|Year : 2015 | Volume
| Issue : 1 | Page : 63-66
Determinants of preventive oral health behavior among senior dental students of Greater Noida, India
Ishan Prabhakar, K Jayaprakash, KK Shivalingesh, Bhuvandeep Gupta, Neha Gupta, Richa Anand
Department of Public Health Dentistry, I T S Dental College, Hospital and Research Centre, Greater Noida, Uttar Pradesh, India
|Date of Web Publication||19-Mar-2015|
Dr. Ishan Prabhakar
I T S Dental College, Hospital and Research Centre, Room No. 18, PG Boys Hostel, Plot No. 47, Knowledge Park-III, Greater Noida, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Introduction: Oral self-care practice is an effective preventive measure for maintaining good oral health. The health beliefs and attitudes of health professionals will not only affect their oral self-care habits, but will have a profound influence on their ability to motivate patients to learn and practice preventive oral health measures. Aim: The aim was to determine the preventive oral health behavior of senior dental students in relation to demography, knowledge of preventive care, and attitudes towards preventive dentistry. Materials and Methods: A cross-sectional study was conducted in a dental institution by distributing pretested questionnaire to 102 final year dental students. The overall response rate was 94%. Data were computed and tabulated. Statistical analysis was performed using Chi-square test using SPSS. Results: More than half of the respondents (56.25%) agreed that the frequency of sugar consumption has a greater role in producing caries. It was observed that 93.75% of students found preventive dentistry practice to be useful. Significant gender differences were observed in the use of recommended oral self-care, knowledge of using sealant as a caries preventive measure and fluoridation of drinking water as an effective way of preventing caries. Conclusion: There was an appreciably high level of good knowledge of preventive dental care among the dental students with a positive attitude towards preventive dentistry practice.
Keywords: Behavior, dental students, knowledge, oral health, practice, self-care
|How to cite this article:|
Prabhakar I, Jayaprakash K, Shivalingesh K K, Gupta B, Gupta N, Anand R. Determinants of preventive oral health behavior among senior dental students of Greater Noida, India. J Indian Assoc Public Health Dent 2015;13:63-6
| Introduction|| |
An integral part of one's general health is oral self-care practice, which is an effective preventive measure for maintaining good individual oral health. The health beliefs and attitudes of dental health professionals not only affect their oral self-care habits but have a potential to influence their ability to motivate patients to undertake preventive oral health measures, , which in turn impacts the public's understanding of preventive oral health measures. 
Kawamura et al.  have strongly advocated undergraduate dental education to include comprehensive programs in preventive care that empowers dentists to motivate patients for oral self-care and also ensures dental students to institute oral self-care regimens. It is expected that such educational effort should enable dental students to develop stable health behaviors, which are not influenced by individual characteristics. ,
Knowledge, attitude, competency and understanding are predisposition to act, as the relationship between knowledge, attitude and practices have been demonstrated previously.  In dental practice, the preventive approach has been cited as a predominant part of the service mix of dental practices and has also been the reason for caries decline in recent decades. ,
The continuous improvement of oral health can be possible by reorientation of services towards health promotion and prevention as cited by WHO in its list of priority.  Therefore, the dental professional's knowledge, attitude and practices need to be directed towards this reorientation. These in turn are influenced by demographic characteristics that form an important part of socialization processes. Gender differences in the frequency of tooth brushing were observed among dental professionals in China, Australia, Hong Kong, Finland, Korean, Japan and the US. ,, In overcoming such differences role of professional education, has been explained. ,
Despite professional education exposure, gender differences still existed among Jordan and Greek dental students. , The need to promote the practice of preventive dental care is critical because the available resources in most developing countries are inadequate to support the traditional curative care of dental diseases.  Therefore, this study aimed at determining the importance, the final year students placed on prevention, which would in turn indicate their readiness to adopt the same.
| Materials and Methods|| |
A cross-sectional study was conducted using a pretested questionnaire (Khami et al.'s)  among 102 final year dental students in a dental institution in Greater Noida. Ethical clearance was obtained from the ethical committee of the institution. All the students who were present in class were asked to fill the form after the objective and the voluntary nature of the study was explained. The filled questionnaires were retrieved after the class was over.
