Knowledge, attitude, and practice regarding oral

health among college students in Eastern China

Wenhao Li 
Bengbu Medical College
Nan Yin 
Bengbu Medical College
Yanyong Zhang 
Bengbu Medical College
Haoyun Zhou 
Bengbu Medical College
Hui Ge 
Bengbu Medical College
Wei Ding 
Bengbu Medical College
Wei Zhang 
Bengbu Medical College
Shunhua Zhang 
(

0800076@bbmc.edu.cn
)
Bengbu Medical College
Shengkai Liao 
First Affiliated Hospital of Bengbu Medical College

Research Article

Keywords: Oral health, Knowledge, Attitude, Practice, Students

Posted Date: April 5th, 2022

DOI: https://doi.org/10.21203/rs.3.rs-1493993/v1

License:
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Page 1/21
Abstract
Background: People are increasingly concerned about the impact of oral health on the whole. College
students represent the future trend of oral health in China. The purpose of this study was to investigate
the status, influencing factors and differences in oral health knowledge, attitude, practice (KAP) between
dental and non-dental students in Anhui Province, Eastern China.

Methods: A cross-sectional survey was conducted on 1,822 college students in Anhui Province. The
Mann-Whitney test and the Kruskal-Wallis test were used to test for differences in oral health KAP scores
by different demographic factors and lifestyle habits. The Spearman test was used to determine the
association between oral health knowledge, attitude and practice. The Person chi-square test was used to
analyse the differences in oral health KAP between dental students and non-dental students.

Results: The oral health KAP scores of dental, medical, and non-medical college students in Anhui
Province decreased in the order. Gender, age, major, grade, place of birth, parents’ education, annual
household income, and smoking status all had a difference on oral health KAP

scores among college students. Positive correlations existed between oral health knowledge, attitude, and
practice. Dental students had a better overall oral health KAP than non-dental students.

Conclusions: The oral health knowledge and attitude of college students in Anhui Province were generally
good. However, oral health practice was unsatisfactory. Our study has implications for targeted
improvement of factors influencing oral health KAP.

Background
Oral health serves as an essential component of overall health and well-being. The fourth national oral
health epidemiological survey showed that, compared with a decade ago, the level of oral health literacy
and health behaviors of Chinese residents have improved to varying degrees [1]. As the successors of a
new era, it’s important for college students to develop lifelong oral health behaviors during their college
years [2]. 

Health status is largely determined by an individual’s knowledge, attitude, and practice (KAP) in the area
[3]. The KAP has developed as an important tool for assessing various health seeking behaviors today [4].
The better oral health KAP contributes to oral health status [3, 5].

Some lifestyles, such as dietary habits, smoking and hygiene standards can also lead to oral health
progressing in different directions [6, 7]. In the adolescent population, family characteristics have subtle
implications for adolescent oral health perception [8]. Previous studies have shown variability in oral
health KAP scores by education level and professional differences [9, 10].

There has been insufficient research on the status of oral health KAP among college students in Eastern
China. There are no more studies on the specific differences of oral health KAP between dental major and
Page 2/21
other majors. Therefore, this study aimed to investigate the status and differences in oral health KAP
between dental and non-dental students in Anhui Province, Eastern China.

Methods
Study design

We cordially invited students from 22 comprehensive colleges in Anhui Province, Eastern China, to

conduct this cross-sectional study from October 2019 to January 2020. Electronic questionnaires were
distributed via the Internet. We received a total of 1,822 valid responses. Incomplete questionnaires were
excluded from the study.

Ethical Approval

This study has been approved by the Medical Ethics Committee of Bengbu Medical College, China
(process 2021/199). Participants were informed about the study’s purpose. Each participant gave
informed consent and participated voluntarily.

Questionnaire design

We designed the questionnaire based on previous research. The questionnaire had a reliability
(Cronbach’s a) of 0.997.

The questionnaire consisted of 4 sections. The first section was demographic information and personal
habits.

The second section was the oral health knowledge, including 13 questions. The participants’ knowledge
is assessed through a series of questions on the causes, preventive measures and treatment of oral
diseases.

