An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students

Evaluation of Self-Reported Oral Health Attitudes and Behavior of Dental Students in Antalya, Turkey

Background Dental students are expected to play a critical role in the oral health education of society as future providers of dental care, and their attitudes on this subject have a possible impact on the awareness of patients regarding the importance of preventing oral diseases and improving oral health. This study aimed to evaluate the oral health attitudes and behavior of dental students. Methodology The Turkish version of the Hiroshima University Dental Behavior Inventory (HU-DBI) questionnaire regarding oral health attitudes and behaviors with an additional nine questions was distributed among 250 native Turkish-speaking dental students at the Faculty of Dentistry in Antalya, Turkey. The validity of the nine questions added to the original questionnaire was evaluated by expert opinion and a pretest method. A self-administered questionnaire was used for data collection. The Mann-Whitney U test and chi-square test were used for statistical analysis, and the statistical significance level was set at p-values <0.05. Results The mean age of the 250 students in the study was 20.96 ± 1.66 years. In total, 157 (62.8%) students were preclinical (first, second, and third year) dentistry students, and 93 (37.2%) students were clinical (fourth and fifth year) dentistry students. The mean HU-DBI score of all students was 5.95 ± 1.65, and the mean HU-DBI score of clinical students (6.42 ± 1.65) was significantly (p < 0.05) higher than that of preclinical students (5.67 ± 1.59). The mean HU-DBI score of male and female students was 5.63 ± 1.55 and 6.24 ± 1.69, respectively, and this difference was statistically significant (p < 0.05). The study showed significant improvement in the behavior and attitude regarding the oral health of the clinical dental students compared with the preclinical dental students. Conclusions Among dental students, clinical students and female students had generally better attitudes and behaviors about oral health self-care compared to preclinical students and male students, respectively.

Oral Health Knowledge, Attitudes, and Behaviors (KAB) of German Dental Students: Descriptive Cross-Sectional Study

Germany's 2030-oral health agenda incorporates behavioral targets such as twice-daily toothbrushing and routine dental check-ups. Given the professional and social roles of dentists in oral health promotion, the oral health-related knowledge, attitudes, and behaviors (KAB) of dentists and dental students became worth investigation. The present study was designed as a descriptive cross-sectional study that aimed to evaluate oral health KAB of German dental students using the Hiroshima University - Dental Behavioral Inventory (HU-DBI). A total of 508 dental students filled in the questionnaire, out of which 74.2% were females, 38.8% were clinical students, 11.4% reported tobacco smoking at least once week, 26.6% reported drinking alcohol at least once a week, and 82.9% reported suffering from problematic internet use. The overall HU-DBI score was high (7.67 ± 1.32), and it was slightly higher among females (7.70 ± 1.33) than males (7.59 ± 1.29), and gender-diverse students (7.33 ± 1.37). Clinical students (7.88 ± 1.26) had a significantly higher HU-DBI score, especially in the domain of oral health behaviors, compared with preclinical students (7.53 ± 1.34). A significant improvement in oral health behaviors and HU-DBI score was found between the third- vs. the fourth year, which corresponds to the period when prophylaxis, hygiene, and periodontology courses are delivered. Tobacco smoking was significantly associated with poor oral health knowledge, behaviors, and overall HU-DBI score. Problematic internet use and alcohol drinking had slightly lower HU-DBI scores. The findings of the present study call for early implementation of preventive dentistry elements in German curricula and addressing oral health needs of gender minorities in Germany by future epidemiologic studies.

Oral Health Knowledge, Attitudes, and Behaviors (KAB) of German Dental Students: Descriptive Cross-Sectional Study

Germany's 2030–oral health agenda incorporates behavioral targets such as twice-daily toothbrushing and routine dental check-ups. Given the professional and social roles of dentists in oral health promotion, the oral health-related knowledge, attitudes, and behaviors (KAB) of dentists and dental students became worth investigation. The present study was designed as a descriptive cross-sectional study that aimed to evaluate oral health KAB of German dental students using the Hiroshima University – Dental Behavioral Inventory (HU-DBI). A total of 508 dental students filled in the questionnaire, out of which 74.2% were females, 38.8% were clinical students, 11.4% reported tobacco smoking at least once week, 26.6% reported drinking alcohol at least once a week, and 82.9% reported suffering from problematic internet use. The overall HU-DBI score was high (7.67 ± 1.32), and it was slightly higher among females (7.70 ± 1.33) than males (7.59 ± 1.29), and gender-diverse students (7.33 ± 1.37). Clinical students (7.88 ± 1.26) had a significantly higher HU-DBI score, especially in the domain of oral health behaviors, compared with preclinical students (7.53 ± 1.34). A significant improvement in oral health behaviors and HU-DBI score was found between the third- vs. the fourth year, which corresponds to the period when prophylaxis, hygiene, and periodontology courses are delivered. Tobacco smoking was significantly associated with poor oral health knowledge, behaviors, and overall HU-DBI score. Problematic internet use and alcohol drinking had slightly lower HU-DBI scores. The findings of the present study call for early implementation of preventive dentistry elements in German curricula and addressing oral health needs of gender minorities in Germany by future epidemiologic studies.

