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Assessment of Oral Hygiene Knowledge, Attitude, and Practices among Medical Students in a Medical College in the State of Telangana: A Cross-sectional Survey.

INTRODUCTION

Oral health is a vital component of the general health of an individual that influences on one's general quality of life and well-being. [1] According to the World Oral Health report 2003, the prevalence of periodontitis is 86% in India. Oral health has been neglected for long in India. [2] Enhanced oral health can be achieved with increased awareness and better practices. [1]

A knowledge, attitude, and practices (KAP) survey is a quantitative method (pre-defined questions formatted in standardized questionnaires) that provides access to quantitative and qualitative information. KAP survey essentially records an "opinion" and is based on the "declarative" (i.e., statements). The survey reveals what was said, but there may be considerable gaps between what is said and what is done. [3]

KAP study tells us what people know about certain things, how they feel, and also how they behave. The knowledge possessed by a community refers to their understanding of any given topic oral hygiene in this case. Attitude is an acquired characteristic of an individual. People demonstrate a wide variety of attitudes toward dental care and dentists. [3] These attitudes naturally reflect their own experiences, cultural perceptions, familial beliefs, and other life situations, and they strongly influence the health status of the oral cavity. [1] Practice refers to the ways in which they demonstrate their knowledge and attitude through their actions. [3]

Keeping a healthy oral profile requires joint efforts from the dentist as well as the patient himself. One of the most important factors that decide the dental health of a population is the outlook of its people toward their dentition. [4] Students play a vital role in health promotion and preventive information dissemination among their family and their society, and therefore, their oral health attitude and practices conform to the expectations of the population. The booming young medical students are not exposed to health-care knowledge as dental professionals. [1] Understanding the levels of KAP will enable a more efficient process of awareness creation as it will allow the program to be tailored more appropriately to the needs of the community. Hence, the present study was aimed to assess the KAP of oral hygiene among medical students aged 17-35 years.

METHODS

Ethical Clearance

An observational, descriptive, cross-sectional survey study was conducted at Kamineni Institute of Medical Sciences, Nalgonda. This proposed study was reviewed by the Institutional Ethical Committee, and their clearance was obtained. A total of 500 students were selected using a convenience sampling technique. A informed consent was obtained from each patient.

Study Sample and Sampling Technique

A cross-sectional study using a 20-item structured was conducted to assess oral hygiene KAP in a sample of medical students (n = 500) [Graph 1].

All the semester students who were present on the day of survey were included in the study. Permission to conduct this study was obtained from the concerned authorities of the college, who in turn, through a circular, notified students about the intent of the study. Pilot study was conducted on 50 students for pre-testing of the questionnaire and to determine feasibility of the study.

Questionnaire

The study involved self-administration of pre-tested structured closed-ended questionnaire, to each student in their classrooms. Questionnaire consisted of 20 multiple choice questions to evaluate knowledge (5 questions) and attitude (5 questions); students received a full explanation on how to fill in the questionnaire. Students were asked to fill in the questionnaire without discussing with each other, and an average time of 15 min was taken to complete the procedure. It was made sure that none of the questions were left un-attempted. Anonymity of the respondents was assured. The students were then provided with health education regarding oral hygiene practices. The study was completed within a period of 2 weeks.

Statistical Analysis

The data collected were compiled using Microsoft Office Excel and was subjected to statistical analysis using the statistical software package, Statistical Package for the Social Sciences version 19.0 for MS Windows, and P < 0.05 was considered statistically significant. Frequency distribution, number, and percentage were calculated. The descriptive statistics and statistical significance of any difference between the two genders were determined using Chi-square test.

RESULTS

The present study was carried out on 500 students. Among them, 40% were males and 60% were females [Graph 2].

