University Students ’ Awareness about Oral Health and Hygiene

Objective: The objective of the study was to evaluate the awareness of university students about oral health and hygiene in a university in Malaysia. Methods: A cross-sectional study was conducted among the students of four different faculties (pharmacy, medical, biotechnology and business) in a university in Malaysia with the help of prevalidated research questionnaire. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze and present the data. Results: The final response gathered was 324 from four faculties. The pharmacy faculty students had better knowledge as compared to the other faculties. The female students had better knowledge of oral health hygiene as compared to males. Final year students reported more appropriate knowledge as compared to pre-final year students. Original Research Article Iqbal et al.; JPRI, 32(37): 54-61, 2020; Article no.JPRI.64053 55 Conclusion: Overall appropriate knowledge was observed among the four studied faculties of the university. The present study concluded that pharmacy students had more appropriate knowledge of oral health and hygiene than the other faculty students.


INTRODUCTION
Maintaining oral hygiene and health is actually keeping the mouth clean, free of disease and other problems such as bad breath by routine brushing and cleaning the teeth [1,2]. Oral hygiene must be carried out regularly to prevent bad breath and dental diseases like tooth decay, cavities, dental caries, and gum diseases such as gingivitis and periodontitis [3,4]. Generally, many guidelines recommend cleaning the teeth twice a day, which can be after breakfast and before sleeping at night. Still, the mouth should be cleaned precisely after every meal [5, 6].
Usually, white or straight teeth are correlated with oral health and hygiene. Still, a hygienic mouth can still have damaged or twisted teeth [7,8]. Attaining healthy teeth requires dental care throughout life [3,9]. There are billions of microorganisms surviving within our mouths at any specific time. Several of these microorganisms develop plaque, producing tooth decay and cavities, leading to gum diseases [3,10]. For maintaining a healthy smile, one must perform good oral hygiene every day [10]. After meals, brushing teeth, using antimicrobic mouthwash, and flossing at least once a day can prevent several infectious diseases which could cause bacterial reproduction in the mouth that often results in tooth decay [11,12].
The university students are generally considered the most educated people in the community. Therefore, all university students must have proper knowledge on oral health and hygiene. Thus, the present study was conducted to evaluate the knowledge of the University students from different faculties on oral health and hygiene.

METHODOLOGY
A cross-sectional study was performed in a university to assess the knowledge of university students on oral health and hygiene. A self-developed and pre-validated research tool was used for the data collection of the current study.
A stratified convenience sampling technique was adopted for enrolling the required sample size from four studied faculties of a university in Malaysia. This university had numerous faculties but in line with the study perspectives, only 4 faculties were chosen to recruit sample size. The final targeted sample size was 350 students.
For assessment of the knowledge, open-ended statements were asked from all the study participants. All the knowledge questions consisted of one right answer, along with two or more wrong answers. All the respondents were asked to understand the questions and sensibly select the answer based on their knowledge of each asked statement on oral health and hygiene. The obtained scores were taken and presented as a percentage of right and wrong answers.
Data evaluations and statistical presentation were done by Statistical Package for Social Science (SPSS) version 24.0. The data were categorical, and thus, the data were analyzed by Chi-square and Fisher exact test to find the pvalue. A value of P < 0.05 was considered statistically significant for the current study. The effect size was measured using Partial Eta Squared (η 2 ), which is according to Cohen's classification of effect size, if 0.01 ≤ η2 ≤ 0.06 = small, if 0.06 ≤ η2 ≤ 0.14 = medium, η2 ≥ 0.14 = large.

RESULTS AND DISCUSSION
The final total of the survey response gathered was 324. From the Faculty of Pharmacy 110 students willingly answered the study questions. As for the Faculty of Medicine 81 students answered. The number of students' respondents from the Faculty of Biotechnology was 67.
Demographics of the current study is presented in the Fig. 1 as follows: A statistically significant and weak positive relationship was observed between the response of question 1 with faculty (p=0.038, year of education (p=0.022, ϕ=0.012) and gender variables (p=0.041, ϕ=0.009). More inappropriate knowledge (80.6%) reported by Biotechnology students.

Question 2:
Periodontitis is a preventable disease if treated on time.  The reason behind this could be the positive attitude of biotechnology students towards oral health and hygiene. The current study findings are supported by another study where the biotechnology students showed a more positive attitude to oral health and hygiene [12].
The current study findings reported that a statistically significant and weak positive relationship was observed between the response to the question on periodontitis is a preventable disease if treated on time with faculty (p=0.014, ϕ=0.013), and the year of education variable (p=0.034, ϕ=0.008). Final year students reported more appropriate knowledge (93.5%). The reason behind this could be the better knowledge of senior students as compared to the juniors. Similar result findings were reported by a study conducted in our Malaysian University according to that the senior students had better knowledge as compared to the juniors [13].   [13,14].
The current study findings also reported that a statistically significant and weak positive relationship was observed between the response of question as dental plaque often leads to gingivitis with faculty (p=0.025, ϕ=0.006), and gender variables (p=0.025, ϕ=0.014). More appropriate knowledge (56.8%) reported by Pharmacy students. Furthermore, a statistically significant and weak positive relationship was observed between the response of question as regular use of mouthwash and flossing results in prevention of gingivitis and plaque deposition with faculty (p=0.021, ϕ=0.008) and place of living variables (p=0.043, ϕ=0.007). A statistically significant and moderate positive association was reported with the question statement and year of education variable (p=0.002, ϕ=0.128).
Final year students reported more appropriate knowledge (47.7%). The findings on final year students had better knowledge than pre-final year students, was also reported by previous studies conducted in Malaysia [12,15,16]. The reason behind this could be that final year students usually have more exposure of major health problems and their epidemiology [17][18][19].
It is of greatest significance for future healthcare providers to have superior medical education which could enable them to well recognize drugdisease knowledge and disease treatment [20][21][22]. Advanced healthcare mock representations, improved drug-disease familiarity, and evidencebased exercises are essential for them in order to treat numerous oral diseases which could further help in improving patients' overall healthrelated quality of life [23][24].

CONCLUSION
The present study concluded varied responses regarding oral health and hygiene among students of a university in Malaysia. Pharmacy students and final year students had better knowledge than the other students about oral health and hygiene. The female students also reported a better knowledge as compared to the males.

CONSENT AND ETHICAL APPROVAL
The informed consent form was signed by all the participants who agreed to take part in the study. The approval on all ethical aspects was taken from the university research and ethics committee at the study location.