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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 12  |  Issue : 1  |  Page : 1-5

Oral hygiene-related knowledge and attitude among nigerian medical and pharmacy students: a cross-sectional study


1 Department of Periodontics, University of Benin, Benin City, Nigeria
2 Department of Periodontics, School of Dentistry, University of Benin, Benin City, Nigeria

Date of Submission29-Apr-2019
Date of Acceptance01-Jul-2019
Date of Web Publication24-Jan-2020

Correspondence Address:
Clement C Azodo
Department of Periodontics, Room No. 21, 2nd Floor, Prof Ejide Dental Complex, University of Benin Teaching Hospital, P.M.B. 1111, Ugbowo, Benin City, Edo State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jorr.jorr_16_19

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  Abstract 


Objective: Oral hygiene, which denotes the cleanliness of the mouth, is a part of the general body hygiene and fundamental to optimal oral health. The objective of the study was to examine the oral hygiene-related knowledge and attitude among Nigerian medical and pharmacy students.
Materials and Methods: This cross-sectional study was conducted among 482 randomly selected medical and pharmacy students. The data collection tool was a self-administered questionnaire.
Results: The majority of the participants never attended dental clinic (74.9%), reported good/excellent self-reported periodontal status (89.8%), and regard for mouth cleanliness as important (97.3%). The knowledge of mouth odor arising from tooth deposit (97.3%) was highest followed by that on bleeding gum (94.8%) and plaque knowledge (77.2%). Participants with inadequate oral hygiene knowledge reported higher mean desire to improve oral care (20.18 ± 0.10), whereas participants with adequate oral hygiene knowledge reported higher mean sociability (7.43 ± 0.05) and persistence (10.27 ± 0.19). Participants with positive oral hygiene attitude reported higher mean sociability (7.37 ± 0.05) and lower mean persistence (10.26 ± 0.13).
Conclusion: The data from this study revealed low prevalence of adequate oral hygiene knowledge, higher positive oral hygiene attitude, good/excellent self-reported periodontal health, and high importance of mouth cleanliness among medical and pharmacy students. Oral hygiene knowledge was also significantly different among the medical and pharmacy students.

Keywords: Attitude, knowledge, medical students, oral hygiene, pharmacy students


How to cite this article:
Azodo CC, Abanaba O. Oral hygiene-related knowledge and attitude among nigerian medical and pharmacy students: a cross-sectional study. J Oral Res Rev 2020;12:1-5

How to cite this URL:
Azodo CC, Abanaba O. Oral hygiene-related knowledge and attitude among nigerian medical and pharmacy students: a cross-sectional study. J Oral Res Rev [serial online] 2020 [cited 2020 Jul 10];12:1-5. Available from: http://www.jorr.org/text.asp?2020/12/1/1/276701




  Introduction Top


Oral hygiene, which denotes cleanliness of the mouth, is a part of the general personal hygiene and is fundamental to the optimal oral health maintenance.[1] Achieving optimal oral health through preventive efforts is the hallmark of dental profession.[2]

Effective oral hygiene education and awareness will change the negative attitudes toward oral hygiene practices. Nondental health-care professionals can play an important role in the oral health education of individuals and groups by acting as role models to the patients, friends, families, and the community at large with proper oral health knowledge and behavior.

The low oral health workforce in developing countries, therefore, necessitates the role of nondental health professionals in oral health-care promotion, especially if they demonstrate good knowledge of basic dentistry and oral hygiene. However, there appears to be a dearth of information on oral hygiene knowledge, attitude, and practices among nondental students in comparison with dental students in the literature.[3],[4] These oral hygiene knowledge and attitude studies among medical and pharmacy students are necessary, bearing in mind the role they play in effecting a behavioral change in the society.

The objective of the study was to examine the oral hygiene-related knowledge and attitude among Nigerian medical and pharmacy students.


