Research Article - Biomedical Research (2017) Volume 28, Issue 12
Influential factors on the quality of life and dental health of university students in a specific area
- *Corresponding Author:
- Dong-Il Chun
Department of Social Welfare
College of Humanities and Social Sciences
Kangwon National University
Republic of Korea
- Hye-Young Kim
Department of Dental Hygiene
College of Health Sciences
Kangwon National University
Republic of Korea
Accepted on May 05, 2017
Health is an important factor that determines a person’s quality of life, which is a major issue in the health and medical field. It is also used in different health-related quality-of-life parameters. This study was conducted by obtaining 130 Google-based self-administrative questionnaires from students in 3 departments of Kangwon National University. The correlation analysis regarding the level of interest on dental health and dental disease symptoms showed a significant correlation between the symptoms (e.g., infection, halitosis, and food stuck between the teeth) and level of interest. The subjects are more aware of the symptoms in advance due to an increased level of interest on their dental health. Tooth brushing instruction (TBI) education also had a significant correlation with the level of interest, as broader knowledge resulted in a higher awareness of dental health. It is necessary to integrate systematic dental health management during the university student’s term. In addition, dental health education is critical to the improvement of their dental health. Therefore, this study aims to improve the awareness on correct dental health concepts and the importance of introducing dental health education programs to university curriculums in order to improve their quality of life.
Dental health, Quality of life, TBI education, University students.
Health is the main factor that determines a person’s quality of life, which is a major issue in the health and medical field. It is used in various health-related quality-of-life parameters and serves as a part of the physical condition assessment, as well as the strategy and policy development aimed at promoting good health . As the income level improved along with a growing economy, the public became more interested on a life that satisfies their own standards rather than a life based on objective standards. Since raising the awareness of the university students on their quality of life has been established, it is necessary to induce health behavior change for the improvement of their health level and to eliminate health risk factors. Health promotion services, including physical examination, and the university’s effort to activate health education programs are necessary .
The university student’s term is a preparatory stage and a transition period from adolescence to adult. It is a very important period because it determines what a person is going to be as an adult; therefore, the awareness of maintaining a healthy life during this period is gradually becoming prevalent . The students are reluctant to receive dental treatment due to their dental diseases that have accumulated over the years. In addition, they are not financially independent. Irregular eating habits, smoking, and alcohol use can cause nutritional imbalance and negatively impact their dental health . According to Lee , 80.1% of the university students are in a subjectively poor dental health.
Dental problem is not only related to dental function state, but it is also correlated to the overall physical condition, sociality, confidence, and life satisfaction . Healthy habits that were established during adolescence, including the university student’s term, can determine their health behavior as an adult , and the ideal health behavior established during this period is known to affect their quality of life. Kim  also states that a good dental status corresponds to good mental health and high quality of life. The university student’s term serves as a preparation for becoming future leaders; therefore, their dental health is an important factor that will enable them to perform well in their studies, as well as gain physiological confidence and a healthy physique . Most of the previous studies conducted on the dental health problems of university students dealt with factors, such as smoking, alcohol, and diet, or assessed the awareness of a subjective dental health state [10-12]. However, there were only a few studies conducted on the quality of life that reflected dental health.
Therefore, this study investigates the quality of life of the university students in relation to dental health in order to raise the awareness and attention on dental health, seek strategies to improve the quality of life into a higher level, and provide fundamental data necessary for making national dental health policies.
Materials and Methods
Study subject and method
From March 2016 to April 2016, students in 3 majors at Kangwon University Dogye Campus answered a selfadministered Google-based survey on the quality of life related to dental health. The 135 questionnaires were obtained, and 130 questionnaires were selected for the analysis, excluding 5 that were left unanswered or omitted. We obtain consent for the information.
The questionnaires were reconstructed for the study objectives that referred to the previous studies according to the quality of life and dental health status of the university students. They were revised in order to supplement the study instruments used in the referred studies. The survey content consisted of sections on the subject’s general features, subjective dental health state and practice, dental disease symptoms, and dental healthrelated quality of life.
