|Year : 2015 | Volume
| Issue : 2 | Page : 51-54
Prevalence of self-medication among dental patients in rural area of Maharashtra, India: A cross-sectional study
Shivlal M Rawlani1, Sudhir Rawlani2, Rahul Bhowte3, Shirish Degwekar3, Shobha Rawlani4, Rakhi Chandak3
1 Department of Dentistry, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
2 Department of Public Health Dentistry, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
3 Department of Oral Medicine and Radiology, Sharad Pawar Dental College, DMIMS, Wardha, Maharashtra, India
4 Department of Anatomy, Dr. MDM Medical College, Amravati, Maharashtra, India
|Date of Submission||29-Mar-2013|
|Date of Acceptance||16-Jun-2015|
|Date of Web Publication||11-Aug-2015|
Dr. Shivlal M Rawlani
Department of Dentistry, Mahatma Gandhi Institute of Medical Sciences, Sevagram, Wardha, Maharashtra
Source of Support: None, Conflict of Interest: None
Aim: Odontalgia is a painful condition which is commonly associated to self-medication. The study was to determine the prevalence of self-medication practices among dental patients presenting at a tertiary health care centers in Maharashtra, India, and to determine various causes associated with self-medication for dental related problems.
Materials and Methods: All patients presenting over a period of 3 months, at the outpatient department of Sharad Pawar Dental College and Hospital at Sawangi (M) Wardha and who consented to participate in the study, were provided a structured questionnaire, highlighting age, sex, income and educational qualifications, history of past practice of self-medication, type of medicine used, and reasons for resorting to self-medication. Data obtained were analyzed with the EpiInfo-7 software. Frequency tables were generated and statistical relationship between the variables were analyzed using the Z-test. Statistical significance was set at P > 0.05.
Results: There were 200 (54.35%) males and 168 (44.65%) females. A total of 190 (51.63%) of the respondents claimed that they have been involved in self-medication. 51.58% of the people involved in self-medication were male, while 48.42% were female, there was no significant difference with P = 1.10. Two hundred and eighty-nine (78.53%) of the respondents had higher secondary education, and only 79 (21.47%) had secondary education or less.
Conclusion: Self-medication practices were quite high in the present study, and these practices were also prevalent among the educated people. Drug control enforcement needs to be intensified and dental public health education needs to be given greater priority.
Keywords: Dental problem, home remedy, India, over-the-counter, rural area, self-medication
|How to cite this article:|
Rawlani SM, Rawlani S, Bhowte R, Degwekar S, Rawlani S, Chandak R. Prevalence of self-medication among dental patients in rural area of Maharashtra, India: A cross-sectional study. Indian J Oral Sci 2015;6:51-4
|How to cite this URL:|
Rawlani SM, Rawlani S, Bhowte R, Degwekar S, Rawlani S, Chandak R. Prevalence of self-medication among dental patients in rural area of Maharashtra, India: A cross-sectional study. Indian J Oral Sci [serial online] 2015 [cited 2020 Apr 4];6:51-4. Available from: http://www.indjos.com/text.asp?2015/6/2/51/162637
| Introduction|| |
William Osler mentioned that "a desire to take medicine was perhaps the greatest feature of man which distinguished him from animals." Self-medication is defined as the use of medications without consulting a doctor regarding indication, dose, and duration of the drug. In simple words, self-medication can be defined as self-administration of medicine to treat self-recognized illness or symptoms.  The public health importance of self-medication increased when in 1980s World Health Organization approved some drugs which were to be changed from prescription status to be sold over-the-counter (OTC)-Drug without any prescription in order to reduce the burden on Health Care Professionals. , Most common reasons toward self-medication practice are to avoid long waiting periods in hospitals for minor illness and to reduce cost and save money. ,,
There are many dental and oral diseases that cause pain and other acute symptoms. Some general principles can assist medical practitioners to understand the common dental disorders. , Most of the common dental conditions are inflammatory in nature. In rural areas, most of the time patients consult their family physician for the management of dental and oral problems. ,
There are many reasons why patients with dental problem visit family physician rather than going to a dentist. Most common causes include: The lack of timely availability of a dentist especially in rural and remote areas, dentists are not always available after out patient department hours. Dental treatment is costly, Fear of dental treatment and instruments, ignorance or lack of knowledge about the role of dentists in management of soft tissue problems of oral cavity, and most important is not understanding about the problem, whether it is dental origin or not. These are some of the reasons why patients are taking self-medication for a dental problem.