The third section was the oral health attitude with 9 questions. Participants made decisions based on
their own health care awareness.

The fourth section was about the participants’ oral health practice responses according to their daily
behaviors and consisted of 9 questions.

The responses of oral health KAP were rated on a 2-point Likert scale, ‘0 = No’ and ‘1 = Yes’, with higher
scores representing higher levels of oral health KAP.

Statistical analysis

We used IBM SPSS Statistics v.20.0 for data analysis. When the p value is less than 0.05, it’s considered
statistically significant. Due to the skewed distribution of our data, we used the Mann-Whitney test and
Kruskal-Wallis test to examine the variability of different demographic factors and lifestyle habits

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regarding oral health KAP scores. The analysis uses M (P25, P75) to describe the KAP scores. Spearman
test was used to analyze the degree of relevance of oral health knowledge, attitude, and practice. We
divided the students into dental and non-dental students according to majors. Analyzed the difference in
the scores of each question in KAP between different groups by the Person Chi-square test.

Results
Demographic characteristics and one-way ANOVA associated with oral health KAP

A total of 1,822 study participants were surveyed, of whom 802 (44%) were males. Other demographic
characteristics are shown in Table 1.

Table 1. Demographic characteristics of subjects participated in the survey (n = 1,822)

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Variables Frequency Knowledge/P50 Attitude/P50 Practice/P50 KAP/P50
(n) (P25, P75) (P25, P75) (P25, P75) (P25, P75)

/Percentage
(%)

Gender          

Male 802/44.0 12.00 (11.00, 8.00 (7.00, 3.00 (2.00, 23.00

13.00) 9.00) 5.00) (20.00,
25.00)

Female 1020/56.0 12.00 (11.00, 8.00 (7.00, 4.00 (3.00, 24.00

13.00) 9.00) 5.00) (22.00,
26.00)

Z   -4.576 -5.317 -5.102 -7.000

P   0.000 0.000 0.000 0.000

Major          

Dental major 286/15.7 13.00 (12.00, 9.00 (8.00, 5.00 (3.00, 26.00
13.00) 9.00) 7.00) (23.00,
28.00)

Medical majors 976/53.6 12.00 (11.00, 8.00 (7.00, 4.00 (2.25, 24.00
13.00) 9.00) 5.00) (21.25,
26.00)

Non-medical 560/30.7 12.00 (11.00, 8.00 (7.00, 3.00 (2.00, 23.00

majors 13.00) 9.00) 5.00) (20.00,
25.00)

χ2   51.789 58.631 108.277 164.149

P   0.000 0.000 0.000 0.000

Grade          

Freshman 476/26.1 12.00 (11.00, 8.00 (7.00, 3.00 (2.00, 23.00

13.00) 9.00) 5.00) (21.00,
25.00)

Sophomore 265/14.5 12.00 (11.00, 8.00 (7.00, 3.00 (2.00, 23.00

13.00) 9.00) 4.50) (21.00,
25.00)

Junior 503/27.6 12.00 (11.00, 8.00 (7.00, 3.00 (2.00, 23.00

13.00) 9.00) 5.00) (21.00,
25.00)

Senior 214/11.8 12.00 (11.00, 8.00 (7.00, 4.00 (3.00, 24.00

13.00) 9.00) 6.00) (22.00,
26.00)

Graduate 180/9.9 13.00 (11.00, 8.00 (7.00, 5.00 (3.00, 25.00

13.00) 9.00) 7.00) (23.00,
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 27.00)

Postgraduate 184/10.1 13.00 (11.00, 8.00 (7.25, 4.00 (3.00, 25.00

13.00) 9.00) 6.00) (22.00,
27.00)

χ2   17.047 19.828 82.295 88.144

P   0.004 0.001 0.000 0.000

Birthplace          

Rural 1253/68.8 12.00 (11.00, 8.00 (7.00, 4.00 (2.00, 23.00

13.00) 9.00) 5.00) (21.00,
25.00)