The questionnaire sought information on knowledge of preventive measures of respondents', their attitude toward preventive dentistry practice and their own oral health behavior.
Regarding knowledge of caries preventive measures, the respondents were asked to respond to nine statements regarding various aspects of caries diagnosis and prevention on a five point Likert scale ranging from "strongly agreed" to "agreed," "disagree," "strongly disagree" and "do not know." In Attitude to preventive dentistry practice, a seven-point semantic differential scale of eight qualities and their opposites was used to record the respondents' attitudes towards preventive dentistry. With respect to oral health behavior, the respondents were asked to report their brushing frequency, use of fluoridated toothpaste, flossing and consumption of sugary snacks between main meals so as to determine self-care levels.
The respondents were also asked to indicate the provider of their own dental check-ups (with the alternatives: A dentist, a classmate, myself, and no need) and the time of the last check-up. Attending a dental check-up within the last year and provision of their own dental check-ups by a classmate and/or a dentist was defined as preventive care use. The questionnaire also requested information on the respondents' cigarette smoking habits.
The overall response rate was 94%. Data was computed and tabulated. Statistical analysis was done using SPSS (IBM Corp. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY). To test for significant differences between subgroups, Chi-square test was used.
| Results|| |
The study comprised 33 males and 63 females. The age ranged from 21 years to 27 years with a mean age of 23.03 years.
Attitude toward preventive dentistry practice
It was found that 93.75% of the respondents found preventive dentistry practice useful, whereas 88.54% found it valuable and 83.33% found it essential for the community.
It was found that 70.8% of the subjects believed preventive dentistry practice to be beneficial, 71.8% of them thought it to be prestigious, 75% of them found it effective, 78.1% of them scientific and 67.7% found it simple for the dentist [Figure 1].
Knowledge of caries preventive measures
More than half of the respondents (56.3%) agreed that frequency of sugar consumption had a greater role in producing caries than the total amount of sugar and 48.9% strongly believed that sealant was effective in the prevention of pit and fissure caries in newly erupted molars.
It was found that 60% of the subjects agreed that the probability of losing a restored tooth was greater when compared to sound tooth and 56.3% of them were of the opinion that using an explorer damages the enamel rods and make the tooth susceptible to caries, while 62.5% agreed that fluoridation of drinking water in regions with low fluoride concentration was an effective, safe, and efficient way to prevent dental caries.
It was found that 48.9% of the respondents agreed that using fluoride toothpaste was more important than the brushing per se for preventing caries and 56.2% agreed that rinsing teeth with a lower amount of water after tooth-brushing increased the effect of fluoride within the toothpaste, 48.9% agreed that having dental problems could lead to general health problems [Figure 2].
Statistical significant difference was found among the gender regarding the knowledge about sealant (P = 0.039) and fluoridation of drinking water (P = 0.048) as an effective ways of preventing dental caries with females having more knowledge of caries preventive measures as P < 0.05 [Table 1].
Oral health behavior
It was found that 87.5% of the senior dental student's brushed at least twice a day, 53.1% of them always used fluoridated toothpaste, 57.3% of them flossed at least once a day, 62.5% of them took sugary snacks once a day, 80.2% of them used preventive care, 76% of them went to a dentist for dental check-up, 60.4% had undergone a dental check up in the last 6 months and 78% did not smoke [Figure 3].
Statistical significant difference was found among the gender regarding their oral health behavior as P < 0.05 with more females complying with the recommended oral health behavior (combination of brushing at least twice a day (P = 0.040), using fluoridated toothpaste always (P = 0.042), sugary snacks less than once a day (P = 0.023) [Table 1].
| Discussion|| |
In our study, we found that 49% of the subjects agreed that the use of fluoridated toothpaste was more important than tooth brushing technique, which was in accordance with the study done on Nigerian dental students. This could be attributed to the more emphasis on the use of traditional preventive measures in the current dental curriculum.  It is, therefore, necessary that that dental professionals are mobilized to update their knowledge and also to review the dental education curriculum with efforts targeted at enabling dental students to build their knowledge and attitude based on current updates.
