Introduction
Health forms an important perspective of life. Good health is the key to human happiness and wellness that definitely contribute to the wealth and economic development of people as well as whole nation. Oral Health plays a significant role in general health.1, 2 According to the oral health organization,” Oral health means being free of chronic mouth and facial pain, oral & throat cancer, oral sores, birth defects such as cleft lip and cleft palate, periodontal disease and tooth decay and tooth loss and other diseases and disorders that affect the mouth and oral cavity.3
Harmony of oral health and overall general health always goes hand in hand. Hence, creating awareness of oral hygiene among the public becomes of utmost importance. Dental plaque is the chief causative agent for dental caries and periodontal diseases. Plaque control plays a key role in oral hygiene management.4 Medical students and allied health students should have adequate knowledge of oral health and maintenance also as they work together to deliver primary health care as well as treat the most vulnerable patients. Hence, their role to teach the community about general health, as well as oral health, becomes a prime necessity in developing countries like India.
Various studies have been done to associate the oral hygiene status of health care professional college students.5, 6, 7, 8, 9 Very few studies have been done among paramedical students regarding oral health which provoked us to do the current study.7, 10 There is a lacuna in the scientific literature about oral hygiene awareness among these students.
The aim of the study is to access the awareness of oral health among allied health students. The objective focuses to gather information on the knowledge of the students about tooth brushing, their frequency, gingival health, and their interest in dental routine checkups. The information gathered can be assessed to know the basic understanding of oral hygiene and its related diseases.
Materials and Methods
A cross-sectional study was conducted in Dr. MGR Educational & Research Institute, Chennai on a group of students studying allied health sciences for a period of one month (14 August 2021-10 September 2021). Informed consent was got from the students prior to conducting the survey. Institutional ethical clearance (No.251/2021 IEC/ACSMCH Dt.10.08.2021) was obtained.
Inclusion criteria
Healthy Students studying the first year in allied health sciences, having a mean age of 20 years.
Exclusion criteria
Students aged more than 20 years, having systemic diseases and also those who provided incomplete data in the questionnaire survey were exempted from the survey.
Sample size
The sample size was calculated using the below formula.
Sample size = Reliability coefficient ^2 × prevalence or variance / precision ^2.
The power of the study was 80% and the prevalence was around 50%.11
Questionnaire design
A self-administered, structured questionnaire was designed using google forms and posted to 1010 students. The questionnaire consisted of 19 questions. The questions focused on demographic data, oral hygiene measures, brushing habits, and the health of gingiva including dental visits.
Results
The total number of students who participated was 1003, of which 659 (65.7%) were females and 344 (34.3%) were males whose age group ranged between 17-19 years. The descriptive statistics featuring various factors influencing oral hygiene are shown in Table 1.
Table 1
Distribution of responses
Table 2
Gender vs visit a dentist
Table 3
Gender vs brushing frequency- chi-square test
Table 4
Gender vs bad breath - chi-square test
Among the total respondents, about 989 (98.6%) students were using toothbrushes and toothpaste for brushing. Participants when questioned about the duration of brushing, more responses were for those brushing for two minutes- 412 (41.08%), while other responses were 399 (39.78%) for more than two minutes, 165 (16.45%) for one minute and 27(2.69%) brushed less than one minute. The percentage of students who change their brush every three months, six months, and one year were 787 (78.6%), 190 (18.94%), and 26 (2.59%) respectively. The number of students who used toothbrushes with medium bristles was high around 507(50.5%) as compared to the usage of toothbrushes with soft bristles was 325 (32.40%) & with Hard bristles was 38 (3.79%). The students reported that the purpose of cleaning teeth was to prevent dental diseases around 727 (72.48%) as compared to other causes. The number of respondents who believed bleeding gums can be prevented by using mouth wash was 361 (35.99%), using toothbrushes was 121 (12.06%), eating soft foods was 80 (7.89%), and the remaining students 183(18.25%) were totally unaware about the condition. Most of the student population around 894 (89.13%) have not used dental auxiliaries like dental floss. Routine dental visits were performed only for 386(38.4%) of which females (54.32%) visited more frequently as compared to males (37.20%) (Table 2). The respondents Who have not noticed bad breadth was 740 (73.78%) and there was minimal usage of mouthwash with students showing 33.7% (338).
