College Student’s Brushing and Eating Habits

Taylor Ashley Hajcak

Technology and Assessment Health & Exercise Science

Professor Powell

Rowan University

Background and Literature Review

The purpose of this program was to educate college students on the importance of daily

dental homecare and reduced sugar intake and fast food consumption and give the students the

tools they need to make healthy decisions regarding their oral health. Oral health is an important

part of whole body health and the consequences of inadequate home care can have a painful and

costly outcome. In rare instances tooth infection can cause death as seen in 2007 when a young

boy from Maryland died when a tooth abscess spread to his brain (Felland, 2008). To give you

an idea of how oral hygiene can impact a person’s life, consider the following information; in the

United States 51 million school hours are missed because of dental related illnesses (Jackson,

2011). According to the National Institute of Health, 67% of adolescents age 16-19 and 86 % of

adults ages 20-34 have had dental caries (tooth decay) in their permanent teeth, not to mention

that 20% of 16-19 year olds and 28% of 20-34 year olds currently have untreated dental caries

(NIDCR,2014). The fact that college students overlap these two age groups is an indication of

what is in store for them. The trend seems to follow that the older you get the higher the risk of

dental caries increases.

College students are at risk for getting dental caries because they are often overwhelmed,

over stressed or just plain tired and they do not always have the time or the energy to brush their

teeth before they go to bed. This is the first time they are living on their own and left to fend for

themselves and they develop habits and behaviors that may last a lifetime. These habits can be

healthy or unhealthy depending on what they deem important at the time. Many college students

develop poor dietary habits while away from home including consuming unhealthy foods and

high sugary beverages. These unhealthy behaviors in addition to being overwhelmed or too tired

to brush their teeth can have a negative impact on a student’s dental health. A regular soda can

have 17g of sugar and sipping it throughout the day can influence a person’s dental health

(Luebke, 2009). Drinking one or more sodas a day can negatively affect your oral health because

constant sugar attack on your teeth can lead to tooth decay. Poor dietary and oral hygiene habits

during the college years can set the stage for habits later in life. The transformation from

adolescence to adulthood is an emotional and stressful time. It is also a time when lifelong

behavioral patterns are developed that could affect their long-term health. The college years are

a key time to help students modify these behaviors and develop healthy habits that could help

prevent long term health issues and chronic disease risk.

In a study by Small et al it was found that college students consumed less than 3

servings of fruits and vegetables per day and drank at least one sugary beverage. (2014) They

also found that over the course of the seven semesters the students tended to eat less fruits and

vegetables, exercise less and positive health behaviors, such as brushing and flossing, decreased

over time (Small, 2014). In another study, Driskell et al concluded that the average college

student eats at a fast food restaurant 6-8 times per week (2006). The food at these restaurants are

mostly comprised of high fatty foods and sugary beverages.

The focus on college students is to help them recognize the importance of overall health,

including dental health, and the relationship that one has to the other. This population was

chosen so that they can be educated on modifying any unhealthy habits they may have started

since entering college. The rationale is that by educating the students at a time in their lives when

they are making decisions for themselves it will help promote healthy habits that will last a

lifetime. This includes visiting the dentist twice a year, brushing twice a day, flossing daily and

reducing the amount of sugary foods and drinks they consume per day.

Program Description

My program was designed to help college students identify their current unhealthy eating

habits and examine their current oral home care and put in place a routine that will help keep

their teeth in optimal health while curbing the intake of sugary foods and beverages. This

program was designed to be self-motivating so that the no extra pressure or requirements were

needed or expected from the participants. The only requirement is that they read the literature

that was sent to them and completed several questionnaires at regular intervals so that their

progress can be documented.

Program Method

The program began on January 21, 2017 when 30 questionnaires were emailed to

undergraduate students attending Rowan University. College students were chosen for this

survey because this is the first time these students were making decisions regarding their

healthcare since they left home.

In order to assess the need for nutritional counseling and oral hygiene instruction, surveys

were emailed to college students that addressed such issues as last dental visit, how many sugary

foods and beverages are consumed on a daily basis and how often they ate at fast food

restaurants. The students were given one week to complete the survey and return it by email. A

total of 30 questionnaires were sent out and 30 were returned completed (15 males and 15

females completed the surveys). Half way through the semester an email was sent to each of the

participants with fun facts about nutrition and teeth. This was sent to help boost the student’s

knowledge of some of the issues related to infrequent brushing/flossing habits.

An identical questionnaire was sent at the end of the semester to evaluate what changes

the students have made in their daily living to be healthier, if they have scheduled a dental check-

up and whether their intake of high sugary foods and beverages has decreased, increased or

stayed the same. Information, such as local dentist or clinics in their area at school or at home,

will also be offered to those who state they do not to have a regular dentist. This information can

be found online at Dentists.com and will be sent to anyone who wishes to move forward with

making an appointment for a routine dental check-up. The hope is that college students will

educated about the importance of regular dental check-ups and how making the decision now to

make a healthy change can be beneficial for the rest of their lives.

