Journal of Advanced Research in Dental & Oral Health

Volume 3, Issue 2 - 2018, Pg. No. 1-6

Peer Reviewed & Open Access Journal

Research Article

Assessment of Knowledge Attitude and

Perception of Dental Students towards Obesity
in Kanpur City
Vishal Mehrotra1, Rohan Sachdev2, Kriti Garg3, Shiv Kumar Singh4
1
Professor and H.O.D., 2BDS Student, 3Reader, 4Postgraduate Student, Department of Oral Medicine and Radiology, Rama
Dental College Hospital and Research Center, Kanpur, U.P., India.
DOI: https://doi.org/10.24321/2456.141X.201805

Abstract
Aim: To assess the knowledge, perception and attitudes toward obesity among dental undergraduate
students and those in internship from a private dental college in Kanpur, India.

Material & Methods: The total sample size in the present study accounted to 250. In order to assess
knowledge, perception and attitude of study subjects towards obesity, a questionnaire developed by
K.H.Awan et al,was adapted from a previous study, which consisted of questions related to the student’s
perception of responsibilities towards obese patients, their knowledge and attitude toward obese patients
and each question had answers on a Likert scale.

Results: Majority of participants (94.8%) reported that obesity is a chronic medical disease and more than
half of the participants (65.2%) perceived obesity as a serious medical condition but only a small proportion
was able to define obesity (10%).

Conclusion: Majority of the students were interested in learning about obesity in dental school.

Keywords: Attitude, Dental students, Knowledge, Obesity

Introduction
Obesity is a global health problem that is spreading at
an extremely high rate across the world. The worldwide
prevalence of obesity is 27.8%.1 Due to this high prevalence
worldwide, obesity is considered as a major health care
issue with respect to the economy of developed nations.2
Overweight (OW) and obesity (OB) have been defined by
the World Health Organization (WHO) as “abnormal or
excessive fat accumulation that may impair health”. Body
mass index (BMI) is a measure of OW/OB status and has
been “defined as a person’s weight in kilograms divided by
the square of his height in meters (kg/m2).” Adults having
BMI ≥25 are classified as overweight, while those having
BMI ≥30 are considered obese.3
The media plays a important role in promoting, and
maintaining as socially acceptable, the stereotypical
image of the overweight individual as ugly, stupid and
negligent and depict weight as being under one’s own
control.4,5 Weight bias is present in basically all aspects
of life: from the stages of employment6,7 and educational
settings8,9,10 to private life where family and friends are a
common source of stigma.11 Obesity may also interfere
with romantic relationships of an individual.12 The stigma
towards overweight and obese individuals is also commonly
encountered in the health care setting.12

Corresponding Author: Dr. Kriti Garg, Department of Oral Medicine and Radiology, Rama Dental College Hospital and Research
Center, Kanpur, U.P., India.
E-mail Id: drkriti_garg@rediffmail.com
Orcid Id: https://orcid.org/0000-0002-4371-7496
How to cite this article: Mehrotra V, Sachdev R, Garg K et al. Assessment of Knowledge Attitude and Perception of Dental Students
towards Obesity in Kanpur City. J Adv Res Dent Oral Health 2018; 3(2): 1-6.