SPSS statistics program (ver. 19.0) was used for the statistical analysis. Frequency analysis was conducted on the general features. Pearson’s correlation coefficient was used for the correlation of the level of interest on dental health and dental health education, and the correlation of the level of interest on dental health and dental disease symptoms. Frequency analysis and descriptive statistics were used to understand the factors related to the quality of life in regard to dental health. In addition, multiple regression analysis was conducted in order to analyze the factors that are affecting the quality of life relevant to dental health.
For the general features shown in Table 1, the age distribution were ‘20 years old’ 37.5%, ‘21 years old’ 22.5%, ‘22 years old’ 15.8%, ‘23 years old’ 9.2%, ‘24 years old’ 10.8%, and ‘25+’ 4.2%. The distribution of age was 25% for ‘male students’ and 75% for ‘female students’. ‘Freshman’ showed the highest grade distribution of 43.3%, followed by ‘sophomore’ with 27.5%, ‘junior’ with 16.7%, and ‘senior’ with 12.5%. For the type of residence, ‘dormitory’ was ranked first with 85.8%, followed by ‘self-residence’ with 13.3%, and ‘home with family’ with 0.8%.
|Age||20 years old||45 (37.5)|
|21 years old||27 (22.5)|
|22 years old||19 (15.8)|
|23 years old||11(9.2)|
|24 years old||13 (10.8)|
|Type of residence||Dormitory||103 (85.8)|
|Home with Family||1 (0.8)|
Table 1. General features.
The level of interest on dental health according to dental health education experience
The level of interest on dental health has a significant correlation with tooth brushing training. The more experience the subject had with tooth brushing training, the more interest they had on dental health (Table 2).
|Dental Health Education Experience||Dental Health Level of Interest|
|Tooth Brushing Training Experience||Pearson correlation coefficient||1||.256**|
|Significance probability (both sides)||.005|
Level of Interest
|Pearson correlation coefficient||.256**||1|
Table 2. Tooth brushing training experience and level of interest on dental health.
Correlation of level of interest on dental health and dental disease symptoms
The correlation analysis result of the subject’s level of interest on dental health and dental symptoms showed that a higher interest on dental health would reduce the experience of soreness or pain due to inflammation in the mouth, the experience of having a bad breath, and the experience of having a foreign object between the teeth. It shows that a person will notice the symptoms earlier if there is a high level of interest on dental health (Table 3).
|Dental Health Level of Interest||Experience of Soreness or Pain due to Inflammation in the Mouth||Experience of Having a Bad Breath||Experience of Having a Foreign Object Between the Teeth|
|Dental Health Level of Interest||Pearson correlation coefficient||1||-.196*||-.229*||-.199*|
|Significance probability (both sides)||.032||.012||.029|
|Experience of Soreness or Pain due to Inflammation in the Mouth||Pearson correlation coefficient||-.196*||1||.490**||.563**|
|Significance probability (both sides)||.032||.000||.000|
|Experience of Having a Bad Breath||Pearson correlation coefficient||-.229*||.490**||1||.611**|
|Significance probability (both sides)||.012||.000||.000|
|Experience of Having a Foreign Object Between the Teeth||Pearson correlation coefficient||-.199*||-563**||.611**||1|
|Significance probability (both sides)||.029||.000||.000|
Table 3. Dental health awareness and dental health level of interest.
Dental health symptoms and dental health-related quality of life
Various dental disease symptoms and dental function levels related to the quality of life were examined. As shown in Table 4, a higher score means that the dental disease symptoms are severe and the dental function is poor. While most of the subjects had good dental health condition, the most frequent dental symptoms were ‘bad breath’ (Mean=2.050), followed by ‘chilling sensation when gargling or rinsing with cold water’ (Mean=2.242), and ‘bleeding when brushing the teeth’ (Mean=1.992).
|Dental health-related quality of life||4.518||.613|
|Biting or chewing difficulty||1.475||.898|
|Bleeding when brushing the teeth||1.992||.912|
|Gap between the teeth||1.267||.730|
|Chilling sensation when gargling or rinsing with cold water||2.242||.953|
|Pain or discomfort when opening the mouth||1.675||1.014|
|Gum or candy use due to dry sensation in the mouth||1.233||.695|
Table 4. The correlation of the dental health symptoms and the dental health-related quality of life.
