Oral Hygiene Habits of Young Adults*
by L I L L I A N O . D A H L A N D J O S E P H C . M U H L E R , Bloomington,
I N a previous study from these labora-
tories, the oral hygiene habits of c h i l -
1 ination including a complete bite-wing
dren was presented. It was shown i n
a group of 514 children, age 6 to 15
years, that the most frequent time of brush-
ing the teeth was before breakfast and be-
fore retiring. The frequency of brushing
for the entire group was 1.4 times per day
w i t h the required time to brush the teeth
being one minute for boys and 70 seconds
for the girls. Less than 5 per cent o f the
children brushed their teeth three times a
day i n accordance w i t h the suggested rec-
ommendation of the dental profession.
Since i t has been recently suggested that a
synergism exists between good brushing
habits and the anti-cariogenic effects of a
stannous fluoride dentifrice i t was con-
2 other factors relating to their oral hygiene.
sidered of general interest to study the
oral hygiene habits of a group of young
adults i n order to determine i f an increase
in oral hygiene occurs w i t h increasing age,
as well as to learn more about the tooth-
brushing habits of these adults which have
shown a reduction in the dental caries ex-
perience through the use of a stannous
fluoride dentifrice.
EXPERIMENTAL PROCEDURE
In this study a total of 340 Indiana U n i -
versity freshmen, ages 17 to 34 years, was
used. The mean age of the group was 19
years. These students were selected at ran-
dom from the 1952 freshman class of I n -
diana University, w i t h an attempt to main-
tain equal distribution of sexes. The entire
group entered the study program through-
out a period of three months and were proc-
essed i n a manner similar to that described
previously for the children's study. Briefly,
1
this consisted of the patients initially com-
ing to the Dental C l i n i c for a thorough
""Indiana University, School of Dentistry. This
study was supported in part by a grant from the
Procter and Gamble Company, Ivorydale, Ohio.
Page 43
Indiana
dental prophylaxis and dental caries exam-
radiographic examination. A f t e r a period
of six weeks they returned to the clinic
and were questioned regarding their oral
hygiene habits. A t this time they were
provided with a new toothbrush and denti-
frice and asked to brush their teeth i n the
same manner as they would at home. F o l -
lowing this their mouth was re-examined
and their brushing efficiency evaluated.
Additional items used for evaluation i n this
study were also recorded during this visit.
Six months following the first prophylaxis
in the program they returned for another
dental prophylaxis, oral and radiographic
examination and were questioned regarding
One important factor considered at this
time was an evaluation of the rate of cal-
culus formation.
A t six-month intervals following the
initial visit a similar routine regarding
prophylaxis, oral and radiographic examin-
ation was followed. However, these data
presented i n this paper concern only the
pertinent findings at the end of one year.
DATA A N D DISCUSSION
These data collected from this study are
summarized in tables 1 through 6. Table 1
shows the time of day the university fresh-
men brushed their teeth, and indicates that
the largest single group of students brush
before breakfast and before bed. This com-
prises 21 per cent of the total group and
corroborates the findings observed i n the
children's study. A b o u t 11 per cent o f
1
the total group brushed their teeth w i t h a
frequency of three times a day after meals.
This is approximately 50 per cent greater
than similar comparisons i n the younger age
group. I t appears from these limited data
that young adults are more conscientious
in their efforts to brush their teeth imme-
Page 44 T H E J O U R N A L O F PERIODONTOLOGY

TABLE 1

The Time of Day 340 College Students, Participating in a Dental Survey,

Brushed Their Teeth

Time of Day Number of Students Percentage

Before breakfast 26 7.6

A f t e r breakfast 13 3.8
Before l u n c h 0
After lunch 0
Before dinner 0
A f t e r dinner 1 0.3
A f t e r breakfast and after dinner 19 5.6
Before breakfast and after dinner 15 4.4
A f t e r breakfast, lunch and dinner 39 11.5
A f t e r breakfast and before bed 42 12.4
Before breakfast and before bed 70 20.5
A f t e r breakfast, lunch and dinner and before bed 23 6.8
A f t e r breakfast, after lunch and before bed 12 3.5
Before bed 21 6.2
Irregular 59 17.4

diately after the ingestion of food than are children's study, are more conscientious
1

children. A somewhat larger portion of the
group, 17 per cent, were found to be i r -
regular i n their brushing habits and were
not able to be classified i n any of the d i -
visions indicated i n table 1. These data,
combined w i t h those i n table 2, corroborate
the fact that the frequency of brushing
per day is below that figure considered
optimal for good dental health, since the
average for both the male and female groups
is only slightly i n excess of twice a day.
The males have a mean of 1.7 times a day
and the females 2.1 times. Thus, it appears
that the females i n the study, as i n the
in their brushing habits. Also, it is evident
that this young adult group has increased
their frequency of brushing per day over
the group participating i n the children's
study by approximately 30 per cent. H o w -
ever, the data i n table 3 seems to indicate
that the time required to brush the teeth
of the females is somewhat less than that
for the males. This is observed i n both the
total time required as well as the range of
time needed to brush the teeth. The males
brushed on the average of 64 seconds and
the females 57 seconds, w i t h the range for
the former 15 to 13 5 seconds and 15 to 117

