Year : 2010 | Volume
: 21 | Issue : 2 | Page : 195--200
Oral hygiene practices and habits among dental professionals in Chennai
Department of Periodontics, Saveetha Dental College and Hospital, Poonamalee High Road, Velapanchavadi, Chennai - 600 077, India
Department of Periodontics, Saveetha Dental College and Hospital, Poonamalee High Road, Velapanchavadi, Chennai - 600 077
Aims and objectives : The present study was carried out to assess the oral hygiene practices and habits among practicing general dentists.
Materials and Methods : The study was carried out in four dental schools with the help of a self administered questionnaire. The questionnaire covered dentists«SQ» oral self care, smoking habits, professional reading and oral health concepts. A total of 700 dentists responded, of which 457 were males. Recommended oral self care (ROSC) included tooth brushing one per day, eating sugary snacks daily or rarely and regularly using fluoride tooth paste.
Results : The data obtained was then subjected to statistical analyses and evaluated using chi-square tests and logistic regressions.It was found that 55.9% of all respondents brushed twice a day, 59.4% consumed sugar containing snacks less than once daily and 55.1% of them used fluoride containing paste regularly while brushing. 81.1% of the 700 dentists never used tobacco products. In all, 19.6% 0f the practicing general dentists followed recommended oral self care.
Conclusion : From the present study, it can be concluded that only 19.6% of south Indian dentists follow recommended oral self care and hence awareness programs and continuous dental education programs among dentists is essential to improve the present scenario and to increase the number of dental professionals following ROSC.
|How to cite this article:|
Gopinath V. Oral hygiene practices and habits among dental professionals in Chennai.Indian J Dent Res 2010;21:195-200
|How to cite this URL:|
Gopinath V. Oral hygiene practices and habits among dental professionals in Chennai. Indian J Dent Res [serial online] 2010 [cited 2021 May 8 ];21:195-200
Available from: https://www.ijdr.in/text.asp?2010/21/2/195/66636
Oral self care practices have been proved to be an effective preventive measure at individual level for maintaining good oral health as part of general health.  Studies have shown that brushing, particularly with fluoride tooth pastes, reduces dental caries,  but the effect of oral hygiene on periodontitis has not been clearly demonstrated. 
Regular dental checkups  and non-smoking  are recommended for maintaining optimal oral health. To improve oral health of the populations, WHO has set the promotion of self care of as one of the goals for the year 2020.  Recommended oral self care (ROSC) includes tooth brushing more than once a day, lesser consumption of sugar containing snacks once daily or rarely and regular use of fluoride containing tooth paste. Since dentists are expected to be role models to their patients, evaluation of ROSC of dentists themselves will provide an estimate of the extent to which they follow ROSC.
Association between smoking and periodontal problems has been studied as far back as the 1940's,  yet there has prevailed as ambivalence as to the role of smoking in periodontal disease up to 1980's. The strongest established risk factors for periodontitis are cigarette smoking and diabetes.  Oral health consequences of using smokeless tobacco i.e. lesions in the oral mucosa and an increased risk of oral cancer, have been clearly recognized. 
The purpose of this study was to investigate the oral hygiene practices and habits among practicing general dentists as well to know their opinions on the use of tobacco and its products on periodontal health and oral health.
Materials and Methods
This study was carried out among general dental practitioners of Chennai city, Tamil Nadu, south India in 2008. Four dental schools were selected randomly and a total of 700 dental professionals from these schools participated in the study. The research instrument was a closed ended questionnaire which was pretested among a group of dental professionals. The study was conducted by means of a self administered questionnaire which inquired about their oral hygiene practices, oral health behavior, knowledge about preventive dental care, reading of professional journals and oral health concepts in relation to usage of tobacco and its products.
The questionnaire inquired as to these dentists' own tobacco use as well as to other background factors such as sex, age, specialization. Dental professionals who were absent for any reason such as sickness, were excluded from the study. The number of absentees was small and did not affect the outcome.
