INTRODUCTION
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Oral health is a state of being free from mouth and facial pain, oral sores and infections, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual\'s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing.^[@R1]^ Dental care is an important aspect of oral health which deals with the maintenance of healthy teeth and it is an important aspect of general oral health. The mouth is the major gateway to the body hence, oral health is essential to the general health and quality of life.^[@R2]^

The practice of regular dental care, otherwise known as oral hygiene, helps in keeping the mouth and teeth clean in order to prevent dental diseases.^[@R3]^ Basic dental care involves brushing and flossing of the teeth regularly, seeing a dentist for regular checkups and cleanings. In a broader perspective, oral hygiene is the practice of keeping the mouth and teeth clean to prevent dental problems, most commonly, dental cavities, gingivitis, periodontal (gum) diseases and bad breath.^[@R1],[@R4]^

Oral care practices such as brushing with fluoride toothpaste, dental flossing, regular dental checkup including cleaning the teeth professionally at least twice a year, are recommended measures for maintaining good oral health.^[@R5]^ Studies by Kempe et al. showed that poor oral hygiene, such as not brushing, not flossing, or not rinsing enough can lead to gum disease and tooth decay.^[@R6]^ The longer food particles are allowed to stay in the mouth, the greater the chance of decay. So the mouth should be rinsed immediately after eating, especially sugary substances to prevent the formation of plaque.^[@R7]^

In a study conducted by Ogunrinde et al., it was documented that students and adolescents in Nigeria faced challenges regarding their oral health because of the daily high consumption of sugary foods and drinks, which predisposed them to dental caries and periodontal disease coupled with poor oral hygiene. ^[@R8],[@R9]^ According to Akpata, dental caries constitutes one of the major oral health problems with its prevalence as high as 20 to 45% among school children and adolescents in Nigeria.^[@R10]^ Periodontal diseases was found in 15-58% in those aged above 15 years, while a national survey involving 7630 persons from the 6 geo political zones in Nigeria reported that only 26.4% had visited the dentist, 10.5%, used dental floss and 42.0% brushed twice daily.^[@R11]^

It is recommended that the teeth be brushed regularly with tooth brush using fluoride containing toothpaste at least twice a day in order to prevent dental caries and maintain good oral hygiene.^[@R12]^ However, there is limited data on dental care practices among undergraduate students especially of private institutions in Nigeria. This study was therefore designed to provide baseline data on the dental care practices among undergraduate students of Adeleke University, Osun State, Nigeria.

MATERIALS AND METHODS
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Study area
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This study was conducted in Adeleke University, Ede, Osun State. Adeleke University (AU) is situated in an ambient and serene environment at Ede, Osun State, Nigeria. The University has six faculties and twenty departments. These faculties are; Faculty of Business and Social Sciences (FBSS), Faculty of Arts (FOA), Faculty of Science (FOS), Faculty of Law (FOL), Faculty of Engineering (FOE) and Faculty of Basic Medical Sciences (FBMS). The departments are; Accounting, Business Administration, Economics, Library and Information Science, Mass Communication, Political Science and Public Administration, History and International Studies, English Language and Literary Studies, Religious Studies, Microbiology, Biochemistry, Computer Science, Computer Information Science (CIS), Law, Agricultural Engineering, Civil Engineering, Electronic and Electrical Engineering, Mechanical Engineering, and Public Health, Nursing, Anatomy and physiology.

Study design
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This was a cross sectional study.

Study participants
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Three hundred and seventy-five undergraduate students participated in the study.

Sampling technique
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Stratified random sampling was used to select study respondents. Each faculty represented a stratum and proportional allocation was employed to determine the copies of questionnaire to be distributed in each faculty.

Methods of data collection and data collection tools
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Quantitative method of data collection was employed and data was collected using a semi structured selfadministered questionnaire.

Data analysis
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Data was inspected, cleaned, checked for completeness and entered into the computer using Statistical Package for Social Sciences (SPSS) version 21. A total of 11 questions covering dental practices were asked and every correct answer was scored 1 and every wrong answer was scored 0. The mean score was computed and respondents scoring below the mean were classified as having poor dental care practice while respondents who had scores above the mean were classified as having good dental care practice. The results were presented using proportions, tables and charts. Chi squared test was used to test for associations and level of significance was set at 5%.

RESULTS
=======

Three hundred and seventy-five respondents participated in the study. Socio-demographic information of respondents is shown in Table [1](#T1){ref-type="table"}. Respondents aged 20 to 24 years constituted 54.4% of respondents. Forty-one percent of the respondents were aged 15 to 19 years, 4.5% of the respondents were aged 25 to 29 years. The mean age of respondents was 20.18±2.61 years. About fifty one percent (50.7%) female students. Most of the respondents (70.4%) were Christians. Respondents who were of Yoruba ethnicity constituted 62.7% of the respondents. The majority of the respondents (96.3%) were never married.

