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 Table of Contents  
ORIGINAL RESEARCH
Year : 2018  |  Volume : 10  |  Issue : 1  |  Page : 21-25

Smoking habits, oral hygiene practices, and self-perceived malodor among arts and science college students of Manimangalam, Chennai


1 Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath University, Thalambur, India
2 Department of Public Health Dentistry, Sri Venkateshwara Dental College and Hospital, Thalambur, India
3 Department of Oral Pathology, Sri Venkateshwara Dental College and Hospital, Thalambur, India
4 Department of Periodontics, Sri Venkateshwara Dental College and Hospital, Thalambur, India
5 Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, MAHER University, Chennai, Tamil Nadu, India

Date of Web Publication26-Feb-2018

Correspondence Address:
Dr. Alagarsamy Venkatesh
Department of Conservative Dentistry and Endodontics, Sree Balaji Dental College and Hospital, Bharath University, Narayanapuram, Pallikaranai, Chennai - 600 100, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jioh.jioh_205_17

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  Abstract 

Aim: To assess the smoking habits, oral hygiene practices, and self-perceived malodor among arts and science college students in Manimangalam, Chennai. Materials and Methods: An epidemiological survey with closed-ended questionnaire was carried out in an Arts and Science College in Manimangalam, Chennai, to assess smoking habits, oral hygiene practices, and self-perceived malodor. All the 1200 students were invited to participate in the study, but only 650 volunteers participated and a self-administered close-ended questionnaire was distributed. Descriptive statistics were used to describe the data. Results: Of 650 students, only 31 (4.8%) had a habit of smoking and 456 (70.1%) were aware of the ill effects of smoking. Among the subjects who participated in the study, 464 (71.3 %) brushed once daily, 457 (70.3%) rinsed their mouth after eating. Self-perceived malodor was expressed by 59 (9%) students and it has interfered with their social life. Conclusion: The habit of smoking was seen in a very small percentage of study participants, and majority of them were aware of its ill effects. There is a need to educate them on brushing techniques and encourage them to visit a physician/dentist whenever they perceive a malodor.

Keywords: Oral hygiene, oral malodor, smoking


How to cite this article:
Venkatesh A, Manikandan K, Sujatha G, Priya R S, Prasad T S, Mitthra S. Smoking habits, oral hygiene practices, and self-perceived malodor among arts and science college students of Manimangalam, Chennai. J Int Oral Health 2018;10:21-5

How to cite this URL:
Venkatesh A, Manikandan K, Sujatha G, Priya R S, Prasad T S, Mitthra S. Smoking habits, oral hygiene practices, and self-perceived malodor among arts and science college students of Manimangalam, Chennai. J Int Oral Health [serial online] 2018 [cited 2022 Jan 18];10:21-5. Available from: https://www.jioh.org/text.asp?2018/10/1/21/226178


  Introduction Top


Smoking is a high-risk activity with grave consequences for young users. The associated behaviors including drug use, violence, and high-risk sexual activity make it one of the most significant public health concerns.[1] However, the frequency of smoking among young adults is lower.[2] Cigarette smoking is one of the factors affecting dental health, but there have been limited studies on the association of smoking and dental health in young adults.[3] There are many studies which prove the increased mortality risk in smokers.[4],[5],[6],[7]

Among the many methods available, toothbrushing is the most prevailing and accepted method among the general public. Studies have proved the efficacy of brushing twice daily along with a fluoride paste in controlling dental caries. Evidence has suggested the use of dental floss along with brushing in controlling interproximal dental decay and periodontal diseases.[8]

Along with poor oral hygiene, smoking, and drug usage, some systemic disorders are also responsible for malodor. Halitosis is the term which is commonly used by dentists to denote the foul smell emanating from the oral cavity. Although the upper and lower respiratory tract, gastrointestinal tract, and diseases from liver and kidney also emanate a bad odor from the mouth, the general thought among the population is the association of poor oral hygiene and halitosis.[9] Oral halitosis is a very common complaint by dental patients.

