View of Knowledge, Attitude and Behavior towards Oral Health among Teaching Staff members of Non-Medical Faculties in Higher Education Institution with Multiple Faculties.

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Annals of R.S.C.B., ISSN:1583-6258, Vol. 25, Issue 6, 2021, Pages. 13260 – 13281 Received 25 April 2021; Accepted 08 May 2021.

13260

Knowledge, Attitude and Behavior towards Oral Health among Teaching Staff members of Non-Medical Faculties in Higher Education Institution with

Multiple Faculties.

Shagun Malik¹, Shilpa Kamra², Amit Bhardwaj ³

1 Senior Lecturer , Department of Periodontology, SGT Dental College, Faculty of Dental Science, SGT University, Budhera, Gurugram, Haryana, India.

2 Senior Lecturer , Department of Periodontology,SGT Dental College, Faculty of Dental Science, SGT University, Budhera, Gurugram, Haryana, India.

3 Professor and Head, Department of Periodontology,SGT Dental College, Faculty of Dental Science, SGT University,Budhera,Gurugram, Haryana, India.

ABSTRACT

Purpose -: This study aimed to evaluate oral health knowledge, attitudes, and behaviors among teaching staff members of non – medical faculties of Higher Education Institution with multiple faculties,Gurugram,Haryana,India.

Method: A Google form containing self-administeredquestionnaire was developed and distributed to 10 non-medical faculties of Higher Education Institution. Percentage and frequency distribution for each option of each question was calculated.

Result and conclusion: The staff demonstrated reasonable knowledge, but some deficiencies were noted. The attitude towards oral hygiene maintenance was poor while the behavior was also reasonable among the participants with some deficiencies. On the basis of information gathered in the study faculty training program should be carried out in the future in order to meet the deficiencies in terms of knowledge, attitude and behavior to improve the oral health and quality of life.

Keywords

Attitude, Behaviour, Knowledge.

Introduction

The oral health is integral part of general health and a valuable asset for any individual. Oral health has always remained a neglected entity. People have underestimated consequences of bad oral health, which have led to bigger problems which later on become difficult to treat.many systemic diseases are related to oral conditions and thus general health requires efforts of both medical and dental health professionals¹.Also, dental problems are associated with considerable pain, anxiety and impaired social functioning². Among the dental diseases, dental caries and the periodontal problem is more prevalence and it is an important component of global disease burden. Moreover, knowledge about oral health has been cited as an important factor determines overall health³.Oral health is a highly personalized concept, the awareness of which highly relies

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13261 on an individual’s culture and socioeconomic status⁴. The prevention of dental disease depends upon the involvement of the community, the professional and an individual. Oral health of an individual depends upon oral and dental health attitude, oral hygiene knowledge and behavior.

Attitudes naturally reflect their own experiences, cultural perceptions, familial beliefs and other life situations and have a strong influence on oral health behavior⁵. Behavior reflect their practice of adapting the various methods of oral hygiene in routine day to day life (e.g. Brushing habits, Flossing etc.). Knowledge will reflect how much they are aware of the oral health today. Studies have shown that there is an association between increased knowledge and better oral health^6,7. In the present study assessing the Knowledge, attitude and behavior about oral and dental health care amongst non – medical faculties of Higher Education Institution, Gurugram,Haryana,India.

Objectives

1. To evaluate the oral health knowledgeamong teaching staff of non – medical faculty members.

2. To assess the attitude towards dental health care among teaching staff of non – medical faculty members.

3. To determine the behavior regarding the oral hygiene activities practiced by teaching staff of non – medical faculty members.

Materials and Methods

This study involved questionnaire in the English Language with 25 variable questions. The questionnaire was in the format of multiple choice questions.The questionnaire was formed over Google form and the Google form was then circulated among 10 faculties of the Higher Education Institution and 82 faculty members participated in the study sample. The participants were told to pick up only one answer for each question. They were allowed to interact with the investigators of the study for the meaning of any word or question. The questionnaire was designed to elicit staff’sknowledge, attitude and behavior towards dental care, oral health practice, knowledge of oral health and the treatment options. The study was approved by Departmental Board of Studies.

1. Knowledge towards oral health (Annexure I) -: It included questions related to basic knowledge of the oral health practices and purpose of maintaining oral health.

2. Attitude towards oral health (Annexure II) -: It includes questions based on the attitude of the faculty members for the maintenance of the oral health.

