Effect of Oil Pulling on Level of Oral Health among College Students at Selected Hostel, Coimbatore

 

Jashmi. G1, Mrs. R. Deepa2, Dr. T. Nirmala3

1Nursing Tutor, College of Nursing, Sri Ramakrishna Institute of Paramedical Science, Coimbatore.

2Associate Professor College of Nursing, Sri Ramakrishna Institute of Paramedical Science, Coimbatore.

3Principal, College of Nursing, Sri Ramakrishna Institute of Paramedical Science, Coimbatore.

*Corresponding Author E-mail: gjashmi@gmail.com

 

 

ABSTRACT:

The study was to assess the effect of oil pulling on level of oral health among college students at selected hostel, Coimbatore. Non randomized quasi experimental pretest- posttest control group design was adopted in this study. By using Modified mouth care assessment tool 62 samples were selected, by using alternative method samples were assigned to experimental and control group. Oil pulling was practiced by experimental group for three times in a day for two days in a week to a extent of 4 weeks. At the end of four weeks post test was done by using mean value score of 9 and was categorized as good, average, poor oral health. The result shows that there was a significant difference in the level of oral health in experimental group before and after oil pulling ( t = 8.641, p=0.005). There was a significance difference in the level of oral health among experimental and control group after oil pulling (t=5.766, p=0.005). Hence, it was concluded that oil pulling is an effective intervention in improving the level of oral health among college students.

 

KEYWORDS: Oil pulling, Oral health.

 

 


INTRODUCTION:

Health is a dynamic process because it is always changing. As lifestyle changes every individual will face some sort of sickness, and it may be mild to serious illness (Greenberg, 2004)

 

Health promotion programs like teaching the student nurses about self care, and educating about proper nutrition, and they can strive to be healthy nurses who are physically and emotionally prepared to provide the best possible care to the patients (Susan Letvak, 2014)

 

India’s oral health care status demonstrates a great need for better education and more accessible service. The National oral Health programme notes that 95% of adults in India suffer from gum diseases and 50% of our citizens don’t use toothbrush. The program also finds that 70% of children under the age of 15 have dental caries (The National Oral Health Programme, 2016).

 

Oral health is essential to general health and well-being at every stage of life. A healthy mouth enables not only nutrition of the physical body, but also enhances social interaction and promotes self esteem and feelings of well- being. The mouth serves as a “window” to the rest of the body, providing signals of general health disorders.The interrelationship between oral and general health is proven by evidence, severe periodontal disease is associated with diabetes. The strong correlation between oral diseases and non communicable chronic diseases is primarily a result of the common risk factors. General diseases also have oral manifestations that increase the risk of oral disease which in turn, is a risk factor for a number of general health conditions. This wider meaning of oral health does not diminish the relevance of the two globally leading oral afflictions dental caries and periodontal disease.

 

Interprofessional and collaboration education between medicine/ nursing and dentistry is important. There exists a critical relationship between oral and general health. Thus, education of health care workers and opportunities for cross- fertilization of ideas should be encouraged. Educational institutions do play a proactive role by creating interdisciplinary opportunities that will serve as the impetus for change in health care delivery. So, as a new curriculum incorporating basic topics on oral health hygiene should be included for nursing students.

 

NEED FOR THE STUDY:

Oral health means more than just an attractive smile. Poor oral health and untreated oral diseases and conditions can have a significant impact on quality of life. And in many cases, the condition of the mouth mirrors the condition of the body as a whole. Recent reports indicate a relationship between periodontal disease and stroke, heart disease and preterm, low birth- weight babies and infections in the mouth can affect major organs, oral bacteria can travel through the bloodstream to the heart, where they can cause bacterial endocarditis, a condition in which the lining of the heart and heart valves become inflamed. Poor mouth care also can contribute to oral cancer. In addition, poor oral health affects the digestive process, which begins with physical and chemical activities in the mouth. Mouth tissues reflect symptoms of other problems throughout the body. In addition, many diseases can be diagnosed in their early stages through an oral examination. These diseases may be characterized by swollen or bleeding gums, mouth ulcers or dry mouth. Some of these diseases include diabetes, leukemia, cancer, heart disease and kidney disease.

