DOI: https://doi.org/10.53350/pjmhs221610274 ORIGINAL ARTICLE 274 P J M H S Vol. 16, No. 10, October, 2022 Oral Health Related Habits, Knowledge, and Frequency of Dental Floss use among Undergraduate Medical and Dental Students in a Public Health Sector University in Pakistan: A Comparative Study HINA SHAH 1 , SANAA AHMED 2 , SADAF TALHA 3 , SUMBUL AYAZ 4 , TALHA BIN SAEED 5 , MARIUM IRSHAD 6 1 BDS, MDS, CHPE, Assistant Professor, Community & Preventive Dentistry, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi 2 BDS, MS (OMFS), MHPE, Assistant Professor Oral Medicine, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi 3 BDS, FCPS part II Trainee Orthodontics, Liaquat College of Medicine and Dentistry 4 BDS, Lecturer Community & Preventive Dentistry, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi 5 BDS, MCPS Trainee, Department of Dentistry, Pakistan Telecommunication Company Limited, Karachi 6 BDS, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi Correspondence to: Hina Shah, Email: shahhina052@gmail.com, Cell: 0315 8750511 ABSTRACT Objective: The current study aimed to evaluate oral health related habits, knowledge, and frequency of dental floss use among undergraduate medical and dental students. Methods: A cross-sectional study was undertaken at two institutes, Sindh Institute of Oral Health Sciences (SIOHS) and Sindh Medical College (SMC) of Jinnah Sindh Medical University (JSMU), Karachi, Pakistan, between March to May 2022. All undergraduate medical and dental students irrespective of gender, cast, creed, or socioeconomic status were eligible to partake in the study. The data on demographics including the age, gender, primary way of cleaning teeth, frequency of dental flossing, general oral health habits, assessment of knowledge of interdental cleaning aids etc. were recorded in a structured questionnaire. Results: The majority of the students acknowledged the importance of the role of students in promoting dental floss use among the community. Years of study in Bachelor of Dental Surgery (BDS) students was significantly associated with cleaning frequency (p < 0.0001) and primary cleaning method (p = 0.001). Interdental cleaning aid awareness, frequency of interdental cleaning, issues from not cleaning the interdental spaces, the role and use of dental floss were all significantly correlated with year of study among BDS students. Use of secondary methods was significantly associated with years of study among Bachelor of Medicine, Bachelor of Surgery (MBBS) students (p < 0.001). Conclusion: The present study concluded that years of study significantly correlated with the knowledge, awareness, and habits of dental students with respect to dental flossing. Keywords: dental hygiene, dental floss, interdental cleaning, oral health, dentist, medicine INTRODUCTION The most common chronic oral health conditions affecting the global population include dental caries and periodontal diseases like gingivitis and periodontitis. The World Health Organization’s fact sheet on oral health describes oral diseases as mostly preventable. Dental caries i.e. tooth decay resulting from plaque formation affects 2 billion adults and around 500 million children around the world. Dental caries result from inadequate plaque removal which provides an optimal environment for bacteria to grow and convert ingested sugars into acids causing enamel damage leading to local infections, systemic complications, psychosocial issues and eventual tooth loss. 1-3 Several national studies have concluded that dental caries is extremely prevalent in Pakistan affecting people of all age groups. 4 These findings have been further solidified within reports presented by the World Health Organization (WHO) on this matter. As a consequence, inter-dental caries and periodontal diseases are also widespread. Prevalence of the latter is documented to be 98% as per the National Oral Health Survey with advanced severe periodontitis at 31%. 5 These staggering statistics necessitate further investigation into the preventive oral hygiene and healthcare practices of the general population. Students of undergraduate programs in medicine and dentistry are the foundation of the country’s future healthcare system and as such are expected to follow the best preventive oral healthcare practices. They are also expected to endorse these practices and educate the population on oral health. As expected the literature suggests that dentistry students exhibit better knowledge and practices with regards to oral hygiene indicating the importance of education being imparted. Yao, Ke et al. conducted a cross-sectional study on oral hygiene practices and oral health amongst medical and dental students and found a dire lack of best practices and knowledge especially among medical students. 6 Munz, Stephanie M et al. also found similar results with their study. Dental students had overall better knowledge and practice when compared to medical students of the same academic year and both knowledge and practice of oral hygiene improved as both sets of students progressed academically. 7 Naseem, Sajida et al. showed the lack of proper cleaning technique used by medical students. 7 The benefits of dental floss in reducing caries and thus improving health outcomes is supported by the literature, especially when paired with regular tooth brushing with proper technique. 8,9 Interdental plaque removal with regular flossing theoretically prevents interdental caries and thus periodontal disease. Hujoel, P P et al. report no substantial benefit of self- flossing in adolescents but did report benefit of flossing done by a professional in children. 10 This study aims to investigate the knowledge and oral hygiene practices of undergraduate medical and dental students with emphasis on dental flossing and presence of interdental caries. The study further compares the two groups and discusses the relevance of education and its impact on the quality of preventive oral hygiene practices. This information can prove beneficial in establishing the importance of flossing and in introducing reforms to better oral health education and ultimately oral health itself. The study aimed to evaluate oral health related habits, knowledge, and frequency of dental floss use among undergraduate medical and dental students in a public health sector university in Pakistan. METHODS AND MATERIAL A cross-sectional study was undertaken at two institutes, Sindh Institute of Oral Health Sciences (SIOHS) and Sindh Medical College (SMC) of Jinnah Sindh Medical University (JSMU), Karachi, Pakistan, between March to May 2022, after approval from the Institutional review board of JSMU. For the enrollment of participants, a non-probability convenience sampling technique was employed. For sample size estimation, select statistics electronic software was used. Knowledge regarding flossing was reported to be 87.14% among