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.     

Oral health and its determinants among Mongolian dentists

This study compares the dental health of dentists with that of their population counterparts, and relates dentists' oral health to oral health behavior and professional preventive knowledge and orientation. A questionnaire requesting information on the dentists' oral health, preventive knowledge, and orientation and oral health behavior, was targeted at all actively practicing dentists (n = 250) in the Mongolian capital of Ulaanbaatar. A self-reported dentigram served as the basis for assessing dental health, while the 1996 National Oral Health Survey provided data for comparison with population counterparts. The response rate was 98%. Compared to their general-population counterparts, younger dentists exhibited a similar level of caries experience (DMFT) and missing teeth (NMT), whereas older dentists exhibited a lower level. In all age groups, mean numbers of decayed teeth (DT) among dentists were much smaller than for their population counterparts, whereas mean numbers of filled teeth (FT) were much higher. Of all, 81% reported brushing their teeth twice daily or more, 62% used fluoride-containing toothpaste always or almost always, and 52% consumed sugar-containing foods between main meals less than once a day. The better oral health behavior of dentists was best explained by their greater preventive knowledge and their better dental health by better oral health behavior in logistic models. It is concluded that among these dentists there is room for improvement of their own oral health behavior. Towards this end, specially designed continuing education courses could serve to improve dentists' health-related knowledge and change their oral self-care behavior.     

Oral health behaviour of Iranian mothers and their 9-year-old children

PURPOSE: The present study examined associations between the oral health behaviour (OHB) of Iranian mothers and the OHB and oral health status of their children. MATERIALS AND METHODS: In 2005, two self-administered questionnaires provided data on the OHB of a random sample of 9-year-old children (n = 459) and their mothers in Tehran, Iran. Brushing frequency, use of fluoridated toothpaste and number of sugary snacks between meals served as oral self-care (OSC) assessment criteria for both. A clinical examination was performed for children at school. DMFT/dmft values, the restoration index (RI) and the unmet treatment needs index (UTN) facilitated an assessment of children's dental status and treatment. Chi-square test, bivariate correlation, and binary logistic regression model were employed in these analyses. RESULTS: Mother's OSC correlated with child's OSC (r = 0.18; p < 0.01). The reported children's brushing frequency correlated with mothers' brushing frequency (r = 0.2; p < 0.01). High maternal OSC levels were associated with lower dental treatment (DT) values in children (p < 0.01). Children's RI was positively and UTN negatively associated with mothers' OSC (p < 0.01). In the model, mothers' OSC (OR = 2.1) and female gender (OR = 2.1) were associated with children's OSC, while mothers' OSC was strongly associated with DT (OR = 11.0) and RI (OR = 34.0) in children. CONCLUSIONS: Higher OSC levels of the surveyed mothers were reflected positively in the oral health status and behaviour of their offspring. The potential of mothers to play a significant role in the oral health of their children should be kept in mind when developing oral health promotion programmes.     

Risk-based approach in preventive practice among Iranian dentists

PURPOSE: To study risk-based preventive practice among Iranian dentists. MATERIALS AND METHODS: A questionnaire survey was conducted at two annual dental meetings in 2004 and 2005 in Tehran. Using a five-point Likert scale, respondents indicated their level of agreement with taking preventive measures including oral hygiene, use of fluoride, diet and dental check-up for a high- and a low-risk (HR and LR, respectively) hypothetical patient case. Respondent's smoking and activity in smoking cessation were enquired about as well. Of 1033 responding dentists, 980 (64% men) were eligible for this study. Statistical evaluation was by the chi-square test and logistic regression. RESULTS: The top four of the eight measures were instructions on tooth brushing and flossing, advice related to fluoridated toothpaste, and regular dental check-ups, with the choice 'fully agree' being more prevalent for the HR (74%-58%) than for the LR case (59%-41%). For the HR case, 45% of the respondents fully agreed with applying chair-side tooth cleaning, 41% with advice on diet modification, and 38% with advice on home-use of sodium fluoride mouthwash. Of all respondents, 76% were nonsmokers and 56% reported that they always recommend their smoking patients to quit. Female gender and activity in professional reading were associated with higher levels of agreement for applying preventive measures to the HR case. Non-smoking was the strongest explanatory factor (OR = 3.6, 95% CI = 2.6-5.1) of dentist's higher involvement in smoking cessation. CONCLUSION: Risk-based preventive dental care should be emphasised and applied in order to maximise efficient use of resources.     

