Investigation of Oral Health Awareness and Associated Factors Among Japanese University Students: Analyzing Behaviors Influencing Lifelong Oral Health Promotion
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Survey
2.2.1. Basic Items
2.2.2. Oral Health
2.2.3. Oral Health Awareness
2.2.4. Oral Health Behavior
2.3. Statistical Analysis
3. Results
3.1. Study Participants
3.2. Factors Associated with Basic Attributes and Oral Health Status
3.3. Factors Associated with Oral Diseases and Symptoms and Oral Health Status
3.4. Factors Associated with Oral Health Awareness and Oral Health Status
3.5. Factors Associated with Oral Health Behavior and Oral Health Status
3.6. Factors Associated with Oral Health Behavior and Year of Study
3.7. Logistic Regression Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Watt, R.G. Emerging theories into the social determinants of health: Implications for oral health promotion. Community Dent. Oral Epidemiol. 2002, 30, 241–247. [Google Scholar] [CrossRef] [PubMed]
- Kapila, Y.L. Oral health’s inextricable connection to systemic health: Special populations bring to bear multimodal relationships and factors connecting periodontal disease to systemic diseases and conditions. Periodontology 2000 2021, 87, 11–16. [Google Scholar] [CrossRef]
- Gallagher, J.; Ashley, P.; Petrie, A.; Needleman, I. Oral health and performance impacts in elite and professional athletes. Community Dent. Oral Epidemiol. 2018, 46, 563–568. [Google Scholar] [CrossRef] [PubMed]
- Jain, N.; Dutt, U.; Radenkov, I.; Jain, S. WHO’s global oral health status report 2022: Actions, discussion and implementation. Oral Dis. 2024, 30, 73–79. [Google Scholar] [CrossRef] [PubMed]
- Petersen, P.E. The World Oral Health Report 2003: Continuous improvement of oral health in the 21st century—The approach of the WHO Global Oral Health Programme. Community Dent. Oral Epidemiol. 2003, 31 (Suppl. S1), 3–23. [Google Scholar] [CrossRef]
- Suzuki, S.; Sugihara, N.; Kamijo, H.; Morita, M.; Kawato, T.; Tsuneishi, M.; Kobayashi, K.; Hasuike, Y.; Sato, T. Reasons for Tooth Extractions in Japan: The Second Nationwide Survey. Int. Dent. J. 2022, 72, 366–372. [Google Scholar] [CrossRef]
- Winning, L.; Linden, G.J. Periodontitis and Systemic Disease: Association or Causality? Curr. Oral Health Rep. 2017, 4, 1–7. [Google Scholar] [CrossRef]
- Teeuw, W.J.; Gerdes, V.E.; Loos, B.G. Effect of periodontal treatment on glycemic control of diabetic patients: A systematic review and meta-analysis. Diabetes Care 2010, 33, 421–427. [Google Scholar] [CrossRef]
- Bascones-Martinez, A.; Matesanz-Perez, P.; Escribano-Bermejo, M.; Gonzalez-Moles, M.A.; Bascones-Ilundain, J.; Meurman, J.H. Periodontal disease and diabetes-Review of the Literature. Med. Oral Patol. Oral Cir. Bucal. 2011, 16, e722-9. [Google Scholar] [CrossRef]
- Humphrey, L.L.; Fu, R.; Buckley, D.I.; Freeman, M.; Helfand, M. Periodontal disease and coronary heart disease incidence: A systematic review and meta-analysis. J. Gen. Intern. Med. 2008, 23, 2079–2086. [Google Scholar] [CrossRef]
- Kassebaum, N.J.; Bernabe, E.; Dahiya, M.; Bhandari, B.; Murray, C.J.; Marcenes, W. Global burden of untreated caries: A systematic review and metaregression. J. Dent. Res. 2015, 94, 650–658. [Google Scholar] [CrossRef]
- Kassebaum, N.J.; Bernabe, E.; Dahiya, M.; Bhandari, B.; Murray, C.J.; Marcenes, W. Global burden of severe periodontitis in 1990–2010: A systematic review and meta-regression. J. Dent. Res. 2014, 93, 1045–1053. [Google Scholar] [CrossRef] [PubMed]
- Furuta, M.; Ekuni, D.; Irie, K.; Azuma, T.; Tomofuji, T.; Ogura, T.; Morita, M. Sex differences in gingivitis relate to interaction of oral health behaviors in young people. J. Periodontol. 2011, 82, 558–565. [Google Scholar] [CrossRef] [PubMed]