Urban 569/31.2 12.00 (11.00, 8.00 (7.00, 4.00 (3.00, 24.00

13.00) 9.00) 5.00) (22.00,
26.00)

Z   -1.676 -2.490 -3.760 -4.229

P   0.094 0.013 0.000 0.000

Father’s          
education

Primary school 352/19.3 12.00 (11.00, 8.00 (7.00, 3.00 (2.00, 23.00
or below 13.00) 9.00) 5.00) (20.00,
25.00)

Middle school 835/45.8 12.00 (11.00, 8.00 (7.00, 4.00 (2.00, 24.00
13.00) 9.00) 5.00) (21.00,
26.00)

High school 321/17.6 13.00 (11.00, 8.00 (7.00, 4.00 (2.00, 24.00
13.00) 9.00) 5.00) (21.00,
26.00)

Junior college 174/9.6 12.00 (11.00, 8.00 (7.00, 4.00 (3.00, 24.00
13.00) 9.00) 6.00) (22.00,
27.00)

Undergraduate 140/7.7 12.00 (11.00, 8.00 (7.00, 4.00 (3.00, 24.00

or above 13.00) 9.00) 6.00) (21.00,
27.00)

χ2   5.963 10.079 24.168 23.146

P   0.202 0.039 0.000 0.000

Mother’s          
education

Primary school 722/39.6 12.00 (11.00, 8.00 (7.00, 3.00 (2.00, 24.00
or below 13.00) 9.00) 5.00) (21.00,
26.00)

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 Middle school 681/37.4 12.00 (11.00, 8.00 (7.00, 4.00 (2.00, 23.00
13.00) 9.00) 5.00) (21.00,
25.00)

High school 207/11.4 13.00 (11.00, 8.00 (7.00, 4.00 (3.00, 24.00
13.00) 9.00) 5.00) (22.00,
26.00)

Junior college 143/7.8 13.00 (11.00, 8.00 (7.00, 4.00 (3.00, 24.00
13.00) 9.00) 6.00) (22.00,
27.00)

Undergraduate 69/3.8 12.00 (11.00, 8.00 (7.00, 5.00 (3.00, 25.00

or above 13.00) 9.00) 7.00) (21.50,
27.00)

χ2   13.624 2.205 30.738 25.962

P   0.009 0.698 0.000 0.000

Annual          
household
income

Less than ¥50, 781/42.9 12.00 (11.00, 8.00 (7.00, 3.00 (2.00, 23.00
000 13.00) 9.00) 5.00) (21.00,
25.00)

¥50, 000 to 745/40.9 12.00 (11.00, 8.00 (7.00, 4.00 (2.00, 24.00
¥120, 000 13.00) 9.00) 5.00) (22.00,
26.00)

More than ¥120, 296/16.2 12.00 (11.00, 8.00 (7.00, 4.00 (3.00, 24.00
000 13.00) 9.00) 6.00) (21.25,
27.00)

χ2   7.838 13.462 20.155 22.077

P   0.020 0.001 0.000 0.000

Cigarette use          

Yes 66/3.6 11.00 (9.00, 7.00 (5.00, 4.00 (2.00, 22.00

12.00) 8.00) 5.25) (17.00,
24.25)

No 1756/96.4 12.00 (11.00, 8.00 (7.00, 4.00 (2.00, 24.00

13.00) 9.00) 5.00) (21.00,
26.00)

Z   -4.272 -5.970 -0.206 -3.998

P   0.000 0.000 0.837 0.000

Table 1 shows the results of one-way ANOVA for oral health knowledge, attitude, and practice by different
demographic characteristics. The results showed that the differences in oral health knowledge, attitude,

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practice and KAP scores of college students by gender, major, grade and annual household income were
statistically significant (p < 0.05), the differences in oral health knowledge, attitude and KAP scores of
college students by cigarette use were statistically significant (p < 0.05), the differences in oral health
knowledge, practice and KAP scores of college students by mother’s education were statistically
significant (p < 0.05), and the differences in oral health knowledge, practice and KAP scores of college
students by birthplace and father’s education were statistically significant (p < 0.05).

