Sociology and Behavioural sciences

S O C I O L O G Y
A N D
B E H AV I O U R A L
S C I E N C E
V.GOUSALYA
1st YEAR POST GRADUATE
DEPARTMENT OF PUBLIC HEALTH DENTISTRY
SRMDC
13/05/2021

CONTENTS
INTRODUCTION
SOCIAL SCIENCES
SOCIOLOGY
CONCEPTS IN SOCIOLOGY
• STRUCTURAL ASPECTS
• FUNCTIONALASPECTS
CULTURAL ANTHROPOLOGY
SOCIAL SCIENCES AND DENTAL PUBLIC HEALTH
HEALTH BEHAVIOUR AND LIFESTYLE
SOCIAL PSYCHOLOGY

INTRODUCTION Social environment is as
important as the
physical and biological
environment in relation
to health and disease in
man.

EFFECT OF
SOCIAL
ENVIRONMENT
ON HEALTH
The effect of social
environment on health is
clearly reflected in the
differences in disease patterns
of rural versus urban and
developing versus developed
countries.
RURAL
URBAN

SOCIAL ENVIRONMENT?
• The term social environment denotes the complex of psychosocial factors
influencing the health of the individual and the community. This environment is
unique to man and includes cultural values, customs, habits, beliefs, attitudes,
morals, religion, education, income, occupation, standard of living, community
life and the social and political organization.

POLITICAL
SCIENCE
ECONOMICS
SOCIOLOGY CULTURAL
ANTHROPOLOGY
SOCIAL
PSYCHOLOGY
BEHAVIOURAL
SCIENCES
S
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SOCIAL SCIENCES

SOCIOLOGY
• Sociology is derived from the latin socio
meaning society and the Greek logos meaning
science.
• The term sociology was first used by Frenchman
Auguste Compte in the 1830s when he proposed
a synthetic science uniting all knowledge about
human activity.

SOCIETY SOCIOLOGY
• Sociology is the study of
individuals as well as groups
in a society
• Society is a group of
individuals who have
organized themselves and
follow a given way of life.

SOCIOLOGY CAN BE VIEWED FROM
TWO ASPECTS
• Study of relationships between
human beings and how these
relationships change or vary in
different parts of the world and at
different times .
• Study of human behavior. Human
behavior is determined not merely
by biological and physical
environmental factors but also by
social factors.

CONCEPTS IN SOCIOLOGY
• STRUCTURAL ASPECTS OF SOCIETY
SOCIAL
INSTITUITION
COMMUNITY ASSOCIATION
Social structure and
machinery through which
human society organizes,
directs and executes the
multifarious activities
required to satisfy human
needs.
According to WHO Expert
Committee “ A community
is a social group determined
by geographical boundaries
and/or common values and
interests.
They are groups of people
united for a specific purpose
or a limited number of
purposes and are based on
utilitarian interest

FUNCTIONAL ASPECTS OF SOCIETY
• “The rules that a group uses
for appropriate and
inappropriate values, beliefs,
attitudes and behaviors”.
• Failure to stick to the rules can
result in severe punishments,
the most feared of which is
exclusion from the group.
• It indicate the established and
approved ways of doing things,
of dress, of speech and of
appearance.
• These vary and evolve not only
through time but also vary
from one age group to another
ad between social classes and
social group.
SOCIAL NORMS

FOLKWAYS
• Famed American sociologist, William
Graham Sumner, is credited with
coining the term folkways in his
monumental work entitled "folkways:
a study of the sociological
importance of manners, customs,
mores, and morals" in 1907.
• The folkways are the right ways of
doing things in what is regarded as
the less vital areas of human conduct.
• Generally, conformity to folkways is
ensured by gentle social pressure
and imitation.
• Breaking or questioning a folkway
does not cause severe punishment.
FOLKWAYS

MORES
• The more
stringent
customs are
called "mores".
• The public takes
an active part in
their
enforcement.
• Breaking the
rules will cause
punishment.

TABOO
• Taboo is a strong social
prohibition (or ban) against
words, objects, actions, or
discussions that are considered
undesirable or offensive by a
group, culture, society, or
community.
• Breaking a taboo is usually
considered objectionable or
abhorrent.
• Some taboo activities or customs
are prohibited by law and
transgressions may lead to severe
penalties.