The dental professionals were asked to fill questions about oral health behavior which comprised of oral self care (questions 1 to 4), dental attendance (questions 5, 6 and 7), smoking (question 8) and professional reading and knowledge about preventive care (question 9) and a questionnaire regarding oral health concepts to analyze knowledge of dental professionals regarding the consequences of tobacco and its usage was also included in the questionnaire and the completed questionnaires were collected.
A total score was calculated based on the response to each question. Out of 700 dental professionals, 457 (65.3 %) were males and 243 (34.7%) were females. A total of 628 dentists who participated in the study were less than 35 years (89.7%), 44 were between 35 -44 years (6.3%) and 28 dentists were above 45 years (4.0%). the data obtained was then subjected to statistical analysis.
Statistical evaluation included the Chi-square test for estimating the differences in frequencies. To evaluate factors related to recommended oral self care, logistic regression models were used to analyze its relation to age, sex, knowledge scores, smoking and professional reading.  The corresponding odds ratios and their 95% confidence intervals were defined. SPSS software was used for data processing and statistical analyses.
A total of 700 dentists completed and returned the questionnaire and the results were statistically analyzed and compared gender wise, age wise regarding oral hygiene practices, dental attendance ,smoking, professional reading and concepts about tobacco use.
Oral hygiene practices
More than half of the dentists (55.9%) reported that they brushed twice a day and used a fluoridated tooth paste always while brushing (55.1%). 59.4% reported that they had a sugar containing snack or drink between meals rarely. 9.2% of them reported that they flossed at least once daily [Table 1].
About 19.6% of dental professionals followed the recommended level of the three behaviors included in recommended oral self care (ROSC). In the above 45 years age group, a prominent gender difference was seen - 56.3% for women against 16.7% for men. The overall ROSC scores were higher for women than men in all categories except in the 35 - 44 years age group were men had a better ROSC as compared to women.
Looking into attendance, 35.7% (250 dentists) reported that they go for a dental check up only when there is a problem and 34% reported regular dental checkups every six months; 40.3% (282) of dentists had gone for a dental check up within the last six months and 24.7% (173) of dentists had a dental check up within the last one year. About 69.3% (485) of dental professionals had no decayed teeth and 27.9% (195) had 1 - 4 decayed teeth; 81.1% (568 dentists) were non smokers, 5.7% (40 dentists) used tobacco products and 5.1% used tobacco products but had quit the habit now.
Out of 700 respondents, 568 were non-smokers; four out of five dentists had never used tobacco products; 18.1% had used tobacco products at sometime and this was greatest in the less than 35 years age group. Compared to men, the usage of tobacco among women was lesser and it was lesser among older age groups. Those who use tobacco products were found to brush more often (61% vs. 55%), consume less sugar containing snacks between meals (43% vs. 63%), use fluoride containing paste regularly (67% vs. 53%) and follow ROSC (21% vs. 19%). Non tobacco users were found to floss regularly when compared to those who use tobacco products (3% vs. 11%).
Among the 700 dental professionals, 85.6% of them were postgraduates; 558 read both national and international dental journals and 11.6% read international journals alone. It can be expected that those with a wider range of professional reading will follow the recommended oral self care and are more likely to brush twice a day, use a fluoridated tooth paste regularly and consume less of sugary snacks between meals.
Oral health concepts
This part of the questionnaire analyzed the knowledge of the dental professionals regarding the consequences of tobacco and its usage. Dentists' answers to these questions revealed that vast majority of them were aware of the effects of tobacco on causing discoloration of teeth and gingiva, producing changes in the oral mucosa, causing greater gingivitis and periodontitis with impaired healing following periodontitis. Responses to the questionnaire also revealed that most of them were aware that smoking increases the risk of oral cancer and that smokeless tobacco increases the risk of cancer incidence. Dental professionals also agreed or strongly agreed that impaired periodontal host response and impaired oral health are also a consequence of tobacco use [Table 2].
[Table 3] and [Table 4] shows the dentists oral health behavior according to their score on consequences to tobacco usage. Dentists with a high score were found to follow ROSC, brush twice daily, consume less sugar containing snacks, use fluoride containing paste regularly, floss regularly, have regular dental checkups and not use tobacco based products. These findings were highly significant.
