|Year : 2017 | Volume
| Issue : 3 | Page : 105-109
Oral hygiene practices of non-dental nurses in a tertiary hospital in North-West Nigeria
Zainab F Ibrahim1, Lawal O Teslim2, Ibrahim Aliyu3
1 Department of Nursing, Aminu Kano Teaching Hospital, Birnin Kebbi, Nigeria
2 Department of Paediatrics, Federal Medical Centre, Birnin Kebbi, Nigeria
3 Department of Paediatrics, Aminu Kano Teaching Hospital, Bayero University Kano, Kano, Nigeria
|Date of Web Publication||18-Sep-2017|
Department of Paediatrics, Aminu Kano Teaching Hospital, Bayero University Kano, Kano
Source of Support: None, Conflict of Interest: None
Introduction: Poor oral hygiene results in dental caries and this has been associated with cardiovascular morbidities. Therefore achieving a good oral hygiene will significantly improve the quality of health. Materials and Methods: This was a crosssectional study; it was carried out between October and December 2016. Non-dental nurses in the hospital were consecutively recruited, and a pretested selfadministered questionnaire was administered. Results: There were 36 (37.1%) males, 61 (62.9%) females with male to female ratio of 1:1.7. Sixtysix percent of the respondents used toothbrush and paste for oral cleansing. However, majority of them changed their brush on 2–3 monthly basis; similarly, 56 (57.7%) of the respondents brushed at least twice in a day. Fortysix (47.4%) of the respondents used mouth wash while 51 (52.6%) did not; and among the nonusers, the majority (47.1%) believed mouth wash was ineffective. Thirtyeight (39.2%) of the respondents did brush for <4 min while 59 (60.8%) brushed for at least 4 min. Nine (14.3%) respondents used dental filament. Fifty (51.5%) of the respondents used mouthwash while 47 (48.5%) did not use mouthwash; however, among 46 respondents who did not use mouth wash, 24 (52.2%) believe that mouth wash are ineffective, 12 (26.1%) did not like mouthwash, 7 (15.2%) were unaware of mouth wash, 2 (4.3%) reported cost as a deterrent; whereas 1 (2.2%) said mouth wash was not available in their vicinity. Conclusion: Commendable oral hygiene practices were observed among the respondents; however, there is knowledge gap which requires improvement such as the use of dental floss.
Keywords: Dental filaments, dental hygiene, mouth wash, nurses, toothbrush
|How to cite this article:|
Ibrahim ZF, Teslim LO, Aliyu I. Oral hygiene practices of non-dental nurses in a tertiary hospital in North-West Nigeria. SRM J Res Dent Sci 2017;8:105-9
|How to cite this URL:|
Ibrahim ZF, Teslim LO, Aliyu I. Oral hygiene practices of non-dental nurses in a tertiary hospital in North-West Nigeria. SRM J Res Dent Sci [serial online] 2017 [cited 2022 May 23];8:105-9. Available from: https://www.srmjrds.in/text.asp?2017/8/3/105/215016
| Introduction|| |
Oral hygiene is an integral part of personal health. Good oral hygiene will lead to good breath, therefore, avoiding halitosis which may result in medical and psychological morbidities. Furthermore, poor oral hygiene results in dental caries, and this has been associated with cardiovascular morbidities. Therefore achieving a good oral hygiene will significantly improve the quality of health.,,, Nurses constituted a large number among the health professionals and based on their work schedule, they spend more time with patients, especially in-patients; furthermore, they are predominantly females, hence their knowledge of good oral hygiene should translate to a better oral care of their children. Therefore, advancing their knowledge on common hygiene practices such as oral hygiene will significantly improve the advocacy on healthy living. However for them to be successful educators on oral hygiene, they should be able to practice what is recommended. Non-dental nurses see larger population of patients; however, their level of training in the field of dentistry is often limited when compared to dental nurses. Therefore, this study hopes to determine, the knowledge, and practice of oral hygiene among non-dental nurses in our health institution with the hope of identifying knowledge gaps in their personal and dental care practices
| Materials and Methods|| |
This was a cross-sectional study; it was done between October and December 2016. Nurses in the hospital were consecutively recruited until the desired sample size was obtained. A pretested self-administered questionnaire was adopted. The questionnaire was developed in English and it contained both open- and close-ended questions, and internal consistency was determined having a Cronbach's Alpha value of 0.8; relevant information contained were age, sex, years of working experience, and common oral hygiene practices among others. Ethical approval was obtained from the Ethical Committee of Federal Medical Centre Birnin Kebbi.