3. Behavior towards oral health maintenance (Annexure III) -: The questionsin this section cover the basic behavior or measures taken by the faculty members towards maintenance of the oral health.

All the filled google form questionnaires were collected and data was processed in the Excel sheet and the percentage was calculated for each option of each question.

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13262 Results

Table I Total of 82 participants participated in this study. Table 1 reveals the percentage for each option of each question.

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13263 1. Percentage: 89% respondents opted for the option “Yes”, 9.75% opted the option “No”

and 1.21% opted for option “Don’t know”.

Interpretation:The reply to this question states that majority of respondents think that brushing of teeth is beneficial for the gums as well which signifies that a large population was aware of additional effects of tooth brushing on gums. The results obtained are in accordance with study of Khursheed D et al⁸ also stated that gums are befitted by tooth brushing. (Graph 1)

The results obtained showed that a large population of respondents have good knowledge about tooth brushing benefits.

2. Percentage: 92% respondents opted for the option “Yes”, 6% opted the option “No” and 3% opted for option “Don’t know”.

Interpretation: The reply to this question states that majority of respondents think that they did not have any gum problem at the time of the survey which means they have healthy gums. The results obtained are similar toDiwan S et al⁹which also states that the oral health was good in majority of population.(Graph 2)

The results obtained showed that a large population of respondents have good knowledge about the status of their gum health that they did not have any gum problem at the time of study.

0 20 40 60 80

Yes No Don't know

Respondents

1. Do you think brushing of teeth helps the gums also?

0 20 40 60 80

Yes No Don't know

Respondents

2. At present time do you have any gum problem?

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13264 3. Percentage: 91.46 % respondents opted for the option “Yes”, 1.21% opted the option

“No” and 7.3% opted for option “Don’t know”.

Interpretation: The reply to this question states that majority of respondents think that dental diseases are preventable which means they have good knowledge about the nature of dental diseases and healing power of the body during maintenance of oral hygiene. The results obtained are in accordance with study of Khairnar M R et al¹⁰which also stated that a large population feel that dental diseases are preventable. (Graph 3)

The results obtained showed that a large population of respondents have good knowledge that dental diseases can be prevented.

4. Percentage: 85.3% respondents opted for the option “Yes”, 4.87% opted the option “No”

and 9.75% opted for option “Don’t know”.

Interpretation: The reply to this question states that majority of respondents states that proper method and frequency of tooth brushing plays an important role in maintaining good oral hygiene which means they have ample knowledge about maintenance of good oral hygiene by using proper method and frequency of tooth brushing. The results obtained are in accordance with study of Aunger R¹¹ whoalso stated that proper way of tooth brushing is helpful in maintaining good oral hygiene. (Graph 4)

The results obtained showed that a large population of respondents have good knowledge about

0 20 40 60 80

Yes No Don't know

Respondents

3. Do you think dental diseases are preventable?

0 10 20 30 40 50 60 70 80

Yes No Don't

know

Respondents

4. Do you know that proper method and frequency of tooth brushing plays an important role in maintaining good oral hygiene?

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13265 the importance of proper method and frequency of tooth brushing in maintaining good oral hygiene.

5. Percentage: 58.5% respondents opted for the option “Yes”, 18.29% opted the option

Interpretation: The reply to this question states that majority of respondentshad knowledge that malalignment of teeth can cause dental diseases which means they knew that it is difficult to maintain oral hygiene and there are increased chances of dental problems in such conditions.

This finding is in accordance with the study of PanN¹² (Graph 5)

The results obtained showed that a large population of respondents have good knowledge about correlation of malalignment with dental diseases.

0 10 20 30 40 50 60

Yes No Don't know

Respondents

5. Do you know that mal-alignment of teeth can cause dental diseases?

0 10 20 30 40 50 60 70

Yes No Don't know

Respondents

6. Do you know that oral health is related to systemic health?

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13266 Interpretation: The reply to this question states that majority of respondents were aware of the fact that oral health is related to systemic health. This means that they knew the importance of good oral health in maintenance of overall or general health. This is supported by study conducted by Gupta S et al¹³. (Graph 6)

The results obtained showed that a large population of respondents have good knowledge about the correlation between oral health and general health.

Interpretation: The reply to this question states that majority of respondents were aware about oral habits and their effect on oral health which means they have knowledge about the detrimental effects of oral habits on oral health. The results obtained are in accordance with study of Gupta S et al¹³. (Graph 7)

The results obtained showed that a large population of respondents have good knowledge about oral habits and their adverse effect on oral health.