Table 1 reveals that 96.6% of the participants agree that there are two sets of dentition in human beings, only 1% of the participants did not know about it, and 2.4% disagree with it. 91.8% of the participants had knowledge about the number of permanent teeth in an adult's mouth, whereas the remaining 8.2% of the participants did not have correct knowledge. 38.2% of the participants had knowledge about dental deposits, whereas 22.8% did not know about it and the rest of the participants, i.e., 39% assume it to be the food particles or stains. The difference between males and females regarding knowledge of dental deposits was statistically significant (P= 0.004), and females had better knowledge regarding it. 72.6% of the participants had knowledge about interdental aids, whereas 27.4% of the students had no knowledge regarding it. The difference between males and females regarding knowledge about interdental aids was statistically significant (P = 0.003), and females had better knowledge regarding it. 75.4% of students knew that bleeding gums are related to our general health conditions, whereas 21.6% of the students disagree with that and 3% of them had no knowledge about it. The difference between males and females regarding the knowledge about bleeding gums corresponding to the general health condition was statistically significant (P = 0.038), and males had better knowledge regarding it.

Table 2 shows that most of the study population (95.4%) think that oral health is important for overall health, whereas the remaining 4.6% do not think that it is important. 56.8% of the participants visit the dentist only in problem, whereas 19.6% of them never visited the dentist. Of the study population, 10.8% prefer scaling as the reason for visiting the dentist, 29.6% said as a routine visit, and 45.2% said for other reasons such as bleeding gums and orthodontic treatment ... According to 51.4% of the study population, they never had a problem, it is the main reason for not having routine dental visits, 5.6% of the participants think that dental treatment is expensive, and 26.8% of the students could not visit the dentist due to lack of time. The difference between males and females regarding the reason for not having routine dental visits is statistically significant (P < 0.05). 96.8% of the participants had a good attitude of using toothbrush and toothpaste to clean the teeth, and 2% of the individuals prefer toothbrush and toothpowder.

Table 3 reveals that 69.4% of the participants brush their teeth once daily, 28.4% of them brush twice daily, and 1.6% of the individuals brush occasionally. The difference between males and females regarding the frequency of tooth-brushing was statistically significant (P = 0.032). 64.0% of the participants prefer the combined type of motion; 7.6% of the individuals use vertical motion; 9.4% of the individuals prefer horizontal motion; and 19.0% of the individuals prefer circular motion while brushing. 48.8% of the population had a practice of using medium bristled toothbrush; 37.2% used soft-bristled toothbrush, whereas only 4.4% used hard-bristled toothbrush and 9.6% of the individuals never noticed the particular type of toothbrush. Majority 49.0% of individuals change their toothbrush once in 2-3 months, whereas 30.8% change it monthly and 6.4% change when it is spoilt.

The difference between males and females, regarding the practice of changing toothbrush, was statistically significant (P = 0.002). 92.2% of the participants clean their tongue and prefer to use a tongue cleaner for this. 80.8% of the people had a good practice of rinsing their mouth after eating. Only 33.8% of the individuals had a practice of using mouthwash; 66.2% of the participants do not use mouthwash, and the difference between males and females, regarding the use of mouthwash, was statistically significant (P = 0.047). 60.8% of the individuals never noticed smell from their mouth. In addition to toothbrush, 32.0% used tooth pricks, only 13.0% had a good practice of using dental floss, and 5.2% used interdental brushes. Only 27.6% of the participants noticed bleeding in their gums; of them, 31.8% had a good practice of visiting the dentist and 28.8% of the participants waited for bleeding to reoccur. The results of the study have pointed out that educational level was one of the important factors that governed the knowledge, attitude, and oral hygiene practices of the people.

DISCUSSION

It has been observed that oral hygiene has mostly remained as an ignored and unrealized major social problem. [2]

According to the consumer usage and attitudes study done in 2010, the most shocking observation is that nearly half of the Indian population does not use a toothbrush and only 51% brushed their teeth using a toothbrush and toothpaste. [2]

Over the past 20 years, a significant amount of emphasis has been made on prevention of diseases rather than the treatment aspect. Healthy teeth can last us a lifetime with the proper preventive dental care. Preventive oral health knowledge, attitude, and its practice are the important ways of keeping our teeth healthy. [2] Hence, in the present study, attempts were made to evaluate preventive oral health knowledge, practice, and attitude of the population of medical students in a private medical college.