Factors affecting the dental health-related quality of life
A regression analysis on different factors, including the function factor, were conducted as independent variables in order to examine what influences dental health-related quality of life. As shown in Table 5, the model fit (F=19.789, p<0.01) was acceptable and its ability to account for the model was 63.5%. The function factor had a statistically significant influence with less than 0.05 significance level. The dental health-related quality of life was reduced based on the following results: ‘Gap between the teeth’ (β=-.345), ‘gum or candy use due to dry sensation in the mouth’ (β=-.202), ‘bad breath’ (β=-.198), ‘chilling sensation when gargling or rinsing with cold water’ (β=-.145), and ‘pain or discomfort when opening the mouth’ (β=-.131). This indicates that the dental health-related quality of life negatively influences the quality of life via factors on dental function.
|Information on caries||-0.096||0.073||-0.076||-1.32||1.081|
|Loss of teeth||-0.193||0.111||-0.105||-1.733†||1.186|
|Dental disease symptoms|
|Biting or chewing difficulty||-0.064||0.049||-0.094||-1.318||1.658|
|Bleeding when brushing the teeth||-0.067||0.044||-0.099||-1.522||1.38|
|Gap between the teeth||-0.29||0.06||-0.345||-4.861 ***||1.643|
|Chilling sensation when gargling or rinsing with cold water||-0.093||0.044||-0.145||-2.138*||1.504|
|Pain or discomfort when opening the mouth||-0.079||0.038||-0.131||-2.092*||1.279|
|Gum or candy use due to dry sensation in the mouth||-0.178||0.061||-0.202||-2.899**||1.579|
|†p<0.1, *p<0.05, **p<0.01, ***p<0.001|
Table 5. Factors affecting the dental health-related quality of life.
In the past, the connection between dental health and physical condition was irrelevant. However, recent studies showed that people are becoming more aware of the effects of dental health on the improvement of their quality of life. Quality of life is influenced by the satisfaction and happiness felt subjectively by an individual through social relations and complexities, such as psychological state and physical health . Wilson and Cleary  stated that dental symptoms can influence dental function, determine the subjective dental health state, and eventually affect the quality of life. Many advanced countries are researching and developing questionnaires related to the quality of life and dental health in order to provide a high-quality life to their citizens [15-17]. For this reason, dental health is a critical determining factor for the quality of life.
University students are invaluable individuals who are in charge of their future, and it is important that they become aware of their health as individuals who are establishing independence from their parents . In the case of university students who are searching for a job, they have an increased level of interest on their physical appearance, and they experience stress from factors affecting their job searching, such as qualifications, career maturity, and job search stress . Furthermore, they are experiencing interpersonal stress, which originated from the psychological separation from their parents and their friends, and ego stress . These stressors make them reluctant to receive dental care, thus resulting in dental symptoms, such as dental caries and periodontal diseases . Systematic dental health education and management is critical, as irregular nutrition and diet substantially influences the dental health of the university students. Although dental health education for dental health improvement is needed, students are often busy with majororiented classes. Awareness on dental health at this stage will affect their dental care behaviors, and it will also influence their long-term dental health . Although many previous studies were conducted on geriatric dental health and their quality of life [23,24], only a few studies were conducted on university students. Studies on the dental health of the university students will bring about a better understanding of their general dental health and quality of life. They are also expected to provide health education programs for the university students. This study emphasizes the significance of dental health awareness and dental health education on university students, and it provides an opportunity to improve their quality of life.
