Year : 2009 | Volume
: 20 | Issue : 2 | Page : 164--168
The knowledge and attitude of general dentists toward denture adhesives in Tehran
Hamidreza Fakhri1, Amir Fayaz2, Farhad Faramarzi3, Homan H Javaheri1,
1 Private Practice, Tehran, Iran
2 Department of Prosthodontics, Shaheed Beheshti University of Medical Sciences, Dental School, Evin, Tehran 19839, Iran
3 Department of Endodontics, Shaheed Beheshti University of Medical Sciences, Dental School, Evin, Tehran 19839, Iran
Homan H Javaheri
Private Practice, Tehran
Background: The purpose of this study was to generate discussion and communication among a group of general dentists in Tehran on their viewpoints regarding denture adhesives. Have they accepted denture adhesive as a material to enhance denture retention, stability and function?
Materials and Methods: In the summer of 2007, a questionnaire was mailed to 300 general dentists who were assigned with a random systematic sampling method from general dentists in Tehran. The questions were arranged in two parts of evaluating knowledge and attitude. In evaluation of knowledge, dentists were classified into groups of good, moderate, weak and lack of knowledge. In evaluation of attitude, dentists were classified into positive, moderate and negative groups. (Evaluating attitude was carried out in good and moderate groups of knowledge.)
Results: The study showed that 14%, 32% and 37% of the general dentists had respectively good, moderate and weak knowledge toward denture adhesive while 16.3% had no knowledge about this material. In evaluation of attitude through dentists with positive and moderate knowledge toward denture adhesive, 9.3%, 71.3% and 19.4% had respectively positive, moderate and negative attitude toward denture adhesive. The χ2 test showed a significant statistical relation between situation of knowledge and experiences of dentists.
Discussion: This study demonstrated that the rate of knowledge of these 300 general dentists in Tehran towards denture adhesives has not been in a good situation. It is believed that denture adhesive be able to enhance the fitness of a denture and provide psychological relief to the patient. Dentists agreed that education, not only for practitioners but also for patients, would raise the advantageous features and reduce the misuse of denture adhesive. Education of the topic «DQ»Denture adhesive«DQ» should be more concerned in dental universities.
|How to cite this article:|
Fakhri H, Fayaz A, Faramarzi F, Javaheri HH. The knowledge and attitude of general dentists toward denture adhesives in Tehran.Indian J Dent Res 2009;20:164-168
|How to cite this URL:|
Fakhri H, Fayaz A, Faramarzi F, Javaheri HH. The knowledge and attitude of general dentists toward denture adhesives in Tehran. Indian J Dent Res [serial online] 2009 [cited 2020 Feb 23 ];20:164-168
Available from: http://www.ijdr.in/text.asp?2009/20/2/164/52892
Denture adhesives were introduced in dentistry in the late 18 th century. The first patent related to adhesives was issued in 1913, followed in the 1920s and 1930s.  Studies investigated that the retention of complete dentures has been improved by using denture adhesive. ,, Although denture adhesives are found beneficial by a wide range of edentulous patients,  dental professionals have been slow to accept them as a material to enhance denture retention, stability and function.  Although clinical studies have not shown damaging effects of denture adhesives to tissues, ,,, many dentists think that denture adhesives could increase the resorption of alveolar ridge and cause soft tissue hyperplasia.
Tarbet and Grossman  stated that about 12% of complete denture wearers used an adhesive. Another study concluded that since the number of edentulous persons was expected to increase till the year 2000, the total consumption was predicted to heighten.  In 1996, More than 5 million Americans used denture adhesives and the use of denture adhesives had been recommended by 75% of dentists for their patients.  Some dental surgeons advise some elderly patients to use denture adhesives during the first weeks of wearing new dentures to enhance the retention of the denture and supply the patient confidence. It may also reduce the discomfort of the patients wearing an immediate denture. 
The purpose of this study was to generate discussion and communication among a group of general dentists in Tehran on their viewpoints regarding denture adhesives.
Materials and Methods
In the summer of 2007, a questionnaire [Appendix] was mailed to 300 general dentists who were assigned a random systematic sampling method from general dentists in Tehran. Each participant received the same questionnaire and a pre-addressed and pre-stamped envelope to return the completed survey. The participants were not asked to identify themselves. The questions were arranged in two parts of evaluating knowledge and attitude. Data were imported to the SPSS for Windows computer program (v. 12.0.1; SPSS Inc., Chicago, IL, USA). χ2 statistics were used to analyze the results.