The most effective way to manage the pain of dental or oral origin is to treat the cause of pain. This requires an accurate diagnosis otherwise the treatment may be inappropriate. It must be emphasized that most of the common diseases that cause dental pain should not be treated only using drugs alone because they require dental treatment for complete relief.  Drugs give only symptomatic relief leaving the underlying problem. Dental diseases are usually continuously progressive unless they are treated by appropriate dental management. 
In the dental profession, pain is the most common symptom. Dentists are aware that some patients with dental pain often use analgesics on their own to treat their symptoms without consulting dentist for dental treatment. In addition, antibiotics are routinely used in combination with analgesics. Toothache is a very agonizing experience and those who experience acute dental pain seek relief through medical counseling, complementary therapies, self-medication or application of clove oil, tobacco, and analgesics. ,,
There is no doubt that prescribing drug/s without consultation should be stopped to avoid harm.  The practice of self-medication is a topic of research, but there is least information about its modality among dental patients in developing countries. Hence, this study was designed to find out prevalence and reasons of self-medication for a dental problem.
| Materials and Methods|| |
This quantitative, cross-sectional study was conducted on 368 patients visiting outpatient department at Sharad Pawar Dental College and Hospital Sawangi (M) Wardha, from March to May 2012. A structured questionnaire was used for the purpose of data collection.  Consent was obtained from all study patients. Questionnaire was designed and divided into two major sections: Section 1: Sought information on the sociodemographic data of study subject such as age, gender, marital status, level of education, socioeconomical status, and place of residence. Section 2: Request information on health seeking behavior and self-medication practice by study subject through close-ended questions about the types of medications, duration, frequency, and who recommended the self-treatment. A few questions were included to ask respondents about reasons for self-medication.
The collected data were analyzed using EpiInfo-7. Descriptive statistics was used and the Z-test was used for proportion.
| Results|| |
Three hundred and sixty-eight respondents were included in the present study, with age range from 7 to 70 years. The mean age was 36 ± 15.62 years. Out of 368 respondents, 200 (54.35%) were male and 168 (45.65%) were female with mean age of 36.38 ± 16.61 years and 35.55 ± 14.45 years, respectively [Table 1]. The majority 289 respondents (78.53%) had at least a secondary school education or higher and only 79 respondents (21.47%) had less than secondary school education [Figure 1]. In the present study, total 190 respondents (51.63%) were involved in self-medication, findings were recorded from data for tabulation and discussion [Table 2].
| Discussion|| |
Self-medication is a universal phenomenon and practiced globally with varied frequency of up to 68% in European countries,  while much higher in low and middle income countries with rates going as high as 92% in the adolescents of Kuwait. , Our neighboring countries have prevalence rates of 57% in Pakistan  and 59% in Nepal.  It is also alarming that the prevalence rates are on the rise despite efforts to limit this problem. , The present study was designed to find out the prevalence of self-medication for dental problem in the rural area of Maharashtra, India.
The present study included total 368 patients, of that 200 (54.35%) were male and 168 (45.65%) were female [Table 1]. In the study group, 284 (77.17%) patients had history of dental pain, 248 (67.39%) patients visited to dentist, and 78 (21.19%) patients visited to general physician for treatment of dental problem.
