Oral health status and oral health knowledge,attitudes and behavior among rural children in Shaanxi,western China: a cross-sectional survey

Background

The current oral health status and possible dental risk factors among children in rural Shaanxi Province, western China are unreported. This study aimed to describe the oral health status and to analyze the possible risk factors for the oral health status in this population.

Methods

A multi-stage cluster sampling method was used to survey 12- to 15-year-olds and 4- to 6-year-olds in villages in Shaanxi Province. The structured questionnaires were provided to the 12- to 15-year-olds and to the caregivers of the 4- to 6-year-olds to collect information on the subjects’ oral health knowledge, attitudes and behavior. A clinical examination was performed to assess dental caries and gingival bleeding (only 12- to 15-year-olds). SPSS 17.0 statistical software was used to analyze the data.

Results

The decayed, missing, filled teeth (DMFT) index scores of 12- to 15-year-olds and 4-to 6-year-olds averaged 0.45 and 3.05, respectively. The caries prevalence was 23.9% in 12- to 15-year-olds and 67% in 4-to 6-year-olds. Additionally, 45.2% of the 12- to 15-year-olds had gingival bleeding and 62.8% had calculus. The oral health knowledge of the subjects was generally poor, whereas they held very positive attitudes toward oral health. A low number of participants reported that they brushed their teeth at least twice daily. Moreover, a statistically significant relationship was found between oral health knowledge scores, tooth brushing frequency and DMFT scores as well as gingival bleeding in the 12- to 15-year-olds. Frequency of sweets consumption was strongly related to dmft scores in the 4- to 6-year-olds.

Conclusion

The oral health status, oral health knowledge and behaviors among village children in Shaanxi Province are poor. Oral health education to improve oral health knowledge and to increase the frequency of tooth brushing should be undertaken in the rural schools in western China.

     

School-based education to improve oral cleanliness and gingival health in adolescents in Tehran, Iran

Background.  Schools can be an important setting for health education programmes, controlling the growing burden of oral diseases and promoting oral health.
Aim.  The aim of this study was to evaluate the short-term effect of school-based educational intervention on oral cleanliness and gingival health of 15-year-olds in Tehran, Iran.
Design.  The present cluster randomized trial was based on exposing students ( n  = 287; control, n  = 130) at public schools to oral health knowledge through a leaflet or a videotape. The outcome was evaluated after 12 weeks. A positive outcome was defined as at minimum a 50% reduction in numbers of teeth with dental plaque or gingival bleeding compared to baseline. Evaluation included percentage changes, number needed to treat (NNT), and students' self-assessment.
Results.  At baseline, all students had dental plaque, and 93% had gingival bleeding on at least one index tooth. Positive outcome for oral cleanliness was 58% ( P  < 0.001) of the students in the leaflet group, 37% ( P  < 0.001) in the videotape group, and 10% of controls. Corresponding figures for gingival health were 72% ( P  < 0.001), 64% ( P  < 0.001), and 30%. For oral cleanliness, NNT was 2 in the leaflet and 3 in the videotape group; for gingival bleeding, NNT in both groups was 3. More than two-thirds of the students assessed their oral health behaviours as having improved moderately.
Conclusion.  An easy-to-organize and inexpensive school-based intervention can in the short term be effective in improving oral cleanliness and gingival health among adolescents; in particular, in countries with a developing oral health system.     

潮州市15～17岁学生口腔健康知识及行为调查

目的：探讨潮州市15～17岁学生对口腔健康知识的了解情况及其口腔健康行为，为口腔卫生保健工作提供信息支持。方法采用分层整群随机抽样的方法，按照样本纳入标准抽取潮州市15～17岁学生933名进行问卷调查。所使用问卷参照第四次全国口腔健康流行病学调查问卷，结合本课题研究目的设计。问卷内容包括：人口统计学和社会学资料、口腔健康知识和口腔健康行为。对问卷调查资料进行分析。结果仅13.1%的学生认同“窝沟封闭可保护牙齿”。女生（t=5.198）、父亲受教育程度较高者（t=2.667）口腔健康知识得分较高（P<0.01）。刷牙频率与年龄和性别相关，年龄较大者（c2=23.002）和女生（c2=98.722）每天刷牙2次或以上的比例较高（P<0.001）。75.2%的学生不知道自己使用的牙膏是否含氟，91.5%的学生没有使用过牙线。口腔科就诊经历在性别（c2=16.406）和母亲受教育程度（c2=12.566）方面的差异具有统计学意义（P<0.01）。结论潮州市15～17岁学生口腔健康知识及行为需要积极改善，男生、低年龄组和父母受教育程度低者是重点教育对象。     

