|Year : 2019 | Volume
| Issue : 1 | Page : 34-38
A study on oral hygiene among students of a secondary school in Harinavi, South 24 Parganas, West Bengal
Jayeeta Burman, Aparajita Dasgupta, Rajarshi Banerjee, Sembagamuthu Sembiah, Lina Bandyopadhyay, Bobby Paul
Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
|Date of Submission||06-May-2018|
|Date of Acceptance||18-Jul-2018|
|Date of Web Publication||22-Jan-2019|
Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal
Source of Support: None, Conflict of Interest: None
Context: It is needless to state that health and hygiene go hand in hand and of the various categories of hygiene, oral hygiene has a colossal contribution to positive health for any individual. Zealous and correct lifestyle characteristics are related to high standards of oral hygiene, and good habits must be inculcated in the early years of one's life. With this background, a study was conducted among some school-going adolescents. Aims: The aim of this study is to find out the status of their oral hygiene and oral health along with their associated risk factors. Methodology: It was a school-based, observational, cross-sectional study conducted among students of standard 7th, 8th, and 9th of the school who were approached, and the parents of 151 students gave their consent for the oral checkup. Students first filled in a self-administered questionnaire following which their oral health and hygiene were examined. Data were analyzed using statistical package of social science software version 16.0 (IBM, SPSS Inc., Chicago, USA) Descriptive statistics and inferential statistics were performed. Results: Among 151 students, 64.2% had poor oral health, 52.3% and 64.2% student had unsatisfactory awareness toward oral health and oral hygiene practice, respectively. Females had better oral health awareness and better practice scores than males. Factors such as satisfactory practice of oral hygiene (odds ratio [OR] = 6.7 [3.4–12.2]); satisfactory awareness toward oral health (OR = 2.9 [1.9–3.5]); and gender (OR = 2.9 [1.5–5.8]) were associated with good oral health. Awareness toward oral health (OR = 5.8 [2.8–12.2]) are also strongly associated with the good practice of oral hygiene. In the final model of multivariable logistic regression analysis, factors such as the practice of oral hygiene (adjusted OR [AOR] = 6.8 [3.2–14.5]) and awareness toward oral health (AOR = 2.1 [1.3–3.6]) retained significance. Conclusion: Oral health promotion programs and periodic health checkups are needed.
Keywords: Assessment, attitude, oral health, oral hygiene, practice
|How to cite this article:|
Burman J, Dasgupta A, Banerjee R, Sembiah S, Bandyopadhyay L, Paul B. A study on oral hygiene among students of a secondary school in Harinavi, South 24 Parganas, West Bengal. Med J DY Patil Vidyapeeth 2019;12:34-8
|How to cite this URL:|
Burman J, Dasgupta A, Banerjee R, Sembiah S, Bandyopadhyay L, Paul B. A study on oral hygiene among students of a secondary school in Harinavi, South 24 Parganas, West Bengal. Med J DY Patil Vidyapeeth [serial online] 2019 [cited 2019 Apr 19];12:34-8. Available from: http://www.mjdrdypv.org/text.asp?2019/12/1/34/250448
| Introduction|| |
It is needless to state that health and hygiene go hand in hand, and of this, oral hygiene has a colossal contribution to positive health for any individual. Worldwide, 60%–90% of children and 100% adults have oral problems. India has an alarming population with oro-dental problems. Being a predisposing factor to periodontal diseases, poor oral health has also been associated with cardiovascular disorders and the preterm low-birthweight rate among infants. Zealous and correct lifestyle characteristics are related to high standards of oral hygiene and good habits must be inculcated in the early years of one's life. With this background, a study was conducted among some school-going adolescents to find out the status of their oral hygiene and oral health along with their associated risk factors.
| Methodology|| |
It was an institution-based, observational study in cross-sectional design. The study was conducted in a private secondary school located in South 24 Parganas during the month of June to August 2017. Students of 7th, 8th, and 9th standards were approached. A total of 450 students were enrolled in school in these three classes. Out of these, parents of 151 students gave consent to attend health camp. A health day was observed on August 12, 2017 in the school premises. Prior notice was given to all the parents of student of standard 7th to 9th by the school authority about the schedule for the day, and consent was obtained. On this particular day, all the students who attended the school were first given a questionnaire. Students were briefed by the researcher regarding the questions. After submission of the filled pro formas, oral health, such as teeth and gum, were examined by the researcher. Checklist for examination of oral hygiene was made with the help of experts of All India Institute of Hygiene and Public Health (AIIH and PH), torch, tongue depressor, sterile disposable gloves, and sterile gauze were also used for data collection. At the end, lecture session on how to maintain a healthy oral health was conducted. Complete enumeration method was followed. Students who did not give informed consent were excluded from the study. A predesigned, pretested, structured, questionnaire containing both open- and close-ended questions were used. Review of Literature was done to enumerate various factors determining the outcome variable. Face and content validity of the instrument was checked by the experts of AIIH and PH, Kolkata. The tool was translated into Bengali and subsequently back to English. The Bengali version was administered to the students.
