|Year : 2013 | Volume
| Issue : 3 | Page : 159-162
Self reported knowledge and practice of inter dental aids among group of dental students, Tumkur, India
Darshana Bennadi1, Mythri Halappa1, Nandita Kshetrimayum2
1 Department of Public Health Dentistry, Sree Siddhartha Dental College and Hospital, Tumkur, Karnataka, India
2 Regional Institute of Medical Sciences, Dental College, Lamphelpat, Imphal, West Manipur, India
|Date of Web Publication||21-Apr-2014|
Department of Public Health Dentistry, Sree Siddhartha Dental College and Hospital, Tumkur, Karnataka
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Objectives : To evaluate knowledge and practice of inter dental aids among a group of dental students in Tumkur, India.
Materials and Methods: A cross sectional descriptive study was conducted among dental students using questionnaire. Results: 84.6% dental students brushed their teeth twice daily. 74% students had knowledge regarding inter dental aids where as only 18% of the students practiced it. Significant differences (P < 0.05) were observed among students of different years in the knowledge and practice of inter dental aids. Conclusions: Among dental students, the overall knowledge of inter dental aids was good, even though there were deficits in knowledge in a few areas. The knowledge and practice of inter dental aids improved with increasing levels of education.
Clinical Relevance to Interdisciplinary Dentistry
- Dental health is highly an individualized concept and dental student become a role model for oral health.
- Most of the studies have shown the oral health behavior of dental students giving importance to routine brushing aids and knowledge.
- The present study deals with knowledge and practice of interdental aids by dental students and recommends change in dental curriculum mainly subject of Preventive dentistry.
- Students have to be informed how to use that knowledge in the real life.
Keywords: Dental students, knowledge, oral hygiene, preventive dentistry
|How to cite this article:|
Bennadi D, Halappa M, Kshetrimayum N. Self reported knowledge and practice of inter dental aids among group of dental students, Tumkur, India. J Interdiscip Dentistry 2013;3:159-62
|How to cite this URL:|
Bennadi D, Halappa M, Kshetrimayum N. Self reported knowledge and practice of inter dental aids among group of dental students, Tumkur, India. J Interdiscip Dentistry [serial online] 2013 [cited 2019 Jul 16];3:159-62. Available from: http://www.jidonline.com/text.asp?2013/3/3/159/131202
| Introduction|| |
According to World Health Organization (WHO), definition of Health, resources around the world have been trying to raise the critical consciousness of people to affect a change from the existing disease-centric, pain relieving notion of healthcare to promote a health centric and well being concept. Central to these attempts has been the idea of health promotion through education, instructions and motivation. An environment which is conducive for shifting the onus of public health from the shoulder of health care personnel to ''people's own hands'' would essentially thrive upon the health literacy of the population. 
As we know that dental problems are very common like tooth decay, periodontal disease and tooth loss, which constitute major public oral health problems in the world today. So, primary prevention - oral health promotion is the key to reduce these problems.
Periodontal disease is a pathological condition affecting the supporting structures of the teeth, and is a common oral ailment seen in dental hygiene practice. Dental plaque is one of the major cause for gingival and periodontal disease. If left untreated, periodontal disease may lead to tooth loss. Studies have shown that oral prophylaxis will reduce gingival and periodontal inflammation by removing the subgingival bacterial population and rendering the environment significantly less pathogenic; however, the microflora gradually shift back to a pathogenic supportive environment over three months. Daily oral self care to control the supra-gingival plaque may assist in slowing or reducing the shift to a pathogenic environment. Toothbrushes are unable to penetrate intact interdental areas, where periodontal disease is prevalent necessitating the use of an interdental aids. 
Self-care has been defined by the World Health Organization as ''Self Care in health refers to the activities individuals, families and communities undertake with the intention of enhancing health, preventing disease, limiting illness, and restoring health. These activities are derived from knowledge and skills from the pool of both professional and lay experience. They are undertaken by lay people on their own behalf, either separately or in participative collaboration with professionals". 
Dental health is highly an individualized concept. The attitude of people toward their own teeth and attitudes of dentists, who provide dental care, play an important role in determining the oral health conditions of the population. By choosing a dental curriculum at an undergraduate level, dental student become a role model for oral health. The attitude and behavior of dental students toward their oral health care reflect their understanding of the importance of dental procedure and improving the oral health of their patients. The dental students are expected to be a good example for oral health behavior. 