- Taniguchi-Tabata, A.; Ekuni, D.; Mizutani, S.; Yamane-Takeuchi, M.; Kataoka, K.; Azuma, T.; Tomofuji, T.; Iwasaki, Y.; Morita, M. Associations between dental knowledge, source of dental knowledge and oral health behavior in Japanese university students: A cross-sectional study. PLoS ONE 2017, 12, e0179298. [Google Scholar] [CrossRef]
- Zheng, S.; Zhao, L.; Ju, N.; Hua, T.; Zhang, S.; Liao, S. Relationship between oral health-related knowledge, attitudes, practice, self-rated oral health and oral health-related quality of life among Chinese college students: A structural equation modeling approach. BMC Oral Health 2021, 21, 99. [Google Scholar] [CrossRef]
- Haag, D.G.; Peres, K.G.; Balasubramanian, M.; Brennan, D.S. Oral Conditions and Health-Related Quality of Life: A Systematic Review. J. Dent. Res. 2017, 96, 864–874. [Google Scholar] [CrossRef] [PubMed]
- Sumita, I.; Toyama, N.; Ekuni, D.; Maruyama, T.; Yokoi, A.; Fukuhara, D.; Uchida-Fukuhara, Y.; Nakahara, M.; Morita, M. The Impact of Oral Health Behaviors, Health Belief Model, and Absolute Risk Aversion on the Willingness of Japanese University Students to Undergo Regular Dental Check-Ups: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2022, 19, 13920. [Google Scholar] [CrossRef]
- Ishikawa, S.; Makino, N.; Togashi, H.; Ito, N.; Tsuya, A.; Hayasaka, M.; Konta, T.; Okuyama, N.; Yusa, K.; Iino, M. A Cross-Sectional Survey on the Association between Dental Health Conditions and University Personality Inventory Scores among University Students: A Single-Center Study in Japan. Int. J. Environ. Res. Public Health 2022, 19, 4622. [Google Scholar] [CrossRef]
- Rana, B.K.; Kiyani, A.; Hassan, S.; Masood, R.; Javed, M.Q.; Abulhamael, A.M.; Atique, S.; Zafar, M.S. Assessment of treatment needs, barriers, and self-perception regarding oral health among female university students: A cross-sectional study. BMC Oral Health 2024, 24, 883. [Google Scholar] [CrossRef]
- Tadin, A.; Poljak Guberina, R.; Domazet, J.; Gavic, L. Oral Hygiene Practices and Oral Health Knowledge among Students in Split, Croatia. Healthcare 2022, 10, 406. [Google Scholar] [CrossRef]
- Peltzer, K.; Pengpid, S. Oral health behaviour and social and health factors in university students from 26 low, middle and high income countries. Int. J. Environ. Res. Public Health 2014, 11, 12247–12260. [Google Scholar] [CrossRef] [PubMed]
- Sghaireen, M.G.; Zwiri, A.M.; Alzoubi, I.A.; Qodceih, S.M.; Al-Omiri, M.K. Anxiety due to Dental Treatment and Procedures among University Students and Its Correlation with Their Gender and Field of Study. Int. J. Dent. 2013, 2013, 647436. [Google Scholar] [CrossRef]
- Kandasamy, G.; Almeleebia, T. Assessment of Oral Health Knowledge, Attitudes, and Behaviours among University Students in the Asir Region-Saudi Arabia: A Cross-Sectional Study. Healthcare 2023, 11, 3100. [Google Scholar] [CrossRef]
- Kunitomo, M.; Ekuni, D.; Mizutani, S.; Tomofuji, T.; Irie, K.; Azuma, T.; Yamane, M.; Kataoka, K.; Taniguchi-Tabata, A.; Mizuno, H.; et al. Association between Knowledge about Comprehensive Food Education and Increase in Dental Caries in Japanese University Students: A Prospective Cohort Study. Nutrients 2016, 8, 114. [Google Scholar] [CrossRef]
- Khan, K.; Qadir, A.; Trakman, G.; Aziz, T.; Khattak, M.I.; Nabi, G.; Alharbi, M.; Alshammari, A.; Shahzad, M. Sports and Energy Drink Consumption, Oral Health Problems and Performance Impact among Elite Athletes. Nutrients 2022, 14, 5089. [Google Scholar] [CrossRef]