In contrast, the differences of birthplace and father’s education on oral health knowledge, mother’s
education on oral health attitude scores and cigarette use on oral health practices scores were not
statistically significant (p > 0.05).

Oral health KAP of college students in Anhui Province

A total of 1,822 college students had a median oral knowledge score of 12.00 (11.00, 13.00) and a
passing rate of 92.26%, a median attitude score of 8.00 (7.00, 9.00) and a passing rate of 89.30%, a
median practice score of 4.00 (2.00, 5.00) and a passing rate of 19.65%, and a median KAP score of
24.00 (21.00, 26.00) and a passing rate of 87.10%. Table 2 shows the oral health KAP scores of the
respondents.

Table 2. Oral health KAP scores of college students in Anhui Province (n = 1,822)

P50 (P25，P75) Total score Pass Rate

Knowledge 12.00 (11.00, 13.00) 13 92.26%

Attitude 8.00 (7.00, 9.00) 9 89.30%

Practice 4.00 (2.00, 5.00) 9 19.65%

KAP 24.00 (21.00, 26.00) 31 87.10%

Correlation analysis of oral health knowledge, attitude, and practice among college students in Anhui
Province.

As shown in Table 3, students’ oral health knowledge and attitude were positively correlated (r = 0.430, p <
0.01), oral health knowledge and practice were positively correlated (r = 0.109, p < 0.01), and oral health
attitude and practice were positively correlated (r = 0.090, p < 0.01).

Table 3. Spearman’s two-by-two analysis between oral health knowledge, attitude, and practice (n =
1,822)

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 Project Knowledge Attitude Practice

Knowledge 1.000 - -

Attitude 0.430** 1.000 -

Practice 0.109** 0.090** 1.000

**P value < 0.01: statistically significant difference

Oral health KAP cardinality test for dental and non-dental college students in Anhui Province

As shown in Table 4, dental students’ overall oral health KAP mastery was significantly better than that of
non-dental students, with a statistically significant response from both majors.

Table 4. Differences in correct oral health KAP scores between dental and non-dental students (n = 1,822)

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Question (recommended Dental Non-dental χ2 P
answer) major(n)/Percentage major(n)/Percentage
(%) (%)

Knowledge        

Plaque can cause tooth decay 276 (96.5) 1372 (89.3) 14.392 0.000
and periodontal disease (K1)

Use of fluoride toothpaste can 257 (89.9) 1190 (77.5) 22.630 0.000
prevent caries (K2)

Effective brushing removes 269 (94.1) 1408 (91.7) 1.879 0.170

plaque and maintains healthy
teeth and periodontal tissue
(K3)

Too much sugary sweets can 275 (96.2) 1423 (92.6) 4,685 0.030
lead to caries (K4)

Smoking can be harmful to oral 256 (89.5) 1320 (85.9) 2.636 0.104
health (K5)

Drinking alcohol can be harmful 255 (89.2) 1319 (85.9) 2.217 0.136
to oral health (K6)

Oral health check-ups at least 267 (93.4) 1350 (87.9) 7.214 0.007
once a year can detect oral
diseases (K7)

Regular oral cleanings at least 268 (93.7) 1292 (84.1) 18.017 0.000
once a year will keep your teeth
strong and periodontal healthy
(K8)

Earlier stages of gingivitis may 267 (93.4) 1365 (88.9) 2.203 0.023
include bleeding gums when
brushing teeth or biting on hard
objects (K9)

Acute pulpitis occurs with 268 (93.7) 1377 (89.6) 4.526 0.033
severe spontaneous and
nocturnal pains (K10)

Caries often manifests as 260 (90.9) 1377 (89.6) 0.420 0.517

discomfort from hot or cold
stimuli, discomfort from biting
or pain (K11)

Bad breath is caused by 80% to 255 (89.2) 1269 (82.6) 7.546 0.006
90% of oral diseases (K12)

Vulcanization protects teeth and 267 (93.4) 1248 (81.2) 25.223 0.000
prevents tooth decay (K13)