大庆市12岁儿童恒牙龋病状况及影响因素分析

目的 了解大庆市12岁儿童龋病患病情况及其影响因素,为大庆市龋病的防治工作提供科学依据.方法 采用分层、等容量、整群随机抽样的方法对大庆市初中一年级12岁儿童共510名进行恒牙龋病的流行病学调查,受检者同时填写调查问卷,问卷内容涉及人口学资料、进食碳酸型饮料的频率、进食饼干等甜食的频率、刷牙次数、含氟牙膏使用情况等.采用SPSS17.0统计软件对结果进行统计学分析.结果 大庆市12岁儿童患龋率为27.06％,龋均为0.58,男女患龋率分别为22.85％和32.17％,差异有统计学意义（P＜0.05）;logistic多因素回归分析显示是否为独生子女、刷牙次数与龋病的发生无相关性,性别、进食碳酸型饮料的频率、进食饼干等甜食的频率、含氟牙膏的使用与恒牙龋病有相关性.结论 大庆市12岁学生女性患龋率高于男性.女性、进食甜食或进食碳酸型饮料每天多于2次的儿童患龋病的概率大.     

Dental Caries Prevalence and Oral Health Status among 15-Year- Old Adolescents in Kosovo

IntroductionCaries has a harmful impact on oral and general health and is a major public health problem among children and adolescents. The objective of present study was to investigate into dental caries, oral hygiene, the frequency of brushing habits and dental visits among 15- year- old adolescents.Material and methodsThis cross-sectional study was carried out on a random sample of 323 15- year- old adolescents in different schools and municipalities of Kosovo. Oral clinical examination and self-administered questionnaire were used to obtain information about dental caries and oral health practices. Oral hygiene and caries status in permanent dentition was assessed through the DMFT index and Oral Hygiene Index - Simplified (OHI-S). The level of statistical significance was set at p<0.05.ResultsThe total mean of the DMFT index was 3.21 ± 2.193, while component D of the DMFT index dominated in both genders, with slightly higher values in boys compared to girls (2.15±2.092, and 1.91±1.919). The mean OHI-S index of adolescents aged 15 was found to be 1.945±3.926. Over 50% of schoolchildren brush their teeth only once per day and they have visited the dentist only when it was necessary. Irregular tooth-brushing, dental visits and poor oral hygiene index were significantly related to dental caries.ConclusionThe results of the study showed poor oral health status among 15- year- old adolescents in Kosovo. There is an emergent need for caries-prevention programs focusing on oral health and healthy habits.Key words: Dental Caries, Oral Hygiene Index, Tooth brushing, Dental Visits, Adolescents     

Knowledge and behaviour related to oral health among secondary school students in Khartoum Province, Sudan

OBJECTIVE: This study explores secondary school students in the Khartoum Province, Sudan, with respect to frequency and quality of use and the socio-demographic distribution of oral health knowledge and behaviour. METHODS: Six secondary schools were selected at random and 10% of the students enrolled in each class (3 grades) were randomly selected to participate. A total of 400 students (207 boys) (mean age 15.3 years) were selected, of which 396 completed questionnaires at school. RESULTS: 44.3% boys and 42.5% girls scored highly on knowledge of caries. The corresponding rates regarding knowledge of gingivitis were 39.2% and 47.0%, respectively. Tooth brushing and use of miswak > or = 2 times a day was confirmed by 67.2% boys and 75.5% girls and by 64.3% boys and 52% girls, respectively. Living in a town, having received oral health information and having a mother of medium education were associated with higher odds for being knowledgeable about tooth decay. CONCLUSION: There is gender equality in knowledge and practise of oral hygiene among secondary school students in Khartoum Province. Awareness of oral health issues is high, but specific misconceptions exist. Mother's education might be used as a social marker in oral health risk group evaluations.     

Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents.