- Blicher, B.; Joshipura, K.; Eke, P. Validation of self-reported periodontal disease: A systematic review. J. Dent. Res. 2005, 84, 881–890. [Google Scholar] [CrossRef] [PubMed]
- Nakahara, M.; Toyama, N.; Ekuni, D.; Takeuchi, N.; Maruyama, T.; Yokoi, A.; Fukuhara, D.; Sawada, N.; Nakashima, Y.; Morita, M. Trends in Self-Rated Oral Health and Its Associations with Oral Health Status and Oral Health Behaviors in Japanese University Students: A Cross-Sectional Study from 2011 to 2019. Int. J. Environ. Res. Public Health 2022, 19, 13580. [Google Scholar] [CrossRef]
- Nakahara, M.; Ekuni, D.; Kataoka, K.; Yokoi, A.; Uchida-Fukuhara, Y.; Fukuhara, D.; Kobayashi, T.; Toyama, N.; Saho, H.; Islam, M.M.; et al. Living with Family Is Directly Associated with Regular Dental Checkup and Indirectly Associated with Gingival Status among Japanese University Students: A 3-Year Cohort Study. Int. J. Environ. Res. Public Health 2021, 18, 324. [Google Scholar] [CrossRef] [PubMed]
- Thirunavukkarasu, A.; Alotaibi, A.M.; Al-Hazmi, A.H.; Alruwaili, B.F.; Alomair, M.A.; Alshaman, W.H.; Alkhamis, A.M. Assessment of Oral Health-Related Quality of Life and Its Associated Factors among the Young Adults of Saudi Arabia: A Multicenter Study. Biomed Res. Int. 2022, 2022, 5945518. [Google Scholar] [CrossRef]
- Hakim, H.; Razak, I.A. Dental fear among medical and dental undergraduates. Sci. World J. 2014, 2014, 747508. [Google Scholar] [CrossRef]
- Australian Research Centre for Population Oral Health; The University of Adelaide; Armfield, J. The avoidance and delaying of dental visits in Australia. Aust. Dent. J. 2012, 57, 243–247. [Google Scholar] [CrossRef] [PubMed]
- Mueller, M.; Schorle, S.; Vach, K.; Hartmann, A.; Zeeck, A.; Schlueter, N. Relationship between dental experiences, oral hygiene education and self-reported oral hygiene behaviour. PLoS ONE 2022, 17, e0264306. [Google Scholar] [CrossRef]
- Kojima, A.; Ekuni, D.; Mizutani, S.; Furuta, M.; Irie, K.; Azuma, T.; Tomofuji, T.; Iwasaki, Y.; Morita, M. Relationships between self-rated oral health, subjective symptoms, oral health behavior and clinical conditions in Japanese university students: A cross-sectional survey at Okayama University. BMC Oral Health 2013, 13, 62. [Google Scholar] [CrossRef]
- Abe, M.; Mitani, A.; Hoshi, K.; Yanagimoto, S. Large Gender Gap in Oral Hygiene Behavior and Its Impact on Gingival Health in Late Adolescence. Int. J. Environ. Res. Public Health 2020, 17, 4394. [Google Scholar] [CrossRef] [PubMed]
- Dumitrescu, A.L.; Kawamura, M.; Dogaru, B.C.; Dogaru, C.D. Relation of achievement motives, satisfaction with life, happiness and oral health in Romanian university students. Oral Health Prev. Dent. 2010, 8, 15–22. [Google Scholar]
- Zimmermann, H.; Zimmermann, N.; Hagenfeld, D.; Veile, A.; Kim, T.S.; Becher, H. Is frequency of tooth brushing a risk factor for periodontitis? A systematic review and meta-analysis. Community Dent. Oral Epidemiol. 2015, 43, 116–127. [Google Scholar] [CrossRef] [PubMed]
- Marinho, V.C.; Chong, L.Y.; Worthington, H.V.; Walsh, T. Fluoride mouthrinses for preventing dental caries in children and adolescents. Cochrane Database Syst. Rev. 2016, 7, CD002284. [Google Scholar] [CrossRef]
- Thangavelu, A.; Kaspar, S.S.; Kathirvelu, R.P.; Srinivasan, B.; Srinivasan, S.; Sundram, R. Chlorhexidine: An Elixir for Periodontics. J. Pharm. Bioallied Sci. 2020, 12, S57–S59. [Google Scholar] [CrossRef]
- Jain, Y. A comparison of the efficacy of powered and manual toothbrushes in controlling plaque and gingivitis: A clinical study. Clin. Cosmet. Investig. Dent. 2013, 5, 3–9. [Google Scholar] [CrossRef]