Dental health knowledge and attitudes of regularly attending mothers of high-risk, pre-school children.

AIM: The aims of this study were to discover the knowledge of and attitudes towards dental health of a group of regularly attending mothers of young children at high-risk of caries, and to evaluate their toothbrushing techniques. METHOD: As part of the baseline examination of a randomised controlled trial to test the influence of dental health counselling on the caries increment of at-risk pre-school children, 268 mothers of 334 children completed a questionnaire enquiring about their dental health knowledge and attitudes, and were also observed brushing their children's teeth. RESULTS: Although most mothers (71%) knew that they should brush their children's teeth twice a day using a small toothbrush (94%) only 52% knew that they should use only a small pea-sized amount of paste, and only 3% knew the recommended level of fluoride in toothpaste for these at-risk children. 40% of the children insisted on brushing their own teeth and 40% of the mothers brushed their children's teeth inadequately. Although three-quarters of the mothers knew that sugary foods and drinks should be consumed only at mealtimes, only 7% knew the four foods and drinks supplying most sugar to a child's diet. Although three-quarters of mothers thought that dental decay in milk teeth was very important, only half wanted their children's carious teeth restored. CONCLUSION: Knowledge, attitudes and behaviour about dental health among these regularly attending mothers of at-risk, pre-school children were superficial. Their attitudes to dental health of primary teeth were equivocal and their demonstrated brushing behaviour on the part of their children was inadequate.     

社会行为危险因素与儿童龋病的关系初探

目的：调查儿童口腔健康状况，探讨儿童患龋情况与社会行为危险因素之间的关系。方法：调查对象为湖北省宜昌市15所小学6—7岁儿童1356名及他们的母亲。采用WHO龋病诊断标准调查儿童患龋情况。采用母亲问卷的调查方法收集儿童和母亲的口腔健康态度、行为以及相关影响因素。结果：1356名6—7岁儿童乳牙患龋率72．9％，龋均3．7。影响儿童龋齿发生的因素是餐间吃甜食、含糖食品的消费和儿童使用氟化牙膏，其中餐间吃甜食是影响龋病最危险的因素。结论：儿童的饮食习惯和氟化牙膏的使用影响儿童的口腔健康状况。     

Oral health behaviour of children and adults in urban and rural areas of Burkina Faso, Africa

OBJECTIVES: To assess the level of dental knowledge and attitudes among 12 year-old children and 35-44 year-olds in Burkina Faso; to evaluate the pattern of oral health behaviour among these cohorts in relation to location, gender and social characteristics and; to evaluate the relative effect of social-behavioural risk factors on caries experience. DESIGN: Across sectional study including urban and rural subgroups of population. Sample and methods: Multistage cluster sampling of households in urban areas; in rural areas random samples of participants were based on the recent population census. The final study population covered two age groups: 12 years (n = 505) and 35-44 years (n = 493). RESULTS: For both children and adults, levels of oral health knowledge, attitudes and self-care were low; 36% of 12-year-olds and 57% of 35-44-year-olds carried out toothcleaning on a daily basis. Pain and discomfort from teeth were common while dental visits were infrequent. Tooth cleaning was mostly performed by use of chewsticks. Use of toothpaste was rare, particularly fluoridated toothpaste was seldom; 9% of 12-year-olds and 18% of 35-44-year-olds reported use of fluoride toothpaste. Significant differences were found in oral health knowledge, attitudes and practices according to location and gender. At age 12, important factors of high caries experience were location (urban), and consumption of soft drinks and fresh fruits. In 35-44-year-olds, gender (female), high education level, dental visit and occupation (government employee) were the significant factors of high dental caries experience whereas adults using traditional chewing sticks had lower DMFT. CONCLUSIONS: Health authorities should strengthen the implementation of oral disease prevention and health promotion programmes rather than traditional curative care. Community-oriented essential care and affordable fluoride toothpaste should be encouraged.     

Relationships between dental health behaviour of Japanese school children and their parents

OBJECTIVE: To determine the relationships between dental care behaviour of Japanese children and of their parents from a community-based study. METHODS: A survey regarding the use of fluoride toothpaste and experience of professional tooth brushing instruction (TBI) was conducted from October 2001 to February 2002 with 3,206 students living in Nagasaki prefecture. RESULTS: The percentages of the use of fluoride toothpaste and the experience of TBI for all the subjects were 54.1% and 43.7%, respectively. Further, the odds ratios of the use of fluoride toothpaste and the experience of TBI were significantly higher among students whose parents had better dental health behaviour index. CONCLUSION: The dental care behaviour of school children was found to be related to that of their parents. In order to reach the targets provided by Healthy Japan 21, various approaches for both school children and their families must be employed.     