 

In some Asian and African countries, 80% of the population depends on traditional medicine for primary health care. In many developed countries, 70% to 80% of the population has used some form of alternative or complementary medicine. Herbal treatments are the most popular form of traditional medicine, and are highly lucrative in the international markplace (WHO, 2003) Oil pulling is considered as one of the alternative or complementary medicine.

 

 

Oil pulling is an ancient Indian folk remedy first mentioned in the early ayurvedic text, the charaka samhita, which was believed to have been written approximately 1500 years ago. Ayurveda advises oil gargling to purify the entire system, as it holds that each section of the tongue is connected to different organ such as to the kidneys, lungs, liver, small intestines, stomach, colon, and spine, similarly to reflexology and TCM. Effect of oil pulling has on the entire body reaches far beyond oral health. This is especially important for people who have conditions that contraindicate brushing such as mouth ulcer, fever, indigestion, those who have tendency to vomit, have asthma, cough, or thirst.

 

Multiple scientific studies show the efficacy of oil pulling therapy. Specially oil pulling with sesame oil can boost overall health. Oil pulling may also increase saponification in the mouth, creating a soapy environment that cleanses the mouth as vegetable fat is an emulsifier by nature. Most interesting is perhaps the ability of oil to cleanse out harmful bacteria, as well as reduce fungal overgrowth. These oils also possibly help in cellular restructuring, and are related to the proper functioning of the lymph nodes and other internal organs. (Group, 2015)

 

Each life stage brings a unique set of issues and considerations. Ultimately, this overview identifies the need for research on health services, health promotion, and disease prevention specific to populations at different life stages and throughout the life span. Our nation’s young and old exemplify the complexities of the individual, family, community, and institutional interactions that shape health and well being. The researcher found that the nursing citizens have to develop harmonious relationship with other health care disciplinaries. Hence the researcher felt that oil pulling would be effective in promoting communication skills, oral health among personnels of health care system.

 

STATEMENT OF THE PROBLEM:

 Effect of oil pulling on level of oral health among college students at selected hostel, Coimbatore.

 

OBJECTIVES:

1    To assess the level of oral health among college students.

2    To evaluate the effect of oil pulling on level of oral health among college students

3    To find out association between the level of oral health and selected demographic variables.

 

OPERATIONAL DEFINITION:

Effect:

It refers to changes in level oral health among college students after oil pulling.

 

Oil pulling:

It refers to swishing one tablespoon of coconut oil on an empty stomach, around the mouth for 20 minutes for twice in a week to an extend of four weeks.

 

Oral health:

It refers to, basic hygiene of the oral cavity, teeth, gums and associated health problems. It was checked by modified mouth care assessment tool, it was categorized to poor, fair, average and good oral health.

 

College students:

Nursing students who have fair level of oral health.

 

CONCEPTUAL FRAMEWORK:

Conceptual framework of this study was based on the helping art in nursing theory by Ernestine wieden bach in 1964. The theory focuses on three concepts such as identification, ministration and validation. According to wieden bach, nursing practice consist of identifying a nursing students for help, ministering the needed help and validating the needed help.

 

LITERATURE REVIEW:

A study was conducted by Peedikayil (2015) a prospective interventional study to evaluate the effect of coconut oil pulling on plaque formation and plaque induced gingivitis. The study progressed with adolescent boys and girls in the age group of 16-18 years with plaque induced gingivitis. Oil pulling was included in their oral hygiene routine. The study period was carried for 30 days plaque and gingival indices of the subjects were assessed at baseline days of 1,7,15 and 30 respectively. The data were analyzed using paired t test. The result shows that a statistically decrease in the plaque and gingival indices was noticed from day 7 and the score continued to decrease during the period of study. The researcher concluded that oil pulling using coconut oil could be an effective adjuvant procedure in decreasing plaque formation and plaque induced gingivitis.

 

A study was conducted by Asokan (2011) to evaluate the effect of oil pulling with sesame oil on halitosis and the microoraganisms that could be responsible for it. The study progressed with Group I (oil pulling) and Group II (chlorhexidine) included 10 adolescent each, marginal gingival index , plaque index, organoleptic breath assessment(ORG 1), self assessment of breath (ORG 2) and BANA test from tongue coating samples on day 0 and 14 of the experimental period . The result shows on the comparisons of the pre and post therapy values of plaque and modified gingival index score showed a statistically significant difference (p=0.005 respectively) in Group I and II. There was a definite reduction in the ORG I,ORG 2, scores and BANA test score in both group I and II. The researcher concluded that oil pulling therapy has been equally effective like chlorhexidine on halitosis and organisms, associated with halitosis.

