Biomedical Research

Abstract

Oral health can be defined that “Individuals have satisfactory functional teeth that can eat, talk and do social activities without pain, disorder and discomfort during whole life and this contributes to general individual’s life welfare. As health problems have become an essential element of life, the importance of oral health care has been increasingly emphasized throughout life, from childhood to old age. To evaluate this purpose, we used this oral health status scale, which was recently developed. We examined the distribution of gender, income, oral health education, the time of tooth brushing, the frequency of tooth brushing, the experience of dental treatment, the period of using tooth brushing, grade and so on to understand the general characteristics of the subjects who are university students. Form this study we can see that we should consider individual dental treatment experience, gender, frequency of tooth brushing and oral health education to improve university students’ oral health knowledge. Therefore, university student’s oral health knowledge is important and oral health education for university students should be provided to contribute to positive change of cognition about oral health care of the subjects. The limit of this study is representing population is difficult because we target only students of some university and there is individual error about answer the survey so we expect a more detailed, developed follow-up study.

Keywords

Functional teeth, Oral health care, Oral health knowledge.

Introduction

Oral health can be defined that “Individuals have satisfactory functional teeth that can eat, talk and do social activities without pain, disorder and discomfort during whole life and this contributes to general individual’s life welfare [1]. As health problems have become an essential element of life, the importance of oral health care has been increasingly emphasized throughout life, from childhood to old age [2]. However, that does not mean income actions for oral health leads to putting actions for health into practice immediately. Starting from realization of health, practice for health can come in to action through awareness and understanding, demand of knowledge and analysis step [3]. Therefore, we can say that the realization of oral health is the most important factor. In addition, oral health education is an important part of the oral care process, and moreover oral health education is necessary because the oral health professionals can participate and exchange opinions with patients [4]. There are currently oral health educations in kindergarteners and the lower grades in elementary school, even if these were insufficient [5]. In addition, almost oral health educations for university students were not implemented. The oral health form while in the college integrates with experience not only in childhood but also in adolescence. The oral health form while in further college causes big influence on the oral health form in the future [6]. Moreover university students will go into the world in the close future and play a role to start a family. For these reasons, the knowledge, attitude and action for oral health of university students affect greatly to social marginal individuals and family [7]. But, university students don’t determine their own oral health status [8]. There is also partly overlap between university students and both of adolescence and adulthood and they have unique characteristics as target of education. So, it is needed to understand target’s social and psychological characteristics for effective oral health education [9]. Especially, prevention before contraction of disease is the most important because oral diseases occur frequently and have the characteristics of chronic disease, progressive disease and diffuse disease. To do this, we should motivate them to change their attitude for the improvement oral health by themselves [10]. The university students have to not only have the knowledge of oral health basically but also put it into action in order to prevent and maintain for oral health.

Therefore, this purpose of this study is to arrange frame of fundamental documents about the knowledge of general oral health targeting university students that is early adulthood. This study is supposed to suggest the exact plan and importance for qualitative improvement of oral health education business and furthermore, contribute oral health of university students to maintain clearly during whole life through examining factors and behaviors that causes influence on the knowledge of oral health of university students and understanding interrelation between them.

Materials and Methods

Materials and procedure

To evaluate this purpose, we used this oral health status scale, which was recently developed. This scale includes 15 questions and consists of dichotomous scale. We gave 1 point to right answer and 0 point to wrong answer and it means the more points the subjects are given, the more knowledge about oral health they have.

We examined the distribution of gender, income, oral health education, the time of tooth brushing, the frequency of tooth brushing, the experience of dental treatment, the period of using tooth brushing, grade and so on to understand the general characteristics of the subjects who are university students.

We performed recruited the university student in G and B province and made up a question voluntary for one week. We discussed the questionnaire items with co-workers (experts in these fields) in advances and we visited several university department and dental institution directly. Almost all questionnaires were collected except some wrong-answered questionnaires.