Respondents\' practice of dental care
-------------------------------------

Respondents\' practice of dental care is shown in Table [2a](#T2a){ref-type="table"}. Half of the respondents (53.6%) brushed morning and night, 44.5% brushed only in the morning and 5% brushed only at night. Almost eighty percent (79.2%) of the respondents used toothpick to remove food debris from in-between the teeth, 11.7% of the respondent made use of broomstick and only 9.1% made use of dental floss.

A total of 62.9% of the respondents had heard about dental floss, while 37.1% had never heard about dental floss. About half (54.7%) of the respondents had ever visited a dentist for treatment and examination of their mouth, while 45.3% had never visited a dentist.

Majority of the respondents (96.3%) used tooth brush and tooth paste to brush their teeth while 1.6% used chewing stick. A total of 50.4% of the respondents made use of fluoridated tooth paste. This is shown in table [2b](#T2b){ref-type="table"}.

Figure [1](#F1){ref-type="fig"} showed 68.5% of the respondent never visited a dentist the previous year while 16.8% visited only once.

Factors associated with good dental care practice
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Table [3](#T3){ref-type="table"} shows the bivariate analysis of respondents\' sociodemographic characteristics and dental practice. Respondents who were singles had good dental practice compared to respondents that were married (p\>0.05). Those of the Yoruba ethnicity had good dental practice compared to the other ethnic groups p\>0.05.

DISCUSSION
==========

This study documented baseline data on dental care practices among Adeleke University undergraduate students.

This study showed that half of the respondents brushed their teeth twice daily. This proportion is just slightly higher than the report documented by Olusile et al ^[@R11]^ in a study among adults in Nigeria which stated that 42% of the respondents reported brushing their teeth twice daily. However, the result is much higher than 8.1% of respondents who brushed twice daily as reported in a study by Braimoh in a study on oral self-care practices among university students in Port Harcourt and 14.6% reported by Kumar in a study on oral awareness among college students in India.^[@R13].[@R14]^

This could be because students rush through the routine of cleaning the mouth and teeth because of their class schedule and at the end of the day, they get so tired that they don\'t bother to clean the teeth after dinner. Most of the respondents used toothbrush and toothpaste as oral hygiene tools. This is similar to the study by Ogunrinde et al on dental care knowledge and practice among adolescents which showed that 93.0% of the respondents used tooth brush and paste and also the study by Olusile et al which documented that the vast majority of the study respondents used toothbrush and toothpaste as oral hygiene tools.^[@R8],[@R11]^

More than half of the respondents never visited a dentist the year prior to the survey. This is similar to a study by Sofola et al where majority of the respondents never visited a dentist and also in a study by Okoye et al where over half of the respondents never visited a dentist. Similarly, a national study documented that less than 20% Nigerians visit a dentist. ^[@R15],[@R16],[@R17]^

About two fifth of the respondents (44.0%) used medium bristles, 26.9% used soft bristles and 19.5% used hard bristles. The proportion of respondents who used medium and hard bristles in this report is slightly lower than what was documented in a study by Braimoh et al on oral self-care practices among university students which stated that 52.2% of his respondents used medium bristles, 30% used hard bristles. However, more respondents used soft bristles in our report as compared with the study by Braimoh (17.5%).^[@R13]^

About 50.4% of the participants used fluoridated toothpaste, 17.3% used toothpastes without fluoride while 32.3% were not sure if the toothpaste they use contained fluoride. This report showed that more than half of the respondents were aware of the fluoride content of the toothpaste they used unlike in a study by Adeyemi et al which documented that 20% of the study respondents used fluoride-containing toothpastes, 10.5% used toothpastes without fluoride while more than half (69.6%) of the respondents were not sure if the toothpaste they used contain fluoride.^[@R18]^ Only 9.1% of the respondents used dental floss out of 62.9% that had heard of dental floss. This is similar to a report by Braimoh et al in a study among university students in Port Harcourt which documented that 6% of the respondents used dental floss; however, this report is lower than 19% reported by Ayanbadejo in a study among College of Medicine students. ^[@R13],[@R19]^ This could probably be because the College of Medicine students had access to information and better knowledge about dental care practices through their field of study.

CONCLUSION
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This study revealed that the practice of dental hygiene among undergraduate students of Adeleke University is inadequate. In view of the importance of good dental hygiene and the poor health impact of dental problems, we recommend that the university medical center should provide the students with dental health education in order to instill good dental hygiene information and practice in the students.