Estonian Dental Students' Oral Health-Related Knowledge, Attitudes and Behaviours (KAB): National Survey-Based Study

The strategic plan for dentistry and oral health in Estonia of 2030 focuses on oral health promotion and disease prevention through undergraduate dental curricula and fostering public health-oriented research among students. The present study was designed as a descriptive cross-sectional study to evaluate oral health-related knowledge, attitudes, and behaviours (KAB) of dental students in Estonia. The study was carried out in the spring semester of 2020, and it used a modified version of the Hiroshima University Dental Behavioural Inventory (HU-DBI). A total of 129 students responded to the survey, constituting a response rate of 93.5% due to the total population sampling (census) technique used in this study and the small target population size. Out of the 124 students included in the final analysis, 79% were females, 62.1% were clinical students, 11.3% reported smoking tobacco at least once a week, and 86.3% reported problematic internet use. The present study found that mean HU-DBI score of Estonian dental students was 8.09 ± 1.22 which is so far the highest recorded HU-DBI score in Europe. There was no significant difference between female vs. male or preclinical vs. clinical students in terms of HU-DBI score. While clinical students reported less faulty oral hygiene practices, such as hard toothbrush use and aggressive toothbrushing, preclinical students reported a slightly higher mean HU-DBI score. Smoking behaviour was more common among male and clinical students, and it was also associated with alcohol drinking and worry about teeth colour and halitosis.

Oral Health-Related Knowledge, Attitudes and Behaviours of Arab Dental Students: Multi-National Cross-Sectional Study and Literature Analysis 2000-2020

Dental students are the future leaders of oral health in their respective communities; therefore, their oral health-related attitudes and behaviours are of practical value for primary disease prevention. The present study aimed to evaluate oral health-related knowledge, attitudes, and behaviours of dental students in Arab countries and explore the potential sociodemographic predictors of their oral health outcomes. A multi-centre, cross-sectional study was conducted during the academic year 2019/2020 in three Arab countries: Lebanon, Syria, and Tunisia. The study used a validated Arabic version of the Hiroshima University Dental Behavioural Inventory (HU-DBI) composed of original twenty items that assess the level of oral health-related knowledge, attitudes, and behaviours, and four additional dichotomous items related to tobacco smoking, alcohol drinking, problematic internet use, and regular dental check-up The HU-DBI score ranges between 0 and 12. A total of 1430 students took part in this study, out of which 60.8% were females, 57.8% were enrolled in clinical years, 24.5% were tobacco smokers, 7.2% were alcohol drinkers, and 87% reported internet addiction. The mean HU-DBI score was 6.31 ± 1.84, with Lebanon having the highest score (6.67 ± 1.83), followed by Syria (6.38 ± 1.83) and Tunisia (6.05 ± 1.83). Clinical students (6.78 ± 1.70) had higher HU-DBI scores than their preclinical peers (5.97 ± 1.86). The year-over-year analysis revealed that dental public health and preventive dentistry courses had significantly and positively impacted the undergraduate students’ knowledge, attitudes, and behaviours. The gender-based differences were not statistically significant, with a modest trend favouring males, especially oral health behaviours. Tobacco smoking, alcohol drinking, and problematic internet use were associated with lower HU-DBI scores. In the Arab world, the economic rank of the country where the dental students live/study was weakly correlated with the students’ mean HU-DBI score.

Self-Reported Oral Health Attitudes and Behaviors, and Gingival Status of Dental Students

Aim

The aim of this study was to assess self-reported oral health attitudes and behaviors of the Iraqi dental students and compare the variations in these attitudes and behaviors that linked to dental education level and gender.

Materials and Methods

A self-administered questionnaire depended on the English version of the Hiroshima University Dental Behavioral Inventory (HU-DBI) was prepared, the questionnaire given to 198 dental students.

