# Oral Health Status (DMFT Index) and Hygiene Practices Among Dental Students in Bulgaria: A Pilot Study

## TL;DR

This study examines the oral health and hygiene practices of dental students in Bulgaria, finding that despite frequent dental visits, rural students have worse oral health outcomes.

## Contribution

The study identifies residence as a significant factor influencing oral health among dental students in Bulgaria.

## Key findings

- 73.2% of students visited the dentist in the past six months, with higher rates among females.
- Rural students had significantly higher DMFT scores compared to urban students.
- Smoking was prevalent (45.3%), but no significant associations were found between lifestyle habits and DMFT.

## Abstract

Background: As a fundamental component of general health, oral health is of significant global concern, with the global burden of dental diseases continuing to rise. Dentists are expected not only to provide clinical care but also to model healthy behaviours and promote oral health through education and advocacy. The knowledge, attitudes and practices of dental students—which represent critical elements of their professional development—play a pivotal role in shaping their future clinical behaviour. However, the extant literature suggests considerable variability in these domains, thus indicating that dental students do not always demonstrate the exemplary oral health practices expected of them. Objectives: The objective of the preliminary study was to assess the oral health practices, utilisation of preventive care, and factors influencing the oral health status of dental students at the Medical University of Plovdiv. Methods: A cross-sectional study was conducted among 138 first- to fifth-year dental students. The study utilised a structured, validated, adapted WHO questionnaire and a clinical examination based on the WHO Basic Oral Health Survey criteria. A comprehensive data set was collected, encompassing sociodemographic characteristics, oral hygiene behaviours, lifestyle habits, and DMFT scores. Results: The utilisation of preventative dental care was found to be high, with 73.2% of the student population reporting a dental visit within the previous six months. This tendency was found to be particularly pronounced among female students, who exhibited a significantly higher frequency of such visits. The prevalence of smoking was found to be significant, with 45.3% of the population reporting current smoking habits. The mean DMFT score was 3.33 (SD 3.13), predominantly driven by filled teeth. The present study found residence to be a significant factor associated with DMFT (p = 0.010). Specifically, rural students exhibited higher scores compared to their urban counterparts. Despite the tendency of smokers and those who brush less frequently to exhibit higher DMFT values, no statistically significant associations were identified regarding toothbrushing frequency, smoking, alcohol consumption, or dental visit frequency. Conclusions: The present study demonstrates that, despite the high utilisation of preventive dental care among dental students, notable disparities in oral health outcomes persist. Residence was identified as the strongest associated factor, with students from rural areas exhibiting substantially higher DMFT scores. Overall, the findings underscore the need for stronger lifestyle-focused education and targeted interventions to better prepare future oral health professionals to promote effective preventive care.