|Year : 2016 | Volume
| Issue : 1 | Page : 75-79
Knowledge, attitude, and practices of oral hygiene among college students in Bengaluru city
V Gopikrishna, Nithin N Bhaskar, Smitha B Kulkarni, Jeswin Jacob, KG Sourabha
Department of Public Health Dentistry, Dayananda Sagar College of Dental Sciences, Bengaluru, Karnataka, India
|Date of Web Publication||15-Mar-2016|
Nithin N Bhaskar
Department of Public Health Dentistry, Dayananda Sagar College of Dental Sciences, Shavige Malleshwara Hills, Kumarswamy Layout, Bengaluru - 560 078, Karnataka
Source of Support: None, Conflict of Interest: None
Introduction: Poor oral health can have a profound effect on the quality of life. The experience of pain, endurance of dental abscesses, problems with eating and chewing, embarrassment about the shape of teeth or about missing, discolored or damaged teeth can adversely affect people's daily lives and well-being. Aim: To assess the knowledge, attitude, and practices of oral hygiene among college students in Bengaluru city. Materials and Methods: A descriptive cross-sectional survey was conducted using a self-administered 21-item structured questionnaire that assessed oral health and hygiene knowledge, attitudes, and practices of 499 students from various professions. 202 engineering students, 99 MBA/BBM students, 99 nursing students, and 99 students from B.Com. The study was conducted during June and July 2013. The results were analyzed by descriptive statistics and Chi-square test using SPSS version 14. All tests were set at a 0.05 significance level. Results: The toothbrush with toothpaste is the most common oral hygiene aid used for cleaning teeth, which was adopted by 304 (60.9%) students. More than half 287 (57.5) of the students felt that dental caries affected their esthetics. 358 (71.7) students felt that the health of the mouth and dentition had an impact on the health of the body. Conclusion: The toothbrush with toothpaste is the most common oral hygiene aid used for cleaning teeth; it was observed that a greater number of students brushed their teeth in the morning. Dental pain was the main reason to visit a dentist.
Keywords: Attitude, knowledge, oral hygiene, students
|How to cite this article:|
Gopikrishna V, Bhaskar NN, Kulkarni SB, Jacob J, Sourabha K G. Knowledge, attitude, and practices of oral hygiene among college students in Bengaluru city. J Indian Assoc Public Health Dent 2016;14:75-9
|How to cite this URL:|
Gopikrishna V, Bhaskar NN, Kulkarni SB, Jacob J, Sourabha K G. Knowledge, attitude, and practices of oral hygiene among college students in Bengaluru city. J Indian Assoc Public Health Dent [serial online] 2016 [cited 2019 Apr 21];14:75-9. Available from: http://www.jiaphd.org/text.asp?2016/14/1/75/178726
| Introduction|| |
Hygiene is a science concerned with the investigations of environmental factors that affect human health. It studies how the human body responds to them. Dental hygiene is the science and practice of the recognition, treatment, and prevention of oral diseases. Good oral hygiene is the foundation for a healthy mouth and prevents 80% of all dental problems.
Obeying the rules of proper oral hygiene is of primary importance in the prevention of dental caries and periodontal diseases. Unfortunately, oral hygiene practice is very low in our society. A survey in India suggested that there was an insufficient degree of education about oral health and that many children in the country did not even use a toothbrush, instead relied on traditional methods to keep their teeth clean.
In a country like India, the awareness about the dental disease and their impact on general health and the need to safeguard oral health and hygiene should be given utmost importance because of the increased use of tobacco, improper eating habits and inefficient maintenance of oral hygiene.
Professional students come across a great number of people of different age groups from different backgrounds in their day to day course of study hence with proper knowledge and oral health behavior they can act as role models for their family and community at large.
