Oral health behaviour and social and health factors in university students from 26 low, middle and high income countries.

Karl Peltzer,Supa Pengpid

doi:10.3390/ijerph111212247

Abstract

Poor oral health is still a major burden for populations throughout the world, particularly in developing countries. The aim of this study was investigate oral health behaviour (tooth brushing and dental attendance) and associated factors in low, middle and high income countries. Using anonymous questionnaires, data were collected from 19,560 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Results indicate that 67.2% of students reported to brush their teeth twice or more times a day, 28.8% about once a day and 4.0% never. Regarding dental check-up visit, 16.3% reported twice a year, 25.6% once a year, 33.9% rarely and 24.3% never. In a multivariate logistic regression analysis, being a male, coming from a wealthy or quite well off family background, living in low income or lower middle income, weak beliefs in the importance of regular tooth brushing, depression and PTSD symptoms, tobacco use and frequent gambling, low physical activity, and low daily meal and snacks frequency were associated with inadequate tooth brushing (<twice daily). Further, being a male, older age, coming from a not well off or poor family background, living in low income or lower middle income, weak beliefs in the importance of regular tooth brushing, PTSD symptoms, illicit drug use, low physical activity, and low daily snacks frequency, skipping breakfast and inadequate fruit and vegetables consumption were associated with less than one annual dental care visit. Oral health behaviour among the students was found to be low. Various risk factors identified can be used to guide interventions to improve oral health behaviour among university students.

Highlights

Healthy habits and good oral hygiene, including twice daily tooth brushing, are critical in preventing gum disease and maintaining good oral health [1]
Less than annual or no dental visits has been found to be associated with being male [15,24,25,26,27], lower socioeconomic status [16,26,28], younger age [9]; poor oral health attitudes [25]; health risk behaviour, including infrequent tooth brushing [26], smoking [29] and anticipation of painful treatment [9]
The overall prevalence of recommended tooth brushing frequency among university students differed by country, ranging from below 30% in Nigeria, India and Egypt, to about 90 or more percent in Thailand, Indonesia and Venezuela

Summary

Introduction

Healthy habits and good oral hygiene, including twice daily tooth brushing, are critical in preventing gum disease and maintaining good oral health [1]. The prevalence of less than twice tooth brushing per day among university students seems to be higher in low and middle income than in high income countries, e.g., 52.2% in India [2], 35% in Lebanon [3], 32% in Turkey [4]; 24% not regularly in Yemen [5]) than in high income countries (7.9% in Italy [6], 25% in USA [7]). Less than annual or no dental visits has been found to be associated with being male [15,24,25,26,27], lower socioeconomic status [16,26,28], younger age [9]; poor oral health attitudes [25]; health risk behaviour, including infrequent tooth brushing [26], smoking [29] and anticipation of painful treatment [9]. The two hypotheses being that (1) male university students from lower socioeconomic backgrounds, having low physical activity, having more addictive risk behaviours, poorer dietary behaviour and poorer mental health are more likely to have poor tooth brushing behaviour, and (2)

Objectives

Methods

Results

Discussion

Conclusion