A cross-sectional dental questionnaire census survey was conducted in classrooms of 17,280 students aged 13-18 years in Skaraborg County, Sweden. The overall response rate, based on school attendance on the test day, was 91% with no gender differences at the senior level, and 86% (boys 87%, girls 85%) at the upper secondary level. The aim was to examine gender differences in knowledge, attitude, behavior and perceived oral health. A retest study showed good agreement. Thirty-one percent of the girls and 21% of the boys flossed regularly. Eleven percent reported daily candy consumption, with no significant gender difference. Girls, however, more often than boys considered their own consumption to be too high. This gender difference in attitude was most pronounced among older daily consumers (odds ratio (OR) = 5.8 [3.7-9.2]). Oral health was regarded as important by a majority of the students (95%). Girls considered sound teeth to be more important than did boys, both among the younger (OR = 1.7 [1.4-2.1]) and the older (OR = 2.4 [1.9-3.1]) adolescents. It is concluded that most adolescents had a positive dental attitude and perceived their own oral health to be good. Poorer knowledge and behaviors concerning oral health were demonstrated. Gender differences existed in most issues. Girls scored more favorably on behavioral measures, showed more interest in oral health, and perceived their own oral health to be good to a higher degree than did boys.     

Oral health knowledge, attitudes and behaviour of adults in China

OBJECTIVES: To describe oral health behaviour, illness behaviour, oral health knowledge and attitudes among 35-44 and 65-74-year-old Chinese; to analyse the oral health behaviour profile of the two age groups in relation to province and urbanisation, and to assess the relative effect of socio-behavioural risk factors on dental caries experience. METHODS: A total number of 4,398 35-44-year-olds and 4,399 65-74-year-olds were selected by multistage stratified cluster random sampling which involved 11 provinces in China. Data were collected by self-administered structured questionnaires and clinical examinations (WHO criteria). RESULTS: 32% of the 35-44-year-olds and 23% of the 65-74-year-olds brushed at least twice a day but only 5% used fluoridated toothpaste; 30% and 17% respectively performed 'Love-Teeth-Day' recommended methods of tooth brushing. A dental visit within the previous 12 months was reported by 25% of all participants and 6% had a dental check-up during the past two years. Nearly 15% of the subjects would visit a dentist if they experienced bleeding from gums; about 60% of the subjects paid no attention to signs of caries if there was no pain. Two thirds of the urban residents and one fifth of the rural participants had economic support for their dental treatment from a third party, either totally or partially. Significant variations in oral health practices were found according to urbanisation and province. At age 35-44 years 43% of participants had daily consumption of sweets against 28% at age 65-74 years. Dental caries experience was affected by urbanisation, gender, frequency, time spent on and method of tooth brushing. Knowledge of causes and prevention of dental diseases was low with somewhat negative attitudes to prevention observed. CONCLUSION: Systematic community-based oral health promotion should be strengthened and preventive-oriented oral health care systems are needed, including promotion of further self-care practices and the use of fluoridated toothpaste.     

The theory of reasoned action in describing tooth brushing,dental caries and diabetes adherence among diabetic patients

OBJECTIVES: Preventive oral health behaviour is important among diabetic patients, as it has been found that dental diseases and insulin-dependent diabetes mellitus (IDDM) have some psychological and biological factors in common. The aim here was to analyze the variables of Ajzen and Fishbein's theory of reasoned action to explain the reported frequency of tooth brushing, dental caries, HbA1c level and diabetes adherence. MATERIAL AND METHODS: Cross-sectional data were gathered from 149 IDDM patients by means of a quantitative questionnaire, clinical examination and patient records. RESULTS: The results showed that a firmer intention to brush the teeth was related to a higher reported frequency of tooth brushing (p < 0.001). The attitude to and the subjective norm of tooth brushing were related to the intention to brush(p < 0.001) and to the reported frequency of tooth brushing. A better dental attitude was related to better diabetes adherence (p = 0.002) and fewer decayed surfaces (p = 0.01), and a firmer intention to brush the teeth was related to a lower HbA1c level (p = 0.015). CONCLUSIONS: Our results suggest that in oral health promotion among diabetic patients, both subjective norm and attitude are important and that diabetes adherence may be influenced by promoting dental attitude.     

Prevalence of intrinsic tooth discolouration among 11-16 year-old Nigerians.

