0.25). [Table 2].

[034] In between group comparison center 1 showed statistically significant values for six parameters for both income and education criteria, these included 1) sticky sugars causes decay, 2) food lodgment causes decay, 3) diabetes associated with poor oral health, 4) systemic infection associated with poor oral health, 5) fluoride prevent decay and 6) use of interdental aids. Center 2, had two statistically significant parameters for income criteria (fluoride use for decay & use of interdental aids) and 6 significant parameters (faulty prosthesis is harmful, fluoride and decay, pregnancy and dental treatment, interdental aids use, artificial teeth cleaning, smoking deleterious effect) for education criteria. While center 3 had no statistically significant parameter for knowledge for both income and education. [Table 3] Between the three centers, center 3 had highest percentage (91.5%) of participant awareness for decay by sticky sugar and food lodgment followed by center 2 (85%) and center 1(52%). For fluoride role center 2 had highest percentage (24.5%) of participant awareness followed by center 1 (19%) and center 3 (16%) [Table 3].

[035] For Belief domain had all six parametersare statistically significant for education criteria. These parameters are 1) extraction effect on eyesight, 2) professional cleaning and tooth loosening, 3) saving primary teeth, 4) Tobacco as pain relief, 5) dental treatment is expensive and 6) extraction is better than restorative procedures. While for income criteria only three parameters are significant, theseare 1) professional cleaning and tooth loosening, 2) Tobacco as pain relief and 3) Extraction is better than restorative procedures. 57.2 % believe extraction effects eyesight, 42 % believed cleaning causing tooth losing, 34 % belief saving deciduous teeth is necessary, 48.2 % belief tobacco act as pain relief, 63% belief dental treatment is expensive, 54.3% believed extraction is better than restoration. Inter center comparison for center 1, parameter of ‘tobacco as pain relief’, is significant for both income and education criteria. While ‘extraction is better than restorative procedure’ is significant for only education criteria. For center 2 parameter of ‘tobacco as pain relief’ and ‘extraction is better than restorative procedure’ is significant for both income and education criteria. While ‘dental treatment is expensive’ is significant for only education criteria. For center 3 parameter of ‘tobacco as pain relief’ is significant for income criteria and ‘dental treatment is expensive’ is significant for only education criteria.
[036] Oral hygiene is a noninvasive intervention which results in prevention of oral & systemic diseases. There are many well-formed deep rooted believes and myths which are population specific and hence require a customized policy and plan of action to address them. These surveys are long used worldwide as an effective tool in community to understand health problems of the population. In context of Indian population there are few studies which have seen dental disease burden and awareness but these are limited to children.
[037] The reason for high values of knowledge domain scores can to contribute to the fact that majority of the population is either young or middle age with graduation and above education and a good level of income. Also, high and frequent information on oral care by means of advertisement on electronic and print media can be an additional reason for such results. There is high awareness that sticky sugar and food lodgement causes decay these findingsare in coordination with finding s of reddy et al. The awareness about effect of poor oral status on systemic health is low, only 33.2 % of population believed that poor oral health can have systemic effects. These finding are contrary to studies by nagesh et al and reddy et al. They reposted that awareness of systemic health and oral health is higher in their participants. One of the reasons for such awareness that the participant in these studies is collage going students and our population is form rural areas with mean age between third and fifth decade. Awareness regarding fluoride use, interdental aids, dental treatment during pregnancy is low, theses finding are similar to the studies. This can be attributed to the fact that there is inadequate importance of oral care emphasized in primary and secondary education.
[038] 84.7% of the population in present study knew about deleterious effect tobacco smoking and 86.7% knew about deleterious effect supari on oral cavity. These results are similar to the reddy et al and Warnakulasuriya et al. this could be attributed to print and electronic media awareness campaigns. Majority of population believed that Eyesight is effect by extraction of upper tooth, professional cleaning loosens the teeth, tobacco reduces tooth pain, saving deciduous dentition is not important, extraction of tooth is better than treatment and dental treatment is expensive similar findings are reported by reddy et al. Belief are deep rooted characteristic of a community and they represent a pattern. In the entire three centres there are low mean scores for adequate beliefs. Beliefs can only be modified with constant reinforcement and acceptance of these facts by the community members.
[039] On the other hand, knowledge can be updated by various means but belief modification requires a more organized and structured approach. Present study is one of its kinds in adult population. From similar population under a nationwide survey is done by global adult tobacco survey. In our study the knowledge for deleterious effect of smoking and areca nut chewing are between 84.7%and 86.7 % respectively. Similar to GATS-2 survey the knowledge about deleterious use of smoking and smokeless tobacco is 96-99%. Adult population already have adequate knowledge and require constant reinforcement for change. Modifying habit in children are easy as it can be structured in school curriculum by teacher and reinforced by parents and later can be formed as part of habit. To modify an adult behavior is difficult but possible by a systematically structured oral awareness program using community health care workers and infrastructure.
[040] The present study is initiated with an aim to formulate policies for oral awareness and education in our center to benefit the population we serve. Baseline knowledge of the prevalent knowledge and belief is essential in efficient delivery of health care. This study will also serve as a base line data for future study on same population. Present study had convenient sampling of patients reporting to our three centers for dental problems which results in problem of non-representative sampling. As there are no previous studies on adult’s population, this makes difficult to provide conclusive recommendations. More studies focusing on adult population with larger sample size are recommended for more clear understanding of the prevalent oral knowledge and belief in adult population.
[041] Present study shows that majority of the population had good knowledge but inadequate belief. A systematic and structured oral health awareness and education policy is the need of the hour for our population. The data form present study has been processed as recommendations to these health centers to develop oral health care guidelines to serve the study population and focus on decreasing dental disease burden by preventive and early dental care and interventions.
[042] The disclosure has been described withreference to the accompanying embodiments herein and the various features and advantageous details thereof are explained with reference to the non-limiting embodiments in the following description. Descriptions of well-known components and processing techniques are omitted so as to not unnecessarily obscure the embodiments herein.
[043] The foregoing description of the specific embodiments so fully revealed the general nature of the embodiments herein that others can, by applying current knowledge, readily modify and/or adapt for various applications such specific embodiments without departing from the generic concept, and, therefore, such adaptations and modifications should and are intended to be comprehended within the meaning and range of equivalents of the disclosed embodiments. It is to be understood that the phraseology or terminology employed herein is for the purpose of description and not of limitation. Therefore, while the embodiments herein have been described in terms of preferred embodiments, those skilled in the art will recognize that the embodiments herein can be practiced with modification within the scope of the embodiments as described herein.