- D’Cruz, A.M.; Aradhya, S. Impact of oral health education on oral hygiene knowledge, practices, plaque control and gingival health of 13- to 15-year-old school children in Bangalore city. Int. J. Dent. Hyg. 2013, 11, 126–133. [Google Scholar] [CrossRef]
- Mato, M.; Tsukasaki, K. Relationship between breakfast consumption and health-related habits among university students in Japan. Nihon Koshu Eisei Zasshi 2020, 67, 791–799. [Google Scholar] [CrossRef] [PubMed]
- Wang, Z.; Pu, R.; Zhang, J.; Yang, G. The mediating role of sugar and lipid metabolism and systemic inflammation in the association between breakfast skipping and periodontitis: A population-based study. J. Periodontol. 2024, 95, 1210–1222. [Google Scholar] [CrossRef] [PubMed]
- Abe, M.; Mitani, A.; Yao, A.; Zong, L.; Zhang, C.D.; Hoshi, K.; Yanagimoto, S. Oral Health in Japan: State-of-the-Art and Perspectives. Int. J. Environ. Res. Public Health 2022, 19, 8232. [Google Scholar] [CrossRef]
- Abe, M.; Mitani, A.; Yao, A.; Takeshima, H.; Zong, L.; Hoshi, K.; Yanagimoto, S. Close Associations of Gum Bleeding with Systemic Diseases in Late Adolescence. Int. J. Environ. Res. Public Health 2020, 17, 4290. [Google Scholar] [CrossRef]
- Sarumathi, T.; Saravanakumar, B.; Datta, M.; Nagarathnam, T. Awareness and knowledge of common oral diseases among primary care physicians. J. Clin. Diagn. Res. 2013, 7, 768–771. [Google Scholar] [CrossRef] [PubMed]
- Akl, S.; Ranatunga, M.; Long, S.; Jennings, E.; Nimmo, A. A systematic review investigating patient knowledge and awareness on the association between oral health and their systemic condition. BMC Public Health 2021, 21, 2077. [Google Scholar] [CrossRef]
- Nakre, P.D.; Harikiran, A.G. Effectiveness of oral health education programs: A systematic review. J. Int. Soc. Prev. Community Dent. 2013, 3, 103–115. [Google Scholar] [CrossRef]
n = 5482 | ||||
n | % | |||
Mean age ± SD | 19.32 ± 1.26 | |||
Sex | ||||
Male | 3693 | 67.4% | ||
Female | 1752 | 32.0% | ||
No answer | 37 | 0.7% | ||
Year of study | ||||
First year | 2176 | 39.7% | ||
Second year | 1175 | 21.4% | ||
Third year | 1121 | 20.4% | ||
Fourth year | 1010 | 18.4% | ||
Living together with family | ||||
Living together | 4623 | 84.3% | ||
Not living together | 859 | 15.7% | ||
Varsity sport participation | ||||
Yes | 720 | 13.1% | ||
No | 4762 | 86.9% | ||
Smoking history | ||||
Yes | 382 | 7.0% | ||
No | 5100 | 93.0% | ||
Satisfaction with current life | ||||
Satisfied | 4031 | 73.5% | ||
Not satisfied | 1451 | 26.5% | ||
Overall health | ||||
Good | 4975 | 90.8% | ||
Poor | 507 | 9.2% |
Variables | All | Oral Health | p-Value | ||||
---|---|---|---|---|---|---|---|
Poor n = 1323, 24.1% | Good n = 4159, 75.9% | ||||||
n | % | n | % | n | % | ||
Attribute | |||||||
Age | |||||||
18–19 years | 3215 | 58.6% | 769 | 58.1% | 2446 | 58.8% | n.s. |
21 years and older | 2267 | 41.4% | 554 | 41.9% | 1713 | 41.2% | |
Sex | |||||||
Male | 3693 | 67.4% | 901 | 68.1% | 2792 | 67.1% | n.s. |
Female | 1752 | 32.0% | 414 | 31.3% | 1338 | 32.2% | |
No answer | 37 | 0.7% | 8 | 0.6% | 29 | 0.7% | |
Year of study | |||||||
First year | 2176 | 39.7% | 495 | 37.4% | 1681 | 40.4% | n.s. |
Second year | 1175 | 21.4% | 306 | 23.1% | 869 | 20.9% | |
Third year | 1121 | 20.4% | 284 | 21.5% | 837 | 20.1% | |
Fourth year | 1010 | 18.4% | 238 | 18.0% | 772 | 18.6% | |
Living together with family | |||||||
Living together | 4623 | 84.3% | 1127 | 85.2% | 3496 | 84.1% | n.s. |
Not living together | 859 | 15.7% | 196 | 14.8% | 663 | 15.9% | |
Varsity sport participation | |||||||
Yes | 720 | 13.1% | 183 | 13.8% | 537 | 12.9% | n.s. |
No | 4762 | 86.9% | 1140 | 86.2% | 3622 | 87.1% | |
Smoking history | |||||||
Yes | 382 | 7.0% | 98 | 7.4% | 284 | 6.8% | n.s. |
No | 5100 | 93.0% | 1225 | 92.6% | 3875 | 93.2% | |