Many studies have shown oral health behavior of professional students but very little attention has been given to awareness and practice of interdental aids among dental professionals. Hence, this study was undertaken with objective to assess the knowledge and practice of inter dental aids among dental students.
| Aim|| |
To assess the knowledge and practice of inter dental aids among dental students of Sri Siddhartha Dental College and Hospital, Tumkur, India.
| Materials and Methods|| |
This study was an anonymous, questionnaire-based survey. A self-developed, pre-validated close-ended questionnaire was used.
The study population comprised of dental students of Sri Siddhartha Dental College and Hospital, Tumkur, India. Prior to the data collection, the questions were pre-tested among a group of 20 students (pilot study) in order to ensure the level of validity and degree of repeatability (Cronbach's alpha = 0.76).
A briefing was given about the nature of the study, and the procedure of completing the questionnaire was explained. Consenting participants anonymously completed the questionnaire. The ethical clearance was obtained from ethical committee of Sri Siddhartha Dental College and Hospital, Tumkur, India. Students were requested to remain in the class at the end of a lecture and Inter Departmental Meet (Interns) to participate in the survey on a voluntary basis. No attempt was made to follow up with students who were absent on the day of the survey. For the purpose of the study, certain operational terms were defined like plaque, calculus and interdental aids.
The questionnaire included year of study, gender and questions regarding student's oral hygiene practice, knowledge about interdental aids, its practice and reasons for not practicing inter dental aids. The students were asked to respond to each item according to the response format provided in the questionnaire. Furthermore, the investigator was always available during the completion of the questionnaire and the participants were encouraged to approach the investigator whenever they needed clarification of any point. The students, who were asked to fill in the questionnaire without discussion with each other.
The collected data were subjected for statistical analysis using SPSS version 16. Descriptive statistics were obtained and mean percentage scores, standard deviation, and frequency distribution were calculated. Along with that, comparison among different year students in relation to use knowledge about interdental aids, its practice on regular basis and their oral health behavior was assessed by using ANOVA test and Post hoc test. P value of < 0.05 was taken as statistically significant.
| Results|| |
A total of 202 (136 female and 66 male) dental students from the 1 st , 2 nd , 3 rd , 4 th year and house surgeons completed the questionnaire [Table 1]. The age of the students ranged from 18 years to 30 years.
The findings concerning tooth brushing habit of participants was 100%. No significant differences in tooth brushing behavior were found by academic years. There was no student with brushing habit ''never'' or ''some times''. Of the total, 84.6% of the respondents claimed to brush their teeth twice daily.
Knowledge about interdental aids
74% of students had knowledge regarding interdental aids. 86% students known that inter proximal area of teeth is the most difficult to clean with brush alone. 56% of the students knew about floss and 81% students thought that interdental aids commonly used during food impaction [Table 2]. 73% students were aware about proxa brush.
Clinical students had good knowledge regarding interdental aids compared to non clinical students and were statistically significant (P < 0.05). More than 50% of the first year students did not give the correct response for the knowledge items regarding meaning of plaque, reason for gum bleeding, methods of prevention of gum bleeding, common surface of food impaction, indications of interdental aids, different methods of using floss, toothpick and reason of tooth loss in old age. The percentage of students giving correct response was significantly higher in the final year of dental studies.
Practice of inter dental aids
18% of students use interdental aids commonly floss and interdental orthodontic tooth brush. Among them 2% of students regularly use floss where as using spool method others do not follow any particular method. Clinical students practiced interdental aids more compared to non clinical students and were statistically significant (P < 0.05). Graph 1 shows the reasons for not practicing inter dental aids.
| Discussion|| |
Dental students should be a good example of positive oral health attitudes and behavior to their families, patients and friends. In general, they have been found to be motivated about maintaining a good oral health. 
In accordance with other studies , 84.6% of students brushed their teeth twice daily. Whereas one-third Kuwait and two-third of Jordanian students brushed their teeth twice a day, respectively.  Only 53% of the dental students brushed each of their teeth carefully, which was a much smaller proportion than that in Finnish (78%) and Japanese (55%) dental students.  Students gave less importance to individual tooth maintenance. This suggests that the level of student's self-care may have been influenced by their course contents. 
Only 18% of the students practiced interdental aids (dental floss, interdental brush) on a regular basis. Evidence in the literature ,, suggests that there is a general lack of use of flossing as a preventive measure by the various population of the world.
Awareness regarding the use of dental floss was low among students in this study and the percentage of those reporting the use of rinse was also low. Among all students, those in the 4 th and 5 th years were the majority who used it. This can be explained by the fact that the basic course in clinical periodontology starts in the third year.