Results

About 91.4% of the dental students were worried about the teeth colour, and merely minor percentage of them (18.8%) thought it is not crucial to seek dental advice until they acquire a tooth pain; however, 26.3% of the students were disturbed because of their gum colour, and 75.3% of them examined their teeth after brushing. Besides, 72.2% of the students replied that gum disease could not be prevented by tooth brushing only, 60.1% of the students do not give visiting the dentist such concern, and 14.1% of dental students were smokers. The plaque and gingival indices were significantly higher in preclinical students than clinical students.

Conclusion

Iraqi dental students had somewhat good oral health behavior and attitudes; however, extra concentrating is required on the anticipatory and behavioral aspects of oral self-care practices. Female dental students displayed better oral health behavior and attitudes than male colleagues on some issues.

Oral health knowledge, attitude and behaviour of dental students in a private university

Introduction

The positive attitude and behaviour of dental students can be improved during their undergraduate studies and is considered an essential factor in promoting the oral self-care habits of their patients and society in general.

Aim

This study was conducted to evaluate the oral health knowledge, attitudes and behaviours among undergraduate dental students at a private university, based on the year of undergraduate studies.

Material and methods

A self-administered questionnaire based on the Hiroshima University-Dental Behavioural Inventory was distributed among 783 undergraduate dental students from 1st to 5th year. Statistical analysis was performed using SPSS version 20. The Mann–Whitney U test and one-way ANOVA tests (Kruskal–Wallis test) were used.

Results

The scores of oral health knowledge, attitude and behaviour between preclinical and clinical dental students were found to have statistically significant differences (P < 0.001). The variation of knowledge, attitude and behaviour scores from 1st to 5th year undergraduate studies was shown to be statistically significant with the year of study (P < 0.001). The study showed significant improvement in the knowledge, attitude and behaviour of the final year dental students as compared with the 1st year dental students.

Conclusion

Preclinical students need properly designed oral health educational programs to increase their attitude and behaviour toward oral health.

Evaluation of oral health attitude and behavior among a group of dental students in Puducherry, India: A preliminary cross-sectional study

CONTEXT

Oral behavior reflects individual perception on oral health. Behavior and attitude of oral health providers, especially dentists, towards oral health affect their capacity to deliver oral health care services. This attitude plays a important role in determining the oral health condition of population.

AIM

The purpose of this study is to evaluate the oral health attitude and behavior among a group of dental students in India and to find any gender-based differences in terms of oral health attitude and behavior.

MATERIALS AND METHODS

A total of 282 dental students of Indira Gandhi Institute of Dental Sciences, SBV University, Puducherry, India participated in the study. A simplified English version of Hiroshima University Dental-Behavioral Inventory (HU-DBI) was adopted.

STATISTICAL ANALYSIS USED

SSP version 2.80 software was used to analyze the data. Chi-square test was used to find the differences in the distribution of "yes" among students from the different academic year as well as between male and female students. Statistical significance was set at P ≤ 0.05.

RESULTS

Statistical significance was observed for the responses between the students from different academic years brushing frequency, careful brushing of teeth, using brush with hard bristles, careful self-evaluation of brushing and satisfied appearance of teeth and gums. Male students preferred to use a tooth brush with hard bristles and regular mouth washes than female students. With regards to worrying about bad breath, male students had more "yes" responses than females.

CONCLUSIONS

Oral health attitude and behavior increased with the increasing levels of dental education, and no significant differences were observed among male and female dental students.

Oral hygiene behavior, smoking, and perceived oral health problems among university students

Background:

Behavioral aspects play a major role in the prevention of oral diseases. Moreover, not many people are aware of the relationship of smoking with potential oral diseases. Therefore, the aims of this study were to analyze oral hygiene behavior, smoking habits, and perceived oral health problems among a sample of university students in Al-Kharj, Saudi Arabia.

Materials and Methods:

A self-administered questionnaire about oral hygiene behavior, smoking, and perceived oral health problems was developed. The questionnaires were mainly distributed in Medical, Dental, and Pharmacy colleges of the university. Questionnaires completed at other colleges were included under the term “other colleges.”

Results:

Overall, 380 questionnaires were returned. Majority of the students (92.4%) reported cleaning their teeth. Most of the students reported cleaning teeth once daily (48.7%). Just over a half (55.8%) reported having a dental check-up in the last 6 months, and a significantly higher number of dental students reported having a dental check-up (P < 0.05). Regarding smoking, the majority (63.4%) reported to have never smoked while 17.3% reported that they were smoking frequently. About 17.6% perceived oral health problems, including a significant proportion of those who reported frequent smoking.

