|Year : 2015 | Volume
| Issue : 4 | Page : 459-464
Oral health attitude, knowledge, and behaviour of dental students of Jaipur, Rajasthan: A comparative study
Shruti Gupta1, Sameer Saxena2, Neha Sikka3, Gouri Bhatia4
1 Department of Oral and Maxillofacial Pathology, Luxmi Bai Institute of Dental Sciences and Hospital, Patiala, Punjab, India
2 Department of Periodontology, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
3 Department of Prosthodontics, Postgraduate Institute of Dental Sciences, Rohtak, Haryana, India
4 Department of Periodontology, Eklavya Dental College, Kotputli, Jaipur, Rajasthan, India
|Date of Web Publication||7-Dec-2015|
H. No. 166, Old PLA Sector, Hisar, Haryana - 125 001
Source of Support: None, Conflict of Interest: None
Introduction: Attitudes of dental students toward their own oral health affect their oral health habits and also have a possible influence on the improvement of the oral health of their patients and society. Aim: To evaluate self-reported oral health attitude, knowledge, and behavior among a group of dental students of one of the dental colleges of Rajasthan and to compare differences in oral health attitudes between years of study and gender. Materials and Methods: In a cross-sectional study, a self-administered structured questionnaire consisting of 19 questions on attitudes toward dental care, oral health practice and knowledge of oral health was distributed to 200 dental students of different years of course. Data collected was subjected to statistical analysis. Results: In the present study, 142 students were from preclinical years and 58 students were from clinical years. Most of the students brush their teeth once daily for 2 min following roll technique of brushing before breakfast using only toothpaste as a cleaning aid. All students from clinical years routinely examined their oral cavity while most of the students visited the dentist only when required. Majority of students considered oral health as important as general health and believed that oral health affects the general health. Students were also aware of the harmful effects of tobacco while only few of them were indulged in them. Conclusions: With increasing years of the study, some aspects of dental student's oral health attitude and behavior improved but this improvement was limited. Thus, the students should be motivated to become an example of oral health for the society, for which few steps to motivate them toward better oral health are proposed.
Keywords: Dental students, oral health, oral health behavior, oral hygiene practice
|How to cite this article:|
Gupta S, Saxena S, Sikka N, Bhatia G. Oral health attitude, knowledge, and behaviour of dental students of Jaipur, Rajasthan: A comparative study. J Indian Assoc Public Health Dent 2015;13:459-64
|How to cite this URL:|
Gupta S, Saxena S, Sikka N, Bhatia G. Oral health attitude, knowledge, and behaviour of dental students of Jaipur, Rajasthan: A comparative study. J Indian Assoc Public Health Dent [serial online] 2015 [cited 2020 Jul 16];13:459-64. Available from: http://www.jiaphd.org/text.asp?2015/13/4/459/171179
| Introduction|| |
Oral health is the mirror to general well-being of an individual as many systemic diseases show their early manifestations in the oral cavity. Thus, maintenance of oral hygiene forms a considerably significant part in everyday life and thereby making the knowledge of oral tissues important for any medical professional. In this modern era, oral health care rely on prevention of the disease rather providing expensive and invasive treatments. Raising public awareness about dental check-up may assist in early diagnosis; however, public awareness in this regard as compared with other medical fields is low to nil mostly in the developing countries, and this contributes to delay in the diagnosis.
By virtue of their profession, dentists play a pivotal role in oral health promotion and dissemination of preventive information among their patients, family, and society. It is, therefore, important that their own health knowledge is good and their oral health behavior conforms to the expectation of the population. Earlier studies have shown dentists to be lacking in self-motivation to practice basic preventive oral hygiene habits. Therefore, imparting knowledge about preventive and community dentistry has a strong positive influence on oral health-related attitudes and behavior of dental students which in turn helps their patients toward a better oral health thus fulfilling the general objective of providing dental education to the patients to adopt good oral hygiene practices.,, Studies have shown that attitude and behavior of dental students vary in accordance with the year of studies (preclinical and clinical years) as well as cultures and countries of origin.
Thus, the aim of this study was to evaluate self-reported oral health attitude, knowledge and behavior among a group of dental students and to compare differences in oral health attitudes between years of study and gender.
| Materials and Methods|| |
The present cross-sectional study was conducted in the month of April–June 2014 in dental institute located in Jaipur district of Rajasthan. Ethical clearance was granted by Ethical Committee of the Institute.
