Knowledge and Practices of Periodontal Health and Oral Hygiene among BDS Students

Background: Periodontal disease is an inflammatory oral disease that affects the soft and hard tissues supporting the teeth. Gingivitis, an early stage, when untreated leads to periodontitis that causes progressive tooth mobility leading towards tooth loss. Periodontitis is ubiquitous and commonly manifests in adult life. Early detection of oral diseases makes them more amenable to treatment and allows better chance of cure. BDS students are young adults who are going to be future oral health care provider. Their knowledge and oral hygiene practices may impact oral health status of a society. Aims: The aim of this study was to evaluate the knowledge of oral health and periodontal disease and correlate it with oral hygiene practices among BDS students not exposed to clinical practice. Materials and Methods: This cross-sectional study was carried out among 120 students of first, second and third year BDS at Kantipur Dental College. The students who were not exposed to clinical practice were invited to participate. The data was collected by self-administered structured questionnaire. There were total of 15 questions on knowledge and oral hygiene practice and scores were assigned to each question. Data analysis was done by SPSS 20 software program. Results: The mean knowledge score of the population was 6.58 ± 1.29 and mean practice score as 6.20 ± 1.73. The participants had good knowledge (55%) of oral health and periodontal diseases. However, only 22.5% of participants followed good oral hygiene practices. There was no significant difference of knowledge between males and females ( p = 0.831) but a statistically significant difference was seen in the practice of oral hygiene ( p = 0.006). Conclusion: Despite having good knowledge (55%) of oral and periodontal health, 77.5% of the BDS students did not follow good oral hygiene practices on a regular basis. Dental students must be encouraged to be good role models in practicing as well as promoting oral health. The authors would like to recommend incorporating some oral health and preventive dentistry topics in the non-clinical BDS curriculum.


INTRODUCTION
Periodontal diseases are one of the most common diseases among population and, when left untreated, lead to tooth loss. 1 Staggering 47.5% of Nepalese population suffer from periodontitis. 2 Periodontitis has been associated with many systemic conditions such as cardiovascular diseases, diabetes, preterm low birth weight deliveries, rheumatoid arthritis, pulmonary diseases, etc. Thus, maintaining good oral health is important not only for healthy dental status but also for improved systemic health. 3 The main cause of periodontal disease is bacterial plaque although many other factors such as smoking, diabetes, drugs, stress, haematological disorders and hormonal changes, may affect the initiation and progression of gingival and periodontal diseases. 4 Taking care of oral hygiene by removing dental plaque remains mainstay of maintaining oral and periodontal health. The young adult age group can be motivated to instil good oral hygiene practices at an early age for life-long good oral health conditions. The Bachelor of Dental Surgery (BDS) students, who are not exposed to the clinical practice and the subject of Periodontology in their curriculum, are good representative of health aware individuals of the young adult age group.
This study was conducted to evaluate the knowledge of periodontal health and various oral hygiene practices among BDS students and to assess the potential relationship among gender, level of knowledge and practices of oral hygiene. proposal was submitted to ethical committee and approval was taken. The students who were not exposed to clinical practice were recruited for the study. Utmost confidentiality was maintained and no names, documents are disclosed anywhere other than among the researchers. The inclusion criteria included students of first, second and third year enrolled in BDS program and willing to sign an informed consent. The exclusion criteria included the students who had attended lectures of Periodontics or exposed to clinical practice. The participants completed a self-administered structured questionnaire. The questionnaire consisted of items to assess participants' personal data (age, gender) and knowledge related to periodontal health and their oral hygiene practices. There were total nine questions on knowledge with maximum score nine (Table 1) and six questions on oral hygiene practice with maximum score of 10 ( Table 2).

MATERIALS AND METHODS
The data from the proforma were entered in Microsoft Excel and statistical analyses were performed using Statistical  (Table 3). Statistical significance was based on probability values of less than 0.05. Potential association among knowledge of periodontal health, oral hygiene practices and gender were analysed (Table 3).

RESULTS
The minimum knowledge score of the population was observed to be three and maximum nine while the minimum practice score was two and maximum 10. The mean knowledge score of the population was found to be 6.58 ± 1.29 and mean practice score as 6.20 ± 1.73 (Table 3).
When the knowledge scores were checked with gender there was no significant difference (p = 0.0831) while the practice scores showed a statistically significant (p =0.006) association ( Table 3).
The age of the participants ranged from 20 to 24 years (21.26 ± 0.95) and among all the participants (120) there were 27 (22.5%) males and 93 (77.5%) females (Table 3).     8 Sharda et al. 9 However, it agrees with authors in that oral hygiene practice scores were better in females, similar to Al-Omari et al. 10 The limitation of this study was that it was an observational study for a short period in only one dental college. A comparative study with BDS students exposed to clinical setting8 including other dental colleges as well or compared to non-dental undergraduate students 7 would have given broader glimpse of actual scenario of knowledge and oral hygiene practice in the young adult age group.

CONCLUSION
Despite having good knowledge (55%) of oral and periodontal health, 77.5% of the BDS students did not follow good oral hygiene practices on a regular basis. The dental students must be encouraged to be good role models in practicing as well as promoting oral health for their patients, families, friends and ultimately the society. The authors would like to recommend incorporating some oral health and preventive dentistry topics in the non-clinical BDS curriculum.