600 children aged 12 to 16 years were examined in the Surulere Local Government Area of Lagos State, Nigeria to determine the prevalence and types of intrinsic tooth discoloration. 306 boys and 294 girls were selected from six schools (3 primary and 3 secondary schools) by stratified random sampling. The teeth of the children were examined in a wet state for intrinsic stains, however, no attempt was made at aetiologic diagnosis of enamel hypoplasia and enamel opacities, diagnosis were based on clinical presentations. A 37.7% (226) prevalence of intrinsic tooth discolouration was recorded among the subjects. 36.0% (110) of the boys and 39.5% (116) of the girls had intrinsic tooth discolourations. The differences in prevalence of intrinsic tooth discolouration among the sexes and among the social classes were not statistically significant (p = 0.375 and p = 0.272). There was, however, a statistical difference in prevalence of intrinsic tooth discolouration among the age categories (p = 0.0013), with the older adolescents showing a higher prevalence of stains. This is linked to the greater possibility of presenting with acquired intrinsic tooth discolouration as one gets older. The commonest types of intrinsic tooth discoloration were enamel opacities (23.0%), tetracycline staining (9.2%) and enamel hypoplasia (7.3%). Other intrinsic tooth discolourations were those due to dental caries (4.3%), pulp necrosis/ haemorrhage (0.8%), toothwear (0.3%), and discoloured restorations (0.3%). A very low level of utilisation of dental services was noted, with 91.5% (549) of the subjects reporting that they had never visited a dentist. The common intrinsic tooth discolorations seen in the study are those usually associated with childhood malnutrition, preventable childhood diseases and the irrational use of drugs (tetracyclines). There is a need to intensify child immunization efforts in the community as well as health education and promotion activities geared toward proper nutrition and the rational use of drugs. The establishment of school meals in primary and secondary schools in the LGA will go a long way in improving nutrition and prevent the tooth discolouration types associated with poor nutrition. Dental services may be made more available, accessible and affordable for the children by the establishment of a school oral healthcare programme.     

Periodontal health, oral health behaviours, and chronic obstructive pulmonary disease

Aim: To evaluate the associations of periodontal health status and oral health behaviours with chronic obstructive pulmonary disease (COPD).
Materials and Methods: We conducted a case–control study of 306 COPD patients and 328 controls with normal pulmonary function. Their periodontal status and respiratory function were clinically examined and information on oral health behaviours was obtained using a validated questionnaire.
Results: Patients with COPD had fewer teeth and a higher plaque index than the controls. Univariate analysis showed that tooth brushing times and method, experience of dental floss use, dental visit and regular supra-gingival scaling, and oral health knowledge were significantly related to the risk of COPD. After adjusting for age, sex, and body mass index and stratifying by smoking status, inappropriate tooth brushing method ( p =0.025 among non-smokers), lower regular supra-gingival scaling ( p =0.027 among non-smokers and p <0.0001 among former smokers), and poorer oral health knowledge ( p <0.0001 among non-smokers and p =0.019 among former smokers and p =0.044 among current smokers) remained significantly associated with COPD.
Conclusions: Poor periodontal health, dental care, and oral health knowledge were significantly associated with an increased risk of COPD. Our findings indicate the importance of promoting dental care and oral health knowledge that can be integrated into the prevention and treatment of COPD.     

Prevalence of breath malodour in 7- 11-year-old children living in Middle Anatolia, Turkey

OBJECTIVE: To determine the prevalence of breath malodour and to assess the relationships between breath malodour parameters such as dental caries, habitual mouth breathing, tooth-brushing, and the frequency of upper respiratory-tract infection. METHODS: A total of 628 healthy children (327 boys, 301 girls) ranging in age from 7 to 11 who were living in Kirikkale, Middle Anatolia, Turkey were included. Subjects who were taking antibiotics, having any suspicion of upper respiratory tract infection, sinusitis or tonsillitis at the time of survey were excluded from the study. Oral malodour assessment was carried out by organoleptic method. The DMFT/S was used to record caries. Pearson's correlation coefficients were calculated to determine the association of each clinical variable to organoleptic oral malodour rating. Bivariate logistic regression analysis was performed to detect the degree of association between oral malodour and various dental-habitual parameters. RESULTS: The prevalence of halitosis was 14.5%. Organoleptic oral malodour ratings were significantly higher in older age groups. Gender, frequency of tooth brushing, habitual mouth breathing did not influence oral malodour ratings. D(T), DMF(T), d(s) played the most significant role in higher oral malodour ratings, followed by d(t) and df(s). The frequency of tooth brushing, habitual mouth breathing did not contribute to the prevalence of halitosis. CONCLUSION: Age, prevalence and severity of dental caries were significantly related to breath malodour.     