Attitude        

Oral diseases can be 269 (94.1) 1163 (75.7) 48.204 0.000

detrimental to general health
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 g
(A1)

Frequent consumption of 195 (68.2) 968 (63.0) 2.782 0.095

carbonated drinks can lead to
tooth decay (A2)

Good or bad teeth are not 249 (87.1) 1273 (82.9) 3.071 0.080
natural and have a lot to do with
protection (A3)

Regular oral cleanings are good 265 (92.7) 1304 (84.9) 12.147 0.000
for your oral health (A4)

Regular oral check-ups are good 269 (94.1) 1361 (88.6) 7.594 0.006
for your oral health (A5)

Oral diseases can be prevented 254 (88.8) 1282 (83.5) 5.210 0.022
(A6)

Oral health is important for your 267 (93.4) 1350 (87.9) 7.214 0.007
health and quality of life (A7)

Oral health education can 271 (94.8) 1353 (88.1) 11.072 0.001
improve an individual’s oral
health literacy (A8)

Oral problems should be treated 273 (95.5) 1354 (88.2) 13.457 0.000
promptly in hospital (A9)

Practice        

Regular oral health check-ups 107 (37.4) 172 (11.2) 127.769 0.000
(P1)

Brush teeth ≥ 2 times a day 241 (84.3) 1108 (72.1) 18.458 0.000
(P2)

Brushing time ≥ 3 minutes per 188 (65.7) 859 (55.9) 9.492 0.002
session (P3)

Regular use of fluoride 169 (59.1) 618 (40.2) 34.939 0.000

toothpaste (P4)

Replace a toothbrush every 247 (86.4) 1182 (77.0) 12.621 0.000

three months or so (P5)

Regular flossing to assist in 113 (39.5) 281 (18.3) 64.035 0.000

cleaning between teeth (P6)

Brushing method the ‘horizontal 165 (57.7) 534 (34.8) 53.596 0.000
tremor brushing
method’ recommended by the
Chinese Stomatological
Association (P7)

Rinse mouth regularly after 138 (48.3) 598 (38.9) 8.697 0.003
meals (P8)

Regular oral cleanings (P9) 99 (34.6) 230 (15.0) 62.863 0.000

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Oral health knowledge

As shown in Figure 1, college students in Anhui Province had a relatively good grasp of oral health
knowledge, with correct rates above 90% for both majors in the answers to questions K3 and K4, and non-
dental students whose correct rate of answers to K2 was below 80%. The non-dental students were
significantly behind the dental students in terms of oral health knowledge. On the questions K3, K5, K6,
and K11, there was no statistical difference between the responses of the two majors (p > 0.05).

Oral health attitude

As shown in Figure 2, the percentage of correct answers for dental students in A1 (94.1%) was much
higher than that of non-dental students (75.7%) (p < 0.001), but both had a better grasp of the questions
except for A2, where the percentage of correct answers was less than satisfactory, and the percentage of
correct answers was greater than 80%. On the questions A2 and A3, there was not statistically difference
between the responses of the two majors (p > 0.05).

Oral health practice

As shown in Figure 3, dental students had much higher correct rates on P1, P4, P6, P7, P9 than non-dental
students (p < 0.05), but both had lower correct rates. All other oral health practice questions were not so
good in terms of correctness.

Discussion
This study analyzed the oral health knowledge, attitude and practice of college students in Anhui as well
as their influencing factors, and compared the oral health KAP of dental and non-dental students. It’s
known that there are fewer studies on dental students. The study aimed to identify the factors affecting
oral health KAP in advance and to carry out prevention.

The results showed that the pass rate of oral health KAP among college students was 87.10%.
Knowledge and attitude were good, with pass rates of 92.26% and 89.30% respectively. The oral health
practice was less favourable, with a pass rate of 19.65%. Similar to previous study [11], the oral health
practice of college students in Anhui were also not promising. As future medical professionals, it is more
important for medical students to acquire correct oral health practice.