• Custom is a broad term embracing all the
norms classified as folkways or mores.
• Repeated by a number of generations,
practices that tend to be followed simply
because they have been followed in the past.
• Customs have a traditional, automatic, mass
character
• Habits are habituated routines of behavior
that are repeated regularly, tend to occur
subconsciously and tend to occur without
directly thinking consciously about those
behaviors.
CUSTOMS HABITS

• Etiquette is a code that governs the
expectations of social behavior, according
to the contemporary conventional norm
within a society, social class, or group.
• Etiquette is dependent on culture.
• What is excellent etiquette in one society
may shock another.
ETIQUETTES CONVENTIONS
• A convention is a set of agreed, stipulated or
generally accepted standards, norms or
criteria, often taking the form of a custom.
• A convention may retain the character of an
“unwritten” law or custom.
E.g. greeting each other by shaking hands
• Law and a regulatory legislation may be
introduced to formalize or enforce the
convention.
E.g. laws which determine which side of the
road, vehicles must be driven.

• Constitute an important part of the
selective behaviour of man.
• Values refer to those standards of
judgement by which things and
actions are evaluated as good or
bad.
• Norms are rules for behaviour in
specific situations while values
identify what should be judged as
good or bad
• Norms are said to be the enactment
of social values.
SOCIAL VALUES NORMS

CULTURAL ANTHROPOLOGY
• Cultural anthropology is the branch dealing with man's behavior and products.
• Its main theme is culture
• Culture is the accumulation of learned behaviors, beliefs and skills of mankind as a whole.
• It comprises everything which one generation can hand down to the next.
• The Oxford dictionary defines culture as," the training and refinement of mind, tastes and manners, the
condition of being thus trained and refined ".
• Culture has three parts. It is an experience which is " learned, shared and transmitted".

SOCIAL
ANTHROPOLGY
LINGUISTICS
ARCHEOLOGY
ETHNOLOGY
Comparative
study of
cultures
Study of past
cultures and
civilization
using their
remains as the
principle source
of information
The study of
speech
patterns of
man i.e. the
study of
languages and
dialects
A specific branch of
cultural anthropology
dealing with
comparative study of
kinship and non
kinship organization
patterns in different
societies.

WHY DENTISTS SHOULD KNOW ABOUT
SOCIOLOGY AND CULTURE ?
• An appreciation of the cultural meanings of health and disease is important
in understanding, why people accept or do not accept professional health
care.
• A person may delay seeking dental treatment from a dentist due to reliance
on home remedies. This could reduce the effectiveness of any health
education or treatment activity planned for improving the oral health status
of the community.
• Health care providers ignorance of cultures can also impair their
communication with patients, resulting in culturally irrelevant services or
misinterpretation of side effects of folk medicines.

• Successful communication requires recognition and consideration
of cultural diversity and differing communication styles.
• Dismissal of beliefs, held by people from other cultures - termed
ethnocentrism — can create a barrier of misunderstanding.

• Developing a deeper understanding of cultural beliefs and
practices and an acknowledgement of respect for these practices by
health care providers could improve the use of health care services
in the community

SOCIAL PSYCHOLOGY
• Social psychology is an important branch of psychology.
• It is defined as the science of behaviour of the individual in society.
• That is, it studies the behaviour of the individual in group, crowd, mob,
audience and other social situations.
• It also studies the attitudes of the individuals towards cultural and social
values.

SOCIAL PSYCHOLOGY
• Group behaviour
Man is a social being. From birth till death, he is associated with
people.
He is born in particular culture which is made up of customs, laws,
ideals, art, literature; crafts, science, technology and institutions.
All these act on the individual and influence his social behaviour.
Group behaviour is also known as social behaviour.

• Social interaction
 Inter-personal relationships : The individual learns many things from
his parents, teachers and friends. This is known as person-to-person
interaction.
 Inter-group relationships: The individual is a member of a group, of a
family and of a community. He has to follow the traditions of the group.
For example, in many communities in India the person is not permitted to
marry outside his caste. This is the result of person-to-group interaction.

CULTURE AND ITS INFLUENCES ON
NUTRITION
• Food habits are one of the most
complex aspects of human behaviour,
being determined by multiple motives
and directed and controlled by
multiple stimuli.
• Food acceptance is a complex
reaction influenced by biochemical,
physiological, psychological, social
and educational factors.
Abraham E. Nizel The science of nutrition and its application in clinical dentistry 2n edition,
W.B. Saunders Company: Philadelphia. Page 219-231.

