# I. Introduction n its broadest sense, Prosthodontics is concerned with the replacement of partial or complete loss of teeth and oral function due to tooth or tissue damage (Carlsson GE and Omar R, 2006). Prosthetic treatment involves the replacement of few missing teeth in a healthy but incomplete dentition, the functional replacement of nearly all teeth in a badly damaged dentition, or restoring function by means of removable or FPDs, implants, complete dentures, or over dentures (Mukatash et al., 2010 andZarb GA et al., 1978). With the rapid improvement in oral health and the reduction of edentulism in many countries, increasing numbers of people are retaining more teeth later in life (Carlsson GE and Omar R, 2006). Knowledge of subjects regarding prosthodontic treatment may play a role in their acceptance of the prostheses (Shigli et al., 2007). The aim of this paper was to evaluate the level of knowledge, perception, awareness, attitude, and behaviour of a group of Jazan population in the southern region of Saudi Arabia aged 21-91 years towards the options available for replacing missing teeth and the factors preventing them from taking treatment. # II. Materials and Methods The present study was a questionnaire survey conducted at College of Dentistry, Jazan University, Jazan. The study samples of 467 subjects were randomly selected from patients in the Department of Prosthodontics. The sample population consists of 248 males and 219 females within an age range of 21 to 91 years. A self-designed questionnaire containing eleven questions was designed on perception and awareness for different Prosthodontic treatment modalities and reasons for choosing or refusing treatments were measured (Table1). Ethical committee clearance was obtained. Initially a pilot study was carried out with twenty patients recruited in the same manner as in the main study to check the feasibility of the study and the questions were modified accordingly. Following the successful pilot study in which the questionnaire was validated, potential subjects were approached to carry out the main study. The questionnaire was made available both in English and Arabic languages. The dentists, dental technicians, and assistants were excluded from the study. Socio-demographic details including age, gender etc. was noted. A total of 500 questionnaire forms were distributed and 467 were returned back (response rate was 93.4%). Collected responses were tabulated. Statistical Analysis: Data was statistically analysed using the SPSS V.20 program. Frequencies were generated and mean calculated with standard deviation using descriptive statistical analysis. Chisquared test was used to identify significance. The probability was assessed using P value by considering p < 0.05 as significant. # Age: Sex: # III. Results The study sample consisted of 53.10% males (N=248) and 46.90% females (N=219) with a mean age of 56.48+11.92 years. Each question was analysed for the frequency and the relation between the gender difference was tabulated (Table 2). Question 1: Awareness about missing teeth replacement: The results show that 95.93 % (N=448) of the study population including both males and females has the awareness that they have to replace the missing tooth. There was marginal statistically significant difference between the genders (P=0.05). Question 2: Knowledge about various treatment options: Out of the 467 individuals 87.79% (N-410), 42.83% (N=200), 36.40% (N=170) and 10.71% (N=50) had the knowledge of complete denture, Removable Partial Denture, Fixed Partial denture and Implants respectively. There were no significant differences noted statistically P>0.05. Question 3: Have any missing teeth: 100% (N=467) individuals that participated in this study had missing teeth. The males showed a higher frequency of missing teeth than females. This result was statistically proven with chi square test, P=0.7111 (Table 2). Question 4: Position of tooth loss: There was marginal statistically significant difference between the genders (P=0.05). Loss of posterior teeth (N=144) 32.73% is more when compared to the anterior teeth (N=95) 21.59% and combination of anterior and posterior teeth is the highest (N=201) 45.68% Question 5: The duration of missing teeth among the participant of the survey was34.98 + 62.38 months for males and 28.11 + 35.04months for females. There was no statistical difference between the genders P= 0.1629. Question 6: Attitude towards prosthetic rehabilitation: Considering the attitude towards the replacement of the missing teeth with prosthesis 57.82% (N=270) individuals were positive and were planning to replace the missing teeth. But there were no significant differences between the genders even though comparatively more men were willing for replacement. Question 7: Type of Replacement perceived: Comparison of the individual's knowledge toward different prosthetic replacement options and their perceived option for replacing the missing tooth were as follows. Most of the people were willing to replace the missing teeth with