Satisfaction with current life | |||||||
Satisfied | 4031 | 73.5% | 868 | 65.6% | 3163 | 76.1% | <0.001 |
Not satisfied | 1451 | 23.5% | 455 | 34.4% | 996 | 23.9% | |
Overall health | |||||||
Good | 4975 | 90.8% | 1083 | 81.9% | 3892 | 93.6% | <0.001 |
Poor | 507 | 9.2% | 240 | 18.1% | 267 | 6.4% |
Variables | All | Oral Health | p-Value | ||||
---|---|---|---|---|---|---|---|
Poor n = 1323, 24.1% | Good n = 4159, 75.9% | ||||||
n | % | n | % | n | % | ||
Oral Diseases and Symptoms | |||||||
Dental caries | |||||||
Yes | 421 | 7.7% | 269 | 20.3% | 152 | 3.7% | <0.001 |
No | 5061 | 92.3% | 1054 | 79.7% | 4007 | 96.3% | |
Periodontal disease | |||||||
Yes | 152 | 2.8% | 98 | 7.4% | 54 | 1.3% | <0.001 |
No | 5330 | 97.2% | 1225 | 92.6% | 4105 | 98.7% | |
Bad breath | |||||||
Yes | 2121 | 38.7% | 747 | 56.5% | 1374 | 33.0% | <0.001 |
No | 3361 | 61.3% | 576 | 43.5% | 2785 | 67.0% | |
Gum bleeding | |||||||
Yes | 2045 | 37.3% | 717 | 54.2% | 1328 | 31.9% | <0.001 |
No | 3437 | 62.7% | 606 | 45.8% | 2831 | 68.1% |
Variables | All | Oral Health | p-Value | ||||
---|---|---|---|---|---|---|---|
Poor n = 1323, 24.1% | Good n = 4159, 75.9% | ||||||
n | % | n | % | n | % | ||
Awareness of Oral Health | |||||||
Interest in oral health | |||||||
Yes | 3960 | 81.5% | 970 | 73.3% | 2990 | 71.9% | n.s. |
No | 1522 | 18.5% | 353 | 26.7% | 1169 | 28.1% | |
Interest in oral hygiene | |||||||
Yes | 4468 | 81.5% | 1059 | 80.0% | 3409 | 82.0% | n.s. |
No | 1014 | 18.5% | 264 | 20.0% | 750 | 18.0% | |
Knowledge of the 8020 campaign | |||||||
Yes | 3246 | 59.2% | 737 | 55.7% | 2509 | 60.3% | 0.003 |
No | 2236 | 40.8% | 586 | 44.3% | 1650 | 39.7% | |
Knowledge that periodontal disease is a lifestyle disease | |||||||
Yes | 4272 | 77.9% | 1017 | 76.9% | 3255 | 78.3% | n.s. |
No | 1210 | 22.1% | 306 | 23.1% | 904 | 21.7% | |
Knowledge of the impact of smoking on periodontal disease development | |||||||
Yes | 4302 | 78.5% | 981 | 74.1% | 3321 | 79.9% | <0.001 |
No | 1180 | 21.5% | 342 | 25.9% | 838 | 20.1% | |
Consciously selected toothbrushing tools | |||||||
Yes | 1717 | 31.3% | 303 | 22.9% | 1414 | 34.0% | <0.001 |
No | 3765 | 68.7% | 1020 | 77.1% | 2745 | 66.0% | |
Tooth brushing with attention to caries and periodontal disease | |||||||
Yes | 3454 | 63.0% | 731 | 55.3% | 2723 | 65.5% | <0.001 |
No | 2028 | 37.0% | 592 | 44.7% | 1436 | 34.5% | |
Anxiety about the cost of dental visits | |||||||
Yes | 1995 | 36.4% | 637 | 48.1% | 1358 | 32.7% | <0.001 |
No | 3487 | 63.6% | 686 | 51.9% | 2801 | 67.3% | |
Anxiety about pain during dental treatment | |||||||
Yes | 995 | 18.2% | 386 | 29.2% | 609 | 14.6% | <0.001 |
No | 4487 | 81.8% | 937 | 70.8% | 3550 | 85.4% |
Variables | All | Oral Health | p-Value | ||||
---|---|---|---|---|---|---|---|
Poor n = 1323, 24.1% | Good n = 4159, 75.9% | ||||||
n | % | n | % | n | % | ||
Oral Health Habits | |||||||
Frequency of tooth brushing (times/day) | |||||||
0–1 times/day | 828 | 15.1% | 340 | 21.4% | 488 | 12.5% | <0.001 |
2 times/day | 3463 | 63.2% | 939 | 59.1% | 2524 | 64.9% | |
3 times/day or more | 1191 | 21.7% | 311 | 19.6% | 880 | 22.6% | |
Use of mouthwash | |||||||
Yes | 904 | 16.5% | 174 | 13.2% | 730 | 17.6% | <0.001 |
No | 4578 | 83.5% | 1149 | 86.8% | 3429 | 82.4% | |
Use of interdental brush and dental floss | |||||||
Yes | 856 | 15.6% | 184 | 13.9% | 672 | 16.2% | n.s. |
No | 4626 | 84.4% | 1139 | 86.1% | 3487 | 83.8% | |
Dental visit (within 6 months) | |||||||
Yes | 2170 | 39.6% | 514 | 38.9% | 1656 | 39.8% | n.s. |
No | 3312 | 60.4% | 809 | 61.1% | 2503 | 60.2% | |
Regular dental visits | |||||||
Yes | 1540 | 28.1% | 331 | 25.0% | 1209 | 29.1% | 0.004 |