In the present study, the knowledge regarding oral hygiene was satisfactory except knowledge about dental floss, whereas poor knowledge on the perception of oral health was reported among engineering students of Tiruchengode. [5]

In the present study, only 28.4% [Table 3] of the medical students reported of brushing their teeth twice daily and it was in contrary with the results of Peltzer and Pengpid who reported it to be 67.2% in university students of 26 low-, middle-, and high-income countries. [6] On the contrary, Rimondini et al. [7] described a much higher percentage (92.1%) in Italian University students, whereas Prasad et al. [5] and Gasgoos et al. [8] reported small percentage 30.7% and 15.4%, respectively. The present observation may be due to the occupancy of the students in their curricular activities and ignorant attitude toward oral hygiene, considering it as less important.

In the present study, males brush their teeth more frequently than females [Table 3] which were statistically significant (P = 0.05), and it was contrary with the result of El-Qaderi and Taani, [9] Gasgoos et al., [8] and Prasad et al., [5] where females brush their teeth more frequently. This difference can attribute to a higher regarding personal hygiene and health care among males.

Hamilton and Coulby found that a high percentage (44%) studied in North Eastern Ontario used dental floss; in contrast, this current study reported only 13% [Table 3] of students used dental floss. [10] Reason for this may be the significant resource allocation to health education programs that are carried out in Canada. This emphasizes the urgent need for educating and motivating the public to use this efficient method for oral health care. Majority of the studied population showed that they clean their tongue either with toothbrush or tongue cleaner. Furthermore, 80.8% [Table 3] of the sample population rinses their mouth after eating food. This very basic method of maintaining oral hygiene is a clear indication of good awareness.

It is noteworthy that 64% [Table 3] of the respondents brushed their teeth using combined motion, which is in contrary to the horizontal motion causing jeopardize of the tooth structure. This finding is in contrary with that of the study done by Zhu et al., [11] where 60% of the sample used horizontal motion. Only 37.2% [Table 3] of the subjects use soft brush, which is more than that observed among Zhu et al.'s subjects where 27% of the sample use the same. [11] 49% change their toothbrush once in 3 months [Table 3], and surprisingly 6.4% [Table 3] change their brush only when it is useless. 33.8% [Table 3] of subjects used a mouthwash. Interestingly enough, they used it to treat malodor. Furthermore, 39.7% reported halitosis. The present study is in contrast with that of an epidemiologic survey of the general population of Japan where 24% of the individuals examined complained about bad breath.

27.6% [Table 3] of the total subjects reported bleeding gums. The present study is in contrary with the studies of Gilbert and Nuttal and Buhlin et al. who showed that self reported bleeding gums were high in percentage. [12,13] The present study is in agreement with the studies of Tervonen and Knuttila and Kallio et al. who showed that most of the patients did not notice bleeding from gums. [14,15]

Visiting a dentist is still not considered a preventive dental behavior, and at present, it only depends on the treatment needs. [16] The present study shows that around 75% [Table 2] of the patients visited the dentist only in problem and only 10% [Table 2] of the population visited the dentist on regular basis after every 6 months. These results are similar to the study done by Jain et al., where 54% of the subjects visited the dentists when there is a problem. [R] These results are also equivocal with the study conducted by Maryln et al. in which 67.9% of the study population reported having had a dental checkup at least once a year in the past 5 years. [17]

Limitations

Student's self-reporting of behaviors may have resulted in over-reporting of proper hygiene practices. Determination of causality is difficult using this cross-sectional study design.

CONCLUSION

The present study presented a comprehensive overview of oral health-related KAP among medical students in a private medical college in Nalgonda. The awareness about the oral health of the studied subjects stands acceptable. Knowledge about dental floss and frequency of visiting the dentist and brushing frequency was inadequate. More concentration needs to be undertaken regarding oral health care in terms of health education programs.

We, as dentists, will have to keep reinforcing the importance of correcting all aspects related to brushing and flossing along with the importance of regular checkups.

doi: 10.5866/2018.10.10007

Received: 18-12-2017

Revised: 27-01-2018

Accepted: 05-02-2018

ACKNOWLEDGMENT

The authors wish to thank all the medical students participated, for their kind cooperation throughout the survey.