The study comprised 200 dental students of various professional years. Subjects in the study were divided into two groups based on their professional years (1) preclinical students (2) clinical students. Categorization according to their gender was also done. Informed consent was obtained from each student before the questionnaire was distributed and the students who were not willing to be a part of this study were excluded.
A self-administered structured questionnaire consisting of 19 questions was pretested through a pilot survey done on five dental faculty members to validate the questions. This questionnaire contained information on their attitudes toward dental care, oral health practice, and knowledge of oral health and was personally distributed.
Data collected was subjected to statistical analysis. Chi-square test was applied to compare the data collected between students from preclinical and clinical years and also between males and females. A P < 0.05 was considered to be statistically significant.
| Results|| |
The present study comprised 200 students from different professional years. Of these 142 were from preclinical years and 58 were from clinical years. Of 200 subjects, 118 were males and 82 were females.
Most of the students brush their teeth once daily and the difference between the frequency of brushing in students from preclinical and clinical years was not significant. The difference between the brushing frequency in males (35.6%) and females (75.6%) was significant. Maximum number of students brushed their teeth before breakfast, and there was no significant difference between brushing time between students from preclinical and clinical years whereas a significant difference was observed between males and females with regard to brushing time. With regard to duration of brushing a significant difference was observed in preclinical and clinical students and males and females. Majority of subjects in the present study brush their teeth for approximately 2 min [Table 1].
|Table 1: Responses to various questions in relation to various oral hygiene practices among the study population according to gender and course of study|
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Most of the students brushed their teeth using roll technique of brushing and a significant difference was observed in males and females and preclinical and clinical students. Majority of students use toothpaste as an aid for cleaning teeth and a significant difference was observed in males and females with regard to aid used for cleaning teeth [Table 1].
A significant difference was seen in males and females with respect to the duration of toothbrush replacement. Most of the students use tongue cleaner for cleaning tongue, and no significant difference was seen between males and females and students from preclinical and clinical years with regard to tongue cleaning aid. Use of back side of brush was other popular method of tongue cleaning among the students [Table 1].
All the clinical students routinely examine their oral cavity as compared to 54.9% of preclinical students and the difference was significant. With respect to a previous visit to the dentist no significant difference was observed between males and females and between preclinical and clinical year students. As compared to 67.8% of males who visit the dentist only when some problem arises, 42.7% of females visited the dentist every 6 months and this difference between males and females with regard to frequency to visit dentist was significant [Table 2].
|Table 2: Responses to various questions related to attitude of the study population towards oral health according to gender and course of study|
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A significant difference was found between males and females with respect to adverse oral habit (smoking, tobacco chewing) as 87.3% of males and 100% of females did not have any adverse oral habit (smoking, tobacco chewing). A significant difference was observed between males and females and clinical and preclinical students with respect to problem of bleeding gums. A significant difference was found between students from preclinical and clinical years with respect to importance of tongue cleaning as 85.9% of students from preclinical years and 96.6% of students from clinical years thought that tongue cleaning was important. No significant difference was observed between males and females with respect to importance of tongue cleaning as 91.5% of females and 87.3% of males thought that tongue cleaning was important [Table 2].
As compared to 95.8% of males 85.4% of females considered oral health to be as important as general health and this difference between males and females was significant. A significant difference was observed between males and females with respect to the effect of oral health on general health as 100% of males and 95.1% of females believed that oral health have an effect on general health. There was no significant difference between students from preclinical and clinical years as 97.9% and 98.3% of students from preclinical and clinical years, respectively, believe that oral health effects general health. Furthermore, no statistically significant difference was observed between male and female students and student of clinical and preclinical years with regard to their concern about esthetics and appearance. Majority of students were aware of harmful effects of tobacco and no significant difference was seen between male and female students and students of clinical and preclinical years. Maximum numbers of students did not know about interdental cleaning aid (other than floss) and a significant difference was observed between students from clinical and preclinical years with regard to knowledge about interdental cleaning aid (other than floss). Majority of students believed that bleeding from gums means inflamed gingiva and there was a statistical significant difference between students from preclinical and clinical years [Table 3].
|Table 3: Responses to various questions to assess the knowledge of the study population according to gender and course of study|
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| Discussion|| |
Baseline information on oral health, associated with adequate preventive procedures, is fundamental to promote self-preventive behavior. An important task of oral health professionals is to instill in their patients the correct oral habits to prevent oral diseases. For educating and motivating general public, it is of great importance that the future dental surgeons should themselves be particularly conscious, educated, and motivated of the pathological effects of poor oral hygiene.
