Survey on Awareness of Knowledge and Attitude in Oral and Maxillofacial Surgeries among Medical Professionals in Andhra Pradesh

Yandeti Srinivasulu^*, Subhashini Ramasubbu and Abdul Wahab

^*Correspondence: Yandeti Srinivasulu, Department of Oral and Maxillofacial surgery, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), India, Email:

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Introduction

The Oral and Maxillofacial Surgeon functions more like a hybrid between medicine and dentistry.

Oral and maxillofacial surgery had include of facial trauma, jaw pathologies, dentofacial deformities, temporomandibular joint disorders, salivary gland pathologies, trigeminal neuralgias, orofacial pains, swellings of the face and neck and oral cancer [1].

Recent methods have also been introduced in the field like distraction osteogenesis, tissue engineering, dental implant surgeries, treatment of cleft lip and palate, and reconstruction, etc. However, still, it is not clear how OMFS is being perceived as a speciality among medical professionals [2]. Most of the people are unaware of the speciality of Oral and Maxillofacial Surgery [3].

The work of an oral and maxillofacial surgeon does not start and end with teeth and its surroundings. It also expands to include procedures that enhance the quality of life by providing better function and aesthetics, as well as life - saving procedures [4].

It is an internationally recognized surgical speciality. People surveyed had heard of OMFS and none expected OMFS to treat patients who were unhappy with their facial appearance [5].

Materials and Methods

This survey was conducted among medical professionals including MBBS students, postgraduate students, practitioners of various colleges/ institutes, Clinics .A questionnaire was prepared google forms an validated by the reader of the Department of Oral and Maxillofacial Surgery, Saveetha Dental College .Ethical approval was obtained from SRB, Saveetha Dental College. Ethical committee approval for this study was obtained from the Institutional Ethics Committee with the following ethical approval number. SDC/SIHEC/2020/DIASDATA/ 0619-0320. A simple random sample was done and a questionnaire was sent to the various medical professionals. None of them were forced to fill the form. As per Helsinki declaration, the guidelines were fallowed.107 responses were received.

The questionnaire is as follows

Survey on awareness of knowledge and attitude in Oral and Maxillofacial Surgeries among medical professionals in Andhra Pradesh.

Are you

• MBBS student.

• PG student.

• Practitioner.

Where are you working?

• Clinic.

• Hospital.

• Institute.

Are you aware of oral and maxillofacial surgery as a speciality branch of dentistry?

• Yes.

• No.

• Don’t know.

Are you aware of the different variety of treatment modalities coming under oral and maxillofacial surgery?

• Yes.

• No.

• Don’t know.

Have you ever come across a patient with facial trauma

• Yes.

• No.

• Don’t know.

Are you aware of the fact that the cosmetic and orthognathic surgery becoming a routine procedure in the field of oral and maxillofacial surgery

• Yes.

• No.

• Don’t know.

Will you agree that oral and maxillofacial surgeons have improved their surgical skills and competence from simple procedure as surgical removal of tooth to micro vascular reconstruction of various jaw defects?

• Yes.

• No.

• Don’t know.

Would you like to introduce oral and maxillofacial surgeon in your panel expertise for delivery of treatment

• Yes.

• No.

• Don’t know.

Oral and maxillofacial surgeons are right to treat facial fractures

• Yes.

• No.

• Don’t know.

Who do you think is the right to treat facial lacerations

• Oral and maxillofacial surgeon.

• Plastic Surgeon.

• ENT surgeon.

Do you think oral and maxillofacial surgeon has a role in treating oral cancer

• Yes.

• No.

• Don’t know.

Do you think oral and maxillofacial surgeon has a role in treating temporomandibular joint disorders?

• Yes.

• No.

• Don’t know.

Do you think oral and maxillofacial surgeon has a role in treating cleft lip and cleft palate?

• Yes.

• No.

• Don’t know.

Do you think oral and maxillofacial surgeon has a role in treating craniofacial anomalies?

• Yes.

• No.

• Don’t know.

Do you think oral and maxillofacial surgeon has a role in treating Salivary gland diseases?

• Yes.

• No.

• Don’t know.

Do you think oral and maxillofacial surgeon has a role in treating obstructive sleep apnoea?

• Yes.

• No.

• Don’t know.

Who treats a child with inability or difficulty in mouth opening?

• Oral and maxillofacial Surgeon.

• ENT Surgeon.

• Plastic Surgeon.

Do you think oral and maxillofacial surgeon has a role in treating facial swellings?

• Yes.

• No.

• Don’t know.