All analyses were conducted with the SPSS software version 16.0 (SPSS Inc., Chicago, USA). Suitable descriptive statistics were used. Univariate and multivariable logistic regressions were used to determine the factors related with good oral health. The strength of association was assessed by odds ratio (OR) at 95% confidence interval; results were considered significant at conventional P < 0.05 level.
Plaque is the sticky, colorless film that constantly forms on teeth. Debris is a useless accumulation of miscellaneous particles; waste in the form of fragments. Dental Stains is the discoloration of teeth due to a variety of factors such as coffee, wine, cola, and smoking. Presence of plaque, debris, caries, dental erosion, dental stain, or any treated teeth (such as root canal treatment and capping) are considered as unhealthy teeth. Dependent variable in this study was oral health (good or bad). It has four components which are assessed by clinical examination – health of the gum, health of teeth, presence of any foul smell, and teeth alignment. Independent variables are age, sex, religion, class, education of the mother, and practice regarding oral hygiene. Scoring pattern of oral health assessment, awareness toward oral hygiene, and practice regarding oral hygiene are shown in [Table 1].
|Table 1: Scoring pattern of oral health assessment, awareness toward oral hygiene, practice regarding oral hygiene|
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Confidentiality of data was ensured to the study participants. School authority was given detailed information regarding the purpose and procedure of the study. They were given a copy of the questionnaire and briefed on the questions. Then, permission was obtained from the school authority. Prior consent from parents of the students, as well as assent from the student, was obtained. Scientific session on ways to maintain a healthy lifestyle and balanced diet was conducted and the researcher put in his utmost effort to solve their queries.
| Results|| |
Forty-eight (31.8%), 46 (30.5%), and 57 (37.7%) students were from class 7th, 8th, and 9th standard, respectively. Most of them were aged between 13 and 14 years (68.8%), and 20.5% were aged 15 years, 55.6% of students were male, and 90.1% of them were Hindu. Most of them lived in nuclear families (55.6%). About 84.1% of mothers were homemaker; 66.2% were graduate or postgraduate, and 33.8% were undergraduate. Nearly 53.7% of fathers were in service, 30.2% were businessmen, 10.7% were a private tutor, and 4% were professional (doctor, engineer). About 83.4% of fathers were postgraduate and 16.6% was undergraduate.
Among them, 51% students brushed their teeth <2 times per day, Brush and toothpaste were used as cleansing materials by 51.7%, 69.5% students changed their toothbrush as a requirement, and 19.2% changed their toothbrush within 3 months of an interval. About 76.2% of them always rinsed their mouth after having food. Only 31.1% students knew that they used a fluoride-containing toothpaste, 68.2% student did not know either the fact that they were using a fluoride-containing toothpaste or not. Nearly 86.8% student never visited dental clinic during the last 1 year.
A total of 139 (92.1%) students told that they consume chocolate daily, 113 (74.8%) drink cold drinks frequently, 7 (4.6%) consume pan masala, and 68 (45.1%) take chewing gums [Table 2]. About 49% students believed that one should brush his teeth twice daily, 45% agreed that poor oral health has an effect on the overall health of a person, and sweets have an adverse effect on teeth is believed by 43.7% of students, According to 45% of students, cold drinks have an effect on their teeth, using of tobacco products affect teeth adversely is believed by 85.4% of the students, 71.5% student agreed that irrespective of one's oral health every person must visit dentist at least once a year. According to 71.5% students, damaged/teeth means worm lives (poka) inside teeth [Table 3].
|Table 2: Distribution of oral health of study population according to the practice of oral hygiene (n=151)|
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|Table 3: Distribution of oral health of the study population according to awareness toward oral health (n=151)|
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Among those who had unhealthy teeth, 29 (40.3%) were suffering from dental caries, 20 (27.7%) had both plaque and debris, 9 (12.5%) had debris, 5 (7%) had caries, plaque and debris, 3 (4.1%) had only plaque, 2 (2.8%) were suffering from dental erosion and dental stain and 2 of them had underwent root canal treatment. Among those who had unhealthy gums, 4 (44.4%) had edematous gum, 5 (55.6%) were suffering from gum ulcer. A total of 75 (49.7%) had a foul smell in their mouth, 104 (68.9%) had satisfactory teeth alignment [Figure 1].
|Figure 1: Distribution of the study participants according to the assessment of oral health (n = 151)|
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About 64.2% had poor oral health, 64.2% had an unsatisfactory practice of oral hygiene, and 52.3% had unsatisfactory awareness toward oral health [Figure 2].