As a result of examining the correlation between the students’ dental health education experience and the level of interest on dental health, more experience with dental health education showed a higher level of interest on dental health. Bakdash  emphasized the necessity of motivation in establishing a dental health education program, and stated that the selfmotivated interest in dental health is crucial to its success. Dental health awareness of primary school students with school-based dental health office was higher than that of schools without the facility , which is similar to the result of this study. Likewise, Baek’s study  showed that the selflevel of interest on dental health has significantly increased following the dental health education given to occupational nurses. This result demonstrates that dental health education gives a substantial influence to the level of interest on dental health care and disease prevention of adults. For this reason, it is necessary for the government to actively support the university students, whose transition to adulthood is in progress, in becoming aware of dental health care.
As a result of examining the correlation between dental disease symptoms and the level of interest on dental health, a higher level of interest on dental health means a higher awareness on self-care practices. Moreover, the higher level of interest on dental health was correlated with a higher level of awareness to the prevention of dental diseases . These are similar to the results in this study, and the interest on dental health is expected to influence self-care practice on dental health and disease prevention. It is previously reported that dental diseases can negatively affect a person’s quality of life . Steele et al.  reported that an individual with more than one type of dental disease may experience a lower quality of life. In the multiple regression analysis conducted in this study to understand the factors of dental health awareness that influence the quality of life, more incidence rate of events, such as gap between the teeth, gum or candy use due to dry sensation in the mouth, bad breath, chilling sensation when gargling or rinsing with cold water, and pain or discomfort when opening the mouth, were related to a lower quality of life. This implies that the dental health-related quality of life is affected by factors regarding dental function. It has a negative impact on a person’s quality of life, as the functional factor of the teeth continues for a long period of time.
Fernandes et al.  also reported that dental health education and dental disease symptoms are in close relation with dental health-related quality of life. A higher interest on dental health means that the individual is becoming more interested in an active dental health care and a faster recognition of the symptoms, thereby leading to a high dentist’s office visit rate. Therefore, a specialized and systematic dental health education is highly required for the prevention and the early treatment of dental disease. However, the limitation of this study is in some areas. The actual research design may investigate a more thorough region of the college group's in the future work.
This study was conducted a person’s quality of life, which is a major issue in the health and medical field from students in 3 departments of Kangwon National University. The subjects are more aware of the symptoms in advance due to an increased level of interest on their dental health. Tooth brushing instruction (TBI) education also had a significant correlation with the level of interest, as broader knowledge resulted in a higher awareness of dental health. It is also recommended that the university students’ interest on their dental health is improved by providing dental health educational opportunities in order to ensure a healthy adulthood.s
- Sohn AR, Yoon JT, Ko SD, Chun SS. Health-related quality of life assessment by socio-demographic characteristics and mental health among Seoul citizens. Korean J Health Promot 2010; 27: 141-152.
- Park NS. Development of comprehensive health promotion policies for university students. Korean J Health Promot 2011; 28: 17-34.
- Hong SR. Perceptions of the self-efficacy of youth and subjective quality of life. J Korean Med Assoc 2011; 29: 71-87.
- Han MJ, Cho HA. Dietary habit and perceived stress of college students in Seoul area. J Korean Soc Food Cult 1998; 13: 317-326.
- Lee SM. A study on factors associated with the oral health promotion behaviors of college students. J Dent Hyg Sci 2006; 6: 187-192.
- Halboub E, Othathi F, Mutawwam F, Madkhali S, Somaili D, Alahmar N. Effect of social networking on academic achievement of dental students, Jazan University, Saudi Arabia. East Mediterr Health J 2017; 22: 865-871.
- Park HJ, Lee MJ, Kim SK, Jeong M. Effects of health practices and oral health behaviors on obesity in university students. Jour of KoCon.a 2011; 11: 395-406.
- Krops LA, Jaarsma EA, Dijkstra PU, Geertzen JH, Dekker R. Health-related quality of life in a Dutch rehabilitation population: Reference values and the effect of physical activity. PLoS One. 2017; 12: 0169169.