The bad breath which is commonly present in the morning after sleep though unacceptable is transitory and reduced salivary flow is pointed as a reason for the same. Persistent bad breath is a result of periodontal disease and bad oral hygiene which houses bacterial reservoirs in the mouth. Systemic diseases such as hepatic cirrhosis, diabetes mellitus, and hernia can also result in persistent malodor. Transitory problems can be controlled with normal brushing practices, whereas persistent problems need immediate attention.[9]

In healthy subjects, tongue coating is by far the most important source of malodor, most of the odor coming from the dorso-posterior surface of the tongue where the crypts are the favored sites for growth of the anaerobic bacteria responsible for halitosis. Some investigators believe that besides volatile sulfur compounds (VSCs), other volatiles produced by oral putrefaction processes such as organic acids, ammonia, and amines may also cause oral malodor. Other than the transitory and persistent problems discussed above, tongue coating seen in normal healthy individuals is also a main reason for bad breath. The normal anatomy of the tongue favors growth of bacteria which is responsible for bad breath and regular tongue cleaning would prevent the same. Researchers believe that the malodor originates due to the presence of VSCs, organic acids, ammonia, and amines.[10] As the young adults of today are indulging in unhealthy habits such as smoking, drug abuse, poor oral hygiene practices, and consumption of fast foods, this study was carried out to know the smoking habits, oral hygiene practices, and self-perceived malodor among arts and science students of Manimangalam, Chennai.


  Materials and Methods Top


An epidemiological cross-sectional survey was carried out to assess the smoking habits, oral hygiene practices, and self-perceived malodor among arts and science students, Manimangalam, Chennai. The nature and purpose of the study were explained to the Institutional Review Board of Sri Venkateswara Dental College and Hospital and ethical clearance was obtained (Ethical approval number: IEC/IRB No:-SVDC/IRB/2C/2017).

There is only one Arts and Science College in Manimangalam and it was included in the study and all the students were invited to participate. Of 1200 students, only 650 students agreed to participate in the study.

The study was carried out for 7 days. Both males and females between the age group of 18 and 25 years who were willing to participate were included in the study.

A specially designed closed-ended questionnaire which consisted of 15 questions was used to assess the smoking habits, oral hygiene practices, and self-perceived malodor among Arts and Science College students in Manimangalam, Chennai. The questionnaire was given to a small group of 50 students who were asked to complete it and to clarify any questions that they found unclear. The students were approached class-wise and the purpose of the study was explained to them, and informed consent was obtained. The questionnaire was distributed to them and was assured of the confidentiality. The filled questionnaire was collected on the same day immediately after completion.

The resulting data were tabulated and statistically analyzed using SPSS (Statistical Package for the Social Sciences) version 17.0 software (SPSS Inc., Chicago, IL, USA); Chi-square test was applied to compare the percentages and the level of significance was set at 0.05.


  Results Top


The subjects consisted of 63.8% (415) males and 36.2% (235) females which totally comprises 650 participants.

The responses of college students on smoking habits indicated that among the study participants, 4.8% were smokers, in which 2.6% were smoking daily, 2.1% were smoking weekly, and 0.1% were smoking occasionally [Table 1]. Among the smokers group, 64.5% were smoking <5 cigarettes, 22.5% were smoking 5–10 cigarettes, and 13% were smoking more than 10 cigarettes per day.
Table 1: Frequency of smoking among study subjects

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On questions based on duration, 25.8% were smoking for 1–3 years, 29% were smoking for 1–2 years, and 19.4% were smoking more than 3 years. 65.5% of males and 78.8% of females responded that they were aware of all the ill effects of smoking. These differences noted between the sexes were statistically highly significant (P = 0.001) [Table 2]. On response to awareness, 70.9% of smokers had attempted to stop smoking and 29.1% smokers had not attempted to stop smoking.
Table 2: Knowledge on ill effects of smoking among study subjects