Using a prevalence of 82% reported by Amith et al., a sample size of 151 was calculated and for a population <10,000 (N/1 + N/n); the sample size of 76 was calculated which was increased to 97 (target population of 150 nurses). Convenience sampling method was adopted.
Nurses present at the time of the study were enrolled.
Respondents who declined consent were excluded from the study.
Nurse who had clinical rotation with the dental unit.
Statistical Package for Social Sciences (SPSS) version 16 (SPSS Inc. Chicago, Illinois, USA) was used for data analysis. Categorical variables such as the use of toothbrush/toothpaste, checking fluoride content, use of mouth wash, and toothpick were presented as frequency tables; and the quantitative date such as age was presented as mean and standard deviation. Test of significance using the Chi square (χ2) and Fisher's exact test were used where appropriate; and P < 0.05 was considered to be statistically significant.
| Results|| |
There were 36 (37.1%) males, 61 (62.9%) females with male to female ratio of 1:1.7. Their age ranged from 19 to 48 years with mean of 35 ± 5 years.
Respondents of the junior cader and those from the pediatrics department were the most predominant [Table 1].
Sixty-six percent of the respondents used toothbrush and paste for oral cleansing, however, the majority of them changed their toothbrush on 2–3 monthly basis; similarly, most of the respondents brushed at least twice in a day [Table 2]. Forty-six (47.4%) of the respondents used mouth wash, whereas 51 (52.6%) did not; and among the nonusers, majority (47.1%) believed mouth wash was ineffective
Forty-three (43.3%) of the respondents did check the fluoride content of their toothpaste; 38 (39.2%) were not sure; while 16 (16.5%) did not check.
Thirty-eight (39.2%) of the respondents did brush for <4 min while 59 (60.8%) brushed for at least 4 min; furthermore, 93 (95.9%) of them brushed their tongue while only 4 (4.1%) did not brush their tongue. Use of other teeth cleansing materials was observed in 63 (64.9%) of the respondents while 34 (35.1%) did not; among those that did not use these options, their main reasons were that (18, 2.9%) they were not aware of these teeth cleansing materials, (8, 23.5%) they believed that they were ineffective, (7, 20.6%) they complained of their nonavailability, however only a single respondent (2.9%) complained of cost.
Among the 63 respondents that used other teeth cleansing devices; 41 (65.1%) used them after after each meal, 19 (30.2%) used daily while only 3 (4.7%) used weekly. The following were used for teeth cleansing: 51 (81.0%) of the respondents used wooden toothpick, 2 (3.2%) used plastic toothpick, one respondent (1.6%) used broom stick, whereas 9 (14.3%) used floss filament. Thirty-three (34%) of the respondents did rinse their mouth with water after every meal while 64 (66.0%) did not. The majority of the respondents (60, 61.9%) were not aware that dental disease could cause heart problems; whereas only 37 (38.1%) were aware of such fact.
Majority of the respondents routinely did oral examination on their patients [Table 3]. They also engaged patients on proper oral hygiene education and they predominantly would referral dental cases [Table 3]; however, among those who would not refer, the main reason alluded was the absence of dentists (82.8%) to handle such cases.
Fifty (51.5%) of the respondents used mouth-wash while 47 (48.5%) did not use mouth-wash; however, among 46 respondents who did not use mouth wash, 24 (52.2%) believed mouth wash was ineffective, 12 (26.1%) did not like mouthwash, 7 (15.2%) were unaware of mouth wash, 2 (4.3%) reported cost as a deterrent; whereas 1 (2.2%) said mouth wash was not available in their vicinity.