Planning the questionnaire and analyzing the data
Twelve questions were designed to evaluate the rate of knowledge of dentists toward denture adhesive. Each question had only one correct answer. The first question asked about the usage of denture adhesive and the second asked about family of denture adhesive, while questions 3-7 asked about solution, structure, mechanism of action and different forms of denture adhesives. Question number 8 concluded four subquestions related to indications and contraindications.
Each correct answer was given a +1 score. In evaluating the rate of knowledge, dentists who got 1-4 scores through all questions were classified in the weak group and those who got 5-8 and 9-12 scores were classified, respectively, into moderate and good groups. It should be noted that the dentists who answered the first question wrong and those who noticed, before starting to answer the questionnaire, that had never heard of any topic about denture adhesive in the past were both classified in the lack of knowledge group.
Attitude scales attempt to determine what an individual believes, perceives or feels. Attitudes can be measured toward self, others and a variety of other activities, institutions and situations. 
The Likert scale (summated scales) was developed by Rensis Likert in 1932. It requires the individuals to make a decision on their level of agreement, generally on a five-point scale (i.e. Strongly Agree, Agree, Disagree and Strongly Disagree) with a statement. The number beside each response becomes the value for that response and the total score is obtained by adding the values for each response, the reason they are also called "summated scales" (the respondents score is found by summing the number of responses).  Dumas also suggested that this is the most commonly used question format for assessing participants' opinions. 
In the second part of the questionnaire, 17 statements in six topics either for or on denture adhesive were planned to evaluate the rate of attitude followed by a previous study.  Statements were designed about efficiency of denture adhesive in different situations (positive or negative side) of clinical usage, educating patients and educating undergraduate students. Each statement had three responses to choose: Agree, Disagree, No Opinion. This part of the questionnaire required that dentists make a decision on their level of agreement, generally on a three-point scale (Agree, Disagree, No Opinion) with a statement. Each person had to choose one response for each statement depending on the Likert scale study. The value of each answered statement was measured by giving the highest value number, which was "+2" to "Agreement" responses in all statements that showed positive views toward denture adhesive. Probably, "Disagreement" responses were scored with the lowest value number. (Agreement = +2, Disagreement = 0, No Opinion = 1.) Statements of topic 2 that mentioned negative views toward denture adhesive responses were scored in a reverse manner. (Disagreement = +2, Agreement = 0, No Opinion = 1.)
Each response was scored with a number that became the value of that response in the statement and the total score was obtained by adding the values for each response in all the statements. Consequently, persons who got 0-12, 12-23 and 24-34 scores, respectively, were classified in three groups of negative, moderate and positive. The rate of attitude was evaluated in two groups of dentists who had good and moderate knowledge toward denture adhesive. Both the weak and the lack of knowledge groups were not evaluated for attitude of dentists.
This study showed that 14%, 32% and 37% of the general dentists had, respectively, good, moderate and weak knowledge toward denture adhesive while 16.3% had no knowledge about this material. The χ2 test showed that there was a significant relation between dentist's knowledge and their previous years of experience but that there was no significant relation between their knowledge and sex. From the answered questions in the evaluation of knowledge part of the questionnaire, it was concluded that more than 50% of the dentists do not have serious knowledge on whether to or not consulate denture adhesive. In evaluation of attitude through dentists with positive and moderate knowledge toward denture adhesive, 9.3%, 71.3% and 19.4% had, respectively, positive, moderate and negative attitude toward denture adhesive. The χ2 test just showed a significant statistical relation between situation of knowledge and experiences of dentists. [Table 1] presents the summary of the final outcome on the second part of the questionnaire followed by a previous study  as regards achievement of consensus opinions by dentists.
More than 65% of the dentists had an overall agreement in using denture adhesive in some statements such as "to increase stability and retention of denture's fitness, contributing to patients not seeing a dentist for recall and/or care, adjustment, or replacement, stabilizing trial bases in the early stages of denture fabrication, augmenting retention, comfort, and function during the interim period after insertion of new denture, providing additional retention and stability for patients who have inadequate oral anatomy."
Although there was a general concurrence toward denture adhesive in some situations in clinical practices, only 9.3% of the dentists that had overall concurrence had a positive attitude toward using this material in the attitude evaluating part of the questionnaire. It maybe the case that not enough experience in using this material clinically or manually is the reason of this attitude.
In this study, dentists` consensus overcome 65% on this statement that mentioned "denture adhesives are useful for providing a psychological relief to the denture patients and also masking underlying denture problems."