8. Percentage: 80.48% respondents opted for the option “Agree”, 1.21% opted the option

“Disagree” and 18.29% opted for option “Don’t know”.

0 10 20 30 40 50 60

Yes No Don't know

Respondents

7. Do you know anything about oral habits and how they affect oral health?

0 10 20 30 40 50 60 70

Agree Disagree Don't know

Respondents

8. Mouthwashes contain medications that can prevent or reduce gum problems?

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13267 Interpretation: The reply to this question states that majority of respondents think that that mouthwashes contain medications that prevent or reduce gum problems which means they were aware about antimicrobial properties of mouthwashes. The results obtained are in accordance with study of Kumar S ¹⁴ showed that use of mouthwashes reduced gum problems. (Graph 8) The results obtained showed that a large population of respondents have good knowledge about that mouthwashes contain medications that prevent or reduce gum problems.

Interpretation: The reply to this question states that majority of respondentsfeel that dental treatment is expensive which means that they have undergone some dental procedures in the past so they are aware of the cost of dental treatments. The results obtained are in accordance with study of H.-Y. Liu et al.¹⁵ (Graph 9)

The results obtained showed that a large population of respondents have good knowledge about the expense of dental treatment.

0 10 20 30 40 50 60

Yes No Don't know

Respondents

9. Do you feel dental treatment is expensive?

0 10 20 30 40 50

Yes No Don't know

Respondents

10. Do you think professional cleaning of teeth in dental clinic …

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Interpretation: The reply to this question states that majority of respondentsbelieved that professional cleaning of teeth causes no harm to the teeth which means that these participants have no fear about the professional cleaning methods used in clinics and are very much aware of them. (Graph 10)

The results obtained showed that a large population of respondents have good knowledge that professional dental cleaning is not harmful to the teeth.

Interpretation: The reply to this question states that majority of respondents did not know about the effect of pregnancy over oral hygiene as the people were unaware of the effects of female hormones on periodontium. This is in accordance with the study done by Avula et al¹⁶ which states that a large population are not aware about the correlation between increased female hormones and periodontal disease. (Graph 11)

The results obtained showed that a large population of respondents have poor knowledge about the detrimental effects of exaggerated female hormones on periodontal tissues.

0 10 20 30 40

Yes No Don't know

Respondents

11. Do you think pregnancy can affect oral hygiene?

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13269 12. Percentage: 32.93% respondents opted for the option “Yes”, 17.07% opted the option

“No” and 50% opted for option “Don’t know”.

Interpretation: The reply to this question states that majority of respondentshave no idea about the necessity of dental clinic visits during pregnancy, theywere not aware that dental clinic visits are important during pregnancy as oral hygiene is an integral part of overall health and need to be taken care during pregnancy. The results obtained are in accordance with study of Kashyap RS etal¹⁷al also stated that as per obstetricians expected mothers should undergo dental check up on routine basis.(Graph 12)

The results obtained showed that a large population of respondents have poor knowledge about the importance of visiting dental clinic during pregnancy.

Interpretation: The reply to this question states that majority of respondents knew about beneficial effects and essentiality of preventive dental care as many dental diseases are reversible in nature can be prevented. This is in accordance with the study of Khairnar MR et al¹⁰,

0 10 20 30 40 50

Yes No Don't know

Respondents

12. Do you think dental visits are necessary during …

0 20 40 60 80

Yes No Don't know

Respondents

13. Do you believe that preventive dental care is beneficial and essential?

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13270 whichalso stated that preventive dental care is essential and beneficial. (Graph 13)

The results obtained showed that a large population of respondents have good knowledge about the beneficial effects of preventive dental care.

14. Percentage: 65.85% respondents opted for the option “Medium”, 32.93% opted the option “Soft” and 1.21% opted for option “Don’t know”.

Interpretation: The reply to this question states that majority of respondents think thatuse soft bristle toothbrush which means they are advised so by their clinician as per their periodontal health. This finding is in accordance with the study conducted by Mangla M et al¹⁸which also favors the use of soft bristle toothbrush for cleaning teeth.(Graph 14)

The results obtained showed that a large population of respondents have good knowledge about the beneficial effect of using soft bristled toothbrush.

