JIOH on LinkedIn JIOH on Facebook
  • Users Online: 36
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
ORIGINAL RESEARCH
Year : 2017  |  Volume : 9  |  Issue : 4  |  Page : 156-164

Oral health attitudes and behavior among health professionals in Riyadh City, Saudi Arabia


1 Department of Dental Public Health, Riyadh College of Dentistry and Pharmacy, Riyadh, Saudi Arabia
2 Department of Prosthodontics and Dental Imlpant, Riyadh College of Dentistry and Pharmacy, Riyadh, Saudi Arabia
3 Department of Preventive and Community Dentistry, Riyadh College of Dentistry and Pharmacy, Riyadh, Saudi Arabia

Date of Web Publication21-Aug-2017

Correspondence Address:
Fahad A Fahad Almarek
Department of Dental Public Health, Riyadh College of Dentistry and Pharmacy, Riyadh
Saudi Arabia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jioh.jioh_134_17

Get Permissions

  Abstract 

Aims and Objectives: The objective of this study was to assess the oral health attitudes and behavior among health professionals (dentists, physicians, nurses, technicians, and pharmacists) working in Prince Sultan Military Medical City (PSMMC), Riyadh, using Hiroshima University Dental Behavioral Inventory (HU-DBI). Materials and Methods: This cross-sectional descriptive study evaluated the oral health attitudes and behavior of health professionals working in PSMMC in Riyadh, Saudi Arabia. A convenient sample of 500 health professionals, such as dentists, physicians, nurses, technicians, and pharmacists working in the PSMMC, Riyadh, was considered for the study. This study used the HU-DBI created by Kawamura to measure oral health attitudes and behaviors among health professionals working in PSMMC. All the data analysis for this study were carried out using IBM-SPSS, version 21.0. Results: A total of 500 questionnaires were distributed among health professionals in PSMMC, Riyadh, and all of the questionnaires were filled and returned back. Thus, a response rate of 100% was obtained. Among all the health professionals considered in the study, highest mean HU-DBI score was observed among pharmacists (6.09 ± 0.85) and dentists (6.08 ± 0.62), followed by physicians (6.06 ± 0.96), technicians (5.90 ± 0.93), and nurses (5.39 ± 1.33). Conclusion: Based on the findings from this study, in general, health professionals considered from PSMMC showed fair oral health attitudes and behaviors as measured by using HU-DBI.

Keywords: Attitude, health professionals, oral health, oral hygiene


How to cite this article:
Almarek FA, Assery MK, Baseer MA. Oral health attitudes and behavior among health professionals in Riyadh City, Saudi Arabia. J Int Oral Health 2017;9:156-64

How to cite this URL:
Almarek FA, Assery MK, Baseer MA. Oral health attitudes and behavior among health professionals in Riyadh City, Saudi Arabia. J Int Oral Health [serial online] 2017 [cited 2017 Sep 22];9:156-64. Available from: http://www.jioh.org/text.asp?2017/9/4/156/213494


  Introduction Top


Dental caries and periodontal diseases are considered as two major dental diseases.[1] In addition, these diseases are not life-threatening [2] and they are preventable through good oral health behaviors [1] and oral health education.[3]

A recent review on dental caries in Saudi Arabia showed a high prevalence and greater severity of caries in various age groups. In addition, secular trends with striking increase in DMFT and caries prevalence rates over the past few decades have been observed.[4] Similarly, the prevalence of plaque-induced moderate to severe gingivitis was found in 100% adults in Saudi Arabia.[5]

Studies have disclosed that gender, age, socioeconomic status, education, cultural background, stress, and anxiety play a role in influencing oral health-related behaviors and problems. Evidence shows socioeconomic status, education level, oral health behavior, and oral health outcomes are correlated.[3]

The majority of studies assessing oral health attitudes and behaviors have utilized the Hiroshima University-Dental Behavioral Inventory (HU-DBI) produced by Kawamura in 1988.[6],[7],[8],[9] The HU-DBI has shown good test-retest reliability.