  Materials and Methods Top


The present cross-sectional study was conducted among students of School of Medicine and Faculty of Pharmacy of University of Benin, Benin City, Nigeria, between April and May, 2016. Students of University of Benin studying medicine and pharmacy from the first to sixth academic years who consented to participate were included.

Stratified sampling technique was employed to recruit 482 students, which exceeded the minimum sample size of 185 calculated using Cochran's formula for epidemiological studies: n = Z2 P (1 − P)/d2 where n = sample size, z = z statistics for a level of confidence (set at 1.96 corresponding to 95.0% confidence level), P = prevalence = 14.0% (0.14),[5]q = 1 – P, and d = degree of accuracy desired (error margin) =5% (0.05).

The data collection tool was a self-administered questionnaire. The questionnaire was developed from a previous literature review[6],[7],[8] and pretested among twenty students of different universities. The questionnaire elicited information on demographic characteristics, oral hygiene knowledge and attitude, self-reported periodontal health, regard for mouth cleanliness, desire to improve oral care (DIOC), sociability, and persistence.

The oral hygiene knowledge[6] was assessed using ten questions related to plaque, calculus, method of their removal, and consequences. The scoring was 1 for correct response and 0 for incorrect response, setting the minimum and maximum knowledge score to 0 and 10, respectively. Higher score indicates better knowledge, whereas lower score indicates lower knowledge. The oral hygiene knowledge was further dichotomized into inadequate (0–6) and adequate (7–10). The oral hygiene attitude was also assessed using ten questions. The attitude was scored as 4 for strongly agree, 3 for agree, 2 for disagree, and 1 for strongly disagree for all questions except statements where reverse scoring was applied as 1 for strongly agree, 2 for agree, 3 for disagree, and 4 for strongly disagree. The minimum and maximum attitude scores were 10 and 40, respectively. Higher score indicates positive attitude, whereas lower score indicates negative attitude. The oral hygiene attitude was further dichotomized into negative (10–25) and positive (26–30).

Eleven out of thirty items on the Oral Self-Care Appraisal Questionnaire used by Kawamura et al.[7] in a study among teenagers in Japan were used to assess DIOC, sociability, and persistence. Six, two, and three of the eleven items were used to assess the DIOC, sociability, and persistence, respectively. The scoring was 4 for agree, 3 for somewhat agree, 2 for somewhat disagree, and 1 for disagree. The results were depicted as mean, with higher score indicating higher DIOC/sociability and persistence, whereas lower score indicating lower DIOC/sociability and persistence.

Ethical approval for this study (REC Approval No: CMS/REC/2016/001) was obtained from the Research Ethics Committee, College of Medical Sciences, University of Benin, Benin City, Nigeria. The study was carried out in accordance with the Declaration of Helsinki. Informed consent was obtained from the participants.

Data were analyzed using IBM SPSS software version 20.0 (IBM Corp. Armonk, NY). Descriptive statistics in terms of frequency and percentages were used for the analysis of demographic variables. Nonparametric statistics in terms of Chi-square test were used to compare demographic characteristics with oral hygiene knowledge and attitude, self-reported periodontal health, regard for mouth cleanliness, and dental attendance, whereas parametric statistics in terms of independent t-test were used to compare oral hygiene knowledge and attitude with DIOC/sociability and persistence. The statistical significance was set at P < 0.05.


  Results Top


More than half (58.3%) of the participants were ≤22 years. The study sample were almost equal in terms of gender and course of study. The majority of the participants were of the indigenous ethnic group, were intracampus dwellers (58.7%), were more religious (87.3%), never attended dental clinic (74.9%), reported good/excellent self-reported periodontal status (89.8%), and had important regard for mouth cleanliness (97.3%) [Table 1].
Table 1: Characteristics of the study population

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The knowledge of mouth odor arising from tooth deposit (97.3%) was highest followed by that on bleeding gum (94.8%) and plaque knowledge (77.2%). Knowledge about scaling and polishing (P = 0.022) and calculus (0.021) was found to be low among medical students but significantly higher among pharmacy students [Table 2].
Table 2: Oral health knowledge among the participants