Conclusions:

Oral hygiene behavior exhibited by the university students sample was similar. Majority cleaned their teeth, although only once. Smoking habit was not exhibited by the vast majority of students. Frequent smokers perceived oral health problems more than other students.

Determinants of preventive oral health behaviour among senior dental students in Nigeria

BACKGROUND

To study the association between oral health behaviour of senior dental students in Nigeria and their gender, age, knowledge of preventive care, and attitudes towards preventive dentistry.

METHODS

Questionnaires were administered to 179 senior dental students in the six dental schools in Nigeria. The questionnaire obtained information on age, gender, oral self-care, knowledge of preventive dental care and attitudes towards preventive dentistry. Attending a dental clinic for check-up by a dentist or a classmate within the last year was defined as preventive care use. Students who performed oral self-care and attended dental clinic for check-ups were noted to have complied with recommended oral self-care. Chi-square test and binary logistic regression models were used for statistical analyses.

RESULTS

More male respondents agreed that the use of fluoride toothpaste was more important than the tooth brushing technique for caries prevention (P < 0.001). While the use of dental floss was very low (7.3%), more females were more likely to report using dental floss (p=0.03). Older students were also more likely to comply with recommended oral self-care (p<0.001). In binary regression models, respondents who were younger (p=0.04) and those with higher knowledge of preventive dental care (p=0.008) were more likely to consume sugary snacks less than once a day.

CONCLUSION

Gender differences in the awareness of the superiority of using fluoridated toothpaste over brushing in caries prevention; and in the use of dental floss were observed. While older students were more likely to comply with recommended oral self-care measures, younger students with good knowledge of preventive dental care were more likely to consume sugary snacks less than once a day.

Determinants of dental health status and dental health behavior among Sana'a University students, Yemen

AIMS

To evaluate the dental health status and toothbrushing behavior among Sana'a University students, and to explore any associations with different factors.

METHODS

In this cross-sectional study, the dental health of 360 students from the dental, medical, and literature faculties (120 each) at Sana'a University were examined using the Decayed, Missing, and Filled Teeth (DMFT) index. Data regarding study field, grade, toothbrushing behavior, parents' education, and smoking and khat chewing habits were recorded.

RESULTS

Nearly 76% of students (n = 273) reported regularly brushing their teeth. Excluding fathers' education levels and khat chewing, other factors (faculty, grade, sex, mothers' education, and smoking) were significant independent predictors for this behavior. The overall mean DMFT score (± standard deviation) was 4.13 ± 3.1, and was found to be adversely influenced by smoking, which explained only 1.1% of the variance. Toothbrushing, sex, and smoking were significant independent predictors for the decay score, and explained 10.6% of its variance. Khat chewing was found to be adversely associated with the missing score, with an influence of only 2.9%. The filling score was found to be positively associated with toothbrushing and study grade, which together had an influence of 10%.

CONCLUSIONS

The dental health and toothbrushing behaviors of Sana'a University students are unsatisfactory, and influenced unequally by different factors.

Major differences in oral health knowledge and behavior in a group of Iranian pre-university students: a cross-sectional study

To establish efficient methods for self-prevention of oral diseases, assessment of dental health behavior and knowledge in various social classes is necessary. The main purpose of this study was to determine the major differences in oral health knowledge and behavior in a group of Iranian pre-university students. In this cross-sectional study, 591 pre-university students from different regions of Mashhad, Iran were randomly selected to complete a questionnaire consisting of two parts including dental health behavior and knowledge. Scores were recorded and statistical analyses performed to determine the correlation between dental health behavior and knowledge. Data was analyzed with Student's t-test, one-way analysis of variance and Pearson correlation. The mean score of dental health knowledge was significantly lower than the dental health behavior (2.95 ± 0.02 vs. 3.31 ± 0.05, P < 0.001). This difference was observed with gender, birth location and major subject of study. The dental health behavior of Iranian pre-university students was inadequate and their dental health knowledge was at a lower level compared to their behavior. Experimental science students had better oral health behavior compared to other students.