Do you think oral and maxillofacial surgeon has a role in treating neck swellings?

• Yes.

• No.

• Don’t know.

 Do you think oral and maxillofacial surgeon has a role in treating black eye following trauma

• Yes.

• No.

• Don’t know.

Do you think oral and maxillofacial surgeon has a role in treating carcinoma of sinuses?

• Yes.

• No.

• Don’t know.

Do you think oral and maxillofacial surgeon has a role in Trigeminal neuralgia and atypical facial pain?

• Yes.

• No.

• Don’t know.

Results

Among 107 responses 39.3% are MBBS students,29.9% are postgraduate students, 30.8% are practitioners(Figure 1). 45.8% are working in clinics, 27.1% are working in hospitals, 27.1% are working in institutions(Figure 2).

Figure 1: Are you.

Figure 2: Where are you working.

92.5% are aware of Oral and Maxillofacial Surgery as a specialty branch of dentistry with significant results (Figure 3). 92.5% are aware of different varieties of treatment modalities coming under Oral and Maxillofacial Surgery with significant results (Figure 4). 83.2% have come across facial trauma. 15.9% have not seen a patient with facial trauma (Figure 5). 84.1% are aware of the fact that cosmetic and orthognathic surgery have become a routine procedure in the field of Oral and Maxillofacial Surgery, 9.3% are not aware of this procedure,6.5% don’t know of this procedure.(Figure 6). 91.6% are agree that Oral and Maxillofacial Surgery have improved they surgical skills and competence from simple procedure as surgical removal of tooth to micro vascular reconstruction of various jaw defects with significant results (Figure 7).92.5% they introduce Oral and Maxillofacial Surgeon in their panel expertise for delivery of treatment with significant results (Figure 8). 92.5% says that an Oral and Maxillofacial Surgeon

Figure 3: Are you aware of oral and maxillofacial as a speciality branch of dentistry.

Figure 4: Are you aware of the different variety of treatment modalities coming under oral and maxillofacial surgery.

Figure 5: Have you ever come across a patient with facial trauma.

Figure 6: Are you aware of the fact that the cosmetic and orthognathic surgery becoming a routine procedure in the field of oral and maxillofacial surgery.

Figure 7: Will you agree that oral and maxillofacial surgeons have improved their surgical skills and competence from simple procedure as surgical removal of tooth to microvascular reconstruction of various jaw defects.

Figure 8: Would you like introduce oral and maxillofacial surgeon in your panel expertise for delivery of treatment.

are right to treat facial fractures with significant result (Figure 9). 80.4% says that Oral and Maxillofacial Surgeons are right to treat facial lacerations, 18.7% says that Plastic Surgeons are right to treat facial lacerations (Figure 10).86%says that Oral and Maxillofacial Surgeon has a role in treating oral cancer,7.5% says that Oral and Maxillofacial Surgeon has a not role in treating oral cancer,6.5% says don’t know about this (Figure 11). 94.4% says Oral and Maxillofacial Surgeon has a role in treating temporomandibular joint disorders with significant results (Figure 12 ).91.6% says Oral and Maxillofacial Surgeon has a role in treating cleft lip and cleft palate with significant results (Figure 13)..83.2% says oral and maxillofacial surgeon has a role in treating craniofacial anomalies,9.3% says oral and maxillofacial surgeon has another role in treating craniofacial anomalies,7.5% don’t know of this ( Figure 14). .84.1% says oral and maxillofacial surgeon has a role in treating salivary gland diseases, 11.2% says oral and maxillofacial surgeon has a not role in treating salivary gland diseases, 4.7% don’t know of this..72.9% Says Oral and Maxillofacial Surgeon has a role in treating obstructive sleep apnoea, 15.9% says Oral and Maxillofacial Surgeon has a not role in treating obstructive sleep apnoea,11.2% don’t know of this (Figure 16). 86.9% Says Oral and Maxillofacial Surgeon as a role in treating a child with inability or difficulty in mouth opening, 12.1% says that ENT Surgeon has a role in treating a child with inability or difficulty in mouth opening (Figure 17). 94.4% says that Oral and Maxillofacial Surgeon has a role in treating facial swellings with significant results seen (Figure 18).77.6% says that Oral and Maxillofacial Surgeon has a role in treating neck swellings, 16.8% says that Oral and Maxillofacial Surgeon has a not role in treating neck swellings, 5.6% don’t know about this (Figure 19). 81.3%. says that Oral and Maxillofacial Surgeon as a role in treating black eye following trauma, 12.1% says that Oral and Maxillofacial Surgeon has a not role in treating black eye following trauma, 6.5% don’t know about this (Figure 20). 84.1% says that Oral and Maxillofacial Surgeon has a role in treating carcinoma of sinuses, 8.4% says that Oral and Maxillofacial Surgeon has a not role in treating carcinoma of sinuses, 7.5% don’t know about this (Figure 21). 86% says that Oral and Maxillofacial Surgeon has a role in treating Trigeminal neuralgia and atypical facial pain, 7.5% says that Oral and Maxillofacial Surgeon has a not role in treating Trigeminal neuralgia and typical facial pain,6.5% don’t know of this (Figure 22).