We Claim:

1) Across-sectional study on oral health knowledge and beliefs assessment in the adult population, the cross-sectional study comprises a total of 600 individuals,200 each from three healthcare centers are enrolled;
wherein a closed-ended questionnaire is used for accessing knowledge and belief aspects; and
wherein 83.67 % had good knowledge and 16.5 % has adequate belief for the combined population.
2) The cross-sectional study as claimed in claim 1, wherein mean ± standard deviation for center 1, center 2 and center 3 are; 0.67±0.47, 0.92±0.27, 0.92±0.26 respectively.
3) The cross-sectional study as claimed in claim 1, wherein mean ± standard deviation for center 1, center 2 and center 3 are; 0.67±0.47, 0.92±0.27, 0.92±0.26 respectively.
4) The cross-sectional study as claimed in claim 1, wherein mean ± standard deviation for center 1, center 2 and center 3 are; 0.67±0.47, 0.92±0.27, 0.92±0.26 respectively.
5) The cross-sectional study as claimed in claim 1, wherein for adequate belief, the Mean ± standard deviation for center 1, center 2, and center 3 are 0.07±0.25, 0.18±0.38 and 0.24±0.42 respectively.
6) The cross-sectional study as claimed in claim 1, wherein higher Education and income are statistically significant for all the parameters (P< 0.05) for the overall population.
7) The cross-sectional study as claimed in claim 1, wherein the majority of the population had good knowledge, while the beliefs are poor.
8) The cross-sectional study as claimed in claim 1, wherein the present study shows that despite good knowledge beliefs are very inadequate and wrong which might result in a significant dental disease burden.
9) The cross-sectional study as claimed in claim 1, wherein the results of the study will provide important information for the formulation of oral healthcare policies for education and awareness in the study population.