No | 3942 | 71.9% | 992 | 75.0% | 2950 | 70.9% | |
Availability of a family dentist | |||||||
Yes | 3039 | 55.4% | 717 | 54.2% | 2322 | 55.8% | n.s. |
No | 2443 | 44.6% | 606 | 45.8% | 1837 | 44.2% | |
Whether the patient has received education on oral hygiene | |||||||
Yes | 3485 | 63.6% | 886 | 67.0% | 2599 | 62.5% | 0.003 |
No | 1997 | 36.4% | 437 | 33.0% | 1560 | 37.5% | |
Eating habits | |||||||
Frequency of breakfast intake (days/week) | |||||||
More than 5 days | 3603 | 65.7% | 774 | 58.5% | 2829 | 68.0% | <0.001 |
Less than 4 days | 1879 | 34.3% | 549 | 41.5% | 1330 | 32.0% | |
Water intake (mL/day) | |||||||
Less than 1000 mL | 2986 | 45.5% | 730 | 55.2% | 2256 | 54.2% | n.s. |
1000 mL or more | 2496 | 54.5% | 593 | 44.8% | 1903 | 45.8% | |
Types of beverages most often consumed | |||||||
Water | 2747 | 50.1% | 645 | 48.8% | 2102 | 50.5% | n.s. |
Green tea | 2506 | 45.7% | 596 | 45.0% | 1910 | 45.9% | |
Soft drinks | 229 | 4.2% | 82 | 6.2% | 147 | 3.5% | |
Frequent gum chewing | |||||||
Yes | 799 | 14.6% | 183 | 13.8% | 616 | 14.8% | n.s. |
No | 4683 | 85.4% | 1140 | 86.2% | 3543 | 85.2% |
Variables | All | Year of Study | p-Value | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
First Year n = 2176, 39.7% | Second Year n = 1175, 21.4% | Third Year n = 1121, 20.5% | Fourth Year n = 1010, 18.4% | ||||||||
n | % | n | % | n | % | n | % | n | % | ||
(A) | |||||||||||
Attribute | |||||||||||
Sex | |||||||||||
Male | 3693 | 67.4% | 1497 | 68.8% | 832 | 70.8% | 734 | 65.5% | 630 | 62.4% | <0.001 |
Female | 1752 | 32.0% | 668 | 30.7% | 335 | 28.5% | 379 | 33.8% | 370 | 36.6% | |
No answer | 37 | 0.7% | 11 | 0.5% | 8 | 0.7% | 8 | 0.7% | 10 | 1.0% | |
Living together with family | |||||||||||
Living together | 859 | 15.7% | 309 | 14.2% | 193 | 16.4% | 196 | 17.5% | 161 | 15.9% | n.s. |
Not living together | 4623 | 84.3% | 1867 | 85.8% | 982 | 83.6% | 925 | 82.5% | 849 | 84.1% | |
Varsity sport participation | |||||||||||
Yes | 720 | 13.1% | 288 | 13.2% | 133 | 11.3% | 163 | 14.5% | 136 | 13.5% | n.s. |
No | 4762 | 86.9% | 1888 | 86.8% | 1042 | 88.7% | 958 | 85.5% | 874 | 86.5% | |
Smoking history | |||||||||||
Yes | 382 | 7.0% | 9 | 0.4% | 27 | 2.3% | 155 | 13.8% | 191 | 18.9% | <0.001 |
No | 5100 | 93.0% | 2167 | 99.6% | 1148 | 97.7% | 966 | 86.2% | 819 | 81.1% | |
Satisfaction with current life | |||||||||||
Satisfied | 4031 | 73.5% | 2027 | 93.2% | 992 | 84.4% | 474 | 42.3% | 538 | 53.3% | <0.001 |
Not satisfied | 1451 | 26.5% | 149 | 6.8% | 183 | 15.6% | 647 | 57.7% | 472 | 46.7% | |
Overall health | |||||||||||
Good | 4975 | 90.8% | 2030 | 93.3% | 1053 | 89.6% | 976 | 87.1% | 916 | 90.7% | <0.001 |
Poor | 507 | 9.2% | 146 | 6.7% | 122 | 10.4% | 145 | 12.9% | 94 | 9.3% | |
(B) | |||||||||||
Oral Health | |||||||||||
Oral health | |||||||||||
Yes | 4159 | 75.9% | 1681 | 77.3% | 869 | 74.0% | 837 | 74.7% | 772 | 76.4% | n.s. |
No | 1323 | 24.1% | 495 | 22.7% | 306 | 26.0% | 284 | 25.3% | 238 | 23.6% | |
Dental caries | |||||||||||
Yes | 421 | 7.7% | 169 | 7.8% | 93 | 7.9% | 71 | 6.3% | 88 | 8.7% | n.s. |
No | 5061 | 92.3% | 2007 | 92.2% | 1082 | 92.1% | 1050 | 93.7% | 922 | 91.3% | |
Periodontal disease | |||||||||||
Yes | 152 | 2.8% | 47 | 2.2% | 35 | 3.0% | 35 | 3.1% | 35 | 3.5% | n.s. |
No | 5330 | 97.2% | 2129 | 97.8% | 1140 | 97.0% | 1086 | 96.9% | 975 | 96.5% | |
Bad breath | |||||||||||
Yes | 2121 | 38.7% | 825 | 37.9% | 488 | 41.5% | 432 | 38.5% | 376 | 37.2% | n.s. |
No | 3361 | 61.3% | 1351 | 62.1% | 687 | 58.5% | 689 | 61.5% | 634 | 62.8% | |
Gum bleeding | |||||||||||
Yes | 2045 | 37.3% | 810 | 37.2% | 449 | 38.2% | 421 | 37.6% | 365 | 36.1% | n.s. |
No | 3437 | 62.7% | 1366 | 62.8% | 726 | 61.8% | 700 | 62.4% | 645 | 63.9% | |