This study will help identify the gaps in oral health attitudes and behaviors of health professionals working in the Prince Sultan Military Medical City (PSMMC). In addition, it also helps better understand and addresses the concerns of the health professionals related to oral health. As a result, health professionals will be more competent to address the issue of oral health in their routine practice. The expectation is that this study will help oral health-care providers better understand the obstacles faced by other healthcare.

Halboub et al., 2016[10] conducted a study to assess self-reported oral health attitudes and behavior among undergraduate dental and medical students and to analyze the variations in oral health attitudes based on gender, level of education, study discipline, academic average, and type of university. The study concluded that Yemeni dental and medical students have shown markedly poor oral health attitude and behavior. Further studies are required to reveal possible shortcoming in these schools' education process. Dental and medical curricula should emphasize the importance of proper oral hygiene, and further participation of medical and dental students in oral hygiene seminars is highly encouraged.


  Materials And Methods Top


This cross-sectional descriptive study evaluated the oral health attitudes and behavior of health professionals working in PSMMC in Riyadh, Saudi Arabia.

The study proposal was submitted to the research center of RCsDP and ethical approval was obtained. The study registered with the registration number FPGRP/43638001/66. Participation in the study was voluntary, and informed consent to participate in the study was obtained from the health professionals.

The study design was cross-sectional with a convenience sample of health professionals from PSMMC, Riyadh. This study design was considered useful for generating hypothesis and intervention plans for the future purposes to take appropriate measures.

A convenient sample of 500 health professionals, such as dentists, physicians, nurses, technicians, and pharmacists working in the PSMMC, Riyadh, was considered for the study. Study participants who could read and understand English were included in the study. Data collection was carried out during July–August 2016.

Assuming acceptable margin of error 4%, confidence level of 95%, number of health professionals working PSMMC 3000, and 50% response rate the required sample size was found to be 500. Sample size calculation was carried out using Raosoft online sample size calculator.

The study was carried out in various departments of PSMMC, Riyadh, Saudi Arabia. Trained research assistant approached every department of the PSMMC and contacted the on-duty health professionals (dentists, physicians, nurses, technicians, and pharmacists) available at that time and distributed the questionnaire.

This study used the HU-DBI created by Kawamura [6] to measure oral health attitudes and behaviors among health professionals working in PSMMC. The HU-DBI is a 20-item questionnaire used to measure the oral health attitudes and behavior. All items from the HU-DBI have dichotomous response format (agree/disagree). The HU-DBI has shown good test-retest reliability and is based on a maximum of 12-point scale and the higher the scores, the better indication for good oral health attitudes and behaviors.[6],[7] Moreover, the HU-DBI has been translated from Japanese into many languages including the English version with good translated validity and test-retest reliability.[11] In addition, health professionals rated their oral health-based three-point scales.

The survey contained 30 questions, of which 20 were questions of the HU-DBI [Table 1] asking about the oral health attitudes and behaviors; 10 were demographic questions asking the participant's age, gender, nationality, qualification, health professional, years of experience, smoking status, last visit to dentist, reason for last visit, and self-rated oral health condition [Figure 1].
Table 1: Hiroshima University-Dental Behavioral Inventory questionnaire items with agree/disagree responses

Click here to view
Figure 1: Flow chart of survey questionnaire

Click here to view


Trained research assistant approached every department of the PSMMC and contacted the on-duty health professionals (dentists, physicians, nurses, technicians, and pharmacists) available at that time and distributed the questionnaire in the respective departments. It took 5–7 min to complete the questionnaire. All the filled questionnaires were returned to the research assistant. No personal information such as names, addresses, or phone numbers was gathered. No attempt was made to record the clinical indices.