Survey of pediatric dentists' own oral health behavior

Oral health behavior is voluntary and, therefore, requires motivation. Dentists serve as role models for their patients. We sought to determine the pediatric dentists' own adherence to oral health behavior recommendations through a 14-question survey administered to 129 pediatric dentists. A significant percentage of respondents fell short in brushing, flossing and regularity of dental exams. A trend was seen for decreasing exam frequency with decreasing population density and for increasing brushing frequency with increasing age. Although most dentists follow their profession's oral health guidelines, a significant percentage does not.     

含氟牙膏认知和使用的问卷调查报告

目的 调查中小学生对含氟牙膏的认知和使用及其影响因素，为进一步推广使用含氟牙膏提供参考。方法 综合运用多阶段、分层、等比和整群按容量比例的概率抽样方法，在北京市海淀区中小学生中进行抽样，采用自填结构式问卷的方法调查受试对象对含氟牙膏的认知和使用情况，最终获得有效问卷1557份。结果 海淀区中小学生含氟牙膏的使用率是87．8％，60％以上的中小学生知道含氟牙膏具有防龋作用及其坚固牙齿表层结构的防龋机制。41．6％的受试对象怀疑“适量用氟”的安全性。媒体的广告宣传是中小学生获得含氟牙膏知识的主要途径。结论 中小学生对含氟牙膏的使用率较高，对其防龋作用有较好的认识，但对合理用氟的安全性并不明确。建议进一步加强关于合理使用氟化物防龋的学校口腔健康教育活动。     

Oral self-care behaviours: comparing Greek and Japanese dental students

AIM: This study explored cross-cultural differences of self-reported oral health behaviours between Greek and Japanese dental students. PARTICIPANTS: The sample population included 877 dental students, 539 students registered at the University of Athens Dental School, and 338 registered at the Hiroshima University Dental School. MATERIAL AND METHODS: Oral health behaviour was assessed using the Greek and Japanese versions of a 20-item questionnaire entitled Hiroshima University-Dental Behavioural Inventory (HU-DBI). RESULTS: The mean questionnaire score of the Japanese students (7.40) was significantly greater than that of the Greek peers (6.86, P = 0.001), indicating better oral self-care behaviour amongst the Japanese students; however, the overall difference was mainly attributed to their additional sixth study year. Greek and Japanese students provided significantly different answers to 14 of 20 HU-DBI items. Greeks significantly more often were required by their dentist to evaluate their brushing technique (OR = 14.4, P < 0.01), checked their teeth in the mirror after brushing (OR = 8.1, P < 0.01), worried about bad breath (OR = 6.7, P < 0.01), and believed that gum disease is preventable by tooth brushing alone (OR = 2.1, P < 0.05), whereas their Japanese peers significantly more often felt comfortable to clean their teeth without the use of a toothpaste (OR = 0.3, P < 0.01), believed that they take much time to brush their teeth (OR = 0.3, P < 0.01), used a child-sized toothbrush (OR = 0.2, P < 0.01), and put off going to the dentist until having toothache (OR = 0.4, P < 0.01). CONCLUSIONS: Considerable differences in dental health attitudes/behaviour exist amongst students in the two countries reflecting the different culture and the health education system of the students; moreover, it is possible to distinguish Greek dental students from Japanese peers with a probability of more than 89% by using the HU-DBI instrument.     

Professional guidance on and self-assessed knowledge of oral self-care as reported by dentate elderly patients in Lithuania

PURPOSE: To investigate the sources of information on oral self-care and the content of professional guidance received on it as reported by dentate elderly patients in Lithuania, and to relate such guidance to their self-assessed knowledge of oral self-care. MATERIALS AND METHODS: A cross-sectional questionnaire study was carried out at two public dental offices, among dentate patients aged > or = 60. In total, 174 dentate elderly responded; mean age was 69.2 years (SD = 6.6). The self-administered questionnaire covered sources of information on and self-assessed knowledge of oral self-care, and the content of professional guidance received. Age, gender, education, and number of teeth served as background information. Statistical evaluation was by Chi-square test, correlation analysis, ANOVA, and logistic regression. RESULTS: Most of the elderly (82%) named the dentist as the source of information. For the professional dental guidance received, 53% of our elderly reported being told how to brush, and 31% how to floss their teeth. Furthermore, 44% assessed their knowledge of oral self-care as poor, 22% as moderate, and 34% as good. At least a moderate level of knowledge of oral self-care was associated with a greater extent of professional guidance (OR 1.3; 95% CI 1.2-1.5; p < 0.001), a better dental state (OR 1.9; 95% CI 1.1-3.2; p = 0.03), and a higher level of education (OR 1.9; 95% CI 1.0-3.5; p = 0.04) in the logistic regression model, controlling for background information. CONCLUSIONS: To increase the awareness of oral self-care among the elderly, dentists play an important role as providers of versatile and regular professional guidance.     