It indicates that the oral health KAP scores gradually decreases for dental (26.00), medical (24.00) and
non-medical (23.00) majors. Previous study on the oral health of different majors’ students supports our
results [12]. Dental students have systematically studied oral expertise and have a more correct and
profound grasp of oral health KAP. Their oral health knowledge, attitude and practice are quite important
for later clinical work applications [12]. Non-dental students should consider their patients’ oral health to

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provide comprehensive care [13]. Meanwhile, the oral health KAP of college students increased with grade
level. This is similar to previous study [14]. Increasing grade level represents an increase in age and
education, and with the adult personality stability, college students will gradually follow a more
disciplined lifestyle and become more concerned with appearance [15]. As they seek ways to maintain a
pleasant mouth, their oral health KAP will naturally increase.

We found that the oral health practice scores of female college students were higher than those of males.
This is similar to the Scottish study on gender differences in oral health behavior [16]. The results of the
fourth national oral health epidemiology survey showed that twice daily brushing was higher among
females than males in all age groups [1]. Compared to male students, female college students may be
more expected to improve their personal image through proper oral health practice [17].

The study showed that urban-born college students had higher oral health KAP scores (24.00) than rural-
born students (23.00). It’s found that affordability and accessibility to dental services is more difficult in
rural communities due to their lower economic levels and poorer dental services, thus urban residents
have better oral health KAP than rural residents [18]. However, our study group was limited to college
students who all received higher education, so there was no difference.

It’s showed that children with more educated parents and an annual household income more
than ¥12,000 had higher oral health KAP scores. A study by Vanobbergen J et al. supports our results
[19]. Parental education, occupation and income are considered to be the main influencing factors on
children’s oral health [19]. While more educated parents can provide effective oral health guidance for
their children, and mothers be critical in influencing their children’s oral health [20]. Parents with higher
levels of education are likely to have more knowledge of oral health and a greater understanding of early
oral interventions and potential risk factors [21]. Thus, it is more helpful for children to have better oral
health KAP. Higher household income has a more positive impact on children’s oral health practice [16].

It’s found that smokers oral health knowledge and attitude scores were relatively low for non-smokers.
This is consistent with previous study [22]. The majority of people with a smoking habit aren’t well aware
of oral health and have inadequate knowledge about maintaining oral health. The result showed no
significant difference in oral health practice. This may be due to the fact that our participants were all
college students, and the smoking group (3.6%) was relatively small and not sufficiently representative
for the results to differ. In the future we will conduct more in-depth research on this group.

The correlation analysis of this study showed that oral health knowledge, attitude and behavior were
positively correlated and influenced each other. Previous studies have shown that there is a correlation
between knowledge and attitude, and that college students with better oral health knowledge have better
oral health practice [23, 24]. Oral health practice has a direct impact on oral health conditions, and good
oral health practice has a significant role in the prevention of oral diseases [15, 25]. Oral health
knowledge and attitude are important factors influencing oral health practice [26]. When people show
improved attitude after gaining knowledge, they may engage in better oral health practice [24].

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We found that dental students have higher oral health KAP than non-dental students. College students
had a better grasp of oral health knowledge. For oral health knowledge, non-dental students significantly
lagged behind dental students. This is in line with the previous finding [27]. Over 90% of college students
in both majors knew that effective brushing removes plaque and keeps teeth and periodontal tissues
healthy as well as excessive sugary sweets that cause dental caries. Only 77.5% of non-dental students
knew that using fluoride toothpaste can prevent dental caries, which is lower compared to the dental
students in this study (89.9%), and previous finding (81%) [14]. Due to the advantage of fluoride, medical
students should have sufficient knowledge to facilitate guidance on the appropriate use of fluoride in the
future [28]. 

In terms of oral health attitude, dental students are more aware than non-dental students that oral
disease can be detrimental to general health. All the other oral health attitude questions were well
mastered, with a correct response rate of over 80%. Oral health attitude reflects college students’
understanding of the importance of oral disease prevention [29]. However, both had a less favourable
response rate on whether regular consumption of carbonated beverages would lead to tooth decay.
Carbonated drinks left on the surface of tooth enamel may lead to caries formation [28], and should be
consumed as little as possible.