All the data analysis for this study were carried out using IBM-SPSS Chicago USA, version 21.0. Normality distribution was assessed and the data were found to be not normally distributed. Descriptive analysis was performed for the demographic variables such as age, gender, nationality, qualification, health professional, years of experience, smoking status, last visit to dentist, and reason for last visit and self-rated oral health condition. Mean and standard deviation scores of HU-DBI were calculated.

Comparisons were made between each HU-DBI items and different categories of health professionals using Chi-square test. Nonparametric tests of Mann–Whitney were applied to compare between HU-DBI scores and different variables (gender, nationality, qualification, smoking status, and reason for dental visit). Kruskal–Wallis tests were applied to compare between HU-DBI scores and participants' age, experience, type of health professionals, and self-rated oral health behavior. In addition, relationship between characteristics of the health professionals and HU-DBI was analyzed by calculating the Spearman's rank correlation coefficient. For all the statistical purposes, a P ≤ 0.05 was considered statistically significant.


  Results Top


A total of 500 questionnaires were distributed among health professionals in PSMMC, Riyadh, and all of the questionnaires were filled and returned back. Thus, a response rate of 100% was obtained.

Analysis of Hiroshima University Dental Behavioral Inventory items

[Table 2] shows the percentage distribution of the agree responses of HU-DBI items by types of health professionals.
Table 2: Hiroshima University-Dental Behavioral Inventory items and percentage of “agree” response by types of health professionals

Click here to view


Item 3 (I worry about the color of my teeth) was responded positively by large percentage of pharmacists (68.6%) followed by dentists (66.7%), physicians (56.9%), nurses (54.8), and technicians (52.3%). These responses did not differ significantly across different types of health professionals (P = 0.088).

Item 17 (I use a toothbrush with hard bristles) was agreed by majority of technicians (46.8%), followed by physicians (44.1%), nurses (41.5%), pharmacists (33.7%), and dentists (18.2%). This response showed statistically significant difference among different types of health professionals (P = 0.002).

In general, agree responses to the 20 HU-DBI items varied among all the health professionals with significant difference except for the item 3 as shown in [Table 2]. Therefore, oral health attitudes and behaviors of health professionals considered in the study were not similar.

Mean HU-DBI score varied among different age groups with high mean score was observed among 20–30 years (5.89 ± 1.03), followed by 41–50 years (5.84 ± 1.18), 31–40 years (5.80 ± 1.01), and above 50 years (5.79 ± 1.51) age groups. Comparison of HU-DBI in different age groups did not yield any statistically significant difference (P = 0.388) using Kruskal–Wallis test as shown in [Table 3].
Table 3: Comparison of Hiroshima University-Dental Behavioral Inventory score in different age groups

Click here to view


Mean HU-DBI score in males and females was 6.12 ± 1.05 and 5.59 ± 0.99; distribution between genders differed significantly (Z = −6.21, P < 0.001) as shown in [Table 4].
Table 4: Comparison of Hiroshima University-Dental Behavioral Inventory score between genders

Click here to view


Comparison of mean HU-DBI scores between Saudi's (6.06 ± 1.05) and non-Saudi's (5.64 ± 1.02) showed significant differences (Z = −2.96, P = 0.003) as shown in [Table 5].
Table 5: Comparison of mean Hiroshima University-Dental Behavioral Inventory score between Saudi and non-Saudi nationals

Click here to view


Health professionals with diploma qualification (6.09 ± 1.62) showed significantly higher mean HU-DBI score (Z = −2.28, P = 0.022) when compared to those with university qualification (5.83 ± 0.98) as shown in [Table 6].
Table 6: Comparison of mean Hiroshima University-Dental Behavioral Inventory score between diploma and university qualified health professionals

Click here to view


Smokers (6.08 ± 0.81) showed significantly higher mean HU-DBI score (Z = −2.24, P = 0.006) when compared to nonsmokers (5.78 ± 1.11) as shown in [Table 7].
Table 7: Comparison of mean Hiroshima University-Dental Behavioral Inventory score between smokers and nonsmokers