DIETARY PREFERENCES ACCORDING TO
SOME CULTURAL AND RELIGIOUS BELIEFS
• African American
 Most popular meat dishes include pork,
fish, small game and poultry.
 Frying and boiling are the most
common preparation methods.
 Primary grain product is corn
Dr. Shreedhar Reddy et al. Culture and
Oral Health -A Review. Journal of the
Indian Association of the Public Health
Dentistry, (16): 163-167

• Asian
 High incidence of lactose intolerance; traditional
sources of calcium include tofu, soy milk, small bones
in fish and poultry.
 Make pastes of shrimp and legumes.
 Wheat and rice are primary grain products, fresh fruits
and vegetables, also pickled, dried or preserved.
Oral Health -A Review. Journal of
the Indian Association of the Public
Health Dentistry, (16): 163-167
Oral Health -A Review. Journal of
the Indian Association of the Public

• Buddhism
 Vegetarianism with five pungent foods
excluded: garlic, leek, scallion, chives, and
onion.
• Hinduism
 Mostly vegetarian except in northern India
where meat is consumed (except for beef).
Dr. Shreedhar Reddy et al. Culture and Oral Health -A Review. Journal of
the Indian Association of the Public Health Dentistry, (16): 163-167

• Islam
 No consumption of animals slaughtered without pronouncing the
name of Allah or killed in manner that prohibits the complete
draining of blood from their bodies.
 No consumption of carnivorous animals with fangs, and land animals
without ears (frogs, snakes).
 Prohibition of eating pork.
Dr. Shreedhar Reddy et al. Culture and Oral Health -A Review. Journal of the Indian Association of the Public
Brondz, I. (2018) Why Judaism and Islam Prohibit Eating Pork and Consuming Blood as a Food? Voice of the
Publisher, 4, 22-31.

• Native American
 Meat is highly valued, mostly grilled, stewed, or preserved
through drying and smoking.
Primary grain used is corn; wild rice is also popularly consumed
Dr. Shreedhar Reddy et al. Culture and Oral Health -A Review. Journal of the Indian Association
of the Public Health Dentistry, (16): 163-167

• Orthodox Judaism
 Prohibits consumption of swine, shellfish, and carrion eaters, Ritual
slaughtering of animals.
The dentist as a member of the health
team can and in fact, is expected to
impart sound nutritional information to
his patients, particularly if it has an
oral relevance. It is essential to have
knowledge of the culture, nutrition and
its effect on oral disease

FACTORS ASSOCIATED WITH ORAL
CLEANLINESS
 The custom of cleaning the teeth is virtually as old as man himself. Toothpicks are known to
have been used by the Babylonians as early as 3500 B.C.
 Very often oral hygiene was, and still is a religious ritual.
 The Buddhists, for example, as early as the fifth century B.C. used tooth sticks made from
twigs. Many of them use the same method today, as well as rinsing their mouths with water
after meals .

• Hindu Brahmins and priests, especially in the region of Varanasi (
Uttar Pradesh, India) clean their teeth using cherry wood for an
hour, facing the rising sun.This may promote oral health if it is done
appropriately.
• Orthodox Jains clean their teeth using fingers and without using the
brush. This may have a negative impact on their oral health.
• Muslims offer prayer in the form of namaz, five times a day. During
each namaz, as part of the ritual, they use miswak stick, tooth picks
and do gum massaging. This may promote the oral health.
• Jain M, Mathur A, Kumar S, Duraiswamy P, Kulkarni S. Oral hygiene and periodontal status among Terapanthi Svetambar Jain monks in India. Brazilian oral
research. 2009 Dec;23(4):370-6.
• Chandra SB, Raja BP. Cultural factors in health and oral health. Indian journal of dental advancements. 2009 Oct 1;1(1):24-31.

RELIGIOUS PRACTICES
• Purdah system: Practiced among Muslims and high caste Hindus
has beneficial as well as detrimental effects. The practice protects
against the exposure to harmful sunrays and there by prevents the
occurrence of basal cell carcinoma.
• Smoking and alcoholism: The habit of alcoholism is prohibited
among Muslims and high caste Hindus. This may promote the oral
health.
• Drug Addiction: Hindu sadhus have the habit of incorporating
charas, bhang and ganja into cigarettes
• Jain M, Mathur A, Kumar S, Duraiswamy P, Kulkarni S. Oral hygiene and periodontal status among Terapanthi Svetambar Jain monks in India. Brazilian oral
research. 2009 Dec;23(4):370-6.
• Chandra SB, Raja BP. Cultural factors in health and oral health. Indian journal of dental advancements. 2009 Oct 1;1(1):24-31.