Students from both majors were not ideal in terms of oral health practice. Compared to non-dental
students, more dental students have regular oral health check-ups, use fluoride toothpaste, floss, use the
‘horizontal tremor brushing method’ recommended by the Chinese Stomatological Association, and have
regular oral cleanings. This suggests better oral hygiene practice among dental students, which is
coherent with research on Indian college student [27]. However, the implementation rates for both majors
are very low. Dental students should have good oral health practice in order to play an active role in the
dental field later on. 

Limitations

This study has some limitations. Firstly, our study population is limited to college students in Anhui
Province and is not representative of the national population. Secondly, this study is a cross-sectional
study and does not allow for the elaboration of causal relationships.

Conclusions
The results and analysis of this study showed that college students had good oral health knowledge and
attitude, but unsatisfactory oral health practice. Gender, major, grade, place of birth, parents’ education
level and annual household income all had a difference on oral health KAP scores. Smoking made a
difference to oral health KAP scores. There was a positive correlation between oral health knowledge,
attitude and practice. In addition, oral health KAP was better in dental students than in non-dental
students, but oral health practice needs to be improved in both majors. The results of our study may
provide insights for the improvement of oral health among college students.

Page 14/21
Abbreviations
KAP: knowledge, attitude, practice

Declarations
Ethics approval and consent to participate 

The protocol of this study was approved by the Medical Ethics Committee of Bengbu Medical College,
China (project code 2021/199). All procedures performed in studies involving human participants were in
accordance with the ethical standards of the institutional and national research committee and with the
1964 Helsinki declaration and its later amendments or comparable ethical standards. Before data
collection, all participants read the consent information, and provided verbal informed consents by
clicking "Continue" to take this online survey. The informed consent protocol was approved by the
Medical Ethics Committee of Bengbu Medical College, China.

Consent for publication 

Not applicable. 

Availability of data and materials 

The datasets used and/or analyzed during the current study were available from the corresponding
author on reasonable request. 

Competing interests 

The authors declare that they have no competing interests. 

Funding

This study was funded by the National Innovation and Entrepreneurship Training Program for college
students of China (No. 201910367045), Key projects of Humanities and Social Sciences of Bengbu
Medical College (No. 2020byzd224sk), Innovation and Entrepreneurship Training Program for college
Students in Anhui Province, China (No. S202010367051).

Authors' contributions

SHZ and SKL gave substantial contributions to conception and design of this study. SHZ made critical
revisions of the manuscript and supervised the whole process. WHL and NY performed the statistical
analysis and drafted the initial manuscript. WD, WZ, HYZ, YYZ, HG, SHZ and SKL all collected the data.
All authors have read and approved the final manuscript.

Acknowledgments

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We thank all respondents for their invaluable contribution to this study. 

Authors' Information

1
School of Stomatology, Bengbu Medical College, Bengbu, Anhui, China,

2
School of Public Health, Bengbu Medical College, Bengbu, Anhui, China, 

3School of Medical Imaging, Bengbu Medical College, Bengbu, Anhui, China, 

4Department of Stomatology, First Affiliated Hospital of Bengbu Medical College, Anhui, China.

Corresponding Author: 

Shunhua Zhang, Professor, School of Medical Imaging, Bengbu Medical College, Bengbu 233030, Anhui,
China, E-mail: 0800076@bbmc.edu.cn

Shengkai Liao, Professor Department of Stomatology, First Affiliated Hospital of Bengbu Medical College,
Bengbu 233004, Anhui, China, E-mail: lsk3166@163.com

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Figures

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Figure 1

Proportion of correct responses for knowledge item between dental and non-dental major students (n =
1,822)

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Figure 2

Differences in the proportion of agreement with oral health attitude between dental and non-dental
students (n = 1,822)

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Figure 3

Differences in the proportion of implementation of oral health practices between dental and non-dental
students (n = 1,822)

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