An international review of tobacco smoking among dental students in 19 countries

This study was conducted as a systematic review of all modern literature describing the prevalence of tobacco smoking among dental students. An electronic keyword search of appropriate terms was initially undertaken to identify relevant material, after which the reference lists of manuscripts were also examined to locate additional publications. A total of 27 studies from 19 countries were identified. The earliest manuscripts appeared in 1970, with the most recent being published in 2006. From a global perspective, our review suggests that tobacco smoking is relatively uncommon among contemporary dental students in Australia, Brazil, Canada, Great Britain and the United States. This is not surprising however, as it has previously been noted that dentists generally smoke at one of the lowest rates among all health professionals, and much lower than that of the communities in which they live. Somewhat discouragingly, we did find that smoking remains quite common among dental students in countries such as Greece, Serbia, Romania and Hungary. Given the fact that some of the student body continue to smoke tobacco, it is clear that more aggressive tobacco-specific measures should become a mandatory component of global dental education in future years.

Oral health behaviour and its determinants amongst Iranian dental students

OBJECTIVES

To study the oral health behaviour (OHB) of Iranian senior dental students in relation to their gender, background characteristics, knowledge of preventive care, and attitudes towards preventive dentistry.

MATERIALS AND METHODS

Using a cluster random sampling approach, a questionnaire survey was conducted with 327 senior dental students in seven dental schools. The questionnaire covered age, gender, parents' employment in dentistry, previous academic education in dental hygiene, oral self-care, most recent dental check-up, knowledge of preventive dentistry and attitudes towards it. Attending a dental check-up by a dentist or a classmate within the last year was defined as preventive care use. Chi-square test and logistic regression models were used for statistical analyses.

RESULTS

Women reported significantly higher frequencies of tooth brushing (P < 0.001), fluoridated toothpaste use (P = 0.001) and flossing (P < 0.001) compared with men. Respondents who had been previously educated as dental hygienists had lower frequencies of eating sugary snacks (P < 0.001) and paid more attention to preventive care (P = 0.03) than others. Those with more extensive knowledge of preventive care reported higher frequencies of using fluoridated toothpaste (P = 0.05). Reported frequencies of brushing were higher amongst those with more positive attitudes (P = 0.03). In logistic regression models, having at least one parent employed as a dentist was significantly associated with higher frequencies of eating sugary snacks (P = 0.047, OR = 0.3) and more frequent preventive care use (P = 0.048, OR = 2.9).

CONCLUSION

Education and training in preventive measures should be effective enough to overcome background characteristics. There is room for improving the OHB of Iranian dental students.

The hierarchical cluster analysis of oral health attitudes and behaviour using the Hiroshima University--Dental Behavioural Inventory (HU-DBI) among final year dental students in 17 countries

OBJECTIVE

To explore and describe international oral health attitudes/ behaviours among final year dental students.

METHODS

Validated translated versions of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) questionnaire were administered to 1,096 final-year dental students in 17 countries. Hierarchical cluster analysis was conducted within the data to detect patterns and groupings.

RESULTS

The overall response rate was 72%. The cluster analysis identified two main groups among the countries. Group 1 consisted of twelve countries: one Oceanic (Australia), one Middle-Eastern (Israel), seven European (Northern Ireland, England, Finland, Greece, Germany, Italy, and France) and three Asian (Korea, Thailand and Malaysia) countries. Group 2 consisted of five countries: one South American (Brazil), one European (Belgium) and three Asian (China, Indonesia and Japan) countries. The percentages of 'agree' responses in three HU-DBI questionnaire items were significantly higher in Group 2 than in Group 1. They include: "I worry about the colour of my teeth."; "I have noticed some white sticky deposits on my teeth."; and "I am bothered by the colour of my gums."

CONCLUSION

Grouping the countries into international clusters yielded useful information for dentistry and dental education.

Attitudes of dental and medical students in their first and final years of undergraduate study to oral health behaviour

OBJECTIVE

To compare differences in attitude to oral health behaviour amongst medical and dental students when they were in years 1 and 5 of University study respectively.

METHODS

Medical and dental students of Peking University in Beijing, China were invited to take part in this study. The original version of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) was written in Japanese. After testing the validity of both English and Chinese versions, the revised Chinese version of the HU-DBI was administered to new medical and dental students. In their final year of University study, the same questionnaire was again administered.

RESULTS

Significant differences were found for 13 of 21 items, reflecting an improvement in oral health attitudes and behaviour in final year dental students when compared with the time they were entrants. This difference was not found to be significant in the sample of medical students.

CONCLUSIONS

There were significant differences in oral health attitudes and behaviours in dental students between entrance to University and the final year of their study. The same was not found to be true for medical students.