The present study evaluated the oral and dental health knowledge and attitude of nursing students who are candidates for healthcare professionals. The most important limitation was the participants’ responses, which could be subjected to verification bias and be affected by social acceptability. Nevertheless, the results of present study will be useful in educational programs that aim to change students' approaches and attitudes towards oral and dental health.
In present study, questions about oral hygiene in children were answered correctly by both groups at similar rates in contrast to a previous study 8. The rate of brushing teeth two or more times a day was lower than Mohd-Dom et al. 9 and higher than Oyetola et al.10. It can be concluded that tooth brushing habits of the students taking the course were relatively better. These studies of well-educated young adults reflect much better oral hygiene behavior than the national average, as 15% of adults in a national study did not have a toothbrush, and only half of those with a toothbrush used it every day. In addition, it is stated that only 26% of people in our country brush their teeth two or more times a day 11. In present study, the oral hygiene behaviors of the nursing students were sufficient and the results of the students taking the course were similar to other studies 8,12,13. On the other hand, the use of dental floss and mouthwash was found to be lower in both groups compared to other studies 14,15. The effects of tooth brushing and flossing on caries prevention and nutrition on caries were perceived by both groups. As in the previous study, this may be related to basic nutrition courses 5. Although, it was stated that dental caries is a driving factor in going to the dentist 14-16, approximately 98% of the students in both groups stated that regular visits are necessary for oral and dental health, and this was higher than in other studies 17,18.
In present study, the use of fluorine-containing products in the prevention of dental caries was better known by the students taking the course. This was confirmed by Kim et al., but they stated that a lack of information was also observed 13. In the literature, the response rate regarding the role of fluoride in dentistry is considered low 14,19.
Sharda and Shetty 17 and Kılınç and Günay 20 concluded that the knowledge level of university students who received health education was higher than those who did not. In another study, it was stated that the lower oral health knowledge of medical students compared to dental students may be due to the absence of an oral health course. Therefore, oral health education should be included in the medical curriculum 21. This was confirmed by the results of the present study as the radiotherapy question, which is a more detailed question, was better known by the students taking the course.
In oral health services, it is essential to inform and guide mothers during pregnancy as the mother's oral hygiene has a significant impact on the child's future oral hygiene status 22. For this reason, midwives and nurses should have sufficient knowledge about dental problems that are common during pregnancy and early childhood 5. This was relatively well known to the students taking the course. Both groups stated that they would highly recommend a dental examination to mothers who gave birth. They also had more information about the gingival health of pregnant women, the importance of dental caries in pregnancy and primary tooth. However, both groups did not have sufficient information about the relation between oral health and general health, unlike the previous study 4. For this reason, these subjects should be included more in the course content.
Andhare et al. stated that oral health attitudes and behaviors were related to education 21. Therefore, the level of oral health can be improved with education programs for various professionals. The motivation of the next generation of professionals to maintain excellent oral health practices may be possible with the oral health motivation program that is part of the academic curriculum of universities and colleges 23. It was also stated that oral health education should be improved and strengthened as nurses and caregivers must be able to meet oral health standards 24. This was confirmed by a study in New Zealand that analyzed the effects of implementing the oral health curriculum on nurses' knowledge and concluded that most nurses had the right knowledge 25. Various studies have demonstrated that continuing and regular education programs help to provide comprehensive knowledge both in the short and long-term 26,27. In this respect, this study seems to be compatible with them.
While most children in many countries are not examined by a dentist before age 3, they are in frequent contact with primary care providers, including nurses, for routine checkups and vaccinations before age 1. These routine check-ups give healthcare professionals an opportunity to assess children's oral and dental health and refer them to the dentist when a disease is diagnosed. Therefore, it is crucial to train these healthcare professionals to enable them to provide appropriate advice and promote oral and dental health in the community 8.
Since the inclusion of oral and dental health education in healthcare curricula has been discussed all over the world 28, there is a need for further studies evaluating oral and dental health education in nursing in order to determine the content of the curriculum and to plan educational programs for the society.
As a result, the oral and dental health awareness increased among nursing students taking the “Community Oral and Dental Health” course. Since, the nurses are potential candidates for public health education and even oral health assessments, inclusion of this course in the nursing curriculum will increase public awareness and improve oral health.
Acknowledgement
We would like to thank all the participating students. The authors declare no competing interest.
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