Instrumentation

The following questionnaire was used to gather the information used in this research program.

The questionnaire consisted of four questions and the students were to circle the number which

most closely represented their habits regarding brushing/flossing, eating fast foods, consuming

sugary beverages and most recent dental visits. It was easy to understand and complete and the

students were very receptive to participating in this program. All 30 of the participants

completed their questionnaires in the allotted time given and returned them via email to me as

asked.

QuestionnaireNAME: _________________________ DATE: _______________

GENDER: M F

PLEASE CIRCLE THE NUMBER THAT MOST CLOSELY REPRESENTS YOUR HABITS.

A. I usually brush and floss my teeth:1.Brush several times per week no floss2.Brush one time per day no floss3.Brush one time per day and floss4.Brush two times per day no floss5.Brush two times per day and floss

B. I eat at Fast food restaurants:

Did You Know??       

 • People who drink three or more sodas a day have 62% more dental issues than those who

drink healthier alternatives.  • The second most common disease in The United States is tooth decay.  • Tooth decay is almost entirely preventable.  • Plaque found on your teeth has over 300 different species of bacteria.    • 51 million school hours are lost annually due to dental related issues.  • Excessive alcohol consumption and tobacco use account for 90% of oral cancers

worldwide.  • Flossing once a day can increase your life expectancy by 6 years.  • Keep your toothbrush at least 6 ½ feet away from the toilet because bacteria after flushing

can travel up to this distance.  • 30% of people ages 65-74 have no natural teeth  • It takes 43 muscles to frown, but only 17 to smile. 

• Rinsing with mouthwash does not take the place of flossing.

• 19% of children ages 2-19 have untreated cavities.

• Bacteria can travel from your mouth to other body parts via your bloodstream.

• Bleeding gums are a sign of gingivitis.

• Periodontal disease (inflamed gum tissue and bone loss) is a risk factor of heart disease.

QuestionnaireNAME: _________________________ DATE: _______________

GENDER: M F

PLEASE CIRCLE THE NUMBER THAT MOST CLOSELY REPRESENTS YOUR HABITS.

A. I usually brush and floss my teeth:1.Brush several times per week no floss2.Brush one time per day no floss3.Brush one time per day and floss4.Brush two times per day no floss5.Brush two times per day and floss

B. I eat at Fast food restaurants:

Results

When the semester concluded, I gathered all the emails and reviewed the results. I

separated the data by gender and in the first set of data, Consumption of Sugary Beverages, the

bar charts show that there was clearly a decline at the end of the semester in the number of

sugary beverages that both male and female students consumed versus the amount at the start of

the research.

Regarding brushing and flossing habits the pie charts have combined totals of female and

male students for the pre test and post test. At the beginning of the semester there were several

students who did not have regular brushing habits and brushed only 5+ days per week. By the

end of the semester, as you can see by the second pie chart, that category does not exists, so both

male and female students were brushing at least 1x per day.

Lastly, the fast food charts show that the college students made a change in their diets

that included consuming less fast food at the end of the semester than they did at the beginning.

This category was broken down by male and female charts so that it was easy to compare the

eating habits by gender. Both charts show that there was a reduction in the amount of fast food

eaten by both female and male students.

1

3

5

7

9

11

13

15

0 1 2 3 4 5 63

22

55

43

2222

13

14

433

55

44

32

33

23

24

Fast Food Consumption

Series2 Series1

Frequency of Consuming Fast Foods (1-several times per day to 5- not at all)

Fem

ale

Stud

ents

1

3

5

7

9

11

13

15

0 1 2 3 4 5 61

34

12

32

13

22

34

55

244

2333

24

23

44

55

Fast Food Consumption

Series2 Series1

Frequency of consuming Fast Foods (1-several times per day to 5- not at all)

Mal

e St

uden

ts

c Pre Pre Pre Post Post PostStudent Gender Brushing Habits Sugary Drinks Fast Food Brushing Habits Sugary Drinks Fast Food

1 F 1 2 3 2 4 42 F 2 2 2 2 3 33 F 3 3 2 3 4 34 F 4 3 5 4 3 55 F 5 1 5 5 2 56 F 3 4 4 4 4 47 F 1 4 3 2 5 48 F 3 5 2 4 5 39 F 1 4 2 3 4 2