Epidemiology of clinical attachment loss in adolescents.

BACKGROUND: Relatively little is known about the prevalence, severity, and determinants of clinical attachment loss among adolescents. METHODS: A multi-stage random sampling procedure was used to obtain a sample of 9,203 high school students aged 12 to 21 years from the Province of Santiago, Chile. All but 41 students were examined for clinical attachment loss in 6 sites of first and second molars and incisors. The students were interviewed with respect to tooth brushing habits, smoking habits, dental visits, and diabetic status. Logistic regression analyses were used to assess the relative strength of the associations between age, gender, smoking, tooth brushing habits, dental attendance patterns, diabetic status, and governmental school support and the occurrence of clinical attachment loss. RESULTS: Overall, clinical attachment loss > or = 1 mm was seen in 69.2% of the students; > or = 2 mm in 16% of the students; and > or = 3 mm in 4.5%. The distribution of clinical attachment loss was markedly skewed, but followed a continuum of disease severity. Logistic regression analyses showed that attachment loss was associated with higher age, female gender, infrequent tooth brushing, infrequent dental visits, and attending a high school receiving governmental support. CONCLUSIONS: No sharp distinction exists between periodontal health and disease among Chilean adolescents. Higher age, poor oral hygiene, and a lower socioeconomic background play a role in the occurrence of clinical attachment loss.     

上海市静安区152名聋哑学生口腔状况及龋病相关影响因素分析

目的: 调查上海市静安区聋哑学生的口腔健康状况,分析聋哑学生龋病的相关影响因素。方法: 对上海市静安区内2所聋哑学校152名9~18岁学生进行口腔检查及问卷调查。采用SPSS 22.0软件包对数据进行统计学处理。结果: 152名聋哑学生中,总患龋率为53.3%,龋均为1.80±2.66,牙龈出血检出率为65.8%,牙石检出率为69.7%。第一恒磨牙患龋率为36.2%,窝沟封闭率为0.6%。其中,12~15岁年龄组患龋率为50.0%,龋均为1.69±3.13,牙龈出血检出率为68.5%,牙石检出率为70.4%,均高于第4次全国口腔健康流行病学调查报告中12~15岁年龄城市组的各项数据。Logistic回归分显示,每天刷牙次数（P=0.009）、刷牙牙面（P<0.001）、刷牙时间（P=0.005）、饮用甜饮料及碳酸饮料频率（P=0.003）和口腔保健知识知晓情况（P=0.036）都是聋哑学生龋病发生的相关影响因素。结论: 针对聋哑学生的龋病防控,应进一步加强口腔健康教育,同时推进局部涂氟、窝沟封闭、早期龋齿充填等干预措施的实施,从而有效控制聋哑学生龋病的发生和发展。     

重庆市12～15岁中学生口腔健康知识、态度、行为的问卷调查分析

目的 对重庆市12~15岁中学生口腔健康知识、态度、行为等情况进行抽样调查并分析,为有针对性地对中学生开展口腔健康指导计划提供依据。方法 采用多阶段分层抽样的方法抽取重庆市4个区县（主城区和郊区各2个）12~15岁4个年龄组中学生,通过问卷方式调查其口腔健康知识、态度及行为等方面的情况。全部数据使用Epidata双录入,使用SPSS 21.0软件进行统计学分析。结果 共计回收有效问卷3 902份,有良好刷牙习惯的比例为39.7%（1 548人）,平均口腔健康知识正确率为58.9%,平均口腔健康正性态度为88.6%,有就医经历的中学生为54.5%（2 127人）,在学校接受过口腔健康教育的为17.5%（681人）。刷牙习惯存在性别和地区性的差异。结论 重庆市12~15岁中学生口腔健康知识知晓情况和口腔卫生行为有待提高,应加强针对中学生的口腔健康教育和口腔健康行为指导,并加强远郊和农村地区的口腔健康教育工作。     

Caries prevalence and bottle-feeding practices in 2-year-old children with cleft lip, cleft palate, or both in Taiwan.