Majority of the respondents in all the sub-groups used dental care materials; [Table 4] however this was experienced mostly among the senior nursing officers; but this observation was not statistically significant (Fishers exact test = 7.439; P = 0.080). The majority of respondents in all the sub-groups except the senior nursing officers subgroup brushed for 4 min or more; however, this observation was also not statistically significant (Fishers exact = 5.709; P = 0.180).
|Table 4: Comparing the staff rank with usage of dental care materials; and time spent on oral care|
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Most of those who brushed for 4 min or more also used dental care materials; similarly, among the group that brushed for <4 min, [Table 5] majority of them used dental care materials but these observations were not statistically significant (χ2 = 0.537; df = 1; P = 0.517).
|Table 5: The relationship of time spent on oral care and use of dental care materials|
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| Discussion|| |
A personal good oral hygiene is a reflection of a positive oral behavior which can influence a health care practitioner's perception and practice of oral care., The current study showed a predominance of females which is a general reflection of gender distribution and choice; this is the common observation among the nursing and paramedic professions.,,
Toothbrush and toothpaste were the most prevalent modality of oral cleansing; our study documented its use in 66.0% of the respondents, which was comparable to the 70% reported by Kaira et al. but higher than the 54.5% reported by Gopikrishna et al. However, this result is lower than the 82% reported by Amith et al., similarly Baseer et al. reported that almost all respondents in their study used toothbrush and toothpaste for oral cleansing. However, isolated use of “teeth stick” (chewing stick) was documented in 3.1% of our respondents which is also less than the 10% reported by Baseer et al.
Routine change of toothbrush is an encouraged dental behavior; respectable dental bodies such as the American Dental Association  generally recommend changing toothbrush after every 3–4 months of usage; due to the effect of wear and tear, the brush bristles lose the ability to remove plaques on the teeth and gum, furthermore, the bacterial load on the surface of the brush bristle increases with prolonged use. The current study showed that 68% of the respondents changed their toothbrush/head within 3 months; this result is comparable to the 65% reported by Younus and Qureshi  however it was higher than the 55% reported by Amith et al. Furthermore, females routinely changed their toothbrush than males in our study; this was similar to that observed by Younus and Qureshi  and Oberoi et al. Females are more beauty conscious; and clean teeth and fresh breath adds to self-esteem and beauty. Therefore, it is not surprising to witness this among our female respondents. The frequency of brushing was at least twice in a day in 67% of the respondents; this observation was higher than the 50% reported by Kaur et al. but lower than the 100% reported by Pradhan et al., however 9.3% of our respondents brushed thrice in a day which was lower than the 22.5% reported by Kaira et al.
Dental floss was invented way back in 1819 by Levi Spear Parmly; use of dental floss prevents biofilm formation, it cleans areas that toothbrush will not reach; however, the use of floss was observed in only 14.3% of our respondents which was lower than the 75% reported by Walsh; however, it was similar to the report of Kaira et al. but higher than the 2% reported by Gopikrishna et al. Despite poor usage (47.4%) of mouthwash in our study, our result was similar to the report of Baseer et al. but higher than that reported (2%) by Gopikrishna et al.
Cleaning of the tongue was regularly done in 60.8% of the respondents in our study, however, this result is lower than that observed by Amith et al.
Majority of respondents were unaware of the impact of dental disease on the cardiovascular system; this observation exposes a knowledge gap, which could affect proper patient oral health education. This result differs from that reported by Oyetola et al. which documented that 64.5% of their respondents associated peridontitis with the risk of infective endocarditis.
Most respondents in the present study visited or at least referred their patients to see a dentist when necessary, this observation was similar to the findings of Baseer et al.; but, this was at variance to the observation of Oyetola et al. in which 61% of their respondents did not see the need for a dental visit.