10 F 4 2 2 4 3 311 F 2 5 2 3 5 312 F 3 5 1 3 5 213 F 2 3 3 3 4 314 F 5 4 1 5 4 215 F 4 1 4 4 3 416 M 2 2 1 2 3 217 M 5 1 3 5 3 418 M 1 3 4 2 2 419 M 4 2 1 4 3 220 M 1 2 2 2 3 321 M 1 5 3 2 5 322 M 4 4 2 4 4 323 M 2 5 1 2 5 224 M 5 1 3 5 2 425 M 5 2 2 5 3 226 M 3 4 2 3 3 327 M 3 3 3 3 3 428 M 1 4 4 2 4 429 M 1 5 5 3 5 530 M 3 2 5 3 3 5

Overall Mean 2.8 3.1 2.73333333 3.266666666667 3.63333333333 3.3333333333SD 1.4488638132 1.37339247724 1.28474694 1.080655399262 0.96430547933 0.9942362632

P Value 0.162499521785 0.0870306449 0.047696011Females Mean 2.86666666667 3.2 2.73333333 3.4 3.86666666667 3.3333333333

SD 1.35576371027 1.37321312465 1.27988095 0.985610760609 0.91547541643 0.9759000729p value 0.006075325941 0.00309142425 0.0004263758

Males Mean 2.73333333333 3 2.73333333 3.133333333333 3.4 3.3333333333SD 1.57963226583 1.41421356237 1.33452328 1.187233679409 0.98561076061 1.0465362369

p value 0.028071371559 0.08241787788 0.6288619065

This spreadsheet has the results of the three categories that the college students were

tested on. As you can see, when comparing the pre brushing surveys to the post brushing surveys

and the consumption of sugary beverages surveys, the p values, which were 0.1624 and 0.0870

respectively, they cannot conclude that there is a significant difference from pre to post test

responses. However, the fast food pre and post tests had a p value of 0.047 which did indicate

that there was a significant difference in the survey outcomes.

Discussion

I feel that the college students improved in all areas of the study. I think that the students

realized that they were not eating as healthy as they should be and that unhealthy eating could

lead to future health issues. There was a decrease in eating at fast food restaurants and

consumption of sugary beverages in both the male and female groups. Regarding the brushing

and flossing element of the survey, there was an increase in students who were brushing and

flossing at the end of the study compared to the beginning of the study. Even though the ttest did

not show that there was a significant change in from the pre test to the post test scores, I am

happy to know that most of the college students have started either brushing or brushing and

flossing more frequently, and the category that included brushing only 5 days per week was no

longer relevant at the end of the study. Even if there were only a few who changed I would

consider it a win because brushing and flossing are key elements to good oral hygiene.

The fast food pre and post tests were the ones that showed that there was a significant

difference in the scores according to the t test and the results would probably be replicated if the

test was performed again. I am very happy to see that the college students made the move from

eating fast food several times per day to less frequently. It shows that they acknowledge the fact

that eating more home cooked meals is the healthier alternative. Anytime a student picks up and

apple instead of a cheeseburger should be considered a good thing and that’s what this program

was meant to inspire.

I am happy with the results of this study and I believe that if repeated I would get good

results again. I think this survey should be given to all freshman students coming into college

along with information to help guide them with healthy eating habits and proper oral hygiene.

They could be followed through to their senior year and given advice and information according

to what their needs are if they lean toward unhealthy eating habits or consuming large amounts

of sugary beverages. I think this survey can be a valuable tool in helping guide freshman students

to healthier, happier lifestyles.

References

Dental Caries (tooth decay) in Adults (age 20-64). (2014, March 7). Retrieved November 17, 2016, from www.nidcr.nih.gov

Driskell, J., Meckna, B., & Scales, N. (2006, September 11). Differences exist in the eating habits of university men and women at fast food restaurants. Science Direct, 524-530. Retrieved November 5, 2016, from www.sciencedirect.com.

Felland, L. E., Lauer, J. (July 2008). Community Efforts to Expand Dental Services for Low Income People. ISSUE BRIEFS, (122). Retrieved April 20, 2017

Jackson, S. L., Vann, W. F., Kotch, J. B., Pahel, B. T., & Lee, J. Y. (2011). Impact of Poor Oral Health on Children’s School Attendance and Performance. American Journal of Public Health, 101(10), 1900–1906. http://doi.org/10.2105/AJPH.2010.200915

Luebke, T., & Driskell, J. (2009, November 13). A Group of Midwestern University students needs to improve their Oral Hygiene and sugar/pop consumption habits. Science Direct, 27-30. http://dx.doi.org/10.1016/j.nutres.2009.11.001

Small, M., Bailey-Davis, L., Morgan, N., & Maggs, J. (2013). Changes in Eating and Physical Activity Behaviors Across Seven Semesters of College: Living On or Off Campus Matters. Health Education & Behavior : The Official Publication of the Society for

Public Health Education, 40(4), 435–441. http://doi.org/10.1177/1090198112467801