Post-meal Oral Care Habit and Dental Health of Hong Kong People Behavioural Survey and Recommendation

1. Post-meal Oral Care Habit and Dental Health of Hong Kong People Behavioural Survey and Recommendation Speakers: Dr. Robert Chung, Programme Director, The University of Hong Kong Public Opinion ProgrammeDr. Cecilia Young, Registered Dental Surgeon Date: May 20, 2004

2. Post-meal Oral Care Habit and Dental Health of Hong Kong People Behavioural Survey Speaker: Dr. Robert Chung Programme Director, The University of Hong Kong Public Opinion Programme

3. Research overview

4. Demographic Information

5. Male Female Gender Successful samples: 506

6. Age Weighted samples: 506

7. Separated/divorced/widowed Married Single Marital status Weighted samples: 506

8. Occupation Weighted samples: 506

9. Job nature Weighted samples: 270 (full-time or part-time workers)

10. Personal income Weighted samples: 247 (full-time or part-time workers)

11. Education Weighted samples: 506

12. Tooth Decay Situation of Hong Kong People

13. Don’t know/hard to tell No Yes 59% Hong Kong people have caries Do you have any carie? (Include milk teeth, permanent teeth, filled and extracted teeth) Successful samples: 506

14. Don’t know/hard to tell 11-15 7-10 1-3 4-6 62% of those who had tooth decay have 1-3 bad teeth How many caries do you have? (Include milk teeth, permanent teeth, filled and extracted teeth) Successful samples: 301 (with caries)

15. Caries increases with age Percentage with caries in different age groups (Include milk teeth, permanent teeth, filled and extracted teeth)

16. Eating Habit

17. 88% 99% 56% 100% 40% 82% 89% 47% Meal habits of respondents Do you eat... Successful samples: 506

18. Over half respondents have 4-6 meals a day On average, how many meals do you have per day? (Include breakfast, lunch, dinner, afternoon tea, supper, snacks, fruits, dessert) Successful samples: 506

19. Don’t know/hard to tell Sour Sweet Hot Salty Sweet is the most popular taste Among sweet, sour, bitter, hot and salty, which is your favourite taste for food? Successful samples: 506

20. Most respondents eat meals or snacks with sugar content Do you eat meals containing sweet foods or drinks, drink milk or add sugar in your drinks? Successful samples: 203 - 506 (who eat particular meal)

21. Over half of the respondents who eat snacks choose sweets The taste of the snacks you eat is mostly... <1% Successful samples: 410(who eat snacks)

22. Post-meal Oral Care Habit

23. 99% have the habit of brushing teeth No habit of brushing teeth Habit of brushing teeth Successful samples: 506

24. The majority of respondents brush their teeth in the morning and before sleep When do you usually brush your teeth? <1% Successful samples: 502 (have the habit of brushing teeth; multiple responses)

25. Often Sometimes Never 87% Hong Kong People Do Not Brush Their Teeth After Every Meal Or Snack Do you brush your teeth every time after you eat? (Include breakfast, lunch, dinner, snacks and fruits etc.) Successful samples: 502 (have the habit of brushing teeth)

26. 74% of respondents do not brush their teeth after eating because of “inconvenience” and “no such habit” Why don’t you brush your teeth after eating? Successful samples: 438(do not brush their teeth after meal or snack; multiple responses)

27. Often Never Sometimes 64% of respondents have oral care habits other than teeth brushing Besides brushing teeth, do you perform any other oral care? Successful samples: 506

28. Flossing and mouth wash are the most common oral care used What types of oral care do you usually use? Successful samples: 325(perform oral care habits other than teeth brushing; multiple responses)

29. “No such habit” is the key reason for respondents who brush their teeth but not using any other oral care methods Why don’t you use other oral care methods to clean your teeth? Successful samples: 181(besides brushing teeth, do not use any other oral care methods; multiple response)

30. Attitude and Knowledge Towards Post-meal Oral Care Methods

31. Don’t know/hard to tell No need Should brush the teeth after meals and snacks 68% respondents feel there is a need to brush their teeth after meals or snacks Do you think there is a need to brush your teeth after meals and snacks? Successful samples: 506