In each statement that mentioned that denture adhesive can contribute to the development of leukoplakia and oral cancer, more than 65% of the dentists disagreed. About developing denture stomatitis and making an imbalance in the oral flora due to microbial contamination and Candidiasis because of denture adhesive, more than 65% of the dentists agreed. Dentists had more than 65% disagreement on the statement that mentioned that denture adhesive can contribute to the development of the resorption of the alveolar bone as a result of tissue irritation. More than 70% of the dentists agreed with the statement that mentioned "recognizing that some patients may independently choose to use denture adhesive, dentists should routinely inform use and misuse of denture adhesive and also education of the topic "Denture adhesive" should be more concerned in dental universities."
The purpose of this study was to generate discussion and communication among a group of general dentists in Tehran on their viewpoints regarding denture adhesive. This study showed that the rate of knowledge of a group of general dentists in Tehran towards denture adhesive is not in a good situation. Slaughter et al.  demonstrated that denture adhesives are a useful adjunct in denture prosthesis services, with specific roles in both fabrication and post-insertion phases. They also indicated that only through education, for dentists and patients, would the dual goals of maximizing the beneficial aspects of denture adhesive use while minimizing the misuse of denture adhesives be achieved.
Our results showed that it is agreed that denture adhesive be able to enhance the fitness of a denture and provide psychological relief to the patients. Dentists indicated that education, not only for practitioners but also for patients, would raise the advantageous features and reduce the misuse of denture adhesive.
This was an effort to clarify the various topics on denture adhesive. Such information could be useful for both the dental professions and dental patients by presenting opinions and beliefs on the topic of denture adhesives. Ozcan et al. showed that the knowledge of the patients is not enough on denture adhesives in Istanbul as it is still generally believed by the practitioners that the prescription of a denture adhesive is a sign of failure of the dentist. This study presented a forum for a group of general dentists to explain their viewpoints of agree/ or disagreement on specific topics related to the clinical use and educational practices of denture adhesives. It could also enhance the knowledge of practitioners to inform patients and dental students on the proper use and misuse of denture adhesive.
Due to agreement over 70% of dentists on informing patients, education of the topic "Denture adhesive" should be more concerned in the undergraduate denture curriculum in dental universities.
|1||Adisman IK. The use of denture adhesives as an aid to denture treatment. J Prosthet Dent 1989;62:711-5.|
|2||Chew CL, Philips RW, Boone ME, Swartz ML. Denture stabilisation with adhesives: A kinesiographic study. Compend Contin Educ Dent. 1984; 4:32-8.|
|3||Coates AJ. Denture adhesives: A review. Aust Prosthodont J 1995;9: 27-31.|
|4||Ghani F, Likeman PR, Picton DC. An investigation into the effect of denture fixatives in increasing incisal biting forces with maxillary complete dentures. Eur J Prosthodont Restor Dent 1995;3:193-7.|
|5||Koppang R, Berg E, Dahm S, Fløystrand F. A method for testing denture adhesives. J Prosthet Dent 1995;73:486-91.|
|6||Grasso JE. Denture adhesives: Changing attitudes. J Am Dent Assoc 1996;127:90-6.|
|7||Abdelmalek RG, Michael C. The effects of denture adhesives on the palatal mucosa under complete dentures: A clinical and histological investigation. Egypt Dent J 1978;24:419-30.|
|8||Tarbet WJ, Grossman E. Observations of denture-supporting tissue during six months of denture adhesive wearing. J Am Dent Assoc 1980;101:789-91.|
|9||Boone M. Analysis of soluble and insoluble denture adhesives and their relationship to tissue irritation and bone resorption. Compend Contin Educ Dent 1984;4:S22-5|
|10||Coates AJ. Usage of denture adhesives. J Dent 2000;28:137-40.|
|11||Karlsson S, Swartz B. Effect of a denture adhesive on mandibular denture dislodgement. Quintessence Int 1990;21:625-7. |
|12||Stafford GD. Denture adhesives: A review of their uses and compositions. Dent Pract Dent Rec 1970;21:17-9.|
|13||Gay LR, Airasian P. Educational Research: Competencies for Analysis and Applications, Seventh Edition.2003 Upper Saddle River, NJ: Pearson Education.|
|14||Likert R. A technique for the measurement of attitudes. Arch. of Psychol. 1932, No. 140. p. 55.|
|15||Dumas, J. Usability testing methods: Subjective measures Part II-Measuring attitudes and opinions. 1998 Common Ground, 8, 4-8.|
|16||Slaughter A, Katz RV, Grasso JE. Professional attitude toward denture adhesives: A delphi technique survey of academic prosthodontits. J Prosthet Dent 1999;82:80-9.|
|17||Ozcan M, Kulak Y, Arikan A, Silahtar E. The attitude of complete denture wearers towards denture adhesives in Istanbul. J Oral Rehabil 2004; 31:131-4.|