Awareness of Oral Health | |||||||||||
Interests in oral health | |||||||||||
Yes | 3960 | 72.2% | 1522 | 69.9% | 836 | 71.1% | 819 | 73.1% | 783 | 77.5% | <0.001 |
No | 1522 | 27.8% | 654 | 30.1% | 339 | 28.9% | 302 | 26.9% | 227 | 22.5% | |
Interest in oral hygiene | |||||||||||
Yes | 4468 | 81.5% | 1755 | 80.7% | 951 | 80.9% | 925 | 82.5% | 837 | 82.9% | n.s. |
No | 1014 | 18.5% | 421 | 19.3% | 224 | 19.1% | 196 | 17.5% | 173 | 17.1% | |
Knowledge of the 8020 campaign | |||||||||||
Yes | 3246 | 59.2% | 1335 | 61.4% | 669 | 56.9% | 657 | 58.6% | 585 | 57.9% | n.s. |
No | 2236 | 40.8% | 841 | 38.6% | 506 | 43.1% | 464 | 41.4% | 425 | 42.1% | |
Knowledge that periodontal disease is a lifestyle disease | |||||||||||
Yes | 4272 | 77.9% | 1682 | 77.3% | 929 | 79.1% | 883 | 78.8% | 778 | 77.0% | n.s. |
No | 1210 | 22.1% | 494 | 22.7% | 246 | 20.9% | 238 | 21.2% | 232 | 23.0% | |
Knowledge of the impact of smoking on periodontal disease development | |||||||||||
Yes | 4302 | 78.5% | 1678 | 77.1% | 950 | 80.9% | 875 | 78.1% | 799 | 79.1% | n.s. |
No | 1180 | 21.5% | 498 | 22.9% | 225 | 19.1% | 246 | 21.9% | 211 | 20.9% | |
Consciously selected toothbrushing tools | |||||||||||
Yes | 1717 | 31.3% | 619 | 28.4% | 373 | 31.7% | 359 | 32.0% | 366 | 36.2% | <0.001 |
No | 3765 | 68.7% | 1557 | 71.6% | 802 | 68.3% | 762 | 68.0% | 644 | 63.8% | |
Brushing teeth with attention to caries and periodontal disease | |||||||||||
Yes | 3454 | 63.0% | 1339 | 61.5% | 753 | 64.1% | 715 | 63.8% | 647 | 64.1% | n.s. |
No | 2028 | 37.0% | 837 | 38.5% | 422 | 35.9% | 406 | 36.2% | 363 | 35.9% | |
Anxiety about the cost of dental visits | |||||||||||
Yes | 1995 | 36.4% | 773 | 35.5% | 418 | 35.6% | 428 | 38.2% | 376 | 37.2% | n.s. |
No | 3487 | 63.6% | 1403 | 64.5% | 757 | 64.4% | 693 | 61.8% | 634 | 62.8% | |
Anxiety about pain during dental treatment | |||||||||||
Yes | 995 | 18.2% | 353 | 16.2% | 223 | 19.0% | 233 | 20.8% | 186 | 18.4% | 0.010 |
No | 4487 | 81.8% | 1823 | 83.8% | 952 | 81.0% | 888 | 79.2% | 824 | 81.6% | |
(C) | |||||||||||
Oral Health Habits | |||||||||||
Frequency of toothbrushing (times/day) | |||||||||||
0–1 times/day | 828 | 15.1% | 283 | 13.0% | 182 | 15.5% | 189 | 16.9% | 174 | 17.2% | <0.001 |
2 times/day | 3463 | 63.2% | 1422 | 65.3% | 758 | 64.5% | 698 | 62.3% | 585 | 57.9% | |
3 times/day or more | 1191 | 21.7% | 471 | 21.6% | 235 | 20.0% | 234 | 20.9% | 251 | 24.9% | |
Use of mouthwash | |||||||||||
Yes | 904 | 16.5% | 323 | 14.8% | 207 | 17.6% | 194 | 17.3% | 180 | 17.8% | n.s. |
No | 4578 | 83.5% | 1853 | 85.2% | 968 | 82.4% | 927 | 82.7% | 830 | 82.2% | |
Use of interdental brush and dental floss | |||||||||||
Yes | 856 | 15.6% | 315 | 14.5% | 187 | 15.9% | 176 | 15.7% | 178 | 17.6% | n.s. |
No | 4626 | 84.4% | 1861 | 85.5% | 988 | 84.1% | 945 | 84.3% | 832 | 82.4% | |
Dental visits (within 6 months) | |||||||||||
Yes | 2170 | 39.6% | 1001 | 46.0% | 420 | 35.7% | 395 | 35.2% | 354 | 35.0% | <0.001 |
No | 3312 | 60.4% | 1175 | 54.0% | 755 | 64.3% | 726 | 64.8% | 656 | 65.0% | |
Regular dental visits | |||||||||||
Yes | 1540 | 28.1% | 677 | 31.1% | 321 | 27.3% | 288 | 25.7% | 254 | 25.1% | <0.001 |
No | 3942 | 71.9% | 1499 | 68.9% | 854 | 72.7% | 833 | 74.3% | 756 | 74.9% | |
Availability of a family dentist | |||||||||||
Yes | 3039 | 55.4% | 1272 | 58.5% | 640 | 54.5% | 592 | 52.8% | 535 | 53.0% | 0.003 |
No | 2443 | 44.6% | 904 | 41.5% | 535 | 45.5% | 529 | 47.2% | 475 | 47.0% | |
Experience with oral hygiene education | |||||||||||
Yes | 3485 | 63.6% | 1396 | 64.2% | 742 | 63.1% | 724 | 64.6% | 623 | 61.7% | n.s. |
No | 1997 | 36.4% | 780 | 35.8% | 433 | 36.9% | 397 | 35.4% | 387 | 38.3% | |