Toothbrushing: why, when and how?

Toothbrushing is a widely practiced oral healthcare habit which, in conjunction with fluoride toothpaste, can help to prevent dental caries and periodontal disease. The effectiveness of toothbrushing is dependent on many different factors including frequency and duration of brushing, rinsing habits and brush type. Knowledge of how these factors influence effectiveness will allow the dental professional to give appropriate advice.     

The role of sugar, xylitol, toothbrushing frequency, and use of fluoride toothpaste in maintenance of adults' dental health: findings from the Finnish National Health 2000 Survey

We assessed the effect of certain oral health-related behaviours on adults' dental health. As part of the Finnish nationwide Health 2000 Survey, dentate subjects, 30-64 yr of age, reported their frequency of consumption of eight sugar- and xylitol-containing products, together with toothbrushing frequency and use of fluoride toothpaste, and underwent clinical oral examination (n = 4,361). The mean number of teeth present (NoT) was 24.2 and the mean numbers of sound teeth (ST), filled teeth (FT), and decayed teeth (DT) were 10.8, 12.1, and 1.1 for men and 9.6, 13.8, and 0.5 for women, respectively. Consumption of sugar-sweetened beverages was more frequent than that of other sugar-containing products, and greater in men than in women. Daily use of xylitol chewing gum was reported by 13% of the men and by 22% of the women. Toothbrushing at least twice daily was reported by 47% of the men and by 79% of the women; 86% and 96%, respectively, reported daily use of fluoride toothpaste. The frequency of consumption of sugar- and xylitol-containing products and of toothbrushing, as well as use of fluoride toothpaste, play a role in the dental health of dentate adults, with the impact being weak on NoT, ST, and FT, but stronger on DT, especially concerning toothbrushing frequency (relative risk = 1.5) and use of fluoride toothpaste (relative risk = 1.8). Understanding the impact of certain oral health-related behaviours on dental health in adults would facilitate better targeting of oral self-care messages.     

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.     

Dentists' perception of their treatment practices versus documented evidence

OBJECTIVE: To compare the quality of real-life treatment practices to dentists' perceptions of treatment rendered. SETTING: One administrative unit of the Finnish public oral health service. METHODS: The original oral health records of a randomly selected sample of young adults who received treatment during 1994-1996 provided data on actual clinical examinations (n=208), radiographs (n=312), and root canal treatment courses (n=148) carried out by 50 dentists. Dentists' perceptions of the treatment rendered were obtained through a structured questionnaire completed during their working hours in 1996. OUTCOME MEASURES: Criteria for assessing the quality of treatment practices were based on Finnish health legislation, authoritative instructions, and consensus reports. RESULTS: Based on responses, 77% of the dentists followed the prevailing instructions on oral health record keeping (82%, if partial agreement included). Most dentists (88% fully agreed, 95% at least partly) perceived that their knowledge gained through continuing education was being applied in practice; no one answered no. A gap was found between dentists' perception of the treatment rendered and everyday treatment practices as recorded on patient documents. CONCLUSIONS: Overall, dentists' perception of the quality of their treatment practices exceeded that found in patient documents. This gap deserves consideration while planning research, education, or quality-improvement projects that relate to dentists' opinions.     