 

METHODS AND MATERIALS:

RESEARCH DESIGN:

A Quantitative Non randomized quasi experimental pretest-posttest control group design was adopted in this study.

 

SETTING:

The study was conducted at Sri Ramakrishna women’s hostel, Coimbatore.

 

POPULATION:

The target population for the present study were nursing students. The accessible population were third year nursing students who are studying in college of nursing, Sri Ramakrishna Institute of Paramedical sciences, Coimbatore.

 

SAMPLING:

A total of 62 students who had fair level of oral health were selected for the study using Non probability- Purposive sampling technique.

 

CRITERIA FOR SAMPLE SELECTION:

Inclusion Criteria:

1    Nursing students who were willing to participate in this study.

2    Nursing students who had fair level of oral health.

 

Exclusion criteria:

1    Nursing students who had good oral health.

 

VARIABLES OF THE STUDY:

The independent variable of the study was oil pulling and dependent variable is the level of oral health among college students.

 

TOOLS FOR DATA COLLECTION:

The following tools were used for data collection

 Section A: Questionnaire to collect demographic profile

 Section B: Questionnaire to collect Dental History

 Section C: Modified mouth care assessment tool

 

A Questionnaire to collect Demographic profile:

The demographic profile consists of age and gender

 

Questionnaire to collect dental history:

Dental history consists of last dentist visit, frequency of brushing, floss habit, teeth sensitivity, color of the teeth, difficulty in the speech/trouble pronouncing words, and rating the condition of the mouth.

 

Modified mouth care assessment tool:

Modified mouth care assessment tool which was developed by National Health Services in the year 2016. This tool was a 4 point likert scale with 7 items which includes tongue, mucous membranes, pain, teeth dentures, lips, gingival bleeding and saliva. It mainly focused on oral health of the college students. The students were expected to tick the significant findings separately.

 

The responses were scored as

Good–1 ; Fair–2 ; Average–3 ; poor–4. A total score interpretation of 1-7 score indicates good oral health, 8-14 score indicates fair level of oral health, 15-21 score indicates average level of oral health, 22-28 score indicates poor level of oral health.

 

 

METHOD OF DATA COLLECTION:

Modified mouth care assessment tool was used to select the fair level of oral health. A total of 62 students were selected and thereby, using alternative method they were equally divided into 31 as experimental group and control group respectively. The experimental group was instructed to practice oil pulling in empty stomach for three times in a day for two days in a week to an extend of 4 weeks, common reminder was given to the students to follow the same. The control group was instructed to continue their routine. At the end of four weeks, posttest was done to assess the level of oral health using mean valve score of 9. The effectiveness of oil pulling on oral health was determined through comparing the pretest scores.


 

DATA ANALYSIS AND INTERPRETATION:

Table no: 1 Demographic Variables of College Students

Sl. No

Demographic profile

Distribution

Experimental group (n=31)

Control group (n=31)

Frequency

Percentage%

Frequency

Percentage %

1.

Age

> 19 years

22

70.97

17

54.84

< 20 years

9

29.03

14

45.16

2.

Gender

Male

5

16.13

5

16.13

Female

26

83.87

26

83.87

3.

Last dentist visit

> 3 years

12

38.71

11

35.49

3-6 years

4

12.9

4

12.90

< 6 years

15

48.39

16

51.61

 

4.

Brushing habit

Once

26

83.87

24

77.42

Twice

5

16.13

7

22.58

 

5.

Flossing habit

Yes

16

51.61

13

41.94

No

15

48.39

18

58.06

 

6.

Teeth sensitivity

Yes

4

12.91

8

25.81

No

27

87.09

23

74.19

 

Sl.No

Demographic profile

Distribution

Experimental group (n=31)

Control group (n=31)

Frequency

Percentage %

Frequency

Percentage %

7.

Worried about color of teeth

Yes

14

45.16

11

35.49

No

17

54.84

20

64.51

8.

Difficulty in speech / trouble pronunciation

Yes

1

3.22

3

9.68

No

30

96.78

28

90.32

9.