Relationship between gender and various factors affecting oral health:
Out of the total participants, 559(55.9%) brushed their teeth twice daily. Among them, 396(39.6%) were females and only 163 (16.3%) were males. The results were statistically significant with P-Value = 0.0005 as shown in Table 3.
Among the respondents, 740 (74.0%) never noticed bad breadth, and among those who observed bad breadth were 263 (26.3%). The gender distribution suggests more females around 507 (50.7%) have not experienced bad breadth as compared to males around 233 (23.3%). The results were statistically significant with p-value = 0.00025 as shown in Table 4.
Discussion
Good oral hygiene measures play a key role in oral health.3 Oral health is an important component of general health.10 poor oral hygiene measures will drastically affect the general well-being of the individual, wherein some medical diseases have a negative effect on the oral cavity and related structures.12 In developing nations, there is a rise in oral diseases and adequate focus has to be given to oral health.12, 11, 13
In this study, most of the participants (98.6%) used toothbrush and toothpaste for cleaning their tooth. Umanah AU et al, Olusile AO et al3, 14 had observed similar findings; although, A study in Nepal by Yadav had fewer respondents for toothbrush usage (28.9%) while the remaining were using tooth powder was 34.8%.13 Our clinical findings suggest that the students are more aware of currently available tools for brushing through education & media.
In the current study, participants were not using mouth wash about 665 (66.3%) and dental floss about 894 (89.1%). These results are in accordance with earlier studies by Neamatollahi H et al, Stenberg P et al & Zhao Q et al.7, 8, 15 Regarding the frequency of tooth brushing, the present study showed more respondents brushed twice or more per day (80%) whose results are similar to Neamatollahi H et al, Davies RM et al, Khami MR et al.7, 8, 9
Toothbrushes worn out upon brushing have to be changed at regular intervals. In the earlier study done by Rimondini L et al, 81.6% of respondents changed their toothbrushes every three months, which surprisingly coincides with our study showing 78.46%.16 However, the observations are contradicted by studies of Tan E & Sforza NM et al.17, 18
Halitosis or Bad breadth is one of the common dental problems frequently encountered. Although Various reasons can be suggested, the most common was plaque accumulation and improper brushing.7 In the present study, most of the respondents have never complained of bad breadth (73.78%). Gender inclination highly corresponds with terrible breadth, with females experiencing good breadth for most of the day (50.7%) compared to males (23.3%), and the findings are statistically significant. More comparable findings of bad breadth were observed with Orenuga OO et al, Ogunro PS et al. & Iqbal MZ et al.19, 20, 21 These results suggest Females have increased awareness and provide better care for oral health. In the current study, knowledge of gingival health was assessed with the evaluation of bleeding gums. Most respondents had found their gingiva as healthy and never noticed bleeding gums (67.8%) which had no correlation with gender. Yazdani et al findings were coinciding with this study.22
Our study suggests that dental behavior was influenced by gender. Education and media also plays important role in influencing the oral health of the individual.23 The overall attitude and knowledge about oral hygiene were good for females than males.
The current survey has its strength in its large sample size and was done under detailed self-explanatory questionnaires.
Limitations
This study has its own limitations. The results are skewed by the large strength of the female population, all inputs are self-reported. Such a study may project potential bias. Moreover, the findings are not confirmed through physical examination by dentists.
Conclusion
This study concludes that the overall behavior of Allied health students towards oral hygiene is less and adequate knowledge has to be gained to meet the current demands. Continuous reinforcement upon dental education through camps to be done so as to aid dental care and know advancement in the field. Oral education and adequate training in preventive measures through community-based health strategies must be ensured to improve periodontal health.
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