REFERENCES

[1.] Kakkad DN, Murali R, Krishna M, Yadav S, Yalamalli M, Kumar AV. Assessment of oral hygiene knowledge, attitude, and practices among engineering students in north Bangalore: A cross-sectional survey. Int J Sci Stud 2015;3:84-9.

[2.] Jain N, Mitra D, Ashok KP, Dundappa J, Soni S, Ahmed S. Oral hygiene-awareness and practice among patients attending OPD at Vyas dental college and hospital, Jodhpur. J Indian Soc Periodontol 2012;16:524-8.

[3.] Kamran A, Bakhteyar K, Heydari H, Lotfi A, Heydari 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.

[4.] Kapoor S, Gill S, Singh A, Kaur I, Kapoor P. Oral hygiene awareness and practice amongst patients visiting the department of periodontology at a dental college and hospital in North India. Indian J Dent 2014;5:64-8.

[5.] Prasad AK, Shankar S. Oral health KAP of first year engineering students of KSR College of technology, Thiruchengode, the future rulers. J Indian Assoc Public Health Dent 2010;16:143-7.

[6.] Peltzer K, Pengpid S. Oral health behaviour and social and health factors in university students from 26 low, middle and high income countries. Int J Environ Res Public Health 2014; 11:12247-60.

[7.] Rimondini L, Zolfanelli B, Bernardi F, Bez C. Self-preventive oral behavior in an Italian university student population. J Clin Periodontol 2001;28:207-11.

[8.] Gasgoos SS, Jazrawi KH, Ajrab MG. Dental health knowledge, attitude and behavior among first year university students, Mosul. Al-Rafidain Dent J 2007;7:138-52.

[9.] El-Qaderi SS, Taani DQ. Oral health knowledge and dental health practices among school children in Jerash district/ Jordan. Int J Dent Hyg 2004;2:78-85.

[10.] Hamilton ME, Coulby WM. Oral health knowledge and habits of senior elementary school students. J Public Health

Dent 1991;51:212-9.

[11.] Zhu L, Petersen PE, Wang HY, Bian JY, Zhang BX. Oral health knowledge, attitudes and behaviour of adults in China. Int Dent J 2005;55:231-41.

[12.] Gilbert AD, Nuttal NM. Self-reporting of periodontal health status. Br Dent J 1999;186:241-4.

[13.] Buhlin K, Gustaffon A, Anderson K, Hakansson K, Klinge B. Validity and limitations of self-reported periodontal health. Community Dent Oral Epidemiol 2002;30:431-7.

[14.] Tervonen T, Knuttila M. Awareness of dental disorders and discrepancy between objective and subjective dental treatment needs. Community Dent Oral Epidemiol 1988;34:345-8.

[15.] Kallio P, Nordblad A, Croucher R, Ainamo J. Self-reported gingivitis and bleeding gums among adolescents in Helsinki. Community Dent Oral Epidemiol 1994;22:277-82.

[16.] Gundala R, Chava VK. Effect of lifestyle, education and socioeconomic status on periodontal health. Contemp Clin Dent 2010;1:23-6.

[17.] Survey of Family Tooth Brushing Practices. Bureau of dental health education. Bureau of research and statistics. J Am Dent Assoc 1966;72:1489-91.

G. Jagadish Reddy (1), K. Suchithra (2), A. Abhinav (3), V. Ravikiran (4)

Department of Periodontics, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Telangana, India

Email for correspondence: drjagadishreddy@gmail.com

Caption: Graph 1: Total number of participants
Table 1: Comparison of gender related to knowledge of oral
hygiene

Items                                        Male (%)    Female (%)