Impressively majority of respondents in this study spent at least 4 min in brushing their teeth; which was similar to previous studies;, however, this had no significant relationship with use of dental care materials such as dental floss; therefore, this showed that despite the observed good oral hygiene behavior, there are still knowledge gaps and areas for improvement. Medical knowledge is dynamic; therefore, information on current oral care recommendations can easily be made available to the respondents through continuous medical education programs.
| Conclusion|| |
Commendable oral hygiene practices were observed among the respondents; however, there is knowledge gap which requires improvement such as in the use of dental floss. However, the absence of nurses in the dental unit which would have allowed for comparison is a limitation in this study.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Bokhari SA, Khan AA. Growing burden of noncommunicable diseases: The contributory role of oral diseases, Eastern Mediterranean region perspective. East Mediterr Health J 2009;15:1011-20.
Harris NO, Godoy FG. Primary preventive dentistry in hospital setting. In: Godoy FG, editor. Primary Preventive Dentistry. 6th
ed. New Jersy: Julie Levin Alexander Publisher; 2004. p. 605-36.
Khami MR, Virtanen JI, Jafarian M, Murtomaa H. Prevention-oriented practice of Iranian senior dental students. Eur J Dent Educ 2007;11:48-53.
Schwarz E, Lo EC. Dental health knowledge and attitudes among the middle-aged and the elderly in Hong Kong. Community Dent Oral Epidemiol 1994;22:358-63.
Kawamura M, Wright FA, Yamasaki Y, Iwamoto Y, Suh S. An analytical study on gender differences in self-reported oral health care and problems of Japanese employees. J Occup Health 1999;41:104-11.
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.
Amith HV, Audrey MD, Shahima S, Shanima S, Shazmi HD, Sheikh MM, et al
. Oral hygiene practices among paramedical staff of a private dental institution in India. RSBO 2013;10:205-10.
US Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General – Executive Summary. Rockville, MD: US Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health; 2000.
Chan EY, Hui-Ling Ng I. Oral care practices among critical care nurses in Singapore: A questionnaire survey. Appl Nurs Res 2012;25:197-204.
Rozier CK. Nurses executive characteristics. Gender differences. Nurs Manage 1996;27:33-7.
Ozdemir A, Akansel N, Tunk GC. Gender and career: Female and male nursing students' perceptions of male nursing role in Turkey. Health Serv J 2008;2:153-61.
Kaira LS, Srivastava V, Giri P, Chopra D. Oral health-related knowledge and practice among nursing students Rohilkland Medical College and Hospital. A questionnaire study. J Orofacial Res 2012;2:20-3.
Gopikrishna V, Bhaskar NN, Kulkarni SB, Jacob J, Sourabha KG. Knowledge, attitude, and practices of oral hygiene among college students in Bengaluru city. J Indian Assoc Public Health Dent 2016;14:75-9. [Full text]
Baseer MA, Alenazy MS, Alasqah M, Algabbani M, Mehkari A. Oral health knowledge, attitude and practices among health professionals in King Fahad Medical City, Riyadh. Dent Res J (Isfahan) 2012;9:386-92.
Younus A, Qureshi A. Tooth brush changing frequency and associated sociodemographic and oral hygiene factors among residents of Karachi. J Dent Oral Hyg 2016;8:4-11.
Oberoi SS, Mohanty V, Mahajan A, Oberoi A. Evaluating awareness regarding oral hygiene practices and exploring gender differences among patients attending for oral prophylaxis. J Indian Soc Periodontol 2014;18:369-74.
] [Full text]
Pradhan D, Kumar J, Shavi GR, Pruthi N, Gupta G, Singh D. Evaluating the oral hygiene knowledge, attitude and practices among dental and medical students in Kanpur City. Natl J Integr Res Med 2016;7:73-6.
Walsh MM. Effects of school-based dental health education on knowledge, attitudes and behavior of adolescents in San Francisco. Community Dent Oral Epidemiol 1985;13:143-7.
Oyetola EO, Oyewole T, Adedigba M, Aregbesola ST, Umezudike K, Adewale A, et al.
Knowledge and awareness of medical doctors, medical students and nurses about dentistry in Nigeria. Pan Afr Med J 2016;23:172.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]