The dental students in our study were lacking in knowledge of the use of interdental aids, the proper force and technique and the use of disclosing solutions to identify deposits on the teeth. These results are in line with studies conducted by Neeraja, Kayalvizhi, Sangeetha, Kirtiloglu and Yavuz. 
Oral health education needs to be provided in these areas in accordance with several studies where study results confirmed that knowledge and practice of inter dental aids improved with increasing levels of education. ,,,, This improvement in personal oral health among dental students has been shown to be linked to their dental education experience.  Knowledge and practice of inter dental aids seem to increase significantly in the fourth and fifth years of dental education. Additionally, the responses of the students in the fourth and fifth years were very similar. ,,
| Conclusion and Recommendation|| |
Among dental students, the overall knowledge of inter dental aids was good, even though there were deficits in knowledge in a few areas. The knowledge and practice of inter dental aids improved with increasing levels of education.
Studies  have shown that, as the students passes through undergraduate curriculum i.e., from first to final year will be having positive changes in the oral health knowledge, attitude and behavior. Preventive behavior among the students can be still improved through achanges in dental curriculum like preventive dentistry courses should be included in the pre-clinical years and professional education should provide meaningful learning experience on modern methods.
Professional education of dental students should create stable health behavior which will overcome differences in personal characteristics and will be helpful for the future dental health providers to provide good preventive oral health care services to their patients, family and friends.
This study has focused light on the knowledge and practice of interdental aids. So, further studies are needed to evaluate whether there is a difference in caries experience and gingival health among preclinical and clinical dental students.
| References|| |
|1.||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. |
|2.||Imai PH, Yu X, MacDonald D. Comparison of interdental brush to dental floss for reduction of clinical parameters of periodontal disease: A systematic review. Can J Dent Hygiene 2012;46:63-78. |
|3.||Available from: http://www.asmi.com.au/self care/WHO definition [Last accessed date on 22/1/2012]. |
|4.||Dagli RJ, Tadakamadla S, Dhanni C, Duraiswamy P, Kulkarni S. Self reported dental health attitude and behavior of dental students in India. J Oral Sci 2008;50:267-72. |
|5.||Neeraja R, Kayalvizhi G, Sangeetha P. Oral Health Attitudes and Behavior among a Group of Dental Students in Bangalore, India. Eur J Dent 2011;5:163-7. |
|6.||Ganss C, Schlueter N, Preiss S, Klimek J. Tooth brushing habits in uninstructed adult-frequency, technique, duration and force. Clin Oral Invest 2009;13:203-8. |
|7.||Al-Omari QD, Hamasha AA. Gender- specific oral health attitudes and behavior among dental students in Jordan. J Contemp Dent Pract 2005;6:107-14. |
|8.||Kawamura M, Honkala E, Widstrom E, Komabayashi T. Cross- cultural differences of self-reported oral health behavior in Japanese and Finnish dental students. Int Dent J 2000;50:46-50. |
|9.||Soh G. Understanting prevention of dental caries and gum disease in an Asian community. J Ir Dent Assoc 1991;37:6-9. |
|10.||Newburn E. Preventing dental caries: Breaking the chain of transmission. J Am Dent Assoc 1992;123:55-9. |
|11.||Kawamura M, Spadafora A, Kim KJ, Komabayashi T. Comparison of United States and Korean dental hygiene students using Hiroshima University-Dental Behavioral Inventory (HU-DBI). Int Dent J 2002;52:156-62. |
|12.||Kawamura M, Iwamoto Y, Wright FA. A comparison of self- reported dental attitudes and behavior between selected Japanese and Australian students. J Dent Educ 1997;61:354-60. |
|13.||Al-WahadniAM, 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. |
|14.||Nusair KB, Alomari Q, Said K. Dental health attitudes and behavior among dental students in Jordan. Community Dent Health 2006;23:147-51. |
|15.||Cortes FJ, Nevot C, Ramon JM, Cuenca E. The evolution of dental health in dental students at the University of Barcelona. J Dent Edu 2002;66:1203-8. |
|16.||Polychronopoulou A, Kawamura M, Athanasouli T. Oral self-care behavior in Japanese and Finish dental students. Int Dent J 2000;50:46-50. |
|17.||Sharda AJ, Shetty S. A comparative study of oral health knowledge, attitude and behavior of first and final year dental students of Udaipur city, Rajasthan. J Oral Health Comm Dent 2008;2:46-54. |
[Table 1], [Table 2]