Analysis

We analysed university students’ knowledge about oral health using frequency analysis and descriptive statistics. We also used multiple regression (F=6.780, P<0.001) to analyse factors that cause influence on the knowledge about oral health. Adjustment Coefficient was adjR2=0.264. From this analysis, Dentistry treatment experience was important factors to the knowledge about oral health of university students. However toothbrush time was not important factor to the knowledge about oral health of university students.

We used SPPS 18.0 program to analyse.

Results

General characteristics and oral health behavior of the subjects who are university students

We examined the distribution of gender, income, oral health education, the time of tooth brushing, the frequency of tooth brushing, the experience of dental treatment, the period of using tooth brushing, grade and so on to understand the general characteristics of the subjects who are university students.

Male is 57.7%, 3000 thousand won to 390 thousand won is the most in median income (32.9%), the experience rate is 41.9% and 2~3 min is the most in the time of tooth brushing (55.9%) (Table 1). In the next, 3~4 times per d is 60.4% in the frequency of tooth brushing, 1~3 mon is the most in the period of using tooth brushing (61.7%) and 92% have dental treatment experience.

Table 1: General characteristics and oral health behavior of the subjects who are university students.

Level of the knowledge about oral health and prime variable

We analysed level of the knowledge about oral health and prime variable using descriptive statistic. The average of the knowledge about oral health is 10.3 points out of 15 points. In the next, the average of income is high 200,000 won, health status is bad, general health concerned is not concerned and oral health status and oral health concerned is the average (Table 2).

Table 2: Level of the knowledge about oral health and prime variable.

Itemized level of the knowledge of oral health of university students

The average of the right answer rate is 10.27 points (100 points convert into 68.44 points) to examine level of the knowledge about oral health of university students whose major is not dental hygiene. The question with high right answer rate is ‘dental caries is usually heals by itself.’ (Right answer 86.9%) followed by ‘dental caries gives pain when it starts first.’ (Right answer 85.1%), ‘dental caries bacteria moves tooth to tooth.’ (Right answer 84.2%). On the other hand, the question with high wrong answer rate is ‘Blooding from gingiva when tooth brushing is the sign of gingival disease.’ (Right answer 37.4%) followed by ‘fluorine plays the role of water disinfection.’ (Right answer 39.2%) and ‘gingival disease gives pain when it starts first.’ (Right answer 54.5%) (Table 3).

Table 3: Level of the knowledge of oral health of university students.

Factors that causes influence on the knowledge of oral health of university students

We analysed factors that causes influence on the knowledge of oral health of university students using multicenter retrospective study. We put level of the knowledge about oral health into dependent variable and both of general characteristics and factor of practice for oral health into independent variable.

We also used multiple regression to analyse factors that cause influence on the knowledge about oral health. It was statistically significant differences (F=6.780, P<0.001) (Table 4). Adjustment Coefficient was adjR2=0.264. From this analysis, of the several factors, dentistry treatment experience and toothbrush time was meaningful factors to the knowledge about oral health of university students.

Table 4: Factors that causes influence on the knowledge of oral health of university students (Interrelation-multicenter retrospective study).

Dentistry treatment experience was important factors to the knowledge about oral health of university students. However toothbrush time was not important factor to the knowledge about oral health of university students.

We used SPPS 18.0 program to analyse.

The analysis result show higher level of the knowledge about oral health in female than male, lower income, lower frequency of tooth brushing and having dental treatment experience than not having. Furthermore, experience of oral health education causes influence on the knowledge of oral health, but it isn’t significant in 0.05 statistical significance level.

Discussion and Conclusion

Despite the growing needs, Oral health care services were relatively small especially in G and B provinces. It was generally understood that Korean people will seek the health care service only when they recognize a need for dental treatment. That’s because, it is most important things that evaluating and educating oral health status and analyzing factors on the knowledge of oral health in the periods of university periods.