complete denture i.e., 62.44 % (N=123/272), compared to 50.25% (N= 99/272) for removable partial denture and 25.38% (N= 50/272) for fixed partial denture. There were no patients who preferred to replace their missing teeth with implants. Question 8: Reasons for not replacing the missing teeth: The main reason for not undergoing the prosthodontic replacement was inadequate knowledge (57.36%, N= 113), followed by lack of motivation, regarding the prosthetic replacements (24.37%, N=48) and the least were due to financial constraints (18.27%, N=36) and these observations were not statistically significant. Question 11: how did you know about the dental college: Out of the 467 participants 61.46% (N=287) came to know about the college from relatives and friends 24.20% (N=113). Few patients were referred by Dentists 10.92% (N=51) whereas media 3.43% (N=16) formed the least in patients knowing about the college. These observations were not statistically significant. P= 0.3352. # IV. Discussion Oral health means much more than just healthy teeth. Good oral health is a major resource for social, economic and personal development of individuals (Khan SA et al., 2012). Teeth are required for mastication, phonetics, aesthetics, structural balance and for the comfort of an individual. With the loss of teeth, the above functions are impaired resulting in physical, physiological and psychological trauma to the individual (S S, Sharma S, 2010). Preventive dental care is almost non-existent in rural India (Parlani S et al., 2011). Initiatives should be aimed not only on the prevention but also on the curative aspects of oral health. Mobile dental clinics, dental camps, and prosthodontic outreach programs are possible solutions to change attitudes, spread awareness, and extend treatment. Lack of awareness of different prosthodontic treatment options among people living in and around Jazan prevents them from availing of treatment even though there are many Government setups that offer treatment free of cost (Menezes M and Aras M, 2009). From the present study, it can be observed that the subjects were aware of the needs of dentures in contrast to previous studies (S S, Sharma S, 2010). This may be due to the increase in technology and media. When asked about the attitude towards the replacement, even though the participants had the knowledge about the need for replacement, majority did not opt for treatment mainly due to inadequate knowledge. Most of the patients opted to get treated from the dental college than private clinics; this may be to reduce the financial burden following a prosthetic replacement. The study suggests that in general the dentist must spend more time on the chair side during examination and motivate the patient regarding the need of a denture so as to get a proper response in relation to need of a denture which was similar to previous observations in literature (S S, Sharma S, 2010). Even though there is a scarcity of data regarding patient's needs and preferences in field of fixed prosthodontics, this study shows an increase in demand for fixed partial denture by the individual with knowledge of the same. From the present study, it can be observed that m o s t o f t h e subjects were not aware of dental implants. This implies that persons whether male or female need motivation and education to help them realize the needs of implants. # V. Conclusion In conclusion complete dentures are associated with lower expected outcomes, while inadequate knowledge and lack of motivation are the major factors associated with the preferences for implant treatment for the study population. 9![The setup where individual would like to get the prosthetic replacement done: Out of the 467participants 60.60% (N=283) preferred to get the prosthesis done from dental college and 26.12% (N=112) from Dental clinic and 11.35% (N=53) opted for general hospitals. These observations show statistical significance p= 0.0001* Question 10: Awareness about the availability of Prosthetic replacement treatment in College of Dentistry Jazan University: The results shows that 91.43% (N=427) participants were aware about the treatment facility in the college.](image-2.png "Question 9 :") :4. Shigli K, Angadi GS, Hebbal M (2007). Knowledge Fixed Partial Dentureof a complete denture among complete edentulous 50 25.38of prosthodontic treatment among denture-wearers Implant supportedpatients. J. Int. Oral health. 3 (2): 65-70. 0 0.00and non-denture-wearers attending a dental institute Q-8 If not replaced then why7. Parlani S, Tripathi A, Singh SV (2011). Increasing thein India: a survey report. Gerodontology. 24(4): Financial Constraintsprosthodontic awareness of an aging Indian rural 36 18.27211-6. Inadequate Knowledgepopulation. Indian J. Dental Res. 22(3): 367. 