Globally, oral diseases represent a considerable public health burden. These conditions affect people of all age groups, and throughout their entire lives. They are associated with pain, discomfort, functional impairment, disfigurement, and in some cases, death [1]. Of these diseases, dental caries remains the most common mouth disease. The Global Burden of Disease Study (2017) indicates that dental cavities in permanent teeth affects an estimated 3.9 billion people, nearly 44 percent of the global population [2]. Untreated dental cavities is thought to be the most common health condition for people around the world and continues to pose a burden to health systems in developed and developing countries [3]. In India, dental caries is reflected as a major public health concern, and state-level surveys indicate high prevalence. For example, the prevalence reported in Tamil Nadu was 61.4 percent, which is significantly higher than the global average. Furthermore, the World Health Organization (WHO) in its comprehensive approach to oral health, notes that a prevention-oriented approach to address the burden of dental caries is needed to realize optimal oral health and prevention of oral diseases [4]. Many risk factors influence the onset and progression of dental caries. Individuals' socio-demographic characteristics such as employment status, family income, and level of education do contribute to oral health, but these factors are not uniformly contributory at the individual level relative to the individual variables [5]. In contrast, personal knowledge about caries, eating and drinking behaviors, the role of oral hygiene practices, and the frequency of dental visits are essential to the onset and progression of disease [6]. Poor dietary habits, especially the increased intake of sweet food and sugary or carbonated drinks, is well-established as the initial etiology of caries [7]. Conversely, protective habits, such as brushing teeth twice a day, using fluoridated toothpaste, rinsing and/or flossing teeth, will result in a lowered risk of developing disease. For urban communities, and especially in communities undergoing lifestyle transitions, these determinants become more important for consideration. Urban populations may experience the combination of increased exposure to unhealthy eating practices and the lack of awareness of prevention. North Chennai, a densely populated urban settlement, illustrates a community where variability of socio-economic status and limited access to prevention programs may correlate to increased burden of dental caries [8]. Taking the aforementioned ideas into consideration, this study was designed to investigate the awareness of patients regarding the prevalence of dental caries among urban dwellers from North Chennai. The study was designed to assess knowledge of dietary intake and restrictions, oral hygiene procedures, and the importance of regular dental visits in the prevention of dental caries. The analysis of these variables across patient= age groups and gender, will reflect on knowledge deficits and inform the process of targeted oral health education activities.

This study aimed to assess patients' knowledge about the incidence of dental caries in the urban population of North Chennai with respect to knowledge about dietary habits and restrictions, oral hygiene, and the need for regular dental visits for the prevention of caries. Study Design and Instrument The creation of the structured, self-administrated questionnaire used existing studies in the literature as a basis, then underwent modifications to reflect the local context. The questionnaire included 30 items regarding basic knowledge of dental caries, the anatomy and physiology of teeth, dietary intake and its impact on the development and prevention of dental carries, oral hygiene practices, and knowledge of prevention of dental caries associated with regular visits with a dentist. Sample Size and Population One hundred participants were recruited for the study. The sample was equally distributed by sex, with 50 males and 50 females. The participants were also stratified into five age groups: 21–30 years, 31–40 years, 41–50 years, 51–60 years, and 61–70 years. Ten males and ten females were represented in each subgroup for equal representation among each age and sex category. Sampling Technique The sampling method utilized a stratified sampling technique to make sure that both genders and all ages were properly represented. Each age group had a total of 20 participants, with equal representation of males and females. Data Collection A questionnaire was used as a self-administered approach to collect the data. After administering the questionnaires, the responses were collected, scored, and coded. Knowledge scores for each participant had a maximum potential score of 30 and were then calculated into percentages for ease of comparison across all groups. Data Analysis The scores were analyzed by age and gender. Each age and gender category had a mean score given as a percentage, which were analyzed to look for differences in levels of knowledge. The results were then analyzed to examine the implications in terms of overall trends and patterns in the knowledge of caries awareness in the population being studied.