|Figure 2: Distribution of the study participants according to their oral health, practice, and awareness (n = 151)|
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Satisfactory awareness toward oral health is strongly associated with the good practice of oral hygiene OR = 5.8 (2.8–12.2) [Table 4].
|Table 4: Univariate and multivariable logistic regression showing factors associated with good oral health|
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| Discussion|| |
In this study, 49% of students brush their teeth twice or more than twice a day. About 51.7% students use brush and toothpaste, 48.3% brush their teeth with finger and toothpaste. Nearly 86.8% of students have never visited a dentist. About 76.2% students rinse their mouth after consuming food. Practice is also associated with good attitude. Seventy-two participants have a good attitude. Among them, 55.6% have a good practice. Seventy-nine participants have an unsatisfactory attitude. Among them, 82.3% have unsatisfactory practice.
A study in the Rural area of Tamil Nadu by Vishnu G Ashok and Krishnaprasad C showed that 3.1% of students brushed twice daily and remaining 46.9% brushed once daily, 92.5% were using toothpaste for brushing. About 72.5% rinsed their mouth always after having food or drink. A similar study was done at different schools of Khoramabad, Iran at 2013 by Kamran et al. Most of the individuals (72.7%) brushed once a day and 15% brushed occasionally. A greater percentage of the students (93%) practiced brushing with toothbrush and toothpaste and few used finger and toothpaste (1.5%). Seventy-five percent of the respondents reported that they would only visit the dentist when they have dental pain, and 15% stated that they have never visited a dentist. Only 8.2% answered that they always rinse their mouth after eating, while 12.9% children rinse sometimes and the majority of them (78.9%) never rinse. A study by Bhardwaj et al found 93.1% of school children using toothbrush, and 79.7% brushing once a day, with 89.8% using toothpaste.
Another study was done at north Jordon by Mahmoud K. Al-Omiri. 83.1% student used toothbrush and toothpaste, 17.6% brushed both morning and night. Sixty-nine percent brushed their teeth twice daily. Seventy-five percent of the subjects reported having two or fewer carious teeth. Forty-seven percent reported that they visited the dentist only when they felt pain. In this study, those who had unsatisfactory teeth, among them 40.3% students were suffering only from dental caries.
In the study at North Jordon by Mahmoud K. Al-Omiri, most of the participants were aware that sweets (87%) and soft drinks (77%) have a negative impact on dental health. In the study at Tamil Nadu, 39.4% had an idea that avoiding sweets and chocolates can prevent tooth decay; in the present study, 43.7% believe that sweet has a bad effect on teeth, 45% know that cold drink affects teeth. In a study at rural area of Tamil Nadu showed that 35.6% changed their toothbrush in 3-6 months as recommended whereas in present study, 19.2% of students change their toothbrush within 3 months.
In general, females had better oral health knowledge, attitude, and behavior scores than males which were in agreement with other studies. This condition may be explained on the basis that females usually care more about their body and appearance. They would thus be more concerned about visiting the dentist and would tend to be more educated about their oral health. The strength of the study is that various factors have been considered to find association with oral hygiene in detail. Limitation is that it was done in a school, so it cannot represent the general population of that age group. Only the students present on the day on the survey were included in the study, so there are chances of missing some significant finding. The respondents were the children aged 12–15 years, so the social and economic status of the family cannot be precisely determined.
| Conclusion and Recommendations|| |
Results of this study prove that oral hygiene habits and oral health awareness level among schoolchildren were unsatisfactory. Good oral health is strongly associated with gender, the practice of oral hygiene and awareness toward oral hygiene. Chance of good oral health increases with the satisfactory practice of oral hygiene and satisfactory awareness toward oral health. Practice and awareness are also strongly associated which showed a linear relationship. In general, females had better oral health awareness and better practice scores than males. Those who had unsatisfactory teeth, oral health is referred to the dental clinics.
To improve the oral health knowledge, attitude, and practices among students, school-based oral health promotion programs are needed. Periodic health checkup should also be done. Parents and teachers need to be informed and motivated about the importance of oral hygiene so that they can inculcate hygienic practices among their children to maintain good oral health.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Loesche WJ. Association of the oral flora with important medical diseases. Curr Opin Periodontol 1997;4:21-8.
Ashok VG, Krishnaprasad C. A study on oral hygiene among school children in a rural area of Tamilnadu. Int J Contemp Med Res 2016;3:2798-9.
Kamran A, Bakhteyar K, Heydari H, Lotfi A, Hey-Dari Z. Survey of oral hygiene behaviors, knowledge and attitude among school children: A cross-sectional study from Iran. Int J Health Sci 2014;2:83-95.
Bhardwaj VK, Sharma KR, Luthra RP, Jhingta P, Sharma D, Justa A, et al.
Impact of school-based oral health education program on oral health of 12 and 15 years old school children. J Educ Health Promot 2013;2:33.
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.
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3], [Table 4]