|Year : 2017 | Volume
| Issue : 1 | Page : 3-7
Oral hygiene practices and factors influencing the choice of oral hygiene materials among undergraduate students at the University of Port Harcourt, Rivers State, Nigeria
Ayamma Udo Umanah1, Omoigberai Bashiru Braimoh2
1 Department of Restorative Dentistry, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, Choba, Port Harcourt, Rivers State, Nigeria
2 Department of Preventive Dentistry, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, Choba, Port Harcourt, Rivers State, Nigeria
|Date of Web Publication||2-May-2017|
Omoigberai Bashiru Braimoh
Department of Preventive Dentistry, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, P.M.B. 1, Choba, Port Harcourt, Rivers State
Source of Support: None, Conflict of Interest: None
Objectives: The objectives of this study were to determine oral hygiene practices among university students; establish any association between oral hygiene practices and sociodemographic variables and find out the factors that may influence the choice of oral hygiene products in this group. Materials and Methods: Self-administered questionnaire containing information on age, gender, material used for tooth cleaning, and frequency of tooth cleaning was completed by the students in their hostels. Data were analyzed using SPSS version 20.0. Test of significance was carried out using Chi-square and logistic regression analysis. Association was considered statistically significant when P ≤ 0.05. Results: In the present study, all the participants irrespective of the age, gender, and field of study used toothbrush and toothpaste as the oral hygiene tool. The use of dental floss, mouth rinse, and interproximal brush was not recorded in this study. About 24% of the participants reported using fluoride-containing toothpastes. Cleaning the teeth twice daily was significantly related to age (P = 0.046), gender (P = 0.01), and field of study (P = 0.032). Logistic regression analysis shows that the relationship between the sociodemographic characteristics of the participants and their frequency of tooth cleaning was statistically significant. The cost was the major factor influencing the selection of oral hygiene tools. Conclusion: The oral hygiene practices of the participants were suboptimal. Less than two-third of the sample cleaned their teeth twice daily. Age, gender, and field of study were significant determinants of oral hygiene practice. The major factor which influenced the selection of toothpaste and toothbrush was the cost.
Keywords: Oral hygiene aids material, oral hygiene practice, sociodemographic characteristics, tooth brushing, undergraduate students
|How to cite this article:|
Umanah AU, Braimoh OB. Oral hygiene practices and factors influencing the choice of oral hygiene materials among undergraduate students at the University of Port Harcourt, Rivers State, Nigeria. J Dent Allied Sci 2017;6:3-7
|How to cite this URL:|
Umanah AU, Braimoh OB. Oral hygiene practices and factors influencing the choice of oral hygiene materials among undergraduate students at the University of Port Harcourt, Rivers State, Nigeria. J Dent Allied Sci [serial online] 2017 [cited 2017 Oct 21];6:3-7. Available from: http://www.jdas.in/text.asp?2017/6/1/3/205440
| Introduction|| |
The promotion of good oral hygiene is advocated and supported by the World Health bodies.,,, The adoption of preventive strategies, both at the individual and population level, helps reduce the negative impact of oral diseases including improving the quality of life. Health behaviors are crucial indicators of oral health status. Effective and efficient oral hygiene practices are an essential tool for achieving good oral health.,,
The value of good oral hygiene practices has increased over the years and studies indicate that the removal of bacteria plaque is essential for the prevention of the two most common dental conditions such as dental caries and periodontal disease., It has been consistently reported that over 70% of adult Nigerians have periodontal disease,, a condition strongly associated with oral hygiene status. Although the prevalence of dental caries is low in Nigeria, between 10% and 20%; it remains a disease of public health interest because most carious lesions remain untreated.,,, Therefore, to achieve and maintain good oral hygiene, and prevent dental caries and periodontal disease, regular tooth brushing using fluoride-containing toothpaste at least twice a day is recommended. The use of dental floss and other oral hygiene aids items for the cleaning of contact surfaces is also important for effective plaque removal.,
The most widely used oral hygiene aids are toothbrushes and toothpaste. Other oral hygiene aids include dental floss, wood stick, interspace brush, and interproximal brush. These products are used based on personal choice or advice from oral health-care workers. Socioeconomic status, information from media (advertisements), and material properties such as taste, flavor, color, and appearance have been reported to influence the choice of an oral hygiene aids product.