Click here to view


Health professionals visiting dentist for regular checkups (5.79 ± 1.25) and those visiting for dental problems (5.89 ± 0.089) did not differ significantly (Z = −0.82, P = 0.408) in mean HU-DBI score as shown in [Table 8].
Table 8: Mean Hiroshima University-Dental Behavioral Inventory score and reason to visit dentist

Click here to view


Highest mean HU-DBI score was observed among pharmacists (6.09 ± 0.85), followed by dentists (6.08 ± 0.62), physicians (6.06 ± 0.96), technicians (5.90 ± 0.93), and nurses (5.39 ± 1.33) as shown in [Table 9].
Table 9: Comparison of mean Hiroshima University-Dental Behavioral Inventory score among different type health professionals

Click here to view


A Kruskal–Wallis test was conducted to evaluate the differences in mean HU-DBI ranks among different types of health professionals (dentists (277.42), pharmacists (275.6), physicians (274.45), technicians (255.14), and nurses (199.44)). The test showed significant differences Chi-square (4, n = 500) = 41.77, P < 0.001. The variability of 41.77/499 = 8.37% in the HU-DBI ranks accounted for by types of health professionals.

Overall Kruskal–Wallis test found to be significant; therefore, a series of Mann–Whitney tests to investigate which groups significantly differ with corrections to control for inflation of type I error was carried out. A Bonferroni correction (α = 0.05/number of comparisons; 0.05/10 = 0.005) with adjusted α-value was used to interpret the results.

The results of these tests indicated that nurses showed significantly lower mean HU-DBI ranks compared to dentists, physicians, technicians, and pharmacists (P < 0.001) as shown in [Table 10].
Table 10: Multiple comparisons of Hiroshima University-Dental Behavioral Inventory ranks among health professionals

Click here to view


Health professionals with 0–5 years of experience showed higher mean HU-DBI score of 6.16 ± 1.98, followed by 11–15 years (5.88 ± 0.68), 6–10 years (5.78 ± 0.74), and 16–20 years (5.75 ± 1.52) without any significant difference (P = 0.126) as shown in [Table 11].
Table 11: Comparison of mean Hiroshima University-Dental Behavioral Inventory score among type health professionals according to the years of experience

Click here to view


Health professional's last dental visit and mean HU-DBI score did not show much variation, those visited before 1 year showed a high mean HU-DBI score of 5.88 ± 0.96, followed by before 6 months (5.84 ± 1.40) and never visited (5.82 ± 0.52). However, last dental visit did not show any significant difference in mean HU-DBI score of health professionals (P = 0.662) as shown in [Table 12].
Table 12: Last dental visit and mean Hiroshima University-Dental Behavioral Inventory score

Click here to view


Mean HU-DBI scores 5.72 ± 1.33, 5.96 ± 0.81, and 5.90 ± 0.72 were observed among good, fair, and poor oral health rated by health professionals as shown in [Table 13]. Kruskal–Wallis test was conducted to evaluate the differences in mean HU-DBI ranks and self-rated oral health. The test showed significant differences Chi-square (2, n = 500) = 7.69, P = 0.02.
Table 13: Self-rated oral health and Hiroshima University-Dental Behavioral Inventory score

Click here to view


A series of Mann–Whitney tests to investigate which groups significantly differ with corrections to control for inflation of type I error was carried out. A Bonferroni correction (α = 0.05/number of comparisons; 0.05/3 = 0.016) with adjusted α-value was used to interpret the results. These comparisons ([good-fair, P = 0.018], [good-poor, P = 0.040] and [fair-poor, P = 0.763]) showed no significant differences with adjusted α value as shown in [Table 14].
Table 14: Multiple comparisons of Hiroshima University-Dental Behavioral Inventory ranks and self-rated oral health

