Article Data

  • Views 1701
  • Dowloads 332

Original Research

Open Access

Self-reported oral health habits, knowledge and conditions of schoolchildren and adolescents in mainland China

  • Ren Yang1,†
  • Tianyi Tang2,†
  • Sujuan Wu3
  • Litong Wu4
  • Lang Lei1,*,
  • Huang Li1,*,

1Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, 210008 Nanjing, China

2Division of Biomaterials and Tissue Engineering, Eastman Dental Institute, University College London, NW3 2PF London, UK

3Nanjing Stomatological Hospital, Medical School of Nanjing University, 210008 Nanjing, China

4Nanjing Foreign Language School, 210008 Nanjing, China

DOI: 10.22514/jocpd.2023.017 Vol.47,Issue 3,May 2023 pp.96-102

Submitted: 28 October 2022 Accepted: 13 February 2023

Published: 03 May 2023

*Corresponding Author(s): Lang Lei E-mail:
*Corresponding Author(s): Huang Li E-mail:

† These authors contributed equally.


To determine the oral health habits, knowledge and conditions of students in China and investigate the impact of associated factors. A self-reported online questionnaire was distributed through social networks in mainland China to assess the oral health habits, knowledge, and conditions of students aged 6–20 years attending primary, middle, and high schools. Factors potentially associated with oral health, such as oral health habits of their parents, family education level, and economic regions, were analyzed using McNemar’s and Chi-square tests. Within one month, 5561 valid questionnaires were retrieved from all 31 provinces or equivalent regions in mainland China. The results showed that 46.9% of students suffered from bleeding when brushing their teeth, while only 11.8% reported professional teeth cleaning at a dental clinic. Soda beverages were widely consumed among them (75.4%). A significant minority of students brushed their teeth less than twice daily (22.8%) and for about 2 minutes each time (19.3%). Only 21.9% of the students had preventive oral health care. Students’ toothbrushing habits and knowledge about interdental cleaning tools were associated with parental habits (p < 0.001). Overall, students from families with higher educational backgrounds and eastern China had better oral health habits, knowledge, and conditions. There is a need to pay more attention to gingival health and caries prevention among schoolchildren and adolescents in mainland China. Improving parental oral hygiene habits could have a positive impact on the oral health of students. Further research on oral health among students is needed in the middle and western regions of China.


Children; Adolescents; Oral health; China

Cite and Share

Ren Yang,Tianyi Tang,Sujuan Wu,Litong Wu,Lang Lei,Huang Li. Self-reported oral health habits, knowledge and conditions of schoolchildren and adolescents in mainland China. Journal of Clinical Pediatric Dentistry. 2023. 47(3);96-102.


[1] Quan JK, Wang XZ, Sun XY, Yuan C, Liu XN, Wang X, et al. Permanent teeth caries status of 12- to 15-year-olds in China: findings from the 4th national oral health survey. Chinese Journal of Dental Research. 2018; 21: 181–193.

[2] Chen X, Ye W, Zhan JY, Wang X, Tai BJ, Hu Y, et al. Periodontal status of Chinese adolescents: findings from the 4th national oral health survey. Chinese Journal of Dental Research. 2018; 21: 195–203.

[3] Worthington HV, Hill KB, Mooney J, Hamilton FA, Blinkhorn AS. A cluster randomized controlled trial of a dental health education program for 10-year-old children. Journal of Public Health Dentistry. 2001; 61: 22–27.

[4] Vanobbergen J, Martens L, Lesaffre E, Bogaerts K, Declerck D. Assessing risk indicators for dental caries in the primary dentition. Community Dentistry and Oral Epidemiology. 2001; 29: 424–434.

[5] Silveira Schuch H, Giang Do L. School-based oral hygiene education program has long-term positive effects on oral health indicators. Journal of Evidence-Based Dental Practice. 2017; 17: 65–67.

[6] Alm A. On dental caries and caries-related factors in children and teenagers. Swedish Dental Journal. Supplement. 2008; 7–63, 1p preceding table of contents.

[7] Gallie A. Home use of interdental cleaning devices and toothbrushing and their role in disease prevention. Evidence-Based Dentistry. 2019; 20: 103–104.

[8] Tadakamadla SK, Tadakamadla J, Kroon J, Lalloo R, Johnson NW. Effect of family characteristics on periodontal diseases in children and adolescents—a systematic review. International Journal of Dental Hygiene. 2020; 18: 3–16.

[9] Neves ETB, Dutra LDC, Gomes MC, Paiva SM, de Abreu MHNG, Ferreira FM, et al. The impact of oral health literacy and family cohesion on dental caries in early adolescence. Community Dentistry and Oral Epidemiology. 2020; 48: 232–239.

[10] Levin KA, Currie C. Adolescent toothbrushing and the home environment: sociodemographic factors, family relationships and mealtime routines and disorganisation. Community Dentistry and Oral Epidemiology. 2010; 38: 10–18.

[11] Ji Y, Zhang Y, Wang Y, Chang C. Association between family factors and children’s oral health behaviors—a cross-sectional comparative study of permanent resident and migrant children in large cities in China. Community Dentistry and Oral Epidemiology. 2016; 44: 92–100.

[12] Baskaradoss JK, AlThunayan MF, Alessa JA, Alobaidy SS, Alwakeel RS, Alshubaiki AH, et al. Relationship between caregivers’ oral health literacy and their child’s caries experience. Community Dental Health. 2019; 36: 111–117.