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Intracampus dwellers (49.5%) had significantly more adequate oral health knowledge than their counterparts (29.6%) (P = 0.007). Intracampus dwellers (75.6%) had significantly more positive oral health attitude than their counterparts (64.3%) (P = 0.007). Pharmacy students (47.5%) had significantly more adequate oral health knowledge than medical students (35.0%) (P = 0.009). Indigenous students (75.9%) had significantly more positive oral health attitude (65.5%) (P = 0.012) [Table 3].
Table 3: Oral hygiene knowledge and attitude among the participants

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Pharmacy students reported better/excellent periodontal status (90.5%), accorded more important regard to mouth cleanliness (97.9%), and had ever attended dental clinic more than medical students (28.1%). However, these were not statistically significant (P > 0.05) [Table 4].
Table 4: Dental attendance, self-reported periodontal health, and mouth cleanliness regard among the participants

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Participants with inadequate oral hygiene knowledge reported higher mean DIOC (20.18 ± 0.10), whereas participants with adequate oral hygiene knowledge reported higher mean sociability (7.43 ± 0.05) and persistence (10.27 ± 0.19). Participants with positive oral hygiene attitude reported higher mean sociability (7.37 ± 0.05) and lower mean persistence (10.26 ± 0.13) [Table 5].
Table 5: Association between desire to improve oral care, sociability, persistence, and oral hygiene-related knowledge and attitude

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  Discussion Top


In this study, the high knowledge about mouth odor arising from tooth deposit and bleeding gum being a disease state may be linked with the prevalent nature and the esthetic implications of these conditions. Although the knowledge of scaling and polishing and calculus was low among the participants, significant higher knowledge was found among pharmacy students than medical students. This higher knowledge found among pharmacy students may be linked to their higher dental attendance (28.1%) than medical students (22.1%) because knowledge is usually gained with dental visit as dental consultations are endowed with a lot of knowledge transfer.

In this study, about a quarter (25.1%) reported dental attendance, which was <33% reported among Nigerian medical and pharmacy students in a previous study.[8] This is in conformity with the fact that regular dental attendance is uncommon in developing countries mainly because the inhabitants prefer symptomatic dental attendance to preventive dental attendance.

Less than half (41.3%) of the participants exhibited adequate oral hygiene knowledge, which was significantly better among pharmacy students than medical students (47.5% vs. 35.0%). This finding is similar to the findings among Malaysian medical and pharmacy students,[9] but contrasted with findings among Nigerian medical and pharmacy students.[8] The reasons stated for such findings in Nigeria which were not obtainable in this study included the fact that the compared study had greater number of medical students and these medical students undertook community oral health in the course of their training.[8] The pattern of oral hygiene knowledge in this study could be due to lack of time and exposure and lesser degree of motivation by medical students to learn about oral health. The higher regard to the importance of mouth cleanliness among pharmacy students than medical students may also be a contributory explanation.

The oral hygiene knowledge was significantly associated with the place of residence, with participants residing in the university campus exhibiting more adequate oral hygiene knowledge than off-campus dwellers. This attest to geographical difference in oral hygiene knowledge as intracampus dwellers may have gained better knowledge from social interactions in the place of residence because university residence is a place where a lot of knowledge and social and cultural transfer are known to occur.

Participants with inadequate knowledge reported higher DIOC, which is encouraging and may lead to positive outcome with intervention. Participants with adequate oral hygiene knowledge were found to be more sociable and more persistent, which may be linked to the interactional effect of oral hygiene and the fact that persistence is needed for optimal maintenance of hygienic routine.

In this study, majority of the participants exhibited a positive attitude toward oral hygiene (71%), with intracampus dwellers and indigenous participants exhibiting significantly more positive attitude than their counterparts. The significant association between place of residence and attitude in this study may also be related to the significant association between place of residence and oral hygiene knowledge among the participants.