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Regarding responses of college students on oral hygiene practices, 20% of males and 46% of females brush their teeth twice a day. These differences noted between the sexes were statistically highly significant (P = 0.000) [Figure 1]. Forty-one percent of males and 63.4% females brush their teeth circularly. These difference noted between the sexes were statistically highly significant (P< 0.005) [Figure 2].
Figure 1: The frequency of toothbrushing daily among study subjects

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Figure 2: The method of brushing among study subjects

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About 38.5% of males and 51.9% of females change their toothbrush once in a month. These differences noted between the sexes were statistically highly significant (P = 0.002) which is represented in [Table 3]. 53.7% of males and 61.7% of females snack once in between meals in a day. These difference noted between the sexes were statistically highly significant (P = 0.001) which is represented in [Table 4].
Table 3: Frequency of changing toothbrush among study subjects

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Table 4: Frequency of snacking in between meals in a day among study subjects

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Almost 67.7% of males and 74.9% of females rinse their mouth after eating. 32.4% of males and 25.1% of females do not rinse their mouth after eating. These differences noted between the sexes were statistically highly significant (P = 0.54).

With regard to responses of college students on self-perceived malodor, 9.8% of males and 0.5% of females responded that they have bad breath. These differences noted between the sexes were statistically highly significant (P = 0.000) which is represented in [Figure 3].
Figure 3: The frequency of self-perception of bad breath among study subjects

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3.07% of males and 0.4% of females had visited a dentist or physician for bad breath. 95.2% of males and 99.6% of females had not visited dentist or physician for bad breath. These difference noted between the sexes were statistically highly significant (P = 0.002). 10.6% of males and 0.5% of females had received treatment from the dentist or physician for bad breath. 89.4% of males and 99.5% females had not received any treatment from dentist or physician for bad breath. These differences noted between the sexes were statistically highly significant (P = 0.000).

9.8% of males and 0.05% of females responded that their bad breath interferes with their social life. These differences noted between the sexes were statistically highly significant (P = 0.000). Eight percent of males and 0.4% of females had self-medicated themselves for bad breath. Ninety-two percent of males and 99% of females had not self-medicated themselves for bad breath. These differences noted between the sexes were statistically highly significant (P = 0.000).


  Discussion Top


This was a cross-sectional study conducted among Arts and Science College students in Manimangalam, Chennai. It was a questionnaire survey, in which 415 (63.8%) males and 235 (36.2%) females participated and responded to questions on smoking habits, oral hygiene practices, and self-perceived malodour.

The main research question in this study was to assess the smoking habits and oral hygiene practices among arts college students and to assess the knowledge on self-perceived malodour. This cross-sectional study obtained the data source through a questionnaire. The data were collected initially on a small group as a pilot study and followed as a cross-sectional survey. The analysis was done using SPSS software.

In the present study, only 4.8% were smokers which are very low when compared with a study conducted by Eldarrat et al., 2008[11] among Libyan students (schools and universities) and employees in which 17% of them were smokers. The smoking attitudes, behaviors of family members and close friends would have influenced the increased frequency of smoking among them. The results of this study were consistent with a study conducted by Shah and Shah, 2017.[12]

In the present study, 64.5% smoke <5 cigarettes, 22.5% smoke 5–10 cigarettes, 13% smoke more than 10 cigarettes per day which coincided with the findings of Kasapila et al. in 2010,[13] among students specializing in Nursing and Agriculture, in which 61.8% smoke <5 cigarettes and 26.5% smoke <10 cigarettes.

In this study, 65.5% of males and 78.8% of males were aware of ill effects of smoking which is similar to a study conducted by Hasim in 2000[14] among students of Applied Medical Sciences in which 73% of the respondents were aware of ill effects of smoking.

In this study, 70.9% have attempted to stop smoking which is similar to that of study conducted by Hasim in 2000,[14] in Saudi Arabia, in which 70% have attempted to stop smoking.