In total, 100 participants attended and completed the study, which included 50 males and 50 females, with equal representation within the five age groups. The scored responses to the questionnaire were scored out of a potential score of 30 total points. Mean scores and percentages were calculated for each of the age-gender groups. Table 1 presents the distribution of scores and percentages across different age categories for both males and females. Table 1. Knowledge scores of patients about the prevalence of dental caries across age and gender groups Age group (years) Mean score (Male, /30) Mean score (Female, /30) Percentage (Males) Percentage (Females) Mean percentage 21–30 19.85 18.37 66% 61% 64% 31–40 19.9 19.85 66% 66% 66% 41–50 20.2 18.8 67% 63% 65% 51–60 19.5 19 65% 63% 64% 61–70 16.4 17 54% 57% 55% Overall 19.17 18.6 63.6% 62% 62.8% Based on the analysis, the 41–50 years age group exhibited the highest knowledge scores, with a mean percentage of 65 percent (67 percent for males and 63 percent for females). They were followed closely by participants in the 31–40 years group, achieving a mean percentage of 66 percent. Participants in the 21–30 years and 51–60 years groups showed similar knowledge levels, both with a mean percentage of 64 percent each. Participants in the 61–70 years age group demonstrated the lowest knowledge scores, with a mean percentage of 55 percent (54 percent for males and 57 percent for females). When comparing gender differences, males showed a slightly higher overall knowledge level than females (males: mean scores of 19.17/30 or 63.6 percent, females: 18.6/30 or 62 percent). These findings suggest that knowledge of dental caries was highest among middle-aged groups (31–50 years) and was lowest among older adults (61–70 years).

The current investigation evaluated the level of patient cognizance of the occurrence of dental caries in the urban population of North Chennai and noted the differences in knowledge level of age demographics, with the highest knowledge levels in 31–40 years and 41–50 years, and the lowest level in 61–70 years. Males tended to have slightly higher knowledge scores than females [9]. One possible reason for the higher knowledge levels in the 31–40 years and 41–50 years groups may be due to more exposure to dental treatment, all forms of health information supplied by the media, and greater awareness attained from professional and work environments. This age cohort may also be more aware of family health, which may ultimately inform oral health care [10]. Participants that were 21–30 years also showed moderate levels of knowledge likely attributed to school-based dental health programs, but these participants may be more vulnerable to unhealthy dietary habits that implicated less than healthy eating, such as diet high in prepared junk foods, sugar-sweet beverages, and westernized diets which associate with a higher risk for caries [11]. In comparison, the 61–70 years group had the lowest knowledge scores. This likely reflects limited exposure to health education programs in earlier life, as well as generational differences in exposure to oral health information. Older adults may also prioritize systemic health conditions over oral health, resulting in decreased knowledge of dental caries prevention strategies [12]. When examining gender comparisons, males had slightly higher knowledge scores than females. This may be due to socio-cultural factors within the study area, where men are more likely to experience higher education levels, have greater external social exposure, and have more opportunities to interact with and access health information than women, who may have less educational and social exposure [13]. The results of this research are in line with previous studies. H. P. Suma Sogi et al. (2016) [14] conducted a cross-sectional study of the population in Belagavi city and showed that level of education affected oral health knowledge positively; mothers scored higher than fathers. Similarly, Dhull et al. (2018) [15], found that first-time moms had poor knowledge of infant oral health care, with almost 96 percent of first-time mothers not having any knowledge of infant oral health care. The results of these studies further highlights that knowledge gaps about infant oral health care exist across various groups and show the need for providing targeted oral health education. International studies further indicate the importance of educational and dietary influences on oral health knowledge. Kunitomo et al. (2016) [16] showed that Japanese students at a university, with limited food education, had greater odds of having dental caries, especially males. Taniguchi-Tabata et al. (2017) [17] found that the place of dental knowledge (such as dental clinics, schools and the media) influenced oral health behaviors. These studies supports the idea that by providing access to reliable health knowledge and reinforcing preventative behaviors, oral health outcomes can improve [18,19,20]. Overall, this study revealed the need for continuous oral health education among all ages and specifically targeted older adults and women, who self-reported lower oral health knowledge levels. Preventive methods, community-based education programs, and reinforcement of healthy dietary practices and oral hygiene, are needed to reduce the burden of dental caries in urban living conditions, such as in North Chennai.

This study assessed patient knowledge regarding prevalence of dental caries in the urban population of North Chennai. The results showed knowledge was highest in the 31–40 and 41–50 years old age range and lowest in those aged 61-70 years. Males had slightly increased knowledge scores compared to females in all age groups. The findings suggest that middle-aged adults show more knowledge, as they are still being exposed to various dental care services and health indicators, compared to older adults, who perhaps have less awareness due to lack of-structured oral health education decades earlier. Younger subjects, although participating in school health programs, are still at risk for unhealthy food habits, which effectively negate gains in knowledge. The study supports the ongoing need for oral health education programs for all ages, with a particular priority for older adults and women who had lower levels of awareness. Prevention should emphasize diet, regular clinical visits, and appropriate oral hygiene practices, as they all contribute to reducing the burden of dental caries. This study advances the establishment of community-based oral health promotion programs for new urban areas, including North Chennai, through identification of knowledge gaps and subpopulations with lower levels of awareness. Enhancing preventive care and patient knowledge will help to reduce rates of dental caries and improve patients' oral health status.

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