15. Percentage: 81.71% respondents opted for the option “Agree”, 6.09% opted the option

“Disagree” and 12.19% opted for option “Don’t know”.

Interpretation: The reply to this question states that majority of respondents agree that oral hygiene can be achieved by adhering to self-care practices or measures as they are

0 10 20 30 40 50 60

Medium Soft Don't know

Respondents

14. What kind of tooth brush do you use?

0 10 20 30 40 50 60 70 80

Agree Disagree Don't know

Respondents

15. Do you believe that oral health can be achieved by adhering to self-care practices or measures?

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13271 aware about the preventive nature of dental diseases end the role of self-care measures achieving good oral hygiene. (Graph 15)

The results obtained showed that a large population of respondents have good knowledge that self-care practices are capable of maintaining oral hygiene.

16. Percentage: 34.15% respondents opted for the option “Interdental floss”, 13.41% opted the option “Interdental brush” and 52.44% opted for option “None”.

Interpretation: The reply to this question states that majority of respondents do not use any additional cleaning aids other than toothpaste and toothbrush as their attitude towards oral hygiene maintenance is negligent. The results obtained are in accordance with study of Mangla M et al.¹⁸which means their attitude towards oral hygiene maintenance is bad. (Graph 16)

The results obtained showed that a large population of respondents have poor knowledge about additional methods for oral hygiene maintenance.

17. Percentage: 9.76% respondents opted for the option “On regular basis”, 75.61% opted the option “In case of dental problem” and 14.63% opted for option “Never”.

Interpretation: The reply to this question states that majority of respondents think that visiting a dental clinic only in case of dental problem which means patients attitude towards oral

0 5 10 15 20 25 30 35 40 45 50

Interdental floss Interdental Brush None

Respondents

16. In addition to the tooth brush and tooth paste what else do you use to maintain your oral hygiene?

0 10 20 30 40 50 60 70

On regular basis In case of dental problem

Never

Respondents

17. How often do you visit a dental clinic?

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13272 hygiene is not good. (Graph 17)

The results obtained showed that a large population of respondents do not have good attitude which means oral health and hygiene is not a priority for them.

18. Percentage: 43.9% respondents opted for the option “Once”, 54.88% opted the option

“Twice” and 1.21% opted for option “Thrice”.

Interpretation: The reply to this question states that majority of respondents think that brushing their teeth twice daily this behavior shows that didn't know the value of oral hygiene maintenance. The results obtained are in accordance with study of Kakkad DN et al¹⁹ also stated that gums are befitted by tooth brushing. (Graph 18)

The results obtained showed that a large population of respondents have good behaviour towards oral hygiene maintenance and they put enough effort in order to keep their oral hygiene maintained.

Interpretation: The reply to this question states that majority of respondentsavoid consuming

0 10 20 30 40 50

Once Twice Thrice

Respondents

18. How many times a day do you brush your teeth?

0 10 20 30 40

Yes No Don't know

Respondents

19. Do you avoid consuming snacks in between meals?

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13273 snacks in-between the meals which is a good behavior to opt if someone wants to have a good oral hygiene. The results obtained are in accordance with study of Grewal N et al²⁰also stated that consumption of snacks in between meals can cause tooth decay and should be avoided.

(Graph 19)

The results obtained showed that a large population of respondents have good behavior of avoiding consumption of snacks in between meals.

“No” and 20% opted for option “Don’t know”.

Interpretation: The reply to this question states that majority of respondents consume sweets in between meals, sweets lower down the pH of the oral cavity and lead to various dental problems since oral pathogens flourish in acidic environment and clearly these individuals are not aware of this. (Graph 20)

The results obtained showed that a large population of respondents did not have a good behavior of avoiding consumption of sweets in between meals.

21. Percentage: 29.27% respondents opted for the option “1-2mins”, 57.32% opted the option

“2-3mins” and 13.41% opted for option “more than 5mins”.

0 5 10 15 20 25 30 35 40

Yes No Sometimes

Respondents

20. Do you avoid consuming sweets in between meals?

0 5 10 15 20 25 30 35 40 45 50

1-2mins 2-3mins More than 5mins

Respondents

21. How much time do you take while brushing?

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13274 Interpretation: The reply to this question states that majority of respondents usually perform brushing for two to three minutes which is considered to enough for maintenance of oral hygiene. The results obtained are in accordancewith study of Kumar MPS¹⁴ also stated that brushing 2-3mins which is considered as ideal time for tooth brushing. (Graph 21)

The results obtained showed that a large population of respondents have good behavior which is considered to be ideal. These participants give ample emphasis on oral hygiene maintenance.