Thus, the aim of this study was to assess the knowledge, attitude and practices of oral hygiene among college students in Bengaluru city.
| Materials and Methods|| |
A descriptive cross-sectional survey was conducted during June and July 2013. The sampling frame consisted of 12,000 students of a college campus in Bengaluru city. Cluster random sampling technique was used to obtain the final sample size. The inclusion criteria for selection of subjects were from the current engineering, MBA/BBM, B. Com and nursing students. A pilot study was conducted on 50 students to assess the feasibility and to estimate the sample size. Using the formula for sample size determination as S = 4pq/n2. The final sample size was 499.
The study proposal was approved by the Institutional Review Board. Standard procedures of informed consent were used inclusive of anonymity and confidentiality. Questionnaires were given to the students during their class hours and then collected within 15 min. The questionnaire was a closed-ended type consisting of 21 questions, of which 11 were knowledge based, 5 were attitude based, and 5 were practice-based questions. The questionnaire contained multiple responses. The answers to each question were numerically coded, and the data were entered in the Statistical Package for Social Sciences (SPSS) software 14.0 version (Chicago, SPSS Inc.). The results were analyzed by descriptive statistics including frequencies, percentages, and Chi-square test. All tests were set at a 0.05 significance level.
| Results|| |
In this study, 202 were engineering students, 99 MBA/BBM students, 99 nursing students and 99 students from B. Com. Preventive oral hygiene behaviors were judged by the use and frequency of oral hygiene aids such as tooth brushing, flossing and use of mouthwash and toothpicks. The toothbrush with toothpaste is the most common oral hygiene aid used for cleaning teeth, which was adopted by 304 (60.9%) students; of which 59.4% were engineering students, 53.5% MBA/BBM students, 54.5% nursing/pharmacy students and 77.8% were B. Com students. Other students used either dental floss (2.6%) or mouthwashes (4.6%) along with toothbrush and toothpaste. It was observed that 159 (31.8%) students were using all these methods. There was a significant difference in the oral hygiene methods between the groups (P = 0.003) [Table 1].
[Table 2] presents the answers to the question about the frequency of toothbrushing. Statistical differences among the students of engineering, MBA/BBM, nursing/pharmacy and B. Com was found. It was observed that 44.1%, 31.2%, 42.5%, and 46% students, respectively brush their teeth in the morning; 49.5% of students respectively brush their teeth both in the morning and before bed.
[Table 3] presents the answers concerning the frequency of changing one's toothbrush. Statistical differences among the students of engineering, MBA/BBM, nursing/pharmacy and B. Com in the frequencies of changing one's toothbrush every month, every 3 months, <6 months and every 6 months: 44.1%, 55.6%, 38.4%, and 49.5% students respectively said that a toothbrush should be changed every month; 36.6%, 24.2%, 38.4%, and 38.4% students respectively said it should be changed every 3 months.
It was observed that 73.3% engineering, 69.7% MBA/BBM, 74.8% nursing/pharmacy and 67.7% B. Com students felt that the health of the mouth and dentition had an impact on the health of the body (P = 0.03) [Table 4].
|Table 4: Response of study groups to the question “does health of the mouth and dentition impact the health of the body”?|
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About 27.8% engineering, 21.2% MBA/BBM, 29.3% nursing/pharmacy and 32.3% B. Com students felt that gingivitis can be prevented by tooth brushing and flossing. Many of them felt that gingivitis can be prevented by taking in soft foods or Vitamin C. 228 (45.6%) students answered that they did not know how to prevent gingivitis. There was a significant difference in their knowledge (P = 0.03) [Table 5].
|Table 5: Response of study groups to the question “methods to prevent gum diseases”|
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The visits to the dentist did not show any interesting trends. A large number of students, 140 (28.05%) had never been to a dentist, and 191 (38.7%) only went to a dentist when in pain. Only 77 (15.43%) students observed the recommended six-twelve monthly dental visits. Again, distribution of this indicator of oral hygiene attitude within the two schools was equal as 39.1% of engineering, 42.4% MBA/BBM, 34.3% nursing/pharmacy and 36.4% B. Com students visited the dentists only when driven by pain. Similarly, 27.7% of engineering, 16.2% MBA/BBM, 37% nursing/pharmacy and 31% B. Com students had never been to the dentist. This similarity in oral health attitude was not significant (P = 0.07) [Table 6].