Good/excellent self-reported periodontal health was found to be higher among participants with positive oral hygiene attitude, and this group was also found to be more sociable. Participants with negative oral hygiene attitude reported more poor/fair self-reported periodontal health and were less persistent, which creates room for likely positive educational and psychological intervention outcome. This is bearing in mind that oral hygiene attitudes naturally reflect experiences, cultural perceptions, familial beliefs, and other life situations and have a strong influence on oral health behavior.[3] Tailored psychological intervention is, therefore, recommended for individuals with poor negative oral hygiene attitude in order to improve their periodontal health rating.

The percentage of good/excellent self-reported periodontal health (89.8%) reported in the present study was higher than 58.3% reported in a nationwide study by Olusile et al,[5] 64.9% reported among medical house officers by Azodo and Unamatokpa,[10] and 78% reported among Port Harcourt dwelling adult Nigerians by Aikins and Braimoh.[11] This finding may be attributed to the fact that good oral health rating is more common in younger than older adults.[12]


  Conclusion Top


The data from this study revealed low prevalence of adequate oral hygiene knowledge, higher positive oral hygiene attitude, good/excellent self-reported periodontal health, and high importance of mouth cleanliness among medical and pharmacy students. Oral hygiene knowledge was also significantly different among the medical and pharmacy students.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Doichinova L, Mitova N. Assessment of oral hygiene habits in children 6 to 12 years. J IMAB 2014;20:664-8.  Back to cited text no. 1
    
2.
Ramsay DS. Patient compliance with oral hygiene regimens: A behavioural self-regulation analysis with implications for technology. Int Dent J 2000;50:304-11.  Back to cited text no. 2
    
3.
Kumar MS, Singarampillay V, Natrajan S. Oral hygiene awareness among two Nonprofessional college students in Chennai, India – A pilot study. Int J Sci Res Publ 2012;2:240-4.  Back to cited text no. 3
    
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Al Nuaimi M, Ferguson DJ, Al-Mulla A. Oral hygiene status in school adolescents: A study of 20,000 school-age adolescents in 66 public and private schools comparing oral hygiene status by gender and ethnicity. Oral Health Dent Manag 2014;13:474-85.  Back to cited text no. 4
    
5.
Olusile AO, Adeniyi AA, Orebanjo O. Self-rated oral health status, oral health service utilization, and oral hygiene practices among adult Nigerians. BMC Oral Health 2014;14:140.  Back to cited text no. 5
    
6.
Azodo CC, Umoh AO. Periodontal disease awareness and knowledge among Nigerian primary school teachers. Ann Med Health Sci Res 2015;5:340-7.  Back to cited text no. 6
[PUBMED]  [Full text]  
7.
Kawamura M, Takase N, Sasahara H, Okada M. Teenagers' oral health attitudes and behavior in Japan: Comparison by sex and age group. J Oral Sci 2008;50:167-74.  Back to cited text no. 7
    
8.
Bashiru BO, Omotola OE. Oral health knowledge, attitude and behavior of medical, pharmacy and nursing students at the University of Port Harcourt, Nigeria. J Oral Res Rev 2016;8:66-71.  Back to cited text no. 8
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9.
Mohd-Dom TN, Said SM, Abidin ZZ. Dental knowledge and self-reported oral care practices among medical, pharmacy and nursing students. J Sains Kesihatan Malaysia 2009;7:13-23.  Back to cited text no. 9
    
10.
Azodo CC, Unamatokpa B. Gender difference in oral health perception and practices among medical house officers. Russ Open Med J 2012;1:0208. DOI: 10.15275/rusomj.2012.0208.  Back to cited text no. 10
    
11.
Aikins EA, Braimoh OB. Self-rated oral health status and associated factors in adult population in Port Harcourt, Rivers state, Nigeria. J Sci 2015;5:505-10.  Back to cited text no. 11
    
12.
Molarius A, Engström S, Flink H, Simonsson B, Tegelberg A. Socioeconomic differences in self-rated oral health and dental care utilisation after the dental care reform in 2008 in Sweden. BMC Oral Health 2014;14:134.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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