Copyright (c) 2018 Journal of Advanced Research in Dental & Oral Health (ISSN: 2456-141X)
Mehrotra V et al.
J. Adv. Res. Dent. Oral Health 2018; 3(2)
Obesity is a disease with multi factorial etiology factors,
with genetics and specific obesity-related genes a vital
role.13 Urbanization plays an important role in obesity;
these include increased refined food product consumption,
unhealthy dietary habits, and a lack of physical activity.14,15
Obesity has been identified as a risk factor for various
systemic diseases, including hypertension, cardiovascular
disease, metabolic diseases, osteoarthritis, respiratory
difficulties, and some oral diseases, such as periodontal
disease.16,17,18 Obesity is also associated with an increasing
incidence of oral diseases and it also adversely effects the
oral health-related quality of life.19,20
As a result, medical and dental professionals are facing
challenges associated with identifying patients with obesity
and providing them with optimal general and oral health
care needs.21 Counseling of the patients visiting dental
hospitals and clinics in order to identify the underlying
causes of obesity and carry out obesity management and
prevention procedures has become an important part of
dental and medical treatment planning. There is a lack of
data about the understanding of dental professionals with
regard to obesity management.19
Medical and dental professionals identified obesity as
a major source of stigmatization and weight bias. The
medical students perceived obese patients as less likely
to making lifestyle changes, following recommended
dietary regimen, responding to counseling and being
compliant22,23 These students believed that the obese
patients are ugly, lazy, sloppy and more depressed.23,24
Dentists reported the lack of knowledge about obesity as
an obstacle in promoting healthy weight in their patients.25
Recent reports indicate that dental students both at the
predoctoral and postdoctoral levels may not be receiving
adequate education regarding identification and prevention
of overweight and obesity.26,27,28
These findings suggest that there is an urgent need for
additional training about obesity-related health risks as part
of the dental school curriculum. Therefore, the purpose of
this study was to understand and identify the underlying
reasons for why dental professionals are often neglectful,
reluctant, and hesitant when treating obese patients, and
to determine the current state of knowledge, perceptions,
and attitudes of dental students with regard to obesity and
its management.
Material & Methods
This was a cross-sectional study conducted among second,
third, fourth-year and internship dental students of the
Rama Dental College Hospital and Research Center, Kanpur,
India over a two-month period (August-September 2015).
The total sample size of 250 students was included and
those unwilling constituted the exclusion criterion.
ISSN: 2456-141X
DOI: https://doi.org/10.24321/2456.141X.201805
2
Students were provided with self administered questionnaire
which were distributed to the students during breaks from
lectures or pre clinical/clinical work. The students were
required to complete the questionnaires on site and to
return them immediately to the research team. Before
the commencement of the study an ethical approval was
obtained from the Ethical Committee of the Dental College
and informed consent was taken from all the participants.
Data Collection
Our study used the self-administered questionnaire
developed by K.H Awan et al. to assess the knowledge,
perceptions, and attitudes of dental students towards
obesity. The questionnaire consisted of 16 items, which
were divided into three sections: (i) knowledge, (ii)
perceptions, and (iii) attitudes. Participant responses were
based on the Likert scale, which included five responses
ranging from strongly agree to strongly disagree. The
students were required to complete the questionnaires
on site/single meeting and to return them immediately
to the research team.
Knowledge-based questions were focused on the total
number of credit hours allocated to obesity education in
dental school and the ability of the participant to define,
diagnose, and understand obesity as a health problem.
Perception-based questions were focused on the ability of
participants to describe their motivation towards making
accommodations for obese individuals in the dental setting
and towards assessing patient dietary habits.
Attitude-based questions were focused primarily on the
behavior and feelings of the dental students towards obese
patients.
Negative responses graded under strongly disagree and
disagree were categorized as disagree, whereas positive
responses graded under strongly agree and agree were
categorized as agree. The neutral response was input with
the mean value of response for each question.
Data analysis
Data was analyzed using the SPSS software (SPSS Inc.
Released 2007. SPSS for Windows, Version 16.0. Chicago,
SPSS Inc.) Descriptive data is presented as percentages and
Chi-square analysis to compare the responses between the
genders and to analyze the difference between courses
of study.
Results
A total of 250 dental students participated in this study.
The response rate of participants was 100%. Among the
participants, 59.2% were female and 40.8 were male. Table
1 shows the distribution of demographic characteristics of
the participants.
 Mehrotra V et al.
3 J. Adv. Res. Dent. Oral Health 2018; 3(2)

Tables 1.Socio demographic characteristics of the participants

Characteristic (N= 250) %
Age
≤20 40 16
21-23 190 76
≥24 20 8
Gender
Male 102 40.8
Female 148 59.2
Year of study
Second year 55 22
Third year 100 40
Final year 70 28
Interns (Junior Residents) 25 10

The responses of participants to knowledge-, attitude-, and perception-based questions are shown in Table 2.
Table 2.Details of the responses given by the participants

Responses Agree Disagree

N % N %
Knowledge score 5 2 245 98
I have taken other courses/training prior to dental college that has trained/
educated me regarding obesity.
Obesity is defined as a chronic medical disease 237 94.8 13 5.2
Small weight losses (5–10% of body weight) can help in producing important 50 20 200 80
medical benefits for the obese patients.
Obesity is associated with serious medical problems. 163 65.2 87 34.8
I am aware of the WHO definitions of overweight, obese, and 25 10 225 90
morbidly obese patients.
Perception score 87 34.8 163 65.2
Treating obese patients in dentistry means that we have to make modifications
and accommodations in the equipments being used and office furniture.
It is important to assess a patient’s dietary habits. 200 80 50 20
would be keen in learning about obesity in dental college. 210 84 40 16
Attitude Score 178 71.2 72 28.8
I have negative reactions/attitude towards the appearance of obese patients.
It is difficult for me to feel empathy for an obese patient. 156 62.4 94 37.6
I feel uncomfortable when examining an obese patient. 204 81.6 46 18.4
Overweight people tend to be lazier than the normal weight people. 195 78 55 22
Overweight people lack will power and lack motivation in comparison to normal 85 34 165 66
weight people.
I would feel uncomfortable asking an obese patient about his or 148 59.2 102 40.8
her dietary habits.
I would feel uncomfortable asking an obese patient about his or her past use of 153 61.2 87 38.8
appetite suppressants or current and past anti-obesity medications.