Statistically significant differences were observed among the students of engineering, MBA/BBM, nursing/pharmacy and B. Com when they were asked if they could decide on the treatment that they require (P = 0.001) [Table 7] and when asked if it was necessary for patients to decide their treatment needs (P = 0.01) [Table 8].
|Table 7: Response of study groups to the question “do you think you can decide the treatment you need”?|
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|Table 8: Response of study groups to the question “is it necessary for patients to decide their dental treatment needs”?|
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This study showed that 87.1% engineering, 81.8% MBA/BBM, 84.8% nursing/pharmacy and 75.6% B. Com students felt that brushing the teeth will prevent dental decay. The others answered that there would not be any influence (P = 0.16) [Table 9].
|Table 9: Response of study groups to the question “does brushing teeth prevent dental decay”?|
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| Discussion|| |
Knowledge and awareness studies on oral hygiene among students have been primarily conducted among dental college students with health sciences backgrounds. Keeping in mind the expected role to be played by the student community on the whole in effecting a behavioral change in the society, a need is felt for assessing the oral hygiene knowledge, attitude and behavior of professional students with different educational backgrounds.
In the study  which compared the oral hygiene practices in dental and pharmacy students, it was found that toothbrush with toothpaste was the most common oral hygiene tool used for cleaning teeth by 423 (92%) students while only 7 (1.6%) used traditional methods of miswak, dandasa, rock salt, etc., only. Toothbrush and toothpaste were the most commonly used oral hygiene aids, as that reported elsewhere ,,, However, the use of dental floss was still not very popular among the secondary school students as evident in this study (11.5%). This was in contrast with the finding in San Francisco where 75% of the 12–14 years old students there used dental floss at least once per day and in Iraq where over half of the students used dental floss once or more a week., This study revealed all of the respondents were using a toothbrush and toothpaste to clean their teeth. This result reflects on the homogeneity of the study group with the current lifestyle (hostel, campus, and access to dental care) influences overpowering the varying cultural backgrounds from which the students come. The use of other recommended oral hygiene methods such as dental floss and mouthwash was found to be rare; this also could be attributed to the lack of oral health education and/or the cost of such aids.
In a study, 95.7% of the students brushed their teeth at least twice a day, which was more than twice the figure (44.4%) reported by WHO. There were 95.7% of the students who brushed their teeth at least twice or more per day, which was higher than Finnish adolescents  girls were found to brush their teeth more frequently, and spent longer time during toothbrushing as compared to boys, supported by other studies , 7, ,,, A study, stated that 282 (61.3%) students brushed their teeth twice or more times a day, 163 (35.4%) brushed at least once a day while only 11 (2.4%) claimed to not brush their teeth on a daily basis. In our study, most of the students had satisfactory knowledge on tooth brushing practices. It was encouraging to note that all participants reported to brush their teeth at least once a day although they did not know how to brush systematically.
In a study, 71.8% students of dentistry (71.9% 2nd-year and 75.95% 5th-year students), 61.49% students of medicine (68.8% 2nd-year and 47.1% 5th-year students) and 54.4% of students of polytechnics (49.5% 2nd-year and 61.3% 5th-year students) change their toothbrush every 3 months. Statistically significant differences were found concerning the answer of changing one's toothbrush every month among the students of dentistry, medicine, and polytechnics: 10.26%, 11.49% and 18.68% students, respectively (P = 0.041). In a study, a comparison of the two groups for the frequency of renewal of toothbrush showed a statistically significant result with 32.5% respondents among the engineering group changing their brush every month as compared to 13.3% among the medical group. Fraying was the most common reason cited for the renewal of toothbrush in both the groups. These results were in accordance with the results of our study.