Out of 368 patients, 190 (51.63%) committed that they were involved in self-medication for dental problem in the form of analgesics for 2-3 days. However, due to repeated same type of dental problem they reported to dental clinic. These findings are similar with the findings mentioned by Qaiser Ali Baig-Pakistan  (57%) 2012, Sallam-Nepal  (59%) 2002. This is higher as compared to findings reported by Phalke-India  (34.5%) 2006 and other findings reported in China  (32.5%), Turkey  (45%) and less when compared with study done in Sudan  (73.9%) and Kuwait  (92%).
Among 190 people taking self-medication, 98 (51.58%) were male and 92 (48.42%) were female, but there was no significant difference (P = 1.10). Most of the studies conducted by various authors show high prevalence of self-medication among females, ,,,,,, while an another study showed 47% prevalence in females  which is similar to the findings of present study. It has also been shown by recent studies that easy accesses to certain pharmaceuticals are determinants for self-medication.
In present study group, out of 368 participants 289 (78.6%) belong to educated group and 79 (21.4%) are having education less than higher secondary school [Figure 1]. Out of 368 participants total 190 participants are involved in self-medication and most of the respondents 152 (80%), had at least higher secondary education or more. While the remaining 38 (20%) were having education less than secondary school. It is also worthy to note that participants with higher education are more engaged in self-medication practice. This is corroborated by many other studies by various authors. ,,
In our present study, total 190 patients are involved in self-medication; most of the patients use single method for self-medication in the form of analgesics while some use multiple remedies like local application or use of home remedy. In the present study, 116 patients (31.52%) purchase medicine from OTC, 56 patients (15.21%) use old prescription, and 50 patients (13.58%) patients use home remedy to relieve the dental pain [Table 2].
In our present study, when we tried to find out the reasons for self-medication, 96 patients (61.04%) mentioned that dental treatment required more time and was costly. 54 patients (28.42%) mentioned that they had fear for dental treatment and dental instruments, while others 40 patients (10.54%) mentioned various reasons such as dentist are not available, dental clinic is far away from home, they can take care of themselves.
| Conclusion|| |
In the present study, self-medication practices were high. It was distressing to note that every other patient attending dental department for treatment was indulged in self-medication in the past or present, and the most disturbing findings were the high prevalence among educated people. It was also found that people were still indulged in some unwholesome practices in the form of home remedy and treatment by local tooth healers. Dental professionals should keep educating their patients about the hazards of self-medication, while dental services should be made readily available and affordable in rural areas, so that self-medication among dental patients can be reduced.
Limitation of study
Sample size is small in the present study; it should be large to comment on overall prevalence.
We are very much thankful to Dr. A. J. Pakhan, Dean, Sharad Pawar Dental College and Hospital (DMIMS-U) for providing all the facilities during the entire course of the study. We are also thankful to all PG students of ODMR Department for their help during the study. We are thankful to Dr. M. S. Bharambe, Associate Professor (Stat and Demo) Department of PSM MGIMS - Sevagram for his kind support.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Aljinovic-Vucic V, Trkulja V, Lackovic Z. Content of home pharmacies and self-medication practices in households of pharmacy and medical students in Zagreb, Croatia: Findings in 2001 with a reference to 1977. Croat Med J 2005;46:74-80.
Islam A, Malik FA, Basaria S. Strengthening primary health care and family planning services in Pakistan: Some critical issues. J Pak Med Assoc 2002;52:2-7.
Phalke VD, Phalke DB, Durgawale PM. Self medication practices in rural Maharashtra. Indian J Community Med 2006;31:34-5.
Abrahams N, Jewkes R, Mvo Z. Indigenous healing practices and self-medication amongst pregnant women in Cape Town, South Africa. Afr J Reprod Health 2002;6:79-86.
Major C, Vincze Z, Meskó A, Balogh J, Zelkó R, Németh E. Medicating outside the consulting room. Orv Hetil 2007;148:291-8.
