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Year : 2013  |  Volume : 3  |  Issue : 1  |  Page : 19-24
A comparative evaluation of oral hygiene practices, oral health status, and behavior between graduate and post-graduate dentists of North India: An epidemiological survey

Department of Prosthodontics, Uttaranchal Dental and Medical Research Institute, Dehradun, Uttarakhand, India

Date of Web Publication26-Jul-2013

Correspondence Address:
Aaswin Kaur Tuli
Department of Periodontics, Uttaranchal Dental and Medical Research Institute, Dehradun, Uttarakhand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2231-0762.115713

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Objectives: The present study was carried out to compare oral hygiene practices, oral health status and behavior of graduate and postgraduate dentists of North India. Materials and Methods: The study was carried out among 727 dentists (446 graduate i.e., Group A and 281 post graduate i.e., Group B) through an online questionnaire. The questionnaire covered oral hygiene regimen, adverse oral habits, information regarding dental visits and dental treatment. Results: Results showed less than adequate oral hygiene practices among both the groups with more so in the graduate group (P ≤ 0.05). Very few dentists in both the groups reported any adverse oral habit. A more positive (P ≤ 0.05) attitude towards regular dental check up and dental treatment was seen in post-graduate dentists when compared to graduates. Conclusion: Very few dentists in both the groups followed ideal dental hygiene regimen. Dentists are the role models for the society as far as oral health is concerned; hence they need to be more responsible and lay more stress on their daily regimen and improve the scenario.

Keywords: Dentists, graduate, oral habits, oral hygiene, post-graduate

How to cite this article:
Singh MS, Tuli AK. A comparative evaluation of oral hygiene practices, oral health status, and behavior between graduate and post-graduate dentists of North India: An epidemiological survey. J Int Soc Prevent Communit Dent 2013;3:19-24

How to cite this URL:
Singh MS, Tuli AK. A comparative evaluation of oral hygiene practices, oral health status, and behavior between graduate and post-graduate dentists of North India: An epidemiological survey. J Int Soc Prevent Communit Dent [serial online] 2013 [cited 2022 Nov 29];3:19-24. Available from: https://www.jispcd.org/text.asp?2013/3/1/19/115713

   Introduction Top

Periodontal disease and dental caries are the two most common oral diseases affecting mankind since the dawn of civilization. [1] Oral health as an essential component of general health can be defined as "a standard of health of oral and related tissues which enable an individual to eat, speak and socialize without active disease, discomfort or embarrassment and which contributes to general well-being." [2] Mechanical methods of plaque control such as the use of toothbrush and dental floss, when applied effectively can promote oral health and decrease the incidence of dental caries and gingival inflammation. [3],[4] Oral hygiene promotion involves a combination of educational, organizational, economic and environmental support for behavior conducive to oral health. [5]

By virtue of their profession, dentists play a pivotal role in health promotion and dissemination of preventive information among their patients, family and society. It is therefore important that their own health knowledge is good and their oral health behavior conforms to the expectation of the population.

Hence, with this in consideration, the study was designed to investigate oral hygiene practices, dental service utilization patterns and attitude toward dental treatment among dentists with varying qualification.

   Materials and Methods Top

A total of 727 dentists from different dental colleges and cities of North India participated in the survey. A structured questionnaire was prepared online and mailed to the dentists. The questionnaire inquired about dentist's qualification, oral hygiene regimen, adverse oral habits, and attitude toward dental treatment.

727 dentists who participated in the survey were divided into two groups on the basis of their qualification; Group A, which included graduates (446 dentists) and Group B, which included post-graduates (281 dentists). Male:female for Group A and Group B was 182:264 and 105:176 respectively.

The data, thus, collected was compiled and put to statistical evaluation.

Statistical analysis

The data was analyzed using SPSS 14 software. Pearson's Chi-square test was used for comparison between the groups and P < 0.0001 statistically highly significant.

   Results Top

A total of 727 dentists participated in the survey and the results were statistically analyzed and compared group wise.

Oral hygiene practices

Frequency, duration and technique of tooth brushing

Majority of dentists in both groups brushed their teeth for 1-2 min twice daily and the difference between them was statistically significant.