Click here to view


A series of Spearman's correlations was conducted to determine if there were any relationships between the HU-DBI ranks and characteristics (age, gender, nationality, qualification, type of health professionals, experience, smoking status, last visit to dentist, reason for last visit, and self-rated oral health) of health professionals. A two-tailed test of significance indicated that there was a significant positive relationship between the HU-DBI score and self-rated oral health r (500) = 0.119, P = 0.008. The better the HU-DBI score of the health professionals better will be the self-rated oral health. On contrary, gender (r = −0.278, P < 0.001), nationality (r = −0.133, P = 0.003), qualification (r = −0.102, P = 0.022), and smoking status (r = −0.123, P = 0.006) were negatively correlated with HU-DBI score. However, a similar two-tailed test of significance indicated that the age (r = −0.035, P = 0.438), health professional type (r = −0.014, P = 0.759), experience (r = 0.006, P = 0.892), last visit to dentist (r = 0.003, P = 0.944), and reason for last visit (r = 0.037, P = 0.409) were not related to the changes in HU-DBI score as shown in [Table 15].
Table 15: Spearman's correlation between Hiroshima University-Dental Behavioral Inventory score and characteristics of the health professionals

Click here to view



  Discussion Top


There is no unanimously recognized or recommended index or inventory to measure dental health attitude and behavior. Oral health information collected on attitudes and behaviors were obtained from a sequence of independent questionnaires. The HU-DBI questionnaire developed by Kawamura [12] has shown usefulness for assessing perceptions and oral health behavior while retaining excellent psychometric properties after translation into English version even after wide variation in oral health knowledge and attitudes. Hence, HU-DBI is proficient of measuring dental health attitudes and behavioral and may serve as a useful standard for cross-cultural comparisons.

HU-DBI was utilized among health professionals in an effort to evaluate the oral health attitude/behaviors. An English version of the HU-DBI was self-administered by participants. In addition, health professional's sociodemographic characteristics were recorded. Each HU-DBI item was calculated and compared between different variables of health professionals to evaluate the difference in oral health attitude/behaviors. A total of 500 questionnaires were distributed among sample of health professionals working in PSMMC, Riyadh, and 100% response rate was obtained.

The present study results are compared with the reported studies on oral health attitude and behaviors based on HU-DBI, due to the lack of reports among health professionals using similar instrument.

In the present study, relationship between characteristics health professionals such as age, gender, nationality, qualification, type, years of experience, smoking status, last visit to dentist, reason for last visit, and self-rated oral health were considered for evaluation of oral health attitude and behaviors on HU-DBI scale. However, in previous studies of the HU-DBI, questionnaires were utilized for comparison between groups such as level of education, cultures, and students of professional schools. The results showed that attitudes and behaviors were significantly different between groups.[7],[9],[10],[13],[14],[15],[16]

The present study showed an overall mean HU-DBI score of 5.85 ± 1.05 among health professionals, which is higher than the reported study among medical and dental students from Yemen. On contrary, this overall HU-DBI score was lower than that of reported by studies among health sciences students in various countries.[9], 13, [17],[18],[19]

Generally, it was observed that female perform better oral health behaviors and show greater interest in oral health and perceive their own oral health care to a higher degree than males.[20] Several studies have reported variations of HU-DBI scores between genders and discovered that female scored slightly more than the males without any significant differences.[9],[16],[21],[22] However, in this study, male health professionals showed significantly higher mean HU-DBI score compared to female counter part. This finding is suggestive of different physiological and psychological behaviors and perception among the gender reflected on their oral health.