In Nigeria, information on common oral hygiene practices among university students is sparse. Most of the available information is from research localized to specific subpopulations such as pregnant women and school children.,, This information indicates poor oral health awareness, irregular tooth brushing, and generally poor oral hygiene., Our investigation also suggests that data on factors influencing the choice of toothpaste among Nigerians are uncommon. Therefore, the objective of this study was in three folds. First, to determine oral hygiene practices of undergraduate students at the University of Port Harcourt. Second, to establish any association between gender, age, and students faculty of study with oral hygiene practices. Finally, to find out the factors that may influence the choice of oral hygiene products in this group.
| Materials and Methods|| |
The cross-sectional epidemiological survey was conducted among the undergraduate students at the University of Port Harcourt, Rivers State, Nigeria, between October and November 2015. Participation was voluntary and the participants were selected by convenience sampling. Ethical clearance was obtained from the Research and Ethics Committee of the University of Port Harcourt Teaching Hospital. Informed consent was obtained from the participants, and the participants were assured of anonymity and confidentiality.
The tool for data collection was a pretested interviewer-administered questionnaire. The questionnaire contained information on age, gender, and field of study. Other information contained in the questionnaire included questions on materials used for tooth cleaning, frequency of tooth cleaning, the interdental cleaning aids used by the students, whether the paste used by the students contained fluoride and factors influencing the choice of toothpaste used by the students. The questionnaire was pretested on twenty randomly selected students who were not part of the study a week before the survey. Necessary modifications were made to the questionnaire before the questionnaires were finally administered to the participants, to ensure the validity, and reliability of the instrument. The questionnaires were completed by the students who consented to participate in the study in their hostels and retrieved immediately after completion. Students who did not give consent were excluded from the study.
Data were analyzed using IBM SPSS Statistics (New York, USA) version 20.0. Univariate analysis for frequency distributions was generated for qualitative variables. Bivariate analysis to identify associations between oral hygiene practices (i.e., the dependent variables including frequency of tooth brushing and tool used) and gender, age, and field of study (the independent variables) of the study participants was also carried out. The Chi-squared test was used as test of significance for comparing proportions. Logistic regression analysis was conducted to identify factors independently associated with adequate tooth brushing frequency in the population (i.e., brushing two or more times daily). Association was considered statistically significant when P ≤ 0.05.
| Results|| |
A total of 150 students aged 16–36 years comprising 53.7% women and 46.7% men participated in the survey. Approximately 43% of the participants were from the College of Health Science. [Table 1] summarizes the demographic characteristics of the participants.
[Table 2] shows the oral hygiene practices of the respondents according to sociodemographics. In the present study, all the participants irrespective of the age, gender, and field of study used toothbrush and toothpaste as the oral hygiene tool. None of the participant used chewing stick either alone or in combination with toothbrush and toothpaste. The use of dental floss, interproximal brush, and mouth rinse was not recorded in this study. Only 24% of the participants reported using fluoride-containing toothpastes while the remaining (76%) was not sure of the fluoride content of their dentifrice.
|Table 2: Association between demographics and frequency of tooth brushing by the participants|
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About two-third (63.3%) of the students cleaned their teeth twice daily. Cleaning the teeth twice daily was significantly related to age (P = 0.046), gender (P = 0.01), and field of study (P = 0.032). Younger age group, females, and students from the College of Health Sciences significantly cleaned their teeth twice daily.
Logistic regression analysis shows that the female participant and the college students were 30.7% and 19.2%, respectively, more likely to clean their teeth twice daily. Similarly, the age group 16–25 years was 2.1% more likely to clean their teeth twice daily than those between 26 and 30 years [Table 3].
|Table 3: Logistic regression analysis of factors determining frequency of tooth brushing|
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Factors influencing the choice of toothpaste and toothbrush are shown in [Figure 1]. The cost of the material was the major factor influencing its selection in 39.3% of the participants. Other factors were taste, 34%; fluoride content of the paste, 29.3%; and television advert (media), 22.7%.
| Discussion|| |
Health behaviors have been reported to be important indicators of oral health status. For instance, oral hygiene plays a significant role in the pathogenesis of dental decay and periodontal disease; thus, good oral hygiene remains essential for oral health. Good oral hygiene could be achieved through regular cleaning of the teeth with toothbrush and toothpaste and the use of interdental cleaning aids. In fact, twice a day cleaning of the teeth and at least once a day flossing is recommended globally to ensure good oral health.