22. Percentage: 50% respondents opted for the option “Every 3 months”, 28.05% opted the option “Every 6 months” and 21.95% opted for option “When it gets spoilt”.

Interpretation: The reply to this question states that majority of respondents change toothbrush after every three months which means they are aware about the expiry date or fraying of bristles which leads to decrease in efficacy off toothbrush. (Graph 22)

The results obtained showed that a large population of respondents change their toothbrush after every three months.

0 5 10 15 20 25 30 35 40 45

Every 3 months Every 6 months When it gets spoilt

Respondents

22. How often do you change your tooth brush?

0 10 20 30 40 50 60 70

Yes No Sometimes

Respondents

23. Do you rinse your mouth with water after eating?

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13275

“No” and 14.63% opted for option “Sometimes”.

Interpretation: The reply to this question states that majority of respondents totally agreed that they rinse with water after eating which means they are aware about the detrimental effects of accumulation of food debris on tooth surface on periodontal health. The results obtained are in accordance with study of Grewal N et al²⁰ also stated that mouth should be rinsed after eating.

(Graph 23)

The results obtained showed that a large population of respondents were aware about the importance of rinsing after every meal.

24. Percentage: 9.76% respondents opted for the option “Always”, 73.17% opted the option

“Occasionally” and 17.97% opted for option “Never”.

Interpretation: The reply to this question states that majority of respondents take carbonated drinks occasionally which means they are not much aware about the acidic nature of these beverages and their effects on teeth. (Graph 24)

The results obtained showed that a large population of respondents did not have good behaviour which means they are unaware about the detrimental effects of these carbonated drinks on teeth as these drinks cause demineralization of tooth surface.

25. Percentage: 20.73% respondents opted for the option “Always”, 60.97% opted the option

0 10 20 30 40 50 60 70

Always Occasionally Never

Respondents

24. How frequently do you take carbonated drinks?

0 10 20 30 40 50 60

Always Sometimes Never

Respondents

25. How frequently you practice preventive measures such as flossing, use of mouthwash, etc.?

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13276

“Sometimes” and 18.29% opted for option “Never”.

Interpretation: The reply to this question states that majority of respondents think that practicing preventive measures sometimes such as flossing use of mouthwash etc. which means they are not very particular about these practices of oral hygiene maintenance. (Graph 25)

The results obtained showed that a large population of respondents did not give the preventive measures much priority in maintenance of oral hygiene.

Discussion

Maintenance of oral hygiene is an integral part of overall health. Knowledge, attitude and behavior of a person determines the success of efficacy of oral hygiene measures for prevention of periodontal diseases. The study was attempted to determine the awareness about oral hygiene maintenance among Non-Medical Faculty of Higher Education Institution with Multiple Faculties (Both Medical and Non-Medical), Gurugram, Haryana.

A questionnaire based study was conducted which included 25 questions concerning the knowledge, attitude and behavior about oral health awareness. 91.46 % respondents which constitutes for majority of the population knew that dental disease are preventable and 85.3%

were aware of the fact that proper method and frequency of tooth brushing plays an important role in maintenance of oral hygiene (Khairnar M R et al)¹⁰ 75.6% of respondents have a good knowledge in terms of the correlation between oral and systemic health. The results obtained are in accordance with study of Aunger R.¹¹

In the present study, the knowledge regarding maintenance of oral health was good in majority of the population, whereas in terms of relationship of dental diseases and pregnancy the knowledge was poor as the majority of population (45.12%) did not know that pregnancy can affect oral hygiene and dental visits are necessary during pregnancy (50%). The results obtained are in accordance to the study conducted by Avula et al¹⁶.

The attitude towards maintenance of oral hygiene maintenance is bad as the majority of the study population (52.44%) opted for option “None” when asked about the use of additional oral hygiene maintenance tools other than the tooth brush and tooth paste to maintain oral hygiene (Mangla M et al¹⁸). 75.61% respondents which constitutes for majority of population stated that they only visit dental clinic in case of dental problem is also an example of bad attitude.