Moreover, there is some reports of educational intervention on oral hygiene is closely related with the good quality of life.

University students belong to the youth oral health target and will play a leading part in the future, so it is helpful a lot to seek for development direction of oral health care in future society that examine their oral health concerned [11]. The level of oral health can be improved through changing the knowledge, attitude and action involved in oral health rationally and the information about these seems to play an important role in long-term comprehensive oral health development [12]. In the past, the major purpose of oral health care was treatment but as changing of cognition, various methods to prevent dental caries and periodontal disease have been found. Especially, the cognition of oral health education has been increased [13]. In the result of examining advanced study, the level of cognition is regarded as similar meaning to the knowledge. The level of knowledge is associated significantly with the level of periodontal treatment demand [14]. Furthermore, the individual level of knowledge about oral health causes influence to management. Individuals recognize and judge their own oral health status based this so its importance has been emphasized [15]. Therefore, it is also important that university students have the right knowledge about oral health. This study researched the university students’ knowledge of oral health, the level of that and the factors that cause influence in the knowledge about oral health in order to provide a framework of base line data for the university students’ knowledge about oral health.

In general characteristic, the experience rate of university students’ oral health education is 41.9%. It is somewhat higher than advanced study’s rate; 28.1% but still seems to be low [16]. Besides, Kim’s study reported the level of knowledge of group that had oral health education is higher than group that didn’t have in the result of estimating after oral health education targeting elementary school students [17]. Kim’s study said 53.0% of health related majors and 52.4% of nonhealth related majors recognized that oral health education is necessary through answering the question about the need of oral health education [18]. So, we consider it is important to increase the chance of university students’ oral health education. Darby and Walsh [19] suggested tooth brushing twice at least in a day in order to prevent formation of dental plaque and control bad breathe although there is not fixed number of tooth brushing that can prevent formation of dental plaque. However, the highest frequency of tooth brushing in this study was 3~4 times per d as 60.4%. The subjects who brush their teeth 3 times per d among 178 elementary students are the highest as 59.0% [20]. In addition, in Joe’s [20] study targeting some professions affiliated to medical care institution for the elderly, 89.1% of the subjects also answered they brush their teeth more than 3 times per d. It is same as advanced study. But, the highest period of using toothbrush was 1~3 mon as 61.7%. In the case of average replacement cycle for toothbrush, 48.9% of men answered 3~4 mon and 38.6% of women answered 2~3 months [21]. It is different result with this study.

The average knowledge about oral health is 10.3 point out of 15 point. It is similar to Lee et al.’s study that the average knowledge about oral health is 8.77 point out of 14 point [22]. Health status is bad and the general health concerned level was also low. Besides, oral health status and oral health concerned level is lower than the knowledge about oral health as 3.24 point and 3.39 point. Currently, the level of knowledge about oral health increases more than before. As shown in Kim and Min’s study [23], the public’s cognition about importance of oral health also increases by economic growth, advertisement through media, increase in dental institution and extending medical insurance. The high knowledge about oral health is very important because it changes attitude for oral health, promote right oral health action and make the public have a habit of it.

In the result of itemized level of the knowledge of oral health of university students (Table 3), the average right answer rate for 15 questions to see non-dental hygiene majors’ oral health knowledge level is 10.27 point (100 points convert into 68.44 points). The question with high right answer rate is ‘Dental caries is usually healed by itself.’ (Right answer 86.9%) followed by ‘Dental caries gives pain when it starts first.’ (Right answer 85.1%). This is same to the study targeting pregnant women in some regions that each same questions’ right answer rate was high as 95.6% and 85.4% [24]. On the other hand, the question with high wrong answer rate is ‘Fluorine plays the role of water disinfection.’ (Right answer 39.2%) although there is the question with high right answer rate; ‘Fluorine prevents dental caries.’ (Right answer 78.8%). This means there is shortage of the knowledge about fluorine’s various roles. It is same as Kim and Song’s study [25] that reported most of subjects have wrong cognition about fluorine generally. We consider it is important to use fluorine with exact knowledge.