In our study, all the participants reported using toothbrushes and toothpaste for cleaning. Generally, no participant utilized other tools, especially the chewing stick either alone or in combination with toothbrush for cleaning. Olusile et al. reported that 81% of sample in their study used toothbrushes and toothpaste for cleaning. The exclusive use of toothbrush among the participants may be an indication of a shift toward the use of modern tools among the Nigerian population. The students may have been influenced by information obtained from school and media. The use of interdental cleaning aids such as dental floss, interspace, and interproximal brushes was not reported by any of the participants in the present study. This is comparable to the study of Olusile et al. who reported very uncommon use of this materials in their study. This was probably due to the fact that the sample may not be aware of these materials or because they are not readily available. There is a need to increase the level of awareness and availability of these tools as a measure toward promoting their use for effective plaque removal in contact areas.
In the present study, 63.3% of the study population reported brushing their teeth at least twice a day (80% for women and 44.3% for men). This was interestingly surprising because it is higher than what has been observed in the previous studies,,, but lower than that reported in other countries.,, Similarly, twice daily cleaning of the teeth was higher when compared to previous study  that used sample from the same institution. The improvement in the practice may not be unrelated to consistent oral health campaign in the university campus carried out by the Faculty of Dentistry through the annual faculty “Dentistry day” and the “World Oral Health Day.” The students of the faculty also provide similar campaign during their annual health week and routinely through organized community oral health education.
Interestingly, gender, age, and field of study were significantly related to frequency of tooth brushing. Our results are in accordance with earlier studies which report poorer oral health and behavior among male than female.,, The reasons for the gender differences are anecdotal, perhaps the values associated with health are different among the genders. Therefore, the future studies explaining the possible mechanisms for this gender difference are suggested. The College of Health Sciences has students in Basic Medical Science, Dentistry, and Medicine. The students from the college may have at one time or the other received oral health education lectures; this may account for significant level of twice daily cleaning observed in this group compared to the students from other faculties. Accordingly, we suggest that efforts at promoting good oral hygiene should focus on the male students and students from other faculties.
Furthermore, we observed in our study that many participants using toothpaste were unaware of the fluoride content of the paste. This is unsatisfactory and indicates lack of awareness about the content of toothpaste which should be addressed urgently. Although a large number of dentifrices available in the Nigerian market contain fluoride, there are areas with high levels of fluoride in Nigeria, and persons resident in such areas would require lower levels of fluoride in their dentifrices. It is, therefore, essential for people to be able to correctly determine the amount of fluoride they require based on the fluoride content of their water and dentifrices. This is important to prevent fluorosis in areas of high fluoride and caries in areas where there is inadequate fluoride.
In the present study, 39.3% of the sample chose their toothbrushes and toothpaste based on the cost, 34% based on the taste of the toothpaste. This was closely followed by fluoride content of the paste (29.3%) and television (media) advert (22.7%). These findings are comparable to another Nigerian study among hospital patients, where cost, taste, and fluoride content were the major factors influencing the choice of toothpaste. This corroborates the fact that the choice of dentifrices is largely determined by other factors rather than its efficacy. Previous studies have reported the media as the main factor which influenced the choice of oral hygiene tools., Media were also a crucial factor in our study, this suggests the need for oral health-care workers to establish effective relationship with the manufacturers to support the dissemination of useful information on oral hygiene products through the media to the public.
The major limitation of this study includes response bias associated with self-reported data. Individuals may give different interpretation to the questions and the responses may have been influenced by the social acceptability of their responses. Another limitation was the convenience sampling and small sample size used in the study; this might limit the generalization of the results. In spite of these limitations, this study would contribute to information available on oral hygiene practice among university students as other studies have focused on other subpopulation. In addition, while a number of studies have investigated the use of toothpaste in adults, factors influencing the choice of toothpaste have been ignored. This was considered in this study.
| Conclusion|| |
The oral hygiene practices of the participants were suboptimal and below the recommended global standard. Less than two-third of the sample cleaned their teeth twice daily and none of the participants used interdental cleaning aids. Age, gender, and field of study were significant determinants of oral hygiene practice. The major factors which influenced the selection of oral hygiene materials in order of magnitude were the fluoride content, taste, and cost of the material.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Petersen PE. Challenges to improvement of oral health in the 21st
century – The approach of the WHO Global Oral Health Programme. Int Dent J 2004;54 6 Suppl 1:329-43.