113 57.365. Khan SA, Dawani N, Bilal S (2012). Perceptions and myths regarding oral health care amongst strata of Not motivated Q-9 Where would you like to go for replacement of missing teeth 8. Menezes M, Aras M (2009). Prosthodontic 48 24.37 Awareness and Fulfillment of Prosthodontic Need inlow socio economic community in Karachi, Dental Clinic Pakistan. J. Pakistan Med. Ass. 62(11): 1198-203. Dental College 6. Suresh S, Sharma S (2010). A clinical survey to General Hospital determine the awareness and preference of needs OthersRural Areas of Goa. J. Indian Dental Ass. (11): 368. 122 26.12 283 60.60 53 11.35 9 1.93TotalTable : Distribution of samples by age groups and sex 467100.00Year 2016 Year 2016Characteristics Age groups >25 Q10 dental college where replacement in Jazan Yes No TotalNo of samples 1% of samples 0.21 427 40 46791.43 8.57 100.00Year 2016 Year 201625-34 Q-11 How did you know about the college61.28Friends35-447415.85 11324.20Volume XVI Issue I Version I Volume XVI Issue I Version I D D D D ) J D D D D ) J>45 Mean age SD age Sex Male Female Total Table : Item wise responses of respondents 386 82.66 56.48 11.92 248.00 53.10 219.00 46.90 467 100.00 Items No of samples Q1 Are you aware that missing teeth have to be replaced Yes 448 No 19 Relatives 287 Dentist 51 Media 16 Total 467 Table : Distribution of samples by age groups and sex Age groups Male % Female % >25 1 0.40 0 0.00 25-34 2 0.81 4 1.83 35-44 34 13.71 40 18.26 >45 211 85.08 175 79.91 Total 248 100.00 219 100.00 Mean age 57.40 55.43 Total 467 SD age 11.28 12.54% of samples 95.93 61.46 10.92 3.43 100.00 Total 1 6 74 386 467 56.48 4.07 100.00 11.92% 0.21 1.28 15.85 82.66 100.00Volume XVI Issue I Version I D D D D ) J Volume XVI Issue I Version I D D D D ) J( (Q2 The various types of replacement that they are aware of Table : Comparison of male and females with Q 1( (Complete Denture Removable Partial Denture Q 1 Male Yes 242% 97.58Female 206% 94.06410 200Total 44887.79 42.83% 95.93NoFixed Partial Denture 62.42135.941701936.404.07Implants Total248100.00219100.005046710.71100.00Q3 Do you have any missing teethChi-square=3.6852 P = 0.0551Yes44094.22No275.78Q 2TotalMale%Female467 %100.00 Total%Q-4 If Yes Complete Denture22289.5218885.8441087.79Front Removable Partial Denture10542.349595 43.3821.59 20042.83Back Fixed Partial Denture Both Implants Q5 How long have the teeth been missing 93 29 Chi-square=0.5383 P = 0.9102 37.50 77 11.69 21144 35.16 201 9.59170 32.73 50 45.6836.40 10.71Means31.76 Table : Comparison of male and females with Q3 i.e. missing teethStd.Dev. Q3 i.e. missing teeth Q6 Did you get them replaced Male Yes 234% 94.35Female 20651.48 % 94.06Total 440% 94.22Yes No145.6513270 5.942757.825.78No Total248100.00219197 100.0046742.18100.00TotalChi-square=0.1327 P = 0.7111467100.00Q-7 Type of replacementComplete Denture12362.44Removable Partial Denture9950.25© 2016 Global Journals Inc. (US) © 2016 Global Journals Inc. (US) :Others31.2162.7491.93TotalQ-11Male248% Chi-square= 40.3122 P = 0.0001* Female 100.00 219% 100.00Total 467100.00 %Q10Friends6526.214821.9211324.20YesRelatives14322957.6692.3414419865.75 90.41287 42761.46 91.43NoDentist311912.507.6620219.13 9.5951 4010.92 8.57TotalMedia92483.63100.0072193.20 100.0016 4673.43 100.00Total248100.00 Chi-square= 0.5527 P = 0.4581 219100.00467100.00Q-11Chi-square=3.3961 P = 0.3352Friends Relatives65 14326.21 57.66OR48 14421.92 65.75113 28724.20 61.46DentistTable : Comparison of male and females in each item 31 12.50 20 9.135110.92Items Media Q 1 Yes No TotalMale 9 242 6 248% 3.63 97.58 2.42 Chi-square=3.3961 P = 0.3352 Female 7 206 13 100.00 219% 3.20 94.06 5.94 100.00Total 16 448 19 4673.43 % 95.93 4.07 100.00Year 2016Total248100.00219100.00467100.00Chi-square=3.6852 P = 0.0551Q 2 Complete Denture Removable Partial Denture Fixed Partial Denture Implants Q3 i.e. missing teeth Yes No Total Q-4 sides Front222 105 93 29 234 14 248 4889.52 42.34 37.50 11.69 Chi-square=0.5383 P = 0.9102 188 95 77 21 94.35 206 5.65 13 100.00 219 Chi-square= 0.1327 P = 0.7111 20.51 4785.84 43.38 35.16 9.59 94.06 5.94 100.00 22.82410 200 170 50 440 27 467 9587.79 42.83 36.40 10.71 94.22 5.78 100.00 21.59Volume XVI Issue I Version IBack Both67 11928.63 50.8577 8237.38 39.81144 20132.73 45.68( D D D D ) JChi-square= 5.7557 P = 0.0565Q5Means352831.76Std.Dev.623551.48t=1.3978, p=0.1629Q6Yes13654.8413461.1927057.82No11245.168538.8119742.18Total248100.00219100.00467100.00Chi-square= 1.9221 P = 0.1662Q-7Complete Denture6860.715564.7112362.44Removable Partial Denture5145.544856.479950.25Fixed Partial Denture1816.073237.655025.38Implant supported00.0000.0000.00Chi-square= 5.3702 P = 0.0681Q-8Financial Constraints2320.541315.293618.27Inadequate Knowledge6154.465261.1811357.36Not motivated2825.002023.534824.37Chi-square= 1.1429 P = 0.5633Q-9Dental Clinic6425.815826.4812226.12Dental College15462.1012958.9028360.60General Hospital2710.892611.875311.35© 2016 Global Journals Inc. (US) © 2016 Global Journals Inc. (US) * Omar R. Trends in prosthodontics GECarlsson Medical Principles and Practice 15 3 2006 * Needs and demands of prosthetic treatment among two groups of individuals GNMukatash MAl-Rousan Al-Sakarna B Indian J Dental Res 21 4 564 2010 * Prosthodontic treatment for edentulous patients. United states of America: Mosby GAZarb CLBolender ABCarr GPMcgivney DTBrown 1978