The analysis result show the higher level of the knowledge about oral health in female than male, lower income, lower frequency of tooth brushing and having dental treatment experience than not having. Furthermore, experience of oral health education causes influence on the knowledge of oral health, but it isn’t significant in 0.05 statistical significance level. This is same as Kim and Woo’s study [26] that reported oral health knowledge level of laborers who have education experience is higher than one of laborers who don’t have. Son [27] let us know the importance of oral health education by saying the knowledge and attitude about oral health change through oral health education. Park and Moon [28] also showed female have higher oral health knowledge level than male. However, the knowledge about oral health by household income didn’t represent significant difference statistically. This is different with this study’s result that the lower income causes influence in the knowledge about oral health. Although Jang and Kim’s study [29] reported the subjects have lower average income per month then have worse oral health status and this is because they have psychological burdens about dental treatment fee so they can’t have been treated on time, this study shows the subjects who have lower income have the higher knowledge about oral health and this seems that psychological burdens about dental treatment fee causes influence in the knowledge about oral health. Lim and Choi’s study [30] reported the higher score of oral health knowledge the subjects have, the higher score of oral health action they have. This study represents lower frequency of tooth brushing causes influence in the oral health knowledge although advanced study there is a result of study that there was no significant difference in dental treatment experience, frequency of tooth brushing, time of brushing by subjective oral health knowledge of parents and children [31]. However, this study showed that the lesser frequency of tooth brushing the more affected by oral health knowledge. We think these results show influence in frequency of tooth brushing and oral health knowledge can be changed by who is the subjects.

In the above results or this study, we can see that we should consider individual dental treatment experience, gender, frequency of tooth brushing and oral health education to improve university students’ oral health knowledge. Therefore, university student’s oral health knowledge is important and oral health education for university students should be provided to contribute to positive change of cognition about oral health care of the subjects. The limit of this study is representing population is difficult because we target only students of some university and there is individual error about answer the survey so we expect a more detailed, developed follow-up study.

Near future researches, developing and educating oral health program consisted of oral health knowledge factors in university students is urgently needed. This study should be help in providing more information about the impact of oral health programs.

Acknowledgement

This paper was supported in part by research funds of Kangwon National University (220150004).

