Oral health in Russian young adults: A study on determinants of dental health, dental anxiety, and oral health-related quality of life in medical and dental students in North-West Russia

Abstract

Background: Dental caries and periodontal diseases are the most common oral diseases, affecting millions of people worldwide. These diseases are highly preventable; therefore any measures that promote oral health (OH) should be implemented at the community and individual level. Although programmes designed to prevent OH problems often focus on children, young adults aged 18-25 years are also an important target group for such programmes. Indeed, this age range comprises periods of biological, psychological, and social development and is a transition between adolescence and adulthood, when persons take responsibility for their health and may still change their health behaviour. Studying factors which may influence OH is extremely important to develop effective preventive programmes for young adults. In Russia, there is little information on OH and factors associated with OH in young adults. Thus, we conducted a study in a group of young medical and dental undergraduate students in North-West Russia. Objective: The study aimed to: i) investigate dental caries experience and determinants (socio-demographic factors, socioeconomic factors, and OH behaviour); ii) assess the prevalence of dental anxiety (DA) and to explore the association between DA and sociodemographic factors, socioeconomic factors, OH behaviour, general health, and OH; and iii) investigate how socio-demographic factors, socioeconomic factors, OH behaviour, selfreported OH characteristics, and clinically-assessed OH are related to OH-related quality of life (OHRQoL). Methods: This cross-sectional study included 474 medical and 333 dental undergraduate students of Russian nationality aged 18-25 years from the Northern State Medical University (NSMU), Arkhangelsk, North-West Russia. Information on socio-demographic factors, socioeconomic factors, OH behaviour, general health, and OH was obtained from a structured, self-administered questionnaire. Corah’s Dental Anxiety Scale (DAS) was applied to measure DA. OHRQoL was measured by the short version of the OH Impact Profile with 14 items. A clinical dental examination was performed to assess dental caries experience, Simplified Oral Hygiene Index, and Gingival Index. Dental caries experience was based on the decayed (D) missing (M) filled (F) teeth (T) index (DMFT index). Results: The prevalence of dental caries (DMFT >0) was 96.0%, overall mean DMFT index was 7.58 (DT 0.61, MT 0.12, and FT 6.84). Older age, being a female, high subjective socioeconomic status, and skipping tooth-brushing were associated with a higher DMFT index. DMFT index also increased among students who reported regular dental visits, and these students also had lower odds of being in the dental caries-free group. High DA (DAS score ≥ 13) was found in 13.7% and 2.2% of medical and dental students, respectively. Female sex, lower mother’s education, and poor self-assessed OH were associated with DA in medical students. Corresponding factors in dental students were female sex, irregular dental visits, infrequent tooth-brushing, pain in mouth, and number of missing teeth due to dental caries. More than half of the students (53.6%) reported low OHRQoL during the last 12 months. Female sex, rural place of childhood residence, poor self-assessed dental aesthetic, dissatisfaction with mouth and teeth, and a higher DMFT index, were all significantly, independently associated with low OHRQoL. Conclusions: High prevalence of dental caries and high DMFT index, with a dominance of FT, were found among our Russian medical and dental undergraduate students. The level of DA was higher in medical than in dental students. The study also showed that OH affects students’ quality of life. Public health measures should focus on promoting dental literacy, increasing knowledge on the prevention of dental diseases, and motivating good OH habits to improve OH and OHRQoL in young adults in North-West Russia