There are two sets of dentition in human
beings, baby teeth set, and permanent
teeth set, and permanent teeth set
  Agree                                      191 (96)     292 (97)
  Disagree                                   5 (2.5)       7(2.3)
  Do not know                                 3(1.5)       2(0.7)
How many permanent teeth are there in
adults mouth
  20                                         5 (2.5)       3(1.0)
  28                                         14 (7.0)     13 (4.3)
  30                                          2(1.0)       4(1.3)
  32                                        178 (89.4)   281 (93.4)
If there is a yellow or brownish yellow
discoloration near tooth/gum, what is it
  Food particles                            28 (14.1)    38 (12.6)
  Calculus/tartar                           59 (29.6)    132 (43.9)
  Stains                                    66 (33.2)    63 (20.9)
  Do not know                               46 (23.1)    68 (22.6)
Do you know there are some aids to
clean the spaces between teeth, which
are named as interdental aids?
  Yes                                       129 (64.8)   234 (77.7)
  No                                        70 (35.2)    67 (22.3)
Is bleeding gums related to our general
health condition
  Agree                                     162 (81.4)   215 (71.4)
  Disagree                                  30 (15.1)    78 (25.9)
  Do not know                                7 (3.5)       8(2.7)

Items                                       Total (%)    Chi-square

There are two sets of dentition in human                   0.882
beings, baby teeth set, and permanent
teeth set, and permanent teeth set
  Agree                                     483 (96.6)
  Disagree                                   12 (2.4)
  Do not know                                 5(1.0)
How many permanent teeth are there in                      3.661
adults mouth

  20                                         8 (1.6)
  28                                         27 (5.4)
  30                                          6(1.2)
  32                                        459 (91.8)
If there is a yellow or brownish yellow                    13.484
discoloration near tooth/gum, what is it
  Food particles                            66 (13.2)
  Calculus/tartar                           191 (38.2)
  Stains                                    129 (25.8)
  Do not know                               114 (22.8)
Do you know there are some aids to                         11.787
clean the spaces between teeth, which
are named as interdental aids?
  Yes                                       363 (72.6)
  No                                        137 (27.4)
Is bleeding gums related to our general                    8.430
health condition
  Agree                                     377 (75.4)
  Disagree                                  108 (21.6)
  Do not know                                15 (3.0)

Items                                       P value

There are two sets of dentition in human     0.643
beings, baby teeth set, and permanent
teeth set, and permanent teeth set
  Agree
  Disagree
  Do not know
How many permanent teeth are there in        0.300
adults mouth
  20
  28
  30
  32
If there is a yellow or brownish yellow     0.004 *
discoloration near tooth/gum, what is it
  Food particles
  Calculus/tartar
  Stains
  Do not know
Do you know there are some aids to          0.003 *
clean the spaces between teeth, which
are named as interdental aids?
  Yes
  No
Is bleeding gums related to our general     0.038 *
health condition
  Agree
  Disagree
  Do not know

* P<0.05 statistically significant

Table 2: Comparison of gender related to the attitude of oral
hygiene

Items                                       Male (%)    Female (%)

Do you think, oral health is
important for overall health?
  Yes                                      189 (95.0)   288 (95.7)
  No                                        10 (5.0)     13 (4.3)
How often should you visit the dentist?
  Only in problem                          112 (56.3)   172 (57.1)
  Once in 3 months                          19 (9.5)     24 (8.0)
  Once in 6 months                         26 (13.0)    49 (16.3)
  Never                                    42 (21.1)    56 (18.6)
Reason for visiting the dentist?
  Extraction                                 2(1.0)       8(2.7)
  As a routine visit                       53 (26.6)    95 (31.6)
  Filling                                  20 (10.1)     24 (8.0)
  Scaling                                  27 (13.6)     27 (9.0)
  Replacement of teeth                      10 (5.0)      8(2.7)
  Others                                   87 (43.7)    139 (46.2)
Reason for not having routine dental
visit?
  Lack of time                             64 (32.2)    70 (23.3)
  Lack of access                            12 (6.0)      4(1.3)
  Expensive                                  8(4.0)      20 (6.6)
  Lack of knowledge and motivation           4(2.0)      25 (8.3)
  I never had a problem                    94 (47.2)    163 (54.2)
  Others                                    17 (8.5)     19 (6.3)
Which one do you prefer to clean your
teeth?
  Toothbrush and toothpaste                191 (96.0)   293 (97.3)
  Toothbrush and powder                      3(1.5)       7(2.3)
  Others                                     5(2.5)      1 (0.3)