References

1. Ahn KS, Shin MA. Association between oral health status and oral health impact profile (OHIP-14) among the community elderlies. J Korean Soc Dent Hyg 2011; 11: 923-938.
2. Avcu N, Ozbek M, Kurtoglu D, Kurtoglu E, Kansu O. Oral findings and health status among hospitalized patients with physical disabilities, aged 60 or above. Arch Gerontol Geriatr 2005; 41: 69-79.
3. Oh YB, Lee HS, Kim SN. Children’s dental health behavior in relation to their mothers socioeconomic factors and dental health beliefs. J Korean Acad Dent Health 1994; 18: 62-83.
4. Lee EJ, Park EH. A study on self-perception of oral health, oral health behavior recognition and oral health practice of adult. J Korean Acad Oral Health 2010; 34: 595-602.
5. Jung YH, Shin HM. The effects of oral health education activities in kindergarten and elementary schools. J Future Early Childhood Edu 2009; 16: 171-191.
6. Jeong GC, Lee HS, Kim SN. A study on the dental services utilization by application of the Andersen model in students of some Korean university. J Korean Acad Dent Health 2003; 27: 357-373.
7. Lee JS, Yoon YM, Lee HS, Kim SN. Restricted activity with oral disease in a Korean university student. J Korean Acad Dent Health 2001; 25: 245-258.
8. Choi EM. A study on the college students’ dental health knowledge and the usage of the oral hygiene devices. Dong-U College Jol 1994; 6: 377-391.
9. Lim JN, Jung YR. Development proposal of oral health educational media based on the oral health care and educational needs of college students. J Korean Soc Dent Hyg 2013; 13: 323-334.
10. Won SY, Shin SC, Kim SY. A study on the correlation between the awareness and the oral status for freshmen students. J Korean Acad Oral Health 1997; 21: 149-503.
11. Lee KH, Kim SK. A study relationship between dental health perception and practice of college students. J Korean Soc Dent Hyg 2013; 13: 845-853.
12. Seong JH, Seo EJ, Cheong HG. An analysis on the treatment needs of periodontal disease of residents in Gwangju and Chunnam Province. Oral Biol Res Inst 2001; 25: 6-18.
13. Choi HS, Hawng SH. Impact of oral health education on the oral health knowledge, attitude, and behavior of college students. JKSSCHE 2010; 11: 7-15.
14. Kang MS, Kim CY, Kim HG, Kim BI. Influence of self-perception, attitude, behavior and knowledge about oral health on caries experience and periodontal treatment need. J Korean Acad Dent Health 1994; 18: 144-163.
15. Lee EJ. A study on self-perception of oral health, oral health behavior recognition and oral health practice of adult. J Korean Acad Oral Health 2010; 34: 595-602.
16. Kim SH, Ku IY, Heo HY, Park IS. A study on the awareness of oral health education for senior high schools. J Korean Soc Dent Hyg 2007; 7: 105-113.
17. Kim YH. Comparative study of the students’ oral health knowledge and behavior between the elementary schools with or without dental clinic. J Korean Con 2012; 12: 361-368.
18. Kim YI, Heo HY. A Comparative study on the oral-health experience of health-related and health. Korean Acad Dent Hyg 2008; 10: 19-27.
19. Darby ML, Walsh MM. Dental hygiene theory and practice. 2nd Missouri Saunders 2003; 348-353.
20. Cho NI, Park SY, Lee HS, Oh HW. Oral health knowledge and behavior among nursing home employees in Seoul, Korea. J Korean Acad Oral Health 2013; 37: 16-24.
21. Kim SJ. Evaluation of wear index of toothbrushes used by university students and analysis of related factors. J Korean Con 2016; 16: 609-617.
22. Lee HK, Park CS, Kim MJ. Interrelation research of the knowledge regarding the oral health of the elementary school child and behavior. J Dent Hyg Sci 2008; 8: 155-161.
23. Kim JH, Min KJ. Research about relationship between the quality of life, oral health and total health of adults. J Korean Soc Health Educ Promot 2008; 25: 31-46.
24. Lee KY, Won BY. A study on the oral health care of pregnant women in a region. J Korean Soc Dent Hyg 2009; 9: 1-14.
25. Lee JS, Kim JS, Song KB. Oral health knowledge and attitudes among elementary school nursing teachers in Taegu and Kyungpook province, changes between 1993 and 1998. J Korean Acad Dent Health 1998; 22: 317-331.
26. Kim EJ, Woo SH. Relationship of oral health education experience to oral health awareness among shipbuilding workers. J Korean Con 2012; 12: 240-246.
27. Son MH. Effects of oral health education program on the oral health knowledge, oral health behavior and oral hygiene status of elementary school students. J Korean Acad Community Health Nurs 2003; 14: 24-35.
28. Park HR, Moon SJ. Connections between the subjective awareness characteristics of oral health of certain adults and their oral health knowledge and practice behavior of oral health. J Korean Con 2013; 13: 300-310.
29. Jang YJ, Kim NS. Relationship of oral health behavior to subjective oral health status and the DMFT index in Korean adults. J Korean Soc Dent Hyg 2011; 11: 499-509.
30. Lim KO, Choi JH. Survey on oral health behavior and knowledge of middle school students. J Korean Soc Dent Hyg 2011; 11: 243-250.
31. Lee YK. A study on mothers oral health knowledge and oral health management behavior of children. J Korean Soc Dent Hyg 2010; 10: 93-106.