However, it was found that 67% of the dentists in Group A used modified Bass technique as compared to 53% in Group B [Table 1].
Table 1: Brushing habits group A and group B

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Oral hygiene aids

Majority of the dentists in both the groups (69% in Group B and 58% in Group A) used fluoridated toothpaste and toothbrushes with soft bristles (around 69% in Group B and 48% in Group A). A few dentists in both the groups reported the use of non-fluoridated and herbal toothpaste. However, none of the participants in either group reported use of any toothpowder or any indigenous method for cleaning teeth [Table 1].

Majority of dentists in both the groups did not report the use of any interdental cleaning aid. However, a few dentists in both the groups reported use of interdental floss and toothpick [Table 2].
Table 2: Interdental aids used by dentists in group A and group B

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Adverse oral habit

Majority of the dentists in both the groups did not report any adverse habit. However, smoking was reported by 11.2% and 4% of dentists in Group A and B respectively [Table 3].
Table 3: Adverse oral habits of group A and group B dentists

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Present oral problem

Significantly more dental problems were reported by Group A as compared to Group B [Table 4].
Table 4: Existing dental problem in group A and group B dentists

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Regular dental check-up and oral prophylaxis

Significantly more number of Group B dentists had regular dental checkups than Group A.

Majority of the dentists in Group B had regular oral prophylaxis in 6 months, whereas once a year in Group A dentists [Table 5].
Table 5: Dental service utilization patterns in group A and group B dentists

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   Discussion Top

Good oral health is essential to improve an individual's overall health and well-being. [1] The dental community, who supposedly are the role models as far as oral health is concerned, play a pivotal role in promoting behavioral change in the society. Keeping this in mind, the study was conducted to provide an insight about the oral hygiene status, behavior and concepts among dental professionals.

It has been seen that health practices of physicians determine what they tell their patients. A similar trend can be anticipated among dental practitioners as well. Dental health practices are learned from a number of sources of which professional learning is an important component. [5] Does the difference in the level of educational qualification as in the case of a graduate and a post-graduate also have an influence on their oral health practices?

A total of 727 dentists of which 446 were graduate and 281 post-graduates participated in the survey. The study groups were of unequal numbers owing to the larger number of graduates as compared to post-graduates.

The dentists were questioned about their daily oral hygiene regimen, adverse oral habits, oral health problems and attitude towards dental treatment.

Oral hygiene practices

Tooth brushing is considered as the primary mechanical means of removing substantial amounts of plaque in order to prevent oral disease, including gingivitis and dental caries and halitosis while also maintaining dental esthetics. It is also used as a means of delivering chemotherapeutic agents via dentifrice. [6],[7]

Frequency/technique/duration of tooth brushing

Greater percentages (80% in Group B and 67% in Group A) were recorded in our study who brushed their teeth twice in comparison to the studies of Anwar (59%) and Gopinath (55.9%), [5] However, the results were in accordance with the studies of Ghasemi et al. (73%), [8] Tseveenjav et al. (81%), [9] and Almas et al. [10] Though these studies did not take into consideration the qualifications of the dentists.

Majority of the dentists used modified Bass method for removing plaque, which is probably the most popular method taught today.

Brushing methods including Bass, Stillman's, Fones, Charter's, horizontal, vertical, scrub etc., have been taught for decades, with Bass and Roll method most commonly recommended. However, no one method of brushing has been found superior to others. [6] Poyato-Ferrera et al. observed in a 3 min comparison between modified Bass and the normal brushing technique that the modified Bass method removed more supra gingival plaque for all sites and at all times examined, especially on the lingual surfaces which commonly show high plaque scores. [11]

However, the best method is one that suits the individual needs and abilities and it is the responsibility of the dentist to instruct the patient on performing the task thoroughly.

Brushing duration is another important variable in plaque removal efficacy. [12] Investigations regarding duration of brushing have been confusing. While it is believed that increased brushing time does result in more plaque removal, the brushing technique could confound study comparisons. Ashley has recommended 3 min as the ideal duration for manual brushing. [13]

It has been reported that individuals typically brush for about 1 min or less but most people significantly over estimate this duration. Studies have shown ranges of brushing times from 56.7 s to 83.5 s, whereas estimated brushing times by these subjects range from 134.1 s to 154.6 s. [14],[15]

Oral hygiene aids

Majority of the dentists in both the groups used brushes with soft bristles. It is believed that filament stiffness can contribute to the traumatic potential of the toothbrush, but the influence of this factor is unclear. However, hard bristled brushes have been shown to be more effective in plaque removal than one with medium bristles. [6]