![Respondents\' visit to the dentist a year prior to the study](AIPM-17-24_F1){#F1}

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Socio-demographic information of respondents

  Variables                                        Frequency (%)
  ------------------------------------------------ ---------------
  **Age (years)**                                  
  15-19                                            154(41.1)
  20-24                                            204(54.4)
  25-29                                            17(4.5)
  Mean age (years)                                 20.18±2.61
  **Sex**                                          
  Male                                             185(49.3)
  Female                                           190(50.7)
  **Religion**                                     
  Islam                                            100(26.7)
  Christianity                                     264(70.4)
  Tradition                                        11(2.9)
  **Tribe**                                        
  Yoruba                                           235(62.7)
  Ibo                                              89(23.7)
  Hausa                                            51(13.6)
  **Marital status**                               
  Single                                           361(96.3)
  Married                                          14(3.7)
  **Faculty**                                      
  Faculty of Basic Medical Science (FBMS)          77(20.5)
  Faculty of Business and Social Sciences (FBSS)   144(30.4)
  Faculty of Art (FOA)                             36(9.6)
  Faculty of Engineering (FOE)                     26(6.9)
  Faculty of Law (FOL)                             20(5.3)
  Faculty of Science (FOS)                         102(27.2)

###### 

Practice of dental care

  Variables                                                              Frequency (%)
  ---------------------------------------------------------------------- ---------------
  **When do you brush?**                                                 
  Morning                                                                167(44.5)
  Night                                                                  2(0.5)
  Afternoon                                                              5(1.3)
  Morning and night                                                      201(53.6)
  **What do you use to remove food debris in-between your teeth?**       
  Toothpick                                                              297(79.2)
  Broomstick                                                             44(11.7)
  Dental floss                                                           34(9.1)
  **Have you ever heard of dental floss?**                               
  Yes                                                                    236(62.9)
  No                                                                     139(37.1)
  **If yes to the above question, how often do you floss your teeth?**   
  Always                                                                 24(6.4)
  Often                                                                  51(13.6)
  Sometimes                                                              161(42.9)
  **How often do you use a mouth wash?**                                 
  Always                                                                 68(18.1)
  Sometimes                                                              235(62.7)
  Never                                                                  72(19.2)
  **Ever visited a Dentist**                                             
  Yes                                                                    205(54.7)
  No                                                                     170(45.3)
  **If yes to the above, how often do you visit a dental clinic?**       
  Once in 6 month                                                        12(3.2)
  Once in a year                                                         33(8.8)
  Twice in a year                                                        28(7.5)
  Only when I have complaint                                             132(35.2)

###### 

Practice of dental care

  Variables                                                   Frequency (%)
  ----------------------------------------------------------- ---------------
  **What do you use to brush your teeth?**                    
  Tooth brush and tooth paste                                 361(96.3)
  Chewing stick                                               6(1.6)
  Tooth brush and chewing stick                               3(0.8)
  Cotton wool/paste                                           5(1.3)
  **If you use toothbrush, what kind of brush do you use?**   
  Soft bristles                                               101(26.9)
  Medium bristles                                             165(44.0)
  Hard bristles                                               73(19.5)
  Very hard bristles                                          23(6.1)
  Don\'t know                                                 13(3.5)
  **Do you make use of fluoridated toothpaste?**              
  Yes                                                         189(50.4)
  No                                                          65(17.3)
  Don\'t know                                                 121(32.3)

###### 

Bivariate analysis of socio-demographic characteristics and dental care practice

  Variables            Dental Practice   X^2^          P value   
  -------------------- ----------------- ------------- --------- -------
  **Sex**                                                        
  Female               50 (47.6%)        135 (50.0%)   0.171     0.679
  Male                 55 (52.4%)        135 (50.0%)             
  **Age**                                                        
  15-19                50 (47.6%)        104 (38.5%)   2.604     0.272
  20-24                51 (48.6%)        153 (56.7%)             
  25-29                4 (3.8%)          13 (4.8%)               
  **Religion**                                                   
  Islam                26 (24.8%)        74 (27.4%)    4.961     0.084
  Christian            79 (75.2%)        185 (68.5%)             
  Tradition            0 (0.0%)          11 (4.1%)               
  **Tribe**                                                      
  Yoruba               64 (61.0%)        171 (63.3%)   2.878     0.411
  Ibo                  22 (21.0%)        67 (24.8%)              
  Hausa                19 (18.0%)        32 (11.9%)              
  **Marital status**                                             
  Single               101 (96.1%)       260 (96.2%)   0.740     0.691
  Married              1(1.0%)           5 (1.9%)                
  Divorced/Separated   3(2.9%)           5 (1.9%)                