32. Over half of the respondents know they will have tooth decay if they do not brush their teeth after meals or snacks If you do not brush your teeth after meals or snacks, what consequence do you think there will be? Successful samples: 506 (multiple responses)

33. Knowledge on oral care methods other than brushing teeth Besides brushing teeth, do you know any other oral care methods? Successful samples: 506 (multiple responses)

34. Conclusion: Hong Kong People like sweets and have multiple meals, but don not brush their teeth after meals, thus increasing the chance of tooth decay • 59% have tooth decay, among which 62% have 1-3 bad teeth. • Respondents have multiple meals in a day. • Sweet is the most popular taste. • Inconvenience is the key reason for not brushing their teeth after meals and snacks for most respondents. This increases the chance of tooth decay. • 24% respondents know gum chewing can help oral care. • Dental flossing and mouth wash are the most common oral care methods, with chewing gum as the third one.

35. Hong Kong people are snacking and taking multiple meals due to long working hours and high pressure • One of the reasons people taking multiple meals a day is the long working hours and high pressure. This echoes with an earlier survey which shows many Hong Kong workers reduce stress by eating, among which snacking is the first choice of women. • The findings reveal that many people have basic knowledge of after meal oral care, however, most are unable to do so because of individual or environmental constraints. • Hong Kong is lucky not to have any case of SARS, but we must continue our effort to promote public health education.

36. Dental Health and Post-meal Oral Care Recommendations Speaker: Dr. Cecilia Young, Registered Dental Surgeon Date: May 20, 2004

37. About the survey • Gender, age, marital status, occupation, job nature, personal income and education in the survey reflect the lifestyle of common Hong Kong people, which is not biased towards any population group. • 80% of respondents eat snacks, among which 93% eat snacks that are sweet. This shows the eating habit of Hong Kong people. • Most respondents feel there is a need to brush their teeth after meals and snacks but are unable to do so. • Multiple meals is the most import issue that needs to be addressed.

38. What is dental plaque?

39. What is Dental Plaque? • It is the mixture of bacteria and its products • Above and below gum • Can be disclosed by stain • Mainly on the lines of the teeth, any sunken area of teeth and adjacent sides between two teeth • Composed of various bacteria

40. What is Dental Plaque? • Bacteria harboured the oral cavity since birth. Glycoprotein in saliva helps the bacteria to attach onto the surface of teeth. Through the generation of mucopolysaccharide matrix, plaque becomes strengthened and more plaque attaches. • In diets with high sugar content, there are more streptococcus mutans and lactobacilli • 30% of the volume of plaque is organic matter • Effects of plaque • Reduce diffusion – acidity by bacteria stays at a high level • Reduce the entrance of buffer – stops the neutralization of acids

41. Plaque disclosing agent

42. Use of plaque disclosing agent

43. Microorganisms commonly present in dental plaque

44. organic starting material catabolites Catabolism substrate end product Example: glucose 2 lactic acid ↘ Energy glucose+maltose Acid amylase bacteria inplaque starch amylase glucose+maltose+dextrin Acid bacteria inplaque glycogen

45. Bacteria in plaque can use all fermentable carbohydrates to form acid, thus, almost all sorts of food lead to increase of acidity in plaque.Both enamel on the surface of teeth and dentine inside teeth are composed of minerals. Loss of minerals due to the increase of acidity is known as demineralization. The whole picture becomes caries.

46. Dental caries

47. Change in plaque pH after eating • Increase the risk after eating • The more times you eat, the higher the risk

48. Healthy tooth vs decayed tooth Health tooth Unhealthy tooth

49. Cariogenic potentials of foods

50. Functions of saliva • Washing effect Mechanically washes the plaque on the surface of teeth • Buffering effect Neutralizes the acids generated by bacteria, hence reduces demineralization • Remineralization Repairs the enamel which has lost minerals; containscalcium, phosphate andfluoride • Combat bacteria Contains immunoglubolin A andlysosome