Items                                      Total (%)    Chi-square

Do you think, oral health is                              1.661
important for overall health?
  Yes                                      477 (95.4)
  No                                        23 (4.6)
How often should you visit the dentist?                   3.374
  Only in problem                          284 (56.8)
  Once in 3 months                          43 (8.6)
  Once in 6 months                         75 (15.0)
  Never                                    98 (19.6)
Reason for visiting the dentist?                          7.577
  Extraction                                10 (2.0)
  As a routine visit                       148 (29.6)
  Filling                                   44 (8.8)
  Scaling                                  54 (10.8)
  Replacement of teeth                      18 (3.6)
  Others                                   226 (45.2)
Reason for not having routine dental                      23.422
visit?
  Lack of time                             134 (26.8)
  Lack of access                            16 (3.2)
  Expensive                                 28 (5.6)
  Lack of knowledge and motivation          29 (5.8)
  I never had a problem                    257 (51.4)
  Others                                    36 (7.2)
Which one do you prefer to clean your                     8.241
teeth?
  Toothbrush and toothpaste                484 (96.8)
  Toothbrush and powder                     10 (2.0)
  Others                                    6 (1.2)

Items                                      P value

Do you think, oral health is                0.436
important for overall health?
  Yes
  No
How often should you visit the dentist?     0.497
  Only in problem
  Once in 3 months
  Once in 6 months
  Never
Reason for visiting the dentist?            0.181
  Extraction
  As a routine visit
  Filling
  Scaling
  Replacement of teeth
  Others
Reason for not having routine dental       0.001 *
visit?
  Lack of time
  Lack of access
  Expensive
  Lack of knowledge and motivation
  I never had a problem
  Others
Which one do you prefer to clean your       0.083
teeth?
  Toothbrush and toothpaste
  Toothbrush and powder
  Others

* P<0.05 statistically significant

Table 3: comparison of gender related to oral hygiene practices

Items                                       Male (%)    Female (%)

How often do you brush your teeth?
  Once a day                               133 (66.8)   214 (71.1)
  Twice a day                              57 (28.6)     85 (28.2)
  More than twice a day                      2(1.0)       1 (0.3)
  Occasionally                               7(3.5)       1 (0.3)
What type of motion do you use while
brushing?
  Vertical                                  17 (8.5)     21 (7.0)
  Horizontal                                17 (8.5)     30 (10.0)
  Combined                                 124 (62.3)   196 (65.1)
  Circular                                 41 (20.6)     54 (17.9)
What type of brush do you use?
  Hard                                      11 (5.5)     11 (3.7)
  Medium                                   106 (53.3)   138 (45.8)
  Soft                                     65 (32.7)    121 (40.2)
  Never noticed                             17 (8.5)     31 (10.3)
How often you change your toothbrush?
  Monthly                                  63 (31.7)     91 (30.2)
  2-3 months                               105 (52.8)   140 (46.5)
  4-5 months                                14 (7.0)     55 (18.3)
  When bristles flare                       17 (8.5)     15 (5.0)
Do you clean your tongue?
  Yes                                      179 (89.9)   282 (93.7)
  No                                       20 (10.1)     19 (6.3)
Do you rinse your mouth after eating?
  Yes                                      165 (82.9)   239 (79.4)
  No                                       34 (17.1)     62 (20.6)
Do you use a mouthwash?
  Yes                                      78 (39.2)     91 (30.2)
  No                                       121 (60.8)   210 (69.8)
Have you ever noticed smell from
your mouth?
  Yes                                      90 (45.2)    106 (35.2)
  No                                       109 (54.8)   195 (64.8)
Apart from brushing, what other methods
do you use to clean your teeth?
  Dental floss                             25 (12.6)     40 (13.3)
  Interdental brushes                       10 (5.0)     16 (5.3)
  Tooth pricks                             74 (37.2)     86 (28.6)
  None                                     90 (45.2)    159 (52.8)
Have you ever noticed bleeding in
your gums?
  Yes                                      56 (28.1)     82 (27.2)
  No                                       143 (71.9)   219 (72.75)
If yes, what method you prefer to
control bleeding
  Visit a medical practitioner              9(14.5)      15 (16.9)
  Visit a dentist                          17 (27.4)     31 (34.8)
  Use some home remedies                   19 (30.6)     26 (29.2)
  Wait for bleeding to reoccur             13 (21.0)     16 (18.0)
  Others                                    4 (6.5)       1 (1.1)