Among all the health professionals considered in the study, highest mean HU-DBI score was observed among pharmacists (6.09 ± 0.85) and dentists (6.08 ± 0.62), followed by physicians (6.06 ± 0.96), technicians (5.90 ± 0.93), and nurses (5.39 ± 1.33). This could be explained by the fact that pharmacists and dentists come in contact with dental patients routinely. It has been reported that pharmacists were involved in providing oral health advices on over the counter dental products on daily basis. It has been suggested that almost 34% of the pharmacists reported 10 daily requests for oral health advice in Saudi Arabia.[23] Whereas dentist showed higher HU-DBI score as the oral health knowledge, attitude, and behavior are significant part of their professional education. Moreover, clinical examination of the oral cavity by dentists and physicians was routine to assess the changes in response to disease, previous dental department postings before graduation, and continuous medical education courses. In addition, personal involvement with dental patients could have been affected the findings. Similar results have been reported among dental students from Colombia, Lithuania.[24],[25]

Comparison of mean HU-DBI score among health professionals from different nationalities showed that the Saudi health professionals (6.06 ± 1.05) showed significantly higher mean scores compared to non-Saudi (5.64 ± 1.02) health professionals. This could be due to the differences in importance given to oral health topics during their health professional training.

In the present study, participants with diploma qualification (6.09 ± 1.62) showed higher mean HU-DBI score when compared to health professionals with university qualification (5.83 ± 0.98). Diploma holders were more involved in patient care and advices which could have affected their oral health attitudes and behaviors as compared with university graduates, who were more likely to be involved in administrative work.

In the present study, smokers (6.08 ± 0.81) showed significantly higher mean HU-DBI score when compared to nonsmokers (5.78 ± 1.11) which is in contrast with the previous reports. Previous research has showed that tobacco users brushed and flossed their teeth less frequently, and cigarette smoking has shown negative association with oral health conditions irrespective of the dental health behaviors.[26],[27] On contrary, mean HU-DBI score and health professional's years of experience, reason to visit dentist, and timing of the last dental visit did not differ significantly.

Exact nature of the interaction between health-related attitudes, beliefs, and behavior is complex. Wide range of factors could play a role in influencing the individual and community health behavior that includes knowledge, values, skills, finance, materials, times, peer inspirations, and even health workers themselves.[28]

Self-rated oral health is often assessed to facilitate easy evaluation of the participants' general oral health condition. An association between self-rated oral health and oral health-related quality of life has been identified.[29] Several previous studies have investigated self-rated oral health and oral health-related quality of life in adults.[30],[31] In the present study, health professionals who identified themselves with good and fair self-rated oral health showed significantly higher mean HU-DBI score when compared with poor self-rated oral health subjects. Thus, suggesting a possible role of self-consciousness and self-reported oral health.

Strengths of the study

  1. The use of a large sample size was an obvious strength of the study
  2. Use of English version of HU-DBI standardized questionnaire
  3. Participation of diverse category of health professionals.


Limitations of the study

This study has some limitations which need to be identified and discussed. These include:

  1. Cross-sectional nature of the study design that could not determine temporality of oral health attitudes and behaviors
  2. Convenient sampling methodology utilized in the study prohibits generalizability of the results to the larger population of health professionals
  3. There may be a possibility of over- or under-reporting of the oral health attitudes and behaviors due to the social desirability
  4. Participants from single hospital (PSMMC) were considered; hence, the results of this study cannot be applicable to the private sector hospitals
  5. Participants aged above 40 years constituted very small proportion of the sample
  6. Insufficiency of participants to compare between ages.


Recommendations

  1. There is a need to conduct future studies using larger sample with diverse health professionals from both private and government hospitals scattered in different regions to obtain more representative data
  2. Oral health educational programs should be planned and implemented to improve oral health attitude and behavior of health professionals
  3. Continuing medical education should emphasize the oral health topics to improve the oral health attitudes and behaviors of health professionals
  4. Dental department should take proactive measures to educate health professionals within the organization to improve oral health attitude and behaviors
  5. Among the health professionals, nurses should be given priority to improve their oral health attitude and behaviors through educational programs.