Oral health services in PR China as evaluated by dentists and patients

OBJECTIVE: To describe the function of oral health services and the delivery of oral health care in PR China. DESIGN: Cross-sectional surveys. Self-administered questionnaires gathered information on professional practices and attitudes of Chinese dentists. Patients were examined clinically for caries and services rendered. Patients were interviewed about oral health status, reason of dental visits and consumption of services, perceived need for care and self-care practices. Setting: Wuhan City of the Hubei Province of China. SUBJECTS: Random samples of dentists (n = 250) working with child and adult patients in 1998 in Wuhan City. Each dentist had a representative sample of 20 patients attending consecutively for care enrolled in the study. RESULTS: On average, the dentists saw 12 patients per day, with most time devoted to restorative treatment and extraction. The majority of dentists held the opinion that in China little attention is given to preventive care. Forty per cent of the patients were new to the dentists and more than half attended care because of pain or acute symptoms. The reported mean number of decayed, missing, and filled teeth varied from 2.6 for 12-year-old patients to 10.7 for patients aged 65-74. Daily toothbrushing was practised by more than 90% of the patients in all age groups, however, the tradition of regular dental visits was weak. Most patients (51-75 per cent) attended for care due to acute problems or pain. CONCLUSION: The study indicated the need for reorientation of the Chinese oral health services towards prevention.     

Experiences from a school-based oral health promotion programme in Wuhan City, PR China

Objectives. To evaluate the effect of a six-year oral health promotion programme for school children of Wuhan City, PR China.
Methods. The programme group (P-group) comprised 233 children who had just entered grade 1 (1989). The programme provided an oral health promotion programme, and 215 12-year-old children from three schools participated as a control group (C-group). After the 6-year period of the programme (1995), all of the children had a clinical examination according to the criteria of the WHO and responded to a structured questionnaire on dental health behaviour.
Results. The results showed that attitudes to dental care, regular tooth brushing habits, use of fluoridated toothpaste, gingival health and dental visits, frequencies of consuming sugary drinks/foods were improved in the p-group when compared with the C-group.
Conclusion. The school-based oral health promotion programme should be expanded.     

Restorative treatment threshold reported by Iranian dentists

OBJECTIVE: To study Iranian dentists' conceptions of the earliest stage to place a restoration on proximal caries lesions. BASIC RESEARCH DESIGN: A questionnaire survey was carried out among the participants of two annual dental meetings in Tehran, Iran, in December 2004 and July 2005. The questionnaire was filled in anonymously and returned during the meeting days. The questions covered two patient paper cases with schematic drawings of the radiolucency of proximal caries lesions according to bitewing radiographs from 20-year-old patients: one high-caries case and one low-caries case. Dentists' gender, age, working experience and place, and participation in continuing education served as background data. In total, 1,033 dentists completed the questionnaire, 63% were men. Statistical evaluation was by the Chi square test and logistic regression. MAIN OUTCOME MEASURES: Respondents were to select from four alternatives the earliest stage in the progression of a lesion at which they would intervene by restorative treatment. RESULTS: For the high-caries case, 77% of the respondents chose to restore a caries lesion confined to enamel; activity in continuing education was the strongest factor (OR = 1.4) to explain dentists' restoring a lesion no earlier than in dentine. For the low-caries case, 32% chose to restore a lesion in enamel. Restoring a lesion no earlier than in dentine was more likely (OR = 1.5) among female dentists. CONCLUSION: Iranian dentists seem to prefer early restorative intervention, which indicates a need to focus on the preventive aspects of caries treatment both in dental curricula and in continuing education.     

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目的了解沈阳市12岁学生12腔健康状况、口腔健康行为和口腔保健资源利用情况,为沈阳市学生12腔预防适宜措施的进一步实施提供依据。方法于2010年1月,沈阳市12腔医院和沈阳市牙病预防保健所采用多阶段分层等容量随机抽样的方法,抽取沈阳市市内5个区12岁学生880名,男女各半。参照《WHO口腔健康调查标准（第4版）》,检查他们全口恒牙牙冠龋病情况,统计患龋率、龋均等。此外,参考《第三次全国口腔健康流行病学问卷调查方案》,设计15个问卷题目,对440名受检学生进行现场询问,了解他们口腔饮食行为、I：2腔卫生行为、利用口腔医疗服务行为等。结果12岁学生恒牙患龋率为32．50％,龋均为0．56,牙龈出血及牙石检出率分别为45．91％和43．07％。每天刷牙1～2次者为91．17％,含氟牙膏使用率为80．30％。在看牙原因调查中以定期口腔健康检查及接受口腔预防措施为目的者占28．00％,仅占有效问卷数的8．56％。结论沈阳市12岁学生恒牙龋齿预防工作取得显著成绩,患龋率和龋均呈下降趋势,但牙龈出血和牙石检出率仍较高。学生口腔健康行为中,刷牙情况和含氟牙膏使用情况良好,但定期检查及采用预防措施行为不能令人满意。提示应重视组织适应目标人群心理特点的健康教育活动和对家长进行口腔健康教育,以促进12岁学生口腔健康行为的建立和巩固。