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ 2005;83:661-9.
Davies RM, Davies GM, Ellwood RP. Prevention. Part 4: Toothbrushing: What advice should be given to patients? Br Dent J 2003;195:135-41.
World Health Organization. The World Oral Health Report, 2003. Geneva: World Health Organization; 2003.
Petersen PE, Kwan S. Evaluation of community-based oral health promotion and oral disease prevention – WHO recommendations for improved evidence in public health practice. Community Dent Health 2004;21 4 Suppl: 319-29.
Ainamo J, Parviainen K. Occurrence of plaque, gingivitis and caries as related to self reported frequency of toothbrushing in fluoride areas in Finland. Community Dent Oral Epidemiol 1979;7:142-6.
Akpata ES. Oral health in Nigeria. Int Dent J 2004;54:362-6.
Adegbembo AO, El Nadeef MA. National survey of periodontal status and treatment needs among Nigerians. Int Dent J 1998;48:44-9.
Adeniyi AA, Sofola OO, Kalliecharan RV. An appraisal of the oral health care system in Nigeria. Int Dent J 2012;62:292-300.
Federal Ministry of Health. National Oral Health Policy. Nigeria: Federal Ministry of Health; 2012.
Paik DI, Moon HS, Horowitz AM, Gift HC, Jeong KL, Suh SS. Knowledge of and practices related to caries prevention among Koreans. J Public Health Dent 1994;54:205-10.
Rimondini L, Zolfanelli B, Bernardi F, Bez C. Self-preventive oral behavior in an Italian university student population. J Clin Periodontol 2001;28:207-11.
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.
Orenuga OO, Sofola OO. A survey of the knowledge, attitude and practices of antenatal mothers in Lagos, Nigeria about the primary teeth. Afr J Med Med Sci 2005;34:285-91.
Jeboda SO, Adeniyi AA, Ogunbodede EO. Assessment of preventive oral health knowledge and practices among rural and urban mothers in Lagos State. Niger Postgrad Med J 2009;16:239-44.
Umesi-Koleoso DC, Ayanbadejo PO. Oral hygiene practices among adolescents in Surulere, Lagos State, Nigeria. Nig Q J Hosp Med 2007;17:112-5.
Christensen LB, Petersen PE, Krustrup U, Kjøller M. Self-reported oral hygiene practices among adults in Denmark. Community Dent Health 2003;20:229-35.
Villa A, Kreimer AR, Polimeni A, Cicciù D, Strohmenger L, Gherlone E, et al
. Self-reported oral hygiene habits among dental patients in Italy. Med Princ Pract 2012;21:452-6.
Al-Otaibi M, Zimmerman M, Angmar-Månsson B. Prevailing oral hygiene practices among urban Saudi Arabians in relation to age, gender and socio-economic background. Acta Odontol Scand 2003;61:212-6.
Bashiru BO, Anthony IN. Oral self-care practices among university students in Port Harcourt, Rivers State. Niger Med J 2014;55:486-9.
] [Full text]
Sofola OO, Agbelusi GA, Jeboda SO. Oral health knowledge, attitude and practices of primary school teachers in Lagos State. Niger J Med 2002;11:73-6.
Akpata ES, Danfillo IS, Otoh EC, Mafeni JO. Geographical mapping of fluoride levels in drinking water sources in Nigeria. Afr Health Sci 2009;9:227-33.
Adegbulugbe IC. Factors governing the choice of dentifrices by patients attending the dental centre, Lagos University Teaching Hospital. Nig Q J Hosp Med 2007;17:18-21.
Sharda A, Sharda J. Factors influencing choice of oral hygiene products used among the population of Udaipur, India. Int J Dent Clin 2010;2:7-12.
Dilip CL. Health status, treatment requirements, knowledge and attitude towards oral health of police recruits in Karnataka. J Indian Assoc Public Health Dent 2005;5:20-34. [Full text]
[Table 1], [Table 2], [Table 3]