In the present study, 19 questions were asked to assess the knowledge, attitude and oral health practices followed by the subjects. There is enough evidence to consider twice a day as the recommended frequency of tooth-brushing to maximize the effect of using fluoridated toothpaste. In the present study, the reported frequency of brushing at least once daily was similar to reported by Iranian, Mongolian  dental students. Although, there was no significant difference in the tooth brushing frequency in the preclinical and the clinical students, the number of the students who brush their teeth twice daily was slightly more in preclinical years as compared to clinical years. Thus, indicating the fact that even with the increased level of knowledge there was no improvement in the oral health attitude and behavior of the students. This was in contrast to the findings of a study by Barrieshi-Nusair et al. which showed that the percentage of students claiming to brush their teeth twice daily or more often was 4 times higher amongst clinical students than amongst preclinical students.
Majority of students in our study brush their teeth for 2 min and that too before breakfast using only toothpaste as a cleaning aid. The percentage of clinical students brushing after having meals was nil that shows that even though they have knowledge about the preventive measures, but all the knowledge has not changed into a positive preventive behavior.
Brushing methods including Bass, Stillman's, Fones, Charter's, horizontal, vertical, scrub, etc., have been taught since decades, with Bass and Roll method most commonly recommended. In our study, majority of students brush their teeth following roll method followed by horizontal brushing of teeth. In the present study, majority of students replaces their brush after every 3 months. In our study, majority of students both from clinical and preclinical years thought that tongue cleaning has an important role in developing better oral health.
In our study, both the male and female students were observed to provide an insight of oral self-care habits in the two genders. Few studies stated that females presented better knowledge, attitude and behavior scores compared to the male students.,, In our study, as compared to males more of females routinely examine oral cavity, visit the dentist more frequently for a routine check-up and do not have any adverse oral habit and less number of female students complaints bleeding from gums as compared to male students.
All the students from clinical years routinely examined their oral cavity in comparison to 54.9% of preclinical students. This difference may be attributed to the preventive knowledge imparted to the students of clinical years. Approximately, 60% of students have visited dentist previously. This proportion was much higher in our study as compared to that in the study by Neeraja et al. where only 32% of the students have visited the dentist before. Majority of students in our study visit dentist only when problem arises.
In our study, majority of students did not have any adverse oral habits (smoking, tobacco chewing) while 12.1% of clinical students had adverse oral habits as compared to 5.6% among the preclinical students. More adverse oral habits and more negligence in following preventive measures may be because of increased demand for studies, or peer pressure as the students just entering the colleges are not influenced by tobacco use. Sofola and Jeboda  in their study reported that transition from preclinical to clinical years may lead to stress in many students and Kumar et al. in their study stated that increased academic stress also allures many students to take up smoking as a means of coping with the burden.
In the present study, majority of students both from clinical and preclinical years considered oral health as important as general health and that oral health affects the general health. This is in agreement with findings of Usman et al. who found that 96% of dental students consider oral health as important as maintaining good general health. Majority of students are concerned about the appearance and esthetics of their teeth. Furthermore, maximum numbers of students were aware of the adverse effects of tobacco use. However, in the present study, majority of students from clinical years are not aware of the interdental cleaning aids (other than floss) thus emphasizing the fact that more knowledge should be imparted to them.
The main limitation of the present study is that the study pertained to a single dental college in India. Although proper care was taken that students were not influenced by responses from their friends, there could have been biased responses in few cases. This article also proposes few steps to motivate the students toward better oral health.