BEHAVIOUR SCIENTISTS
CLASSIFICATION OF SOCIAL CLASS
THE UPPER MIDDLE CLASS
• The professional and business executive group, well educated,
living in well maintained homes.
• Seek out expert advice and follow the advice religiously when it
comes to health care.
• They value their teeth and are interested in preventive dentistry and
actively pursue dental care

THE LOWER MIDDLE CLASS
• Includes small business owners, minor executives, teachers,
salesman.
• They are highly moralistic group with at least a high school
education
• They live in a clean pleasant neighbourhood.
• Most compulsive in dental care attitudes.
• Dentist is regarded as an authority who fixes teeth.
• The necessity to be socially presentable makes for a high standard of
dental care among this status level.

THE UPPER LOWER CLASS
• Generally skilled and semiskilled blue collar workers with limited
education.
• The group which needs to become the objective of major educational
efforts regarding dental care.
• They are most accessible to these attempts and offer best possibilities of
behavioural and attitudinal changes.
• They acquire artificial dentures at an early age and are reasonably
happy with them.

THE LOWER CLASS
• They are called underprivileged or disadvantaged class.
• Consists of unskilled labourers, people who shift from job to job,
limited education, live in slum areas and exhibit no stable pattern of life.
• Reveal most consistent neglect of teeth.
• They require careful understanding if they are to receive adequate care
in public health facilities

BARRIERS TO UTILIZATION OF ORAL
HEALTH CARE SERVICES
• Socioeconomic and dental insurance status has an effect on the
utilization of preventive care.
• Poor adolescents are less likely than near-poor and rich adolescents
to visit the dentist and to have dental sealants as per need.

• Effective verbal and nonverbal communications are critical aspects of
all phases of the dental care. Failure to communicate effectively and
appropriately can result in misunderstanding, lack of trust, and
increased anxiety levels for the dentist and client as well as the
collection of inaccurate data and diagnosis, improper care planning,
and treatment.
• To be successful in the mediation of cultural differences, the dentist must
be mindful of not only the verbal but also the nonverbal cultural
variations in communication. However, use and meaning of hand
gestures, acceptable physical touching, proximity, and eye contact differ
depending upon cultural background and should be used with caution.
Salim rayman. Transcultural Barriers and Cultural Competence in Dentral Hygiene Practice.
The Journal of Contemporary Dental Practice 2007, 8(4).

• Physical touching and eye contact also varies from culture to culture.
While African Americans and Hispanics are more likely to prefer close
proximity when communicating. Asians, Middle Eastern, and
individuals who practice the religion of Islam may not.
• Direct eye contact in Native Americans and Chinese cultures may be
seen as a sign of disrespect, while Hispanics view this as a show of
concern and attentiveness.
Salim rayman. Transcultural Barriers and Cultural Competence in Dentral Hygiene Practice.
The Journal of Contemporary Dental Practice 2007, 8(4).

TOOTH MUTILATIONS
• Today, tooth mutilations are largely confined to societies, that have
been able to maintain their geographical or cultural isolation such as
tooth avulsion, the breaking off tooth crowns, alteration in the shape
of the tooth crown by filing and chipping; dental inlay work;
acquiring and staining of teeth; and miscellaneous practices such as
the placement of gold crowns for adornment purposes.

Author Country Description
Barrett et at
(1975)
Australia Tooth evulsions among aboriginal men at Yuendumu in
the northern territory of Australia recorded that the
older men of the tribe associated ritual evulsions with
aboriginal law and a kangaroo myth.
Mosha.N
(1983)
Iraq and
Tanzania
The removal of the permanent mandibular central
incisors among the Iraq, Waarusa and Masai people of
Tanzana.
Elvinleis and
Lewis
(1983)
Peru and
Ecuador
The practice of blackening the teeth among the Jivaro
Indian people of northern Peru and Ecuador. This
custom is carried out in order to prevent dental caries.
Barrett et at
(1975)
Africa 1-15 blows were needed to evulse anterior teeth. The
patient may be seated, but more commonly, has on
the ground.
Mosha H J
(1983)
Tansanian Reported that out of 124 children having had tooth
germs removed by traditional healers, 10 resulted in
death.
Iriso R et al
(2000) Uganda
A more recent study analyzed discharge records from
a paediatric ward in a Ugandan hospital and found
156 out of 740 admissions due to the effects of
treatment for ’nylon teeth’ resulted in death’. This
gives a fatality rate of 21.1%

MUTILATIONS OF SOFT TISSUES
• Tattooing
• Tattooing of soft tissues is a practice which remains popular in many
non-tropical and tropical areas of the world.
• Tattoos in the oral region must be distinguished from other forms of
diffuse, intrinsic, or acquired pigmentation of the oral mucosa.