OBJECTIVE: The purposes of this study were to investigate the caries prevalence in cleft lip, cleft palate, or both in children under the age of 2 years and to evaluate parental attitudes toward bottle-feeding, dental care, and their relationship to baby bottle tooth decay (BBTD) in Taiwan. DESIGN: Randomized and prospective study. SETTING: Institutional setting. PATIENTS AND METHODS: One hundred twenty-three 2-year-old children (68 boys and 55 girls) with cleft lip, cleft palate, or both were selected for this study. A questionnaire that asked questions about knowledge of oral health, knowledge and beliefs about BBTD, children's feeding habits, children's dental care, and parenting attitudes toward children with clefts was completed by the parents or caretakers. Children were divided into bottle-feeding and non-bottle-feeding groups according to the questionnaire responses of parents or caretakers. Each child was examined with a dental mirror and explorer under focused flashlight using defs index to determine the presence of BBTD. RESULTS: Thirty-nine percent (48) subjects reported a bottle-feeding habit; the overall prevalence of BBTD was 15.4%. The habit of bottle-feeding was significantly related to BBTD (p = .019). The defs score for children who were bottle-fed was significantly higher than children who were not bottle-fed (p = .045). Parents or caretakers of both bottle-feeding and non-bottle-feeding children showed no significant differences in their attitudes toward bottle-feeding and feeding habits (p > .05). However, parents of non-bottle-fed children had significantly better dental care than parents of bottle-fed children in brushing frequency (p < .001) and brushing before bed (p < .001). CONCLUSIONS: Children with clefts who took a bottle to bed showed an increased risk of developing BBTD. The parents or caretakers of bottle-fed children also showed a lack of motivation to perform regular preventive dental home care for their children. This suggests that oral health promotion programs should begin in infancy for children with clefts and their parents.     

Oral health-related knowledge,attitudes and habits in relation to perceived oral symptoms among 12-year-old school children

Objective The aim of the study was to investigate oral health-related knowledge, attitudes and habits and their relationship to perceived oral symptoms among 12-year-olds and differences between boys and girls. Material and methods The study population consisted of children (n?=?588) in 15 randomly selected elementary schools in Turku, Finland. Associations between oral health-related habits, knowledge and attitudes with perceived oral symptoms and gender differences were evaluated with χ²-test, Mann-Whitney U-test and logistic regression analysis. Results Oral health promoting habits but not knowledge or attitudes associated significantly with absence of oral symptoms. Girls reported a higher percentage of several health promotional habits than boys. Girls reported more frequently gingival bleeding and less frequently dental calculus than boys did. The most common oral symptom was gingival bleeding. Conclusions The present findings suggest some gender-related differences in oral health habits, attitudes, as well as perceived oral symptoms in 12-year-olds. There seems, however, not to be gender differences in relation to knowledge or the association of health habits with perceived oral symptoms. It is important to maintain health promotion at schools and additional efforts should be aimed at translating knowledge into action.     

National oral health knowledge, attitudes and behaviour survey of Israeli 12-year-olds, 2002

OBJECTIVE: To gather epidemiological information on oral health knowledge, attitudes and behaviour of Israeli 12-year-olds. MATERIALS AND METHODS: A stratified, cluster, random and convenience sample of 12-year-old children was drawn. Stratification was by size of community, by administrative areas (regions) and by ethnicity (Jewish/other). The representative sample of 12-year-olds was asked to self-complete the questionnaire of ICS II, which was translated into Hebrew. The questions gather information regarding knowledge, attitude and dental health behaviour. RESULTS: 1294 children completed the questionnaire, of which 84% reported brushing their teeth once or more per day. Girls brushed 1.68 times more frequently than boys. Of the children, 64% had visited a dentist in the last year. The vast majority of the children (90%) expressed satisfaction with their last visit. CONCLUSIONS: Oral health habits of 12-year-old Israeli children are comparable to those of other countries. The dental health education in Israel should focus health messages to different schoolchildren according to the differences found in this survey.