In the current study, the behavior of the participants towards oral hygiene maintenance was good and when asked about the frequency of tooth brushing on daily basis, the majority of population (54.88%) opted the option “Twice”. The results obtained are similar to the study conducted by Kakkad DN et al¹⁹. When the participants were asked about the brushing time, the majority of population confirmed that it is 2-3 minutes, which is in accordance with the study conducted by Kumar M.P.S.¹⁴A large number of (80.48%) respondents rinse their mouth after eating food which is a good habit to opt in order maintain good oral hygiene, which is in accordance with study of Grewal N et al²⁰. The behavior of faculty members towards oral hygiene maintenance was satisfactory, whereas bad behavior in terms of frequency of use of preventive measures such as flossing, use of mouthwash etc. was seen where the majority of participants (60.97%) opted for option “Sometimes”. The results obtained showed that for a very large population of

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13277 respondents the use of preventive measures is not part of routine and maintenance of oral hygiene is not a priority for them.

In this study, knowledge was good in terms of different types of dental diseases and measures to control them whereas it was limited in terms of correlation of pregnancy and dental diseases. The attitude towards maintenance of oral hygiene in a professional environment was not appropriate.

Practicing various preventive measures in order to prevent dental diseases and maintenance of oral hygiene constitute the behavior aspect. The behavior was good in terms of standard tooth brushing while it was bad in terms of use of additional preventive measures other than tooth brushing for oral hygiene maintenance.

Conclusion

This study provides valuable information on the knowledge, attitude and behavior of oral health of non-medical faculties. The deficiencies in their knowledge could be addressed through the provision of appropriate training,motivational workshops and by engaging in improving the oral health and quality of life of their own, their family and the community. The attitude and behavior towards oral health was also deficient and needs improvement as well. Everyone should be well versed with the importance of good oral health. As Dental Practitioners we must provide practical and theoretical support to them so that they are able to perform their duties better.

Further studies can then be carried out with more study population.

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Annexure I (Knowledge)

1. Do you think brushing of teeth helps the gums also?

1) Yes 2.) No 3) Don’t know

2. At the present time, do you have any gum problem?

1) Yes 2) No 3) Don’t know

3. Do you think dental diseases are preventable?

1) Yes 2)No 3)Don’t know

4. Do you know that proper method and frequency of tooth brushing plays an important role in maintaining good oral hygiene?

1) Yes 2)No 3) Don’t know

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13279 5. Do you know that mal-alignment of teeth can cause dental disease?

1)Yes 2)No 3) Don’t know

6. Do you know oral health is related to systemic health?

7. Do you know anything about oral habits and how they affect the oral health?

1)Yes 2.)No 3) Don’t know

8. Mouth washes contain medications that can prevent or reduce gum problems?

1) Agree 2)Disagree 3) Don’t know

9. Do you feel dental treatment is expensive?

1) Yes 2)No 3) Don’t know

10. Do you think professional cleaning of teeth in dental clinic cause harm to the teeth?

11. Do you think pregnancy can affectoral hygiene?

12. Do you think dental visits are necessary during pregnancy?

13. Do you believe that preventive dental care is beneficial and essential?

1.) Yes 2) No 3) Don’t know

14. What kind of tooth brush do you use?

1) Medium 2) Soft 3) Don’t know

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13280 15. Do you believe that oral health can be achieved by adhering to self-care practices or

measures?

1) Agree 2) Disagree 3) Don’t know

Annexure II (Attitude)

16. In addition to the tooth brush and tooth paste what else do you use to maintain your oral hygiene?

1) Dental floss 2)Tongue cleaner3) None 17. How often do you visit a dental clinic?

1) On regular basis 2) In case of dental problem 3) Never

Annexure III (Behavior)

18. How many times a day do you brush your teeth?

1) Once 2) Twice 3) Thrice

19. Do you avoid consuming snacks in between meals?

1.)Yes 2.)No 3) Sometimes 20. Do you avoid consuming sweets in between meals?

1.)Yes 2.)No 3) Sometimes

21. How much time do you take while brushing?

1) 1-2 mins 2)2-3 mins 3) More than 5 mins

22. How often do you change your tooth brush?

1) Every 3 months 2) Every 6 months 3) When it gets spoilt

23. Do you rinse your mouth with water after eating?

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13281 1) Yes2) No 3) Sometimes

24. How frequently do you take carbonated drinks?

1) Daily 2) Occasionally 3) Never

25. How frequently you practice preventive measures such as flossing, use of mouthwashetc..?

1) Always 2) Sometimes 3) Never