- Lee JS, Yoon YM, Lee HS, Kim SN. Restricted activity with oral disease in a Korean university student. J Korean Acad Dent Health 2001; 25: 245-258.
- Kim SH, Jang JH, Park YD. The relationship of smoking behaviors to perceived oral health among university students. J Dent Hyg Sci 2005; 5: 139-143.
- Kim YB. An analysis on the change of health status, health behavior, and influencing factors among American college and university students. Korean J Health Promot 2010; 27: 153-163.
- Kim JH, Oh HS, Min SH. Health life behavior and perceived stress of university students. J East Asian Soc Dietary Life 2004; 14: 207-216.
- Whoqol Group. The World Health Organization Quality of Life Assessment (WHOQOL): Position paper from the World Health Organization. Soc Sci Med 1995; 41: 1403-1409.
- Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA 1995; 273: 59-65.
- Robinson PG, Gibson B, Khan FA, Birnbaum W. A comparison of OHIP 14 and OIDP as interviews and questionnaires. Community Dent Health 2001; 18: 144-149.
- Lawrence HP. Cross-cultural perceptions of oral health and oral-health-related quality of life. Community Dent Health 2001; 18: 207-208.
- Grath CM, Bedi R, Gilthorpe MS. Oral health related quality of life--views of the public in the United Kingdom. Community Dent Health 2000; 17: 3-7.
- Han YS, Lee GY, Lee JY, Kim HY. Factors of oral health-related quality of life among college students. J Korean Soc Sch Health 2014; 15: 51-61.
- Jeon MJ, Jung SE, Cho SH, Han EJ, Hyeon JW, Kim SH. The relationship between self-esteem and employment, appearance of university students in some regions. J Dent Hyg Sci 2015; 15: 518-526.
- Ahn SA, Sim MY. A study on the mediation effects of depression and self-efficacy on college students' stress and subjective happiness. J Korean Acad Indust Coop Soc 2015; 16: 7021-7033.
- Lee DH, Koo MJ, Lee SM. A study on the evaluation of oral health-related quality of life of high schoolers in some regions. J Dent Hyg Sci 2009; 9: 109-113.
- Kim YH. Comparative study of the students' oral health knowledge and behavior between the elementary schools with or without dental clinic. Jour of KoCon.a 2012; 12: 361-368.
- Ryu KJ, Lee TY, Kim KY. A study on oral health-related quality of life of among elderly in metropolis. J Korean Soc Dent Hyg 2009; 9: 620-632.
- Park JH, Jeong SH, Lee GR, Song KB. The impact of tooth loss on oral health-related quality of life among the elderly in Seongju. Korea. J Korean Acad Dent Health 2008; 32: 63-74.
- Bakdash MB. Patient motivation and education: a conceptual model. Clin Prev Dent 1979; 1: 10-14.
- Choi SL, Kwun HS, Song KB, Lee JH, Kang HK, Choi, JM. Effects of school-based oral health programs among schoolchildren: Focus on the oral health knowledge and behaviors. J Korean Soc Dent Hyg 2006; 6: 455-467.
- Lee HY, Paik DI. Effects of oral health education for occupational health nurses. J Dent Hyg Sci 2016; 16: 77-83.
- Han SY, Song KS, Ryu DY. Oral health concern and oral healthcare recognition of some soldiers. J Korean Soc Dent Hyg 2012; 12: 1007-1015.
- Ng SK, Leung WK. Oral health-related quality of life and periodontal status. Community Dent Oral Epidemiol 2006; 34: 114-122.
- Steele JG, Sanders AE, Slade GD, Allen PF, Lahti S, Nuttall N, Spencer AJ. How do age and tooth loss affect oral health impacts and quality of life? A study comparing two national samples. Community Dent Oral Epidemiol 2004; 32: 107-114.
- Fernandes MJ, Ruta DA, Ogden GR, Pitts NB, Ogston SA. Assessing oral health-related quality of life in general dental practice in Scotland: validation of the OHIP-14. Community Dent Oral Epidemiol 2006; 34: 53-62.