  Conclusions Top


Based on the findings from this study, the following conclusions can be drawn:

  • In general, health professionals considered from PSMMC showed fair oral health attitudes and behaviors as measured using HU-DBI
  • There is an urgent need to improve oral health attitudes and behavior of oral health professionals working in PSMMC by organizing continuous medical educations on oral health-related topics
  • Nurses should be given high priority for improving oral health attitudes and behaviors
  • Health professional's self-rated oral health showed significantly positive correlation with health attitude and behaviors as measured by HU-DBI.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ndiokwelu E. Applicability of Rosenstock-Hochbaum health behaviour model to prevention of periodontal disease in Enugu students. Odontostomatol Trop 2004;27:4-8.  Back to cited text no. 1
    
2.
Kassak KM, Dagher R, Doughan B. Oral hygiene and lifestyle correlates among new undergraduate university students in Lebanon. J Am Coll Health 2001;50:15-20.  Back to cited text no. 2
    
3.
Broadbent JM, Thomson WM, Poulton R. Oral health beliefs in adolescence and oral health in young adulthood. J Dent Res 2006;85:339-43.  Back to cited text no. 3
    
4.
Al-Ansari AA. Prevalence, severity, and secular trends of dental caries among various Saudi populations: A literature review. Saudi J Med Med Sci 2014;2:142-50.  Back to cited text no. 4
  [Full text]  
5.
Idrees MM, Azzeghaiby SN, Hammad MM, Kujan OB. Prevalence and severity of plaque-induced gingivitis in a Saudi adult population. Saudi Med J 2014;35:1373-7.  Back to cited text no. 5
    
6.
Kawamura M. Dental behavioral science. The relationship between perceptions of oral health and oral status in adults. Hiroshima Daigaku Shigaku Zasshi 1988;20:273-86.  Back to cited text no. 6
    
7.
Kim KJ, Komabayashi T, Moon SE, Goo KM, Okada M, Kawamura M. Oral health attitudes/behavior and gingival self-care level of Korean dental hygiene students. J Oral Sci 2001;43:49-53.  Back to cited text no. 7
    
8.
Levin L, Shenkman A. The relationship between dental caries status and oral health attitudes and behavior in young Israeli adults. J Dent Educ 2004;68:1185-91.  Back to cited text no. 8
    
9.
Polychronopoulou A, Kawamura M. Oral self-care behaviours: Comparing Greek and Japanese dental students. Eur J Dent Educ 2005;9:164-70.  Back to cited text no. 9
    
10.
Halboub ES, Al-Maweri SA, Al-Jamaei AA, Al-Wesabi MA, Shamala A, Al-Kamel A, et al. Self-reported oral health attitudes and behavior of dental and medical students, Yemen. Glob J Health Sci 2016;8:56676.  Back to cited text no. 10
    
11.
Kawamura M, Kawabata K, Sashara H, Fukuda S, Iwamoto Y. Dental behavioural science Part IX. Bilinguals' responses to the dental inventory (HUDBI) written in English and Japanese. J Hiroshima Univ Dent Soc 1992;1:24.  Back to cited text no. 11
    
12.
Kawamura M, Honkala E, Widström E, Komabayashi T. Cross-cultural differences of self-reported oral health behaviour in Japanese and Finnish dental students. Int Dent J 2000;50:46-50.  Back to cited text no. 12
    
13.
Al-Wahadni AM, 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.  Back to cited text no. 13
    
14.
Komabayashi T, Kwan SY, Hu DY, Kajiwara K, Sasahara H, Kawamura M. A comparative study of oral health attitudes and behaviour using the Hiroshima University - Dental Behavioural Inventory (HU-DBI) between dental students in Britain and China. J Oral Sci 2005;47:1-7.  Back to cited text no. 14
    
15.
Baseer MA, Rahman G, Asa'ad F, Alamoudi F, Albluwi F. Knowledge, attitude and practices of gynecologists regarding the prevention of oral diseases in Riyadh city, Saudi Arabia. Oral Health Dent Manag 2014;13:97-102.  Back to cited text no. 15
    