Dentifrices are adjuncts to tooth brushing and vehicles for various chemotherapeutic agents to inhibit calculus, reduce plaque, prevent caries, whiten enamel and desensitize exposed root surfaces. [4]

The present study revealed that all the respondents used toothpaste along with a tooth brush for cleaning their teeth and the majority of them used fluoridated toothpaste. In a study by Gopinath, [5] it was reported that 55% of the dentists used fluoride containing toothpaste on a daily basis. Tseveenjav et al. revealed in their study that 62% of the Mongolian dentists were using fluoridated toothpaste always or almost always. [9] Around 74% of the Iranian dentists were found to use fluoridated toothpaste regularly. [8] Similar results were reported by Doshi et al. [16] and Vaish et al. [1]

The removal of interproximal plaque is considered to be important for the maintenance of gingival health, prevention of periodontal disease and the reduction of caries. Unfortunately, the toothbrush is relatively ineffective at removing interproximal plaque, and therefore, patients need to resort to additional techniques. Floss, wood sticks, rubber tips and interdental brushes currently represent the primary methods available for interproximal cleaning. Floss is the most widely used method of interdental cleaning and the American Dental Association reports that up to 80% of interdental plaque may be removed by this method. [17]

Very few dentists in both the groups used any interdental device with significantly more number of dentists in Group B as compared to Group A. Gopinath 2010; however, in his study reported that quite a low number i.e., around 9.2% of the Indian dentists used floss. [5] 54% of the Iranian dentists were found to use floss at least once a day. [8]

Adverse habits

Very few dentists in both the groups reported any adverse habits. The results of this study were in accordance with the results of various other studies, which also reported very few percentage of dentists having any adverse habits. [5],[8],[18],[19] Vaish et al. 2010, also reported that 93% of the dental students did not follow any adverse habit. This high percentage of Indian dentists not consuming tobacco could be attributed to their knowledge regarding the consequences of tobacco consumption. [1]

Oral health problems

In the present study, significantly more number of dentists in Group A, reported about dental diseases such as dental caries, bleeding gingiva and halitosis. The results of this study are in accordance with the study of Almas et al., [10] who observed that with an increase in age, that is from high school to dental college, there was a decrease in the prevalence of bleeding gingiva and dental caries. Halitosis, caries and bleeding gingiva were reported by 78%, 57% and 26% of the population respectively. Also, it was observed that the dental diseases were more prevalent in females in comparison to males.

A more positive attitude and adherence to good oral hygiene behavior was observed in Group B dentists as compared to Group A. In Group A, majority of the participants visited the dental clinic only in case of any dental ailment, whereas dentists in Group B went in for regular dental checkups. Gopinath, [5] Ghasemi et al., [8] Tseveenjav et al. [9] and Al-Wahadni, [20] et al. reported in their studies that approximately 40% of the South Indian dentists, 41% of Iranian dentists, 75% of the Mongolian dentists respectively visited dental clinic at least once a year.

Sharda and Shetty 2009 stated that a positive attitude and adherence to good oral hygiene behavior is associated with better oral health. [21]

Maatouk et al. (2006) emphasized that dental students achieved better oral health practices and status at the end of their 5 years of their course, highlighting the importance of dental studies on motivation and attitude towards treatment. [22]

Thus, similar studies with a larger study sample should be undertaken to give a broader perspective of the current scenario. In the current study, age was not considered as a demographic variable because of the wide age difference among the dentists in the same group. This could have affected the overall result distribution. Also, there could have been over reporting of oral hygiene behavior.

   Summary and Conclusion Top

Due to their profession, dentists are expected to exhibit meticulous oral hygiene procedures as compared to the general public. However, the results of the present study reveal that the oral hygiene practice of dentists in both groups is far from ideal. Also, the graduates oral health status and attitude towards dental treatment lag in comparison to the post-graduates. Thus, it is recommended that dentists should contemplate changes in their attitude so that they practice, what they preach.

We, as dentists, should realize our role in disseminating positive oral health concepts to their patients and the general public but before this, we ourselves should follow the ideal regimen and act as role models for the society.