TABLE 2

Number of Times Per Day 340 College Students Brush Their Teeth

Times per day

Group 1 2 3 4 5 6 irregular average

Male (n = 187) 69 75 32 6 1 0 3 1.7

Female (n = 153) 27 69 28 14 9 1 0 2.1
 ORAL HYGIENE Page 45

TABLE 3

Length of Time Required by Young Adults to Brush Their Teeth

Mean number of seconds Minimum Maximum

brushed ( seconds )

Male 63.5 15 135

Female 56.7 15 117

seconds for the latter. Further evidence for females were classified initially as "very
this increased time requirement f o r males good" or "good" (52.3 percent) while less
to brush their teeth is shown i n table 4, than 40 percent of the males were similarly
where the percentage of individuals i n each classified. A f t e r six months i n the study
brushing time interval is shown. These program the same conclusions are evident.
data indicate that about 5 percent o f the A b o u t 4 percent of the males were classified
males and 8 percent of the females require as having "very poor" oral hygiene at the
less than 30 seconds to brush their teeth. initial visit while 2.6 percent of the females
However, about 50 per cent of both sexes were similarly classified. The greatest change
fall into the 30 to 60 second range. F r o m in the condition of the oral hygiene during
these data i t may be seen that a greater the six month period occurred i n the male
number of females fall into the low brush- group classified as "poor". Initially, ap-
ing time range, while the males seem to proximately 16 percent were classified as
have a tendency to brush for longer periods. "poor" b u t after six months less than 5
These findings, i n regard to the length of percent were included i n this category.
time required to brush the teeth, are not
significantly different from those data Some estimate of the rate o f calculus
found i n the younger age g r o u p . 1
formation i n this young adult group can be
seen from the data comprising table 6.
Table 5 indicates the condition o f the Initially, 67.9 percent of the group were
oral hygiene at the initial visit and again essentially free of dental calculus, while 11
after six months following the initial den- percent were classified as having a severe
tal prophylaxis. These data are somewhat amount. F o l l o w i n g a thorough prophylaxis
difficult to interpret i n light o f the data and a period o f six months, 5.7 percent
found i n tables 2 through 4, since i t ap- were classified as severe. The decrease i n the
pears from the data i n table 5 that the severe group was not shared b y an increase
females possess a better state o f oral h y - in the calculus free group, b u t was appar-
giene. Approximately 50 percent o f the ent by an increase i n the slight and medium

TABLE 4

Range of Time Required to Brush the Teeth

Time (in seconds)

Group 0-30 30-60 60-90 90-120 120 or over

No. % No. % No. % No. % No. %

Male 5 4.9 49 47.5 32 31.1 14 13.6 3 2.9
Female 8 8.2 54 55.7 28 29.9 7 7.2 0 —
Page 46 T H E J O U R N A L O F PERIODONTOLOGY

TABLE 5

The Condition of Oral Hygiene in College Students at Initial Visit to the Dental Clinic
and Six Months Later in the Sa me Patients

Very Good Good Fair Poor Very Poor

Males
No. No, , % No. % No. No. %
Initial
Examination 17 9.1 54 28.9 80 42.8 29 15.5 7 3.7

Six M o n t h
Examination 18 9.6 66 35.3 91 48.7 9 4.8 3 1.6

Females
Initial
Examination 18 11.8 62 40.5 56 36.6 13 8.5 4 2.6

Six M o n t h
Examination 19 12.4 64 41.8 57 37.3 13 8.5 0 —

groups. These data appear interesting i n
light of the fact that a m u c h larger per-
centage of the population i n the age group
over 3 5 falls into the severe classification.
Thus, i t appears that i n this younger age
group calculus formation is not a rapid
process.
SUMMARY
The oral hygiene and toothbrushing
habits of a group of 340 freshmen students
at Indiana U n i v e r s i t y were studied for a
period of one year i n order to ascertain
pertinent facts relating to the oral hygiene.
It was apparent from the data i n this study
that the toothbrushing habits i n young
adults are quite similar to those of a c h i l -
dren's group. The single factor w h i c h is
different in the adult study is i n relation
to an increase by approximately 30 percent
i n the frequency per day of toothbrushing.
There appears to be little relationship be-
tween the time required to brush the teeth
and the overall oral hygiene, since females
brush for shorter periods of time but more
are found to have a good oral hygiene than
males. O n l y 11.5 percent of this group
brushed their teeth three times a day after
meals.
The rate of calculus formation was esti-
mated during a six month period following
a thorough dental prophylaxis. It was ob-
served to be a very, slow process i n this
young adult group. More study is indicated
concerning this latter phenomenon.

TABLE 6
Calculus Formation in a Young Adult G roup During a Six Month Study Period

Amount of Initial Examination Six Month Examination

Calculus Number Percent Number Percent

None 191 67.9 188 66.9

Slight 46 16.4 53 18.8
Medium 13 4.6 24 8.5
Severe 31 11.0 16 5.7
 PSYCHOSOMATIC A S P E C T S Page 47

SELECTED REFERENCES 2. Muhler, J. C , Radike, A. W., Nebergall, W.

H . and Day, H . G.: The Effect of a Stannous Fluo-
1. Dahl, L. O. and Davis, B. B.: Oral Hygiene ride Containing Dentifrice on Dental Caries in
Habits of Young Children, J. Periodontal., 25:209 Adults. Unpublished Data.
(1954).