Eating Habits | |||||||||||
Frequency of breakfast intake (days/week) | |||||||||||
More than 5 days | 3603 | 65.7% | 1643 | 75.5% | 763 | 64.9% | 666 | 59.4% | 531 | 52.6% | <0.001 |
Less than 4 days | 1879 | 34.3% | 533 | 24.5% | 412 | 35.1% | 455 | 40.6% | 479 | 47.4% | |
Water intake (mL/day) | |||||||||||
Less than 1000 mL | 2986 | 54.5% | 1183 | 54.4% | 644 | 54.8% | 623 | 55.6% | 536 | 53.1% | n.s. |
1000 mL or more | 2496 | 45.5% | 993 | 45.6% | 531 | 45.2% | 498 | 44.4% | 474 | 46.9% | |
Types of beverages most often consumed | |||||||||||
Water | 2747 | 50.1% | 1047 | 48.1% | 604 | 51.4% | 572 | 51.0% | 524 | 51.9% | n.s. |
Green tea | 2506 | 45.7% | 1038 | 47.7% | 514 | 43.7% | 508 | 45.3% | 446 | 44.2% | |
Soft drinks | 229 | 4.2% | 91 | 4.2% | 57 | 4.9% | 41 | 3.7% | 40 | 4.0% | |
Frequent gum chewing | |||||||||||
Yes | 799 | 14.6% | 362 | 16.6% | 227 | 19.3% | 194 | 17.3% | 16 | 1.6% | <0.001 |
No | 4683 | 85.4% | 1814 | 83.4% | 948 | 80.7% | 927 | 82.7% | 994 | 98.4% |
OR | OR 95% CI | p-Value | ||
---|---|---|---|---|
Lower Limit | Upper Limit | |||
Predictors of Oral Health Status | ||||
No dental caries | 6.253 | 4.952 | 7.897 | <0.001 |
No periodontal disease | 4.476 | 3.083 | 6.497 | <0.001 |
Good overall health | 2.493 | 2.011 | 3.092 | <0.001 |
No gum bleeding | 1.834 | 1.588 | 2.117 | <0.001 |
No bad breath | 1.829 | 1.584 | 2.111 | <0.001 |
Brushing teeth 3 times/day or more (reference: 1 time/day or less) ⁑ | 1.745 | 1.386 | 2.195 | <0.001 |
Brushing teeth twice/day (reference: 1 time/day or less) ⁑ | 1.604 | 1.336 | 1.924 | <0.001 |
Conscious selection of toothbrushing tools | 1.466 | 1.230 | 1.746 | <0.001 |
Brushing teeth with attention to caries and periodontal disease | 1.378 | 1.181 | 1.608 | <0.001 |
Consuming breakfast more than 5 days/week | 1.261 | 1.091 | 1.458 | 0.002 |
Use of mouthwash | 1.255 | 1.022 | 1.540 | 0.030 |
Satisfaction with present life | 1.251 | 1.073 | 1.459 | 0.004 |
Regular dental visits | 1.235 | 1.049 | 1.455 | 0.012 |
Experience with oral hygiene education | 0.812 | 0.698 | 0.945 | 0.007 |
Anxiety about the cost of dental visits | 0.769 | 0.664 | 0.890 | <0.001 |
Anxiety about pain during dental treatment | 0.572 | 0.482 | 0.679 | <0.001 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Yamamoto, T.; Seguchi, M.; Mori, Y.; Ejiri, H.; Tanaka, M.; Kozai, H.; Iio, Y.; Aoyama, Y.; Ito, M. Investigation of Oral Health Awareness and Associated Factors Among Japanese University Students: Analyzing Behaviors Influencing Lifelong Oral Health Promotion. Healthcare 2025, 13, 1370. https://doi.org/10.3390/healthcare13121370
Yamamoto T, Seguchi M, Mori Y, Ejiri H, Tanaka M, Kozai H, Iio Y, Aoyama Y, Ito M. Investigation of Oral Health Awareness and Associated Factors Among Japanese University Students: Analyzing Behaviors Influencing Lifelong Oral Health Promotion. Healthcare. 2025; 13(12):1370. https://doi.org/10.3390/healthcare13121370
Chicago/Turabian StyleYamamoto, Tsukasa, Manato Seguchi, Yukihiro Mori, Harumi Ejiri, Mamoru Tanaka, Hana Kozai, Yoko Iio, Yuka Aoyama, and Morihiro Ito. 2025. "Investigation of Oral Health Awareness and Associated Factors Among Japanese University Students: Analyzing Behaviors Influencing Lifelong Oral Health Promotion" Healthcare 13, no. 12: 1370. https://doi.org/10.3390/healthcare13121370
APA StyleYamamoto, T., Seguchi, M., Mori, Y., Ejiri, H., Tanaka, M., Kozai, H., Iio, Y., Aoyama, Y., & Ito, M. (2025). Investigation of Oral Health Awareness and Associated Factors Among Japanese University Students: Analyzing Behaviors Influencing Lifelong Oral Health Promotion. Healthcare, 13(12), 1370. https://doi.org/10.3390/healthcare13121370