This study was conducted in a sample of 700 dental professionals who were selected randomly from four dental schools based on the ease of access. The study was done to provide information about oral health behavior and concepts among practicing dentists. As a dental professional, he or she is expected to be a role model to his or her parents, to his or her patients and to the public in general. Patterns of oral health behavior in dentists, their beliefs and attitudes, play an important role in the knowledge they impart to the general public and their community. 
It has been shown that health practices of physicians determine what they tell their patients.  A similar trend can be anticipated among dental practitioners as well. Oral diseases are primarily considered behavioral diseases, thus adopting healthy habits is essential to control them.  Dental health practices are predominantly learned from a combination of sources: the dental profession, through professional learning and through personal and parental influences.
The direct causes for the current improvement in oral health include improved nutrition and diet, regular use of fluoride and better oral hygiene.  Recommended oral self care (ROSC) includes tooth brushing more than once a day, eating sugary snacks less daily and regular use of fluoride tooth paste.
About 55.9% of the dentists reported that they brushed twice a day and this was lesser when compared to the findings of Hadi et al.,  who reported that 59% of Iranian dentists brushed twice daily. It was also less than the findings of Anwar et al.,  who reported that 73% of dental professionals brush twice a day in USA and to that of the findings of Tseveenjav et al., in Mongolia (81%). About 98.9% of south Indian dentists brushed at least once daily. Female dentists were found to brush twice daily more commonly than their male counterparts; 59.4% of dentists consumed sugar containing snacks at least once between meals and 40.6% of the dentists consumed sugar containing snacks twice or more between meals. This finding was close to that of 59% for Iranian dentists  and 52% for Mongolian dentists.  Female dentists consumed more sugar containing snacks as compared to male dentists.
Fluoride containing tooth paste was used on a regular basis by 55% of the dentists. Female dentists were found to follow this regime more than their male counterparts. The findings of Tseveenjav et al., revealed that 62% of Mongolian dentists were using fluoridated tooth paste always or almost always. Around 74% of Iranian dentists were found to use fluoride toothpaste regularly. 
Use of dental floss among Indian dentists was considerably low at 9.2%. 54% of Iranian dentists were found to use floss at least once a day. Even though the usage of dental floss was low, the incidence of dental caries among the dental professionals was only 30.7%. Only 2.9% of them had more than 5 decayed teeth. This is considerably less than the findings of Merchant et al., who reported that 70% of healthcare professionals in USA had more than five decayed teeth.
Around 40% of the dentists go for a dental check up at least once a year and 65% of the dentists had gone for a dental checkup within the last one year. This was more than that for Iranian dentists were only 41% of the dental professionals went for a checkup in the last one year.  The value was 75% for Mongolian dentists. 
About 81.1% of the south Indian dentists never used tobacco products. This was very high when compared to that of Iranian dentists - only 76% were non smokers, only 65% of Jordanian dentists were non smokers and 88% of Finnish dentists were non smokers. ,, This high value for non tobacco usage among Indian dentists could be explained by the fact that knowledge about the consequences of tobacco usage was high among them. More than 85% of them either agreed or strongly agreed to the questions on consequences of tobacco usage.
ROSC was around 19.6% among Indian dentists. Hadi et al., report that 27% of Iranian dentists followed ROSC. Since 86% of the participants were postgraduates and 80% of them read both national and international journals, a better compliance with ROSC was anticipated. Due to their profession, dentists are expected to exhibit better oral health behaviors when compared to the general public. A response of 19.6% ROSC among dentists themselves reveals that they fall short of being in a position to educate lay people about the importance of ROSC.
Dentists must follow the ROSC as part of maintaining good general health. As dental professionals, they have a responsibility to stress on the public the importance of good oral hygiene practices. The present data reveals that the ROSC levels are less among south Indian dentists and special awareness programs, continuing dental education programs and modifications of dental training can be contemplated for making a change in the attitudes of practicing general dentists. The importance of ROSC must be stressed upon in these awareness programs and a change in oral health behavior is necessary to improve the oral health of GDP's. This approach would also be helpful in disseminating positive oral health concepts to the general public.
I thank Dr. Joseph John M.D.S and Dr. T. Ramakrishnan M.D.S for their technical support and help.
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