In the present study, 80% of the males and 54% of the females brush their teeth once daily and 20% of the males and 46% of the females brush their teeth twice daily. In a study conducted by Al-Hussaini et al., 2003[8] among students of Kuwait University Health Sciences Centre, 94% of the students brushes once a day and 79% of the girls brush their teeth twice a day which is comparatively higher than our study. Mattila et al. in their study concluded some gender-related differences in oral health habits and attitudes.[15]

In the present study, 28% of the males and 26.8% of the females changed their toothbrush once in 3 months, and 3.6% of the males and 1.3% of the females changed their toothbrush once in 6 months. In a study conducted by Neamatollahi and Ebrahimi, 2009[16] in Iran, 33% of them changed their toothbrush once in 3 months, and 43% of them changed their toothbrush once in 3–6 months which is comparatively higher than our study. This difference would be because the subjects of the above-mentioned study were dental and medical students with more awareness on healthy oral practices.

In the present study, 9.8% of the males and 0.5% of the females responded for self-perception on malodor which is comparatively low to a study conducted by Ashwath et al.[17] among dental students, in which 21.7% of the males and 35.3% of the females responded for the self-perception of malodor. This difference would be because the subjects of the above-mentioned study were dental students who could have perceived malodor better because of their awareness about it.

In the present study, 10.6% of the males and 0.5% of the females had received treatment for malodor from the dentist or physician which is comparatively low to a study conducted by Eldarrat, 2011[18] in Libya among University students in which 27% of students received treatment for malodor from the dentist (24%) or physician (3%). The positive attitudes among Libyan college students as mentioned by the authors in the study would have encouraged them to take treatment for malodor.

In this study, 9.8% of the males and 0.5% of the females responded that their bad breath interfere with their social life. In a research by Ashwath et al. in 2003,[17] among dental students in Saudi Arabia, 5.8% of the males and 44% of the females responded that their bad breath interferes with their social life.

In the present study, 8% of the males and 0.4% of the females had self-medicated themselves for malodor which is comparatively low to the study conducted by Ashwath et al., 2003[17] among dental students in which 12% of the males and 26% of the females have self-medicated themselves probably due to the awareness from their educational training.

However, for future research directions, the questionnaire can be modified in terms of method of usage of mouthwash and dental floss and maintenance of oral hygiene. We can further detail the study about the ill-effects of smoking on the oral cavity.


  Conclusion Top


The present study indicates that the habit of smoking was seen in a very small percentage of study subjects and majority of them were aware of its ill effects. A good proportion of smokers had attempted to stop smoking. Majority of them brushes their teeth once daily using circular motion and rinse their mouth after eating. Majority of them had no self-perception on their bad breath and who responded for malodor also accepted that it interferes with their social life.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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Eldarrat A, Alkhabuli J, Malik A. The prevalence of self-reported halitosis and oral hygiene practices among Libyan students and office workers. Libyan J Med 2008;3:170-6.  Back to cited text no. 11
    
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Shah S, Shah SS. Assessment of smoking habits, oral hygiene practices and self perceived malodour among the college students in Ahmedabad. Indian J Dent Educ 2017;10:25-9.  Back to cited text no. 12
    
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Kasapila W, Susan T, Mkandawire P. Drinking and smoking habits among college students in Malawi. Eur J Soc Sci 2010;15:441-8.  Back to cited text no. 13
    
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Hasim TJ. Smoking habits of students in college of applied medical science, Saudi Arabia. Saudi Med J 2000;21:76-80.  Back to cited text no. 14
    
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Mattila ML, Tolvanen M, Kivelä J, Pienihäkkinen K, Lahti S, Merne-Grafström M, et al. Oral health-related knowledge, attitudes and habits in relation to perceived oral symptoms among 12-year-old school children. Acta Odontol Scand 2016;74:343-7.  Back to cited text no. 15
    
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    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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