Author
(year)
Country Conclusion
Gazi
(1986)
North Africa
and Middle east
The gingiva may be tattooed when
females reach puberty
Prabhu
(1987}
Sudan A tattooed lower lip in a Sudanese
woman signifies that the woman is
married.
(Ndiaye
1975)
Dakar Expression of this belief is found in
Dakar where gingival tattooing is
incorporated in the training programme
of dental auxiliaries.
TATTOOING

OROFACIAL PIERCING
• Piercing of the tongue and perioral regions have become an
increasingly popular form of body art.
• Oral and perioral piercing has become so prevalent that it is
highly currently seen in most dental settings.

• The complication of piercing such as
functional issues involving the gag reflex
throat irritation
deglutition
For individuals with several oral piercings the effects on speech,
mastication, and deglutition are compounded.

Ring.S
(1985)
Venezuela The through — through piercing of tissue from the
skin surface to the oral cavity. This practiced by
females of the south American yonamami tribe in
Venezuela.
Fisher. N.M
(1984)
African Among some toposa females of southern sedan who
wear a long piece of tightly coiled wire in their lower
lip and among dogon females of mali who wear small
coil rings in their lower lip.
Cheong
(1984)
China Chinese temple custodians perform uvulectomy is
carried out mainly by Muslim
population
Prabu India
The ceremony of thapasyam (penance-white:
thaipusam men sanyasis) in a state of apparently self
induced trance pierce the skin of the body with a
variety of sharp weight bearing hopps and lances. It
is not uncommon for the cheeks

HEALTH BEHAVIOUR
• Health behaviour refers to those activities that people undertake to avoid
disease and to detect asymptomatic infections through appropriate
screening tests.
• People with good health habits (e.g., daily brushing of teeth,
non"smoking) are less likely to develop infection than persons with poor
health habits.
• Example for positive behavior: effective tooth cleaning practices.
• Example for negative behavior or risk behavior: Frequent consumption
of sugary foods.
WHO (1987), Tech. Rep. Ser. No. 755.

ILLNESS BEHAVIOUR
• Illness behaviour refers to how people react to symptoms.
Generally, people who detect symptoms will wait to see if the
symptoms persist or worsen. If the symptoms continue, the affected
person may ask a friend or acquaintance for advice, before seeking
medical help.

TREATMENT BEHAVIOUR
• Treatment behaviour refers to those activities used to cure diseases and
restore health. It is important for patients to take medication as directed,
return for tests for cure, and cooperate in efforts to identify untreated
cases.

• All forms of behaviour are responses to stimuli. For example, a child sees
a dog rushing towards him, and starts running away. The sight of a dog
rushing towards him is the stimulus and running away is the response.
To understand behaviour, we must find out the cause for stimulus. The
goal of psychology is to find relations that exist between stimuli and
responses.

LIFESTYLE
• "Lifestyle is a way of living based on identifiable patterns of
behavior, which are determined by the interplay between an
individual's personal characteristics, social interactions, and
socioeconomic and environmental living conditions".
- WHO Health Promotion Glossary, 1998

• Individual lifestyles, characterized by identifiable patterns of behavior, can
have a profound effect on an individual's health and on the health of
others. If health is to be improved by enabling individuals to change their
lifestyles, action must be directed not only at the individual but also at the
social and living conditions which interact to produce and maintain these
patterns of behavior.
• It is important to recognize, however, that there is no "optimal" lifestyle to
be prescribed for all people. Culture, income, family structure, age,
physical ability, home and work environment will make certain ways and
conditions of living more attractive, feasible and appropriate.

DENTAL PUBLIC HEALTH
• According to Healthy People 2020, one of the oral health high-priority
health issues is to increase the proportion of children, adolescents, and
adults who used the oral health care system in the past year.
• Traditionally, training and education on oral health and disease for the
primary care provider are limited.
• To achieve this goal, a change in culture will need to take place.
• Primary care providers, specifically nurse practitioners, nurse midwives,
physicians, and physician assistants, will need to be educated and trained
oeducated and trained
Healthy People 2020. Oral health. https://www.healthypeople.gov/2020/topics -objectives/topic/oral-
health/objectives. Accessed October 21, 2016

SOCIAL SCIENCE IN DENTAL PUBLIC
HEALTH
• Social scientists are called to aid in adapting new health programmes to
existing cultural patterns
• Adds a new dimension to the process of surveying and evaluation.
• In finding out why effort and effect do not match??
• How well the programme fits with the socio cultural group with which
we are working.
Bussenius H, Reznik D, Moore C. Building a culture of oral health care. The Journal for
Nurse Practitioners. 2017 Oct 1;13(9):623-7.

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