ISSN: 2456-141X
DOI: https://doi.org/10.24321/2456.141X.201805
Mehrotra V et al.
J. Adv. Res. Dent. Oral Health 2018; 3(2)
When participants were asked whether they had attended
any prior courses that helped increase their professional
acumen in relation to obesity, only 5% participants
responded positively. While the majority of participants
(94.8%) reported that obesity is a chronic medical disease,
only 20% thought that small weight loss could have
beneficial effects. More than half of the participants (65.2%)
perceived obesity as a serious medical condition, but only
a small proportion was able to define obesity (10%).
Knowledge-based questions and their responses are
provided in Table 2.
Participants responded about their professional
impressions of obesity in sequenced questions. Around
34.8% of participants agreed that they would make special
accommodations in their dental offices for obese patients
with their equipment and office furniture. 80% of the
participants were in favor of assessment of patient’s dietary
habits and its importance in management of obese patients.
Although the majority of participants reported that
the assessment of the dietary habits of their patients is
important, about 84% of participants stated their interest
in obesity-related courses in dental school.
When asked questions about their attitudes towards obese
patients, more than half (59.2%) of the participants reported
that they feel uncomfortable examining obese patients
and asking them about their dietary habits and history
of appetite suppressants. Around 78% of participants
thought that obese individuals are lazier than normal
weight patients, and 34% of participants thought that
obese patients lack will power and motivation for health.
Discussion
The principle objective of this study was to evaluate the
knowledge, perceptions, and attitudes of dental students
about obesity. The results of this study divert our attention
towards the lack of curriculum and its overall impact on
obesity-related attitudes among dental students.
In our study it was reported that only about 5% of dental
students have taken other courses/training related to
obesity prior to joining the dental college. This finding is
contrary to the study conducted by Awan KH et al.29 who
reported 70.6% students having a prior training on obesity
before joining the dental college. This may be because of
difference in the curriculum of schools and also attitude
of the Indian population towards obesity.
The majority of the participants in our study not only failed
to define and identify obesity but they also lack knowledge
to recognize potential health benefits associated with
weight loss. Similar findings was observed in previous
ISSN: 2456-141X
DOI: https://doi.org/10.24321/2456.141X.201805
4
study conducted on dental students who had a limited
understanding of obesity by Magliocca et al.26 and Awan
KH et al.29 This lack of knowledge in identifying obesity and
its related health risks presents a significant challenge to
dentists and raises serious questions about their clinical
training.
In our study, 94.8% of the participants recognized obesity
as a chronic medical condition. This finding was consistent
with the studies conducted by Kumar et al.30 where 92% of
primary care physicians and 56.3% of dental students were
reported to recognize obesity as a chronic medical condition
and by 89.0% of dental students in study conducted by
Awan KH et al.29
In our study, only around 34.8% of participants reported
feeling a need to make special accommodations with their
dental office equipment and furniture for obese individuals.
A similar finding was reported by Kumar et al.[30] where
54.4%, and in study conducted by Awan KH et al.29 where
29.4% of the dental students responded negatively towards
making special accommodations for obese patients in their
dental offices. This may be due to a fear of extra expenditure
to make special accommodations for obese patients and
also the feasibility of their dental set-up. The majority of
the participants in our study believed in the importance of
dietary assessments for their patients. This not only helps
to establish obesity-related risk factor assessments but also
facilitate the implementation of prevention protocols, such
as dietary modifications, increased physical activity, and
exercise programs. In our study 84% of students were in
favor of having more obesity-related courses during their
dental school training. These findings were consistent with
Kumar et al.30 where 60.6% of dental students and 46.8%
of dental students in conducted by Awan KH et al.29 were
interested in learning more about obesity. This suggests
that dental students are keen to learn about obesity, and
that the proper implementation of a curriculum focused
on obesity prevention and rehabilitation may play a key
role in controlling obesity.
Our study presented some worrisome findings regarding
the attitudes of dental students towards obesity. It revealed
that dental students considered obesity to be related
to personality and aesthetics. It showed that the dental
students attributed personality characteristics, such as
appearance, laziness, feeling uncomfortable, lack of self-
control, and low motivation, to obesity. Around 78% of the
dental students considered obese people to be lazier than
normal weight people. Over 59.2% of the dental students
reported that they feel uncomfortable asking obese patients
about their dietary habits and diet control medications.
Similarly, more than half of the participants reported a
negative reaction to the appearance of obese patients and
were uncomfortable with examining obese patients. This

5 J. Adv. Res. Dent. Oral Health 2018; 3(2)
finding was consistent with the obesity related attitudes
among health care providers in the study conducted by
Awen KH et al.29
Conclusion
Dental education reforms lack the basic and specialized
concepts of obesity-related education as a core component
of the dental curriculum. Since obesity is a potential
modifying factor for a variety of dental conditions, it
should be an integral part of the dental curriculum, with
a focus on the need for implementing proper obesity-
related education in response to dental treatment needs.
Counselling should be conducted for all the dental students
who are future practitioners in order to instill positive
attitudes in them toward obesity patients. Oral health
physicians should also educate their patients about the
benefits of weight loss with regard to both their general
and oral health.
Conflict of Interest: None
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Date of Submission: 2018-07-09
Date of Acceptance: 2018-07-21