   References Top

1.Vaish S, Ahuja S, Dodwad V. A comparative evaluation of oral hygiene practices and periodontal status among dental and paramedical students: An epidemiological survey. Journal of Indian Dental Association 2010;4:343-346  Back to cited text no. 1
2.Carneiro L, Kabulwa M, Makyao M, Mrosso G, Choum R. Oral health knowledge and practices of secondary school students, tanga, Tanzania. Int J Dent 2011;2011:806258.  Back to cited text no. 2
3.Bardal PA, Olympio KP, Bastos MR, Henriques FC, Buzalaf RA. Education and motivation in oral health: Preventing disease and promoting health in patients undergoing orthodontic treatment. Dental Press J Orthod 2011;16:95-102.  Back to cited text no. 3
4.Choo A, Delac DM, Messer LB. Oral hygiene measures and promotion: Review and considerations. Aust Dent J 2001;46:166-73.  Back to cited text no. 4
5.Gopinath V. Oral hygiene practices and habits among dental professionals in Chennai. Indian J Dent Res 2010;21:195-200.  Back to cited text no. 5
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7.Terézhalmy GT, Bartizek RD, Biesbrock AR. Relative plaque removal of three toothbrushes in a nine-period crossover study. J Periodontol 2005;76:2230-5.  Back to cited text no. 7
8.Ghasemi H, Murtomaa H, Vehkalahti MM, Torabzadeh H. Determinants of oral health behaviour among Iranian dentists. Int Dent J 2007;57:237-42.  Back to cited text no. 8
9.Tseveenjav B, Vehkalahti M, Murtomaa H. Oral health and its determinants among Mongolian dentists. Acta Odontol Scand 2004;62:1-6.  Back to cited text no. 9
10.Almas K, Al-Hawish A, Al-Khamis W. Oral hygiene practices, smoking habit, and self-perceived oral malodor among dental students. J Contemp Dent Pract 2003;4:77-90.  Back to cited text no. 10
11.Poyato-Ferrera M, Segura-Egea JJ, Bullón-Fernández P. Comparison of modified Bass technique with normal tooth brushing practices for efficacy in supragingival plaque removal. Int J Dent Hyg 2003;1:110-4.  Back to cited text no. 11
12.Terezhalmy GT, Bsoul SA, Bartizek RD, Biesbrock AR. Plaque removal efficacy of a prototype manual toothbrush versus an ADA reference manual toothbrush with and without dental floss. J Contemp Dent Pract 2005;6:1-13.  Back to cited text no. 12
13.Ashley P. Tooth brushing: Why, when and how? Dent Update 2001;28:36-40.  Back to cited text no. 13
14.Saxer UP, Barbakow J, Yankell SL. New studies on estimated and actual toothbrushing times and dentifrice use. J Clin Dent 1998;9:49-51.  Back to cited text no. 14
15.Warren DP, Rice HC, Turner S. Comparison of plaque removing ability of one standard and two flexible-head toothbrushes. J Dent Hyg 2004;78:340-2.  Back to cited text no. 15
16.Doshi D, Baldava P, Anup N, Sequeira PS. A comparative evaluation of self-reported oral hygiene practices among medical and engineering university students with access to health-promotive dental care. J Contemp Dent Pract 2007;8:68-75.  Back to cited text no. 16
17.Warren PR, Chater BV. An overview of established interdental cleaning methods. J Clin Dent 1996;7:65-9.  Back to cited text no. 17
18.Burgan SZ. Smoking behavior and views of Jordanian dentists: A pilot survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95:163-8.  Back to cited text no. 18
19.Telivuo M, Murtomaa H, Lahtinen A. Observations and concepts of the oral health consequences of tobacco use of Finnish periodontists and dentists. J Clin Periodontol 1992;19:15-8.  Back to cited text no. 19
20.Al-Wahadni AM, Al-Omiri MK, Kawamura M. Differences in self-reported oral health behavior between dental students and dental technology/dental hygiene students in Jordan. J Oral Sci 2004;46:191-7.  Back to cited text no. 20
21.Sharda AJ, Shetty S. Relationship of periodontal status and dental caries status with oral health knowledge, attitude and behavior among professional students in India. Int J Oral Sci 2009;1:196-206.  Back to cited text no. 21
22.Maatouk F, Maatouk W, Ghedira H, Ben Mimoun S. Effect of 5 years of dental studies on the oral health of Tunisian dental students. East Mediterr Health J 2006;12:625-31.  Back to cited text no. 22


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

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