[13] Chen Z, Liu M, Zhang S, Xiong Z, Zhong X, Yang D, et al. Urban index and lifestyle risk factors for cardiovascular diseases in China: a cross-sectional study. Science Progress. 2021; 104: 003685042110037.

[14] Wu MY, Wang JB, Zhu Y, Lu JM, Li D, Yu ZB, et al. Impact of individual and combined lifestyle factors on mortality in China: a cohort study. American Journal of Preventive Medicine. 2020; 59: 461–468.

[15] Huang S, Garshick E, Weschler LB, Hong C, Li J, Li L, et al. Home environmental and lifestyle factors associated with asthma, rhinitis and wheeze in children in Beijing, China. Environmental Pollution. 2020; 256: 113426.

[16] Telleen S, Rhee Kim YO, Chavez N, Barrett RE, Hall W, Gajendra S. Access to oral health services for urban low-income Latino children: social ecological influences. Journal of Public Health Dentistry. 2012; 72: 8–18.

[17] Dorri M, Sheiham A, Watt RG. Modelling the factors influencing general and oral hygiene behaviours in adolescents. International Journal of Paediatric Dentistry. 2010; 20: 261–269.

[18] Xiao JC, An SW. From regional unbalanced development to regional coordinated development—forty years of regional development in China. Regional Economic Review. 2019; 13–24.

[19] Ning jizhe, et al. China Statisitical Yearbook 2019. China Statisitical: Beijing. 2019.

[20] Su H, Zhang Y, Qian W, Shi H. Impact of behavioural factors and living conditions on dental caries among pupils from Shanghai and Jiangxi province in China: a school-based cross-sectional study. Oral Health and Preventive Dentistry. 2019; 17: 557–565.

[21] Aljafari AK, Gallagher JE, Hosey MT. Failure on all fronts: general dental practitioners’ views on promoting oral health in high caries risk children—a qualitative study. BMC Oral Health. 2015; 15: 45.

[22] Michalak E, Łoboda J, Chomyszyn-Gajewska M. Reasons for patients’ visits in the dental offices of Cracow in the years 2005–2006 and 2013–2014. Przegla̧ d Epidemiologiczny. 2015; 69: 787–94, 913–8.

[23] Li J, Zhang K, Lu Z. Prevalence and factors contributing to dental caries in 12–15-year-old school adolescents in northeast China. BMJ Open. 2021; 11: e044758.

[24] Wang M, Ding D, Zhang Q, Zhu G, Ge Y, Yang B, et al. Oral health and dental status in people with epilepsy in rural China. Seizure. 2019; 65: 42–47.

[25] Hu J, Jiang W, Lin X, Zhu H, Zhou N, Chen Y, et al. Dental caries status and caries risk factors in students ages 12–14 years in Zhejiang, China. Medical Science Monitor. 2018; 24: 3670–3678.

[26] Bagherian A, Sarraf Shirazi A. Preparation before acid etching in fissure sealant therapy: yes or no? A systematic review and meta-analysis. The Journal of the American Dental Association. 2016; 147: 943–951.

[27] Rolla G, Ogaard B, Cruz Rde A. Topical application of fluorides on teeth. New concepts of mechanisms of interaction. Journal of Clinical Periodontology. 1993; 20: 105–108.

[28] Ahovuo-Saloranta A, Forss H, Walsh T, Nordblad A, Makela M, Worthington HV. Pit and fissure sealants for preventing dental decay in permanent teeth. Cochrane Database of Systematic Reviews. 2017; 7: CD001830.

[29] Lebrun-Harris LA, Canto MT, Vodicka P. Preventive oral health care use and oral health status among us children. The Journal of the American Dental Association. 2019; 150: 246–258.

[30] Baiju RMP, Peter E, Nayar BR, Varughese JM, Varghese NO. Prevalence and predictors of early periodontal disease among adolescents. Journal of Indian Society of Periodontology. 2019; 23: 356–361.

[31] Das UM, Vadakkekuttical RJ, Kanakkath H, Shankunni SP. Dental health awareness, attitude, and dental health-care seeking practices as risk indicators for the prevalence of periodontal disease among 15–17-year-old school children in Kozhikode district, Kerala, India. Journal of Indian Society of Periodontology. 2017; 21: 144–151.

[32] Kino S, Bernabe E, Sabbah W, Aukett J. Relationship between family characteristics and children’s regular toothbrushing with fluoride toothpaste. Community Dental Health. 2015; 32: 132–136.

[33] Mannaa A, Carlén A, Lingström P. Dental caries and associated factors in mothers and their preschool and school children—a cross-sectional study. Journal of Dental Sciences. 2013; 8: 101–108.

[34] Pan N, Cai L, Xu C, Guan H, Jin Y. Oral health knowledge, behaviors and parental practices among rural-urban migrant children in Guangzhou: a follow-up study. BMC Oral Health. 2017; 17: 97.

[35] Sun XY, Yuan C, Wang XZ, Wang X, Feng XP, Tai BJ, et al. Report of the national investigation of resources for oral health in China. The Chinese Journal of Dental Research. 2018; 21: 285–297.

[36] Buhlin K, Gustafsson A, Andersson K, Hakansson J, Klinge B. Validity and limitations of self-reported periodontal health. Community Dentistry and Oral Epidemiology. 2002; 30: 431–437.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

PubMed (MEDLINE) PubMed comprises more than 35 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full text content from PubMed Central and publisher web sites.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time