Figure 9: Oral and maxillofacial surgeons are right to treat facial fractures.

Figure 10: Who do you think is the right to treat facial lacerations.

Figure 11: Do you think oral and maxillofacial surgeon has a role in treating oral cancer.

Figure 12: Do you think oral and maxillofacial surgeon has a role in treating temporomandibular joint disorders.

Figure 13: Do you think oral and maxillofacial surgeon has role in cleft lip and cleft palate.

Figure 14: Do you think oral and maxillofacial surgeon has role in treating craniofacial anomalies.

Figure 15: Do you think oral and maxillofacial surgeon has role in treating salivary gland disease.

Figure 16: Do you think oral and maxillofacial surgeon has role in treating obstructive sleep apnoea.

Figure 17: Who treats a child with inability or difficulty in mouth opening.

Figure 18: Do you think oral and maxillofacial surgeon has role in treating facial swelling.

Figure 19: Do you think oral and maxillofacial surgeon has role in treating neck swelling.

Figure 20: Do you think oral and maxillofacial surgeon has role in treating black eye following trauma.

Figure 21: Do you think oral and maxillofacial surgeon has role in treating carcinoma of sinuses.

Figure 22: Do you think oral and maxillofacial surgeon has role in treating trigeminal neuralgia and atypical facial pain.

Discussion

The name “oral and maxillofacial surgery” was given in 1977 before it was oral surgery; the goal was to more clearly define the scope of practice of the field to the public. Although OMFS is a branch of dentistry, the way it has evolved seems that it actually bridges the medical and dental community [5]. The department of OMFS has offered its service for the past few decades in medical colleges, dental colleges, and major health care centres [6]. Correction of facial deformities is being performed by maxillofacial surgeons in most of the teaching hospitals in India [7]. Still, the medical professionals believe that those procedures are being done by plastic surgery [8]. The medical faculty's knowledge about dental diseases, relationship of oral health with systemic diseases and life threatening dental diseases are scarce. Overall, the dental students and dental practitioners seem to have better appreciation and knowledge of the clinical expertise of the specialty [3].

Regional variations exist, and surgeons are responsible for educating their own community and referral circles about the scope of their practice, which will depend on the training, experience and areas of interest [9]. It is clear that greater progress needs to be made in the education of general practitioners, if the specialty of OMFS is to be practiced to its full potential [10]. Patients consult oral and maxillofacial surgeon pathologies or abnormalities requiring an oral and maxillofacial surgeon for various treatments [4].

Obviously, everyone accepts that dental implants and removal of third molars is being done by OMFS. It is disheartening to see that the medical students and professionals look at OMFS still as dentists who work around the tooth. Medical professionals are aware of OMFS, but they do not completely understand the scope and expertise of the specialty [11]. Laskin et al. [12] evaluated the knowledge of 12 different specialties to determine whether such unfamiliarity is true only for OMFS, or whether it occurs with other specialties also.

Oral and Maxillofacial Surgery includes treatment of many diseases, defects and injuries in the head, face, neck, jaws and also the hard and soft tissues of the oral and maxillofacial region [13]. Oral and Maxillofacial Surgery is an internationally accepted surgical specialty.

The department of the Oral and Maxillofacial Surgery improved from simple surgical procedures such as dental surgeries and basic maxillofacial trauma to more advanced procedures like management of pathologies of head and neck, bone grafting, craniofacial surgery, TMJ surgery, cleft lip and palate, facial deformities correction, aesthetic facial surgery, implant surgery [2]. Also, OMFS deals with non - surgical difficulties affecting the oral and maxillofacial area like the treatment of facial pain or oral mucosal disease [12].

Conclusion

There is awareness about the scope of oral and maxillofacial surgery among the medical practitioners in Andhra Pradesh. Knowledge and awareness of the oral and maxillofacial surgery can improve the success and the delivery of quality service. Also, there is a need to increase the awareness of OMFS among the general public so that they can request their doctors for the appropriate referral pattern.

References

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