Wetherell J, Richards L, Sambrook P, Townsend G. Management of acute dental pain: A practical approach for primary health care providers. Aust Prescr 2001;24:144-8.
Abbott PV. Dental first aid for the medical practitioner. Mod Med Aust 1989;32:43-50.
Hargreaves K, Abbott PV. Drugs for pain management in dentistry. Aust Dent J 2005;50:S14-22.
Schwenkglenks M. Self-treatment and self-medication of Swiss primary care physicians: A cause for concern? Swiss Med Wkly 2007;137:105-6.
Adedapo HA, Lawal AO, Adisa AO, Adeyemi BF. Non-doctor consultations and self-medication practices in patients seen at a tertiary dental center in Ibadan. Indian J Dent Res 2011;22:795-8.
Cohen LA, Bonito AJ, Akin DR, Manski RJ, Macek MD, Edwards RR, et al.
Toothache pain: Behavioral impact and self-care strategies. Spec Care Dentist 2009;29:85-95.
Daniel AB, Nagaraj K, Kamath R. Prevalence and determinants of tobacco use in a highly literate rural community in southern India. Natl Med J India 2008;21:163-5.
Francis SA, Barnett N, Denham M. Switching of prescription drugs to over-the-counter status: Is it a good thing for the elderly? Drugs Aging 2005;22:361-70.
Hsiao FY, Lee JA, Huang WF, Chen SM, Chen HY. Survey of medication knowledge and behaviours among college students in Taiwan. Am J Pharm Educ 2006;70:30.
Bretagne JF, Richard-Molard B, Honnorat C, Caekaert A, Barthélemy P. Gastroesophageal reflux in the French general population: National survey of 8000 adults. Presse Med 2006;35(1 Pt 1):23-31.
Zafar SN, Syed R, Waqar S, Zubairi AJ, Vaqar T, Shaikh M, et al.
Self-medication amongst university students of Karachi: Prevalence, knowledge and attitudes. J Pak Med Assoc 2008;58:214-7.
Abahussain E, Matowe LK, Nicholls PJ. Self-reported medication use among adolescents in Kuwait. Med Princ Pract 2005;14:161-4.
Abid I, Yousaf A, Akhtar T, Yousaf N, Manzoor MA. Self medication practice among dental patients of afid: A cross sectional study. Pak Oral Dent J 2012;32:513-7.
Shankar PR, Partha P, Shenoy N. Self-medication and non-doctor prescription practices in Pokhara valley, Western Nepal: A questionnaire-based study. BMC Fam Pract 2002;3:17.
Mumtaz Y, Jahangeer A, Mujtaba T, Zafar S, Adnan S. Self medication among university students of Karachi. J Liaquat Univ Med Health Sci 2011;10:102-5.
Baig QA, Muzaffer D, Afaq A, Bilal S, Iqbal N. Prevalence of self medication among dental patients. Pak Oral Dent J 2012;32:292-5.
Bi P, Tong S, Parton KA. Family self-medication and antibiotics abuse for children and juveniles in a Chinese city. Soc Sci Med 2000;50:1445-50.
Buke C, Hosgor-Limoncu M, Ermertcan S, Ciceklioglu M, Tuncel M, Köse T, et al.
Irrational use of antibiotics among university students. J Infect 2005;51:135-9.
Awad A, Eltayeb I, Matowe L, Thalib L. Self-medication with antibiotics and antimalarials in the community of Khartoum State, Sudan. J Pharm Pharm Sci 2005;8:326-31.
Angeles-Chimal P, Medina-Flores ML, Molina-Rodríguez JF. Self-medication in a urban population of Cuernavaca, Morelos. Salud Publica Mex 1992;34:554-61.
Al-Azzam SI, Al-Husein BA, Alzoubi F, Masadeh MM, Al-Horani MA. Self-medication with antibiotics in Jordanian population. Int J Occup Med Environ Health 2007;20:373-80.
[Table 1], [Table 2]