Items                                      Total (%)    Chi-square

How often do you brush your teeth?                        8.821
  Once a day                               347 (69.4)
  Twice a day                              142 (28.4)
  More than twice a day                     3 (0.6)
  Occasionally                              8 (1.6)
What type of motion do you use while                      1.239
brushing?
  Vertical                                  38 (7.6)
  Horizontal                                47 (9.4)
  Combined                                 320 (64.0)
  Circular                                 95 (19.0)
What type of brush do you use?                            4.520
  Hard                                      22 (4.4)
  Medium                                   244 (48.8)
  Soft                                     186 (37.2)
  Never noticed                             48 (9.6)
How often you change your toothbrush?                     14.368
  Monthly                                  154 (30.8)
  2-3 months                               245 (49.0)
  4-5 months                               69 (13.8)
  When bristles flare                       32 (6.4)
Do you clean your tongue?                                 2.328
  Yes                                      461 (92.2)
  No                                        39 (7.8)
Do you rinse your mouth after eating?                     0.953
  Yes                                      404 (80.8)
  No                                       96 (19.2)
Do you use a mouthwash?                                   6.101
  Yes                                      169 (33.8)
  No                                       331 (66.2)
Have you ever noticed smell from                          3.991
your mouth?
  Yes                                      196 (39.2)
  No                                       304 (60.8)
Apart from brushing, what other methods                   4.235
do you use to clean your teeth?
  Dental floss                             65 (13.0)
  Interdental brushes                       26 (5.2)
  Tooth pricks                             160 (32.0)
  None                                     249 (49.8)
Have you ever noticed bleeding in                         5.710
your gums?
  Yes                                      138 (27.6)
  No                                       362 (72.4)
If yes, what method you prefer to                         4.085
control bleeding
  Visit a medical practitioner             24 (15.9)
  Visit a dentist                          48 (31.8)
  Use some home remedies                   45 (29.8)
  Wait for bleeding to reoccur             29 (19.2)
  Others                                    5 (3.3)

Items                                      P value

How often do you brush your teeth?         0.032 *
  Once a day
  Twice a day
  More than twice a day
  Occasionally
What type of motion do you use while        0.744
brushing?
  Vertical
  Horizontal
  Combined
  Circular
What type of brush do you use?              0.210
  Hard
  Medium
  Soft
  Never noticed
How often you change your toothbrush?      0.002 *
  Monthly
  2-3 months
  4-5 months
  When bristles flare
Do you clean your tongue?                   0.127
  Yes
  No
Do you rinse your mouth after eating?       0.329
  Yes
  No
Do you use a mouthwash?                    0.047 *
  Yes
  No
Have you ever noticed smell from            0.262
your mouth?
  Yes
  No
Apart from brushing, what other methods     0.237
do you use to clean your teeth?
  Dental floss
  Interdental brushes
  Tooth pricks
  None
Have you ever noticed bleeding in           0.127
your gums?
  Yes
  No
If yes, what method you prefer to           0.395
control bleeding
  Visit a medical practitioner
  Visit a dentist
  Use some home remedies
  Wait for bleeding to reoccur
  Others

* P<0.05 statistically significant

Graph 2: Gender distribution of participants

female   60%
male     40%

Note: Table made from pie chart.
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Article Details
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Title Annotation:ORIGINAL ARTICLE
Author:Reddy, G. Jagadish; Suchithra, K.; Abhinav, A.; Ravikiran, V.
Publication:Indian Journal of Dental Advancements
Article Type:Survey
Date:Jan 1, 2018
Words:4761
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