It was observed that the frequency of brushing twice daily among dental students of present study was high (87.5%) as compared to their counterparts in Iran (57%), Mongolia (81%) and Nigeria (47.5%). ,, Whereas, only 53% of the dental students use fluoridated toothpaste when compared to Nigerian dental students (95%).  Just about 52% of the respondent practice recommended oral self-care habits, which was high when compared to Nigerian students (23%). While in the use of recommended oral self-care, significant gender differences existed, which is in accordance with the study done in Iranian and Jordan population, , but it was in contrast with the findings of study was done in Spain  and Mongolia. 
It is recommended that the current dental curriculum should emphasize more on preventive dentistry to increase the knowledge of the undergraduate dental students. Furthermore, in order to facilitate life-long learning, continuing dental education programs should be supported.
As the respondents were dental students, so some overrepresentation may have occurred as they tend to be knowledgeable and confident. Furthermore, when using a self-assessment tool, there might be chances of existence of social desirability bias. Further studies to examine the cultural differences among undergraduate dental students are needed because of the rich cultural heritage of India.
| Conclusion|| |
Although there was an appreciably high level of good knowledge of preventive dental care amongst the dental students with a positive attitude toward preventive dentistry practice, this did not seem to necessarily reflect on their oral health behavior.
| References|| |
Ghasemi H, Murtomaa H, Vehkalahti MM, Torabzadeh H. Determinants of oral health behaviour among Iranian dentists. Int Dent J 2007;57:237-42.
Freeman R. The psychology of dental patient care 5. The determinants of dental health attitudes and behaviours. Br Dent J 1999;187:15-8.
Cortes FJ, Nevot C, Ramon JM, Cuenca E. The evolution of dental health in dental students at the University of Barcelona. J Dent Educ 2002;66:1203-8.
Kawamura M, Yip HK, Hu DY, Komabayashi T. A cross-cultural comparison of dental health attitudes and behaviour among freshman dental students in Japan, Hong Kong and West China. Int Dent J 2001;51:159-63.
Tseveenjav B. Preventive Dentistry in Mongolia. Helsinki: Academic Dissertation Submitted to the University of Helsinki; 2004.
Polychronopoulou A, Kawamura M, Athanasouli T. Oral self-care behavior among dental school students in Greece. J Oral Sci 2002;44:73-8.
Brown G, Manogue M, Rohlin M. Assessing attitudes in dental education: Is it worthwhile? Br Dent J 2002;193:703-7.
Kawamura M, Iwamoto Y, Wright FA. A comparison of self-reported dental health attitudes and behavior between selected Japanese and Australian students. J Dent Educ 1997;61:354-60.
Kawamura M, Honkala E, Widström E, Komabayashi T. Cross-cultural differences of self-reported oral health behaviour in Japanese and Finnish dental students. Int Dent J 2000;50:46-50.
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.
Rong WS, Wang WJ, Yip HK. Attitudes of dental and medical students in their first and final years of undergraduate study to oral health behaviour. Eur J Dent Educ 2006;10:178-84.
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.
WHO. Diet, Nutrition and the Prevention of Chronic Diseases. Geneva: WHO Technical Report Series 916; 2003. p. 105-28.
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.
Folayan MO, Khami MR, Folaranmi N, Popoola BO, Sofola OO, Ligali TO, et al.
Determinants of preventive oral health behaviour among senior dental students in Nigeria. BMC Oral Health 2013;13:28.
Tseveenjav B, Vehkalahti M, Murtomaa H. Oral health and its determinants among Mongolian dentists. Acta Odontol Scand 2004;62:1-6.
[Figure 1], [Figure 2], [Figure 3]