In a study, most of the medical (80%), dental (96%) and paramedical (85%) students considers oral health as important as maintaining a good general health (P < 0.001). This result was in accordance with the results of our study as students felt that the health of the mouth and dentition had an impact on the health of the body. The study also showed that only a small proportion of medical (20%), paramedical (12%), and dental (34%) thought that visiting dentist was the right way to prevent dental problems while a greater majority held the belief that tooth brushing with paste was the right option (P < 0.001).
A study, showed that pain is the main driving factor for patients to visit the dentist. Most of the study subjects in this study reported irregular dental attendance, and this finding is consistent with the findings of other studies. In this study, there was no difference in the frequency of dental visits, and the most common reason for a dental visit was cited to be pain. This may be due to the lack of oral health knowledge among these students that caused the frequency of visit low. Low dental visits may probably due to low awareness of the importance of oral health thus affects the student's health seeking behavior.
| Conclusion|| |
The toothbrush with toothpaste is the most common oral hygiene aid used for cleaning teeth; it was observed that a greater number of students brushed their teeth in the morning. Dental pain was the main reason to visit a dentist. The majority of the students felt that patients should be given autonomy to decide their dental treatment. Effective oral health education and promotion programs are needed to improve oral health knowledge, attitude, and practices of the students.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Krawczyk D, Pels E, Prucia G, Kosek K, Hoehne D. Students' knowledge of oral hygiene vs its use in practice. Adv Med Sci 2006;51 Suppl 1:122-5.
Bakdash B. Current patterns of oral hygiene product use and practices. Periodontol 2000. 1995;8:11-4.
Mumtaz R, Attaullah, Khan AA. A comparative evaluation of oral health knowledge, attitudes and practices of dental and pharmacy students of Riphah International University. Pak Oral Dent J 2009;29:131-36.
Russell BA, Horowitz AM, Frazier PJ. School-based preventive regimens and oral health knowledge and practices of sixth graders. J Public Health Dent 1989;49:192-200.
Lin HC, Wong MC, Wang ZJ, Lo EC. Oral health knowledge, attitudes, and practices of Chinese adults. J Dent Res 2001;80:1466-70.
Al-Sadhan SA. Oral health practices and dietary habits of intermediate school children in Riyadh, Saudi Arabia. Saudi Dent J 2003;15:81-7.
Al-Ansari JM, Al-Jairan LY, Gillespie GM. Dietary habits of the primary to secondary school population and implications for oral health. J Allied Health 2006;35:75-80.
Walsh MM. Effects of school-based dental health education on knowledge, attitudes and behavior of adolescents in San Francisco. Community Dent Oral Epidemiol 1985;13:143-7.
Cheah WL, Tay PS, Chai SC, Bong CS, Luqmanul HB, Zhuleikha BJ. Oral health knowledge, attitude and practice among secondary school students in Kuching, Sarawak. Arch Orofac Sci 2010;5:9-16.
Kuusela S, Honkala E, Rimpelä A, Karvonen S, Rimpelä M. Trends in toothbrushing frequency among Finnish adolescents between 1977 and 1995. Community Dent Health 1997;14:84-8.
Rise J, Haugejorden O, Wold B, Aarö LE. Distribution of dental health behaviors in Nordic schoolchildren. Community Dent Oral Epidemiol 1991;19:9-13.
Honkala S, Honkala E, Rimpelä A, Vikat A. Oral hygiene instructions and dietary sugar advice received by adolescents in 1989 and 1997. Community Dent Oral Epidemiol 2002;30:124-32.
Doshi D, Baldava P, Anup N, Sequeira PS. A comparative evaluation of self-reported oral hygiene practices among medical and engineering university students with access to health-promotive dental care. J Contemp Dent Pract 2007;8:68-75.
Usman S, Bhat SS, Sargod SS. Oral health knowledge and behavior of clinical medical, dental and paramedical students in Mangalore. JOHCD 2007;1:46-8.
Al-Omiri MK, Al-Wahadni AM, Saeed KN. Oral health attitudes, knowledge, and behavior among school children in North Jordan. J Dent Educ 2006;70:179-87.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]