Few recommendations for motivating dental students are:
- Emphasis must be laid on preventive health education right from their preclinical courses. More stress should be laid on clinical considerations while imparting them knowledge about normal structure of tissues during their preclinical courses
- Regular quizzes on oral health should be conducted in colleges to test their knowledge and also for imparting them knowledge. Regular competition between students regarding better oral health should be conducted in colleges, and the one with better oral hygiene should be awarded
- Dental students, on a turn basis, should serve as a model for educating the general public, when they are posted for camps. This could motivate them to change their attitude.
| Conclusion|| |
In this study, it was observed that all the oral health knowledge had not changed to positive preventive oral health behavior among the students. Thus, the attitude toward proper practicing of oral health measures and regular visit to dentist needs to be improved. In conclusion, there is a lack of motivation among dental students to practice basic preventive oral health habit. Thus, students should be provided with better comprehensive dental education with early exposure to dental health and prevention.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kumar S, Motwani K, Dak N, Balasubramanyam G, Duraiswamy P, Kulkarni S. Dental health behaviour in relation to caries status among medical and dental undergraduate students of Udaipur district, India. Int J Dent Hyg 2010;8:86-94.
Davidovic B, Jankovic S, Ivanovic D, Grujicic I. Oral health assessment among dental students. Serbian Dent J 2012;59:141-4.
Emmanuel A, Chang'endo E. Oral health related behaviour, knowledge, attitudes and beliefs among secondary school students in Iringa municipality. Dar Es Salaam Med Stud J 2010;17:24-30.
Singh MS, Tuli AK. A comparative evaluation of oral hygiene practices, oral health status, and behavior between graduate and post-graduate dentists of North India: An epidemiological survey. J Int Soc Prev Community Dent 2013;3:19-24.
Usman S, Bhat SS, Sargod SS. Oral health knowledge and behavior of clinical medical, dental and paramedical students in Mangalore. J Oral Health Community Dent 2007;1:46-8.
Al-Kawas S, Fakhruddin KS, Ur Rehman B. A comparative study of oral health attitudes and behavior between dental and medical students; the impact of dental education in United Arab Emirates. J Int Dent Med Res 2010;3:6-10.
Kawamura M, Spadafora A, Kim KJ, Komabayashi T. Comparison of United States and Korean dental hygiene students using the Hiroshima university-dental behavioural inventory(HU-DBI). Int Dent J 2002;52:156-62.
Maatouk F, Maatouk W, Ghedira H, Ben Mimoun S. Effect of 5 years of dental studies on the oral health of Tunisian dental students. East Mediterr Health J 2006;12:625-31.
Dumitrescu AL, Kawamura M, Sasahara H. An assessment of oral self-care among Romanian dental students using the Hiroshima University – Dental Behavioural Inventory. Oral Health Prev Dent 2007;5:95-100.
Dagli RJ, Tadakamadla S, Dhanni C, Duraiswamy P, Kulkarni S. Self reported dental health attitude and behavior of dental students in India. J Oral Sci 2008;50:267-72.
Chestnutt IG, Schäfer F, Jacobson AP, Stephen KW. The influence of toothbrushing frequency and post-brushing rinsing on caries experience in a caries clinical trial. Community Dent Oral Epidemiol 1998;26:406-11.
Khami MR, Virtanen JI, Jafarian M, Murtomaa H. Oral health behaviour and its determinants amongst Iranian dental students. Eur J Dent Educ 2007;11:42-7.
Tseveenjav B, Vehkalahti M, Murtomaa H. Preventive practice of Mongolian dental students. Eur J Dent Educ 2002;6:74-8.
Barrieshi-Nusair K, Alomari Q, Said K. Dental health attitudes and behaviour among dental students in Jordan. Community Dent Health 2006;23:147-51.
Asadoorian J. Position paper on tooth brushing. Can J Dent Hyg 2006;40:232-48.
Sharda AJ, Shetty S. A comparative study of oral health knowledge, attitude and behaviour of first and final year dental students of Udaipur city, Rajasthan, India. Int J Dent Hyg 2008;6:347-53.
Polychronopoulou A, Kawamura M, Athanasouli T. Oral self-care behavior among dental school students in Greece. J Oral Sci 2002;44:73-8.
Al-Omari QD, Hamasha AA. Gender-specific oral health attitudes and behavior among dental students in Jordan. J Contemp Dent Pract 2005;6:107-14.
Neeraja R, Kayalvizhi G, Sangeetha P. Oral health attitudes and behavior among a group of dental students in Bangalore, India. Eur J Dent 2011;5:163-7.
Sofola OO, Jeboda SO. Perceived sources of stress in Nigerian dental students. Eur J Dent Educ 2006;10:20-3.
[Table 1], [Table 2], [Table 3]