16.
Muthu J, Priyadarshini G, Muthanandam S, Ravichndran S, Balu P. Evaluation of oral health attitude and behavior among a group of dental students in Puducherry, India: A preliminary cross-sectional study. J Indian Soc Periodontol 2015;19:683-6.  Back to cited text no. 16
[PUBMED]  [Full text]  
17.
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.  Back to cited text no. 17
    
18.
Yildiz S, Dogan B. Self reported dental health attitudes and behaviour of dental students in Turkey. Eur J Dent 2011;5:253-9.  Back to cited text no. 18
    
19.
Baseer MA, Rahman G, Al Kawaey Z, Al Awamy B, Al Manmeen Z, Al Shalaty F. Evaluation of oral health behavior of female dental hygiene students and interns of Saudi Arabia by using Hiroshima University Dental Behavioural Inventory (HU-DBI). Oral Health Dent Manag 2013;12:255-61.  Back to cited text no. 19
    
20.
Ostberg AL, Halling A, Lindblad U. Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents. Acta Odontol Scand 1999;57:231-6.  Back to cited text no. 20
    
21.
Kawamura M, Iwamoto Y, Wright FA. A comparison of self-reported dental health attitudes and behavior between selected Japanese and Australian students. J Dent Educ 1997;61:354-60.  Back to cited text no. 21
    
22.
Kawamura M, Ikeda-Nakaoka Y, Sasahara H. An assessment of oral self-care level among Japanese dental hygiene students and general nursing students using the Hiroshima University – Dental Behavioural Inventory (HU-DBI): Surveys in 1990/1999. Eur J Dent Educ 2000;4:82-8.  Back to cited text no. 22
    
23.
Bawazir OA. Knowledge and attitudes of pharmacists regarding oral healthcare and oral hygiene products in Riyadh, Saudi Arabia. J Int Oral Health 2014;6:10-3.  Back to cited text no. 23
    
24.
Jaramillo A, Contreras A, Lafaurie GI, Duque A, Ardila CM, Duarte S, et al. Association of metabolic syndrome and chronic periodontitis in Colombians. Clin Oral Investig 2017;21:1537-44.  Back to cited text no. 24
    
25.
Pacauskiene IM, Smailiene D, Siudikiene J, Savanevskyte J, Nedzelskiene I. Self-reported oral health behavior and attitudes of dental and technology students in Lithuania. Stomatologija 2014;16:65-71.  Back to cited text no. 25
    
26.
Ide R, Mizoue T, Ueno K, Fujino Y, Yoshimura T. Relationship between cigarette smoking and oral health status. Sangyo Eiseigaku Zasshi 2002;44:6-11.  Back to cited text no. 26
    
27.
Andrews JA, Severson HH, Lichtenstein E, Gordon JS. Relationship between tobacco use and self-reported oral hygiene habits. J Am Dent Assoc 1998;129:313-20.  Back to cited text no. 27
    
28.
Park K. Medicine and social sciences. In: Textbook of Preventive and Social Medicine. Jabalpur: Banarasidas Bhanot; 2005. p. 581-614.  Back to cited text no. 28
    
29.
Mariño R, Schofield M, Wright C, Calache H, Minichiello V. Self-reported and clinically determined oral health status predictors for quality of life in dentate older migrant adults. Community Dent Oral Epidemiol 2008;36:85-94.  Back to cited text no. 29
    
30.
Dahl KE, Wang NJ, Skau I, Ohrn K. Oral health-related quality of life and associated factors in Norwegian adults. Acta Odontol Scand 2011;69:208-14.  Back to cited text no. 30
    
31.
Gonzales-Sullcahuamán JA, Ferreira FM, de Menezes JV, Paiva SM, Fraiz FC. Oral health-related quality of life among Brazilian dental students. Acta Odontol Latinoam 2013;26:76-83.  Back to cited text no. 31
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11], [Table 12], [Table 13], [Table 14], [Table 15]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Materials And Me...
Results
Discussion
Conclusions
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed93    
    Printed5    
    Emailed0    
    PDF Downloaded25    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]