Condition of the mouth

 

Excellent

1

3.22

-

-

Good

15

48.39

21

67.7

Fair

15

48.39

10

32.3

Poor

-

-

-

-

 


Distribution on Age revealed that, majority (70.97%) of the students in experimental group and (54.84%) control group were >19 years, and rest were <20 years.

 

Gender distribution revealed that, majority (83.87%) of students in the Experimental group and Control group, were girls and rest were boys.

 

Distribution on last dentist dental visit revealed that, majority (48.39%) of students in experimental group and (51.61%) of control group, were <6 years of last dentist visit. Among students in the experimental group and control group (12.9%) had 3-6 years of last dentist visit.

Distribution on Brushing habit revealed that, majority (83.87%) of students in experimental group and (77.42%) of control group, brushes their teeth once daily and the rest brushes their teeth twice.

 

Distribution on flossing habit revealed that, majority (51.61%) of students in experimental group had flossing habit and (58.06%) of students in control group had no flossing habit.

 

Distribution on teeth sensitivity revealed that, majority (87.09%) in experimental group and (74.19%) in control group had no teeth sensitivity.

 

Distribution on worried about color of teeth revealed that, majority (54.84%) in experimental group and (64.51%) in control group were not worried about their color of the teeth.

 

Distribution on difficulty in speech/trouble pronunciation revealed that, majority (96.77%) in experimental group and (90.32%) in control group had no difficulty in speech/ trouble pronunciation, and rest had difficulty in speech/ trouble pronunciation.

 

Distribution on rating the condition of the mouth majority, (48.39%) in experimental group had rated the condition of the mouth as good and fair, and (67.7%) in control group had rated the condition of the mouth as good.

RESULTS AND DISCUSSIONS:

There is no homogeneity in the pretest oral health level between experimental and control group nursing students.

 

There is a significant difference in the posttest oral health between the experimental and control group at ‘t’ value 5.766 significant at 0.005 level.

 

 

 


 

Table no: 2 Comparison on Level of Oral health among College Students

 

Sl.No

Level of oral health

Before oil pulling

After oil pulling

Experimental group (n=31)

Control group (n=31)

Experimental group (n=31)

Control group (n=31)

No

%

No

%

No

%

No

%

1.

 Good (>9)

13

41.93

13

41.9

30

96.78

15

48.39

2.

Average (9)

3

9.68

5

16.2

1

3.22

5

16.13

3.

Poor (<9)

15

48.39

13

41.9

-

-

11

35.48

 


The above table depicts that, level of oral health among college students before oil pulling revealed that (48.39%) of college students had poor level of oral health in experimental group, and (9.68%) of them had average level of oral health. Among students in the control group, (41.9%) had good level of oral health, (41.9%) of the students had poor level of oral health.

 

Level of oral health among college students after oil pulling revealed that (96.78%) of college students had good level of oral health in experimental group, and (3.22%) of them had average level of oral health. Among students in the control group, (48.39%) of the students had good level of oral health and (16.13%) of the students had average level of oral health.

 

Table no: 3 Analysis on Effect of Oil pulling on Level of Oral health among College students in Experimental Group

Group

Mean Score

Standard Deviation

Mean Difference

‘t’

Value

 

 

Experimental group

Pre test

9.6

1.73

 

 

2.4

 

 

8.641*

Post test

7.2

0.5

 

The above table shows that, among the experimental group, the pre and post test mean scores were 9.6 and 7.2 respectively, with a mean difference of 2.4. The standard deviation was 1.73 and 0.5 for pre and post test respectively. The calculated ‘t’ value (8.641) is greater than the table value (2.750) at 0.005 level of significance. Hence the hypothesis “There will be a significant difference between the pretest and posttest level of oral health among the experimental group” was accepted.

 

There is significant association with the level of oral health among college students on gender (ᵡ2= 3.04) and last dentist visit (ᵡ2=6.12) had association at 0.05 and 0.005 level significance respectively.

Delimitations:

1.    The study was confined to only one batch of nursing students.

2.    There was a chance for sample contamination since students in both experimental and control group belongs to the same batch.

 

RECOMMENDATIONS:

1.    The same study could be undertaken with large samples to show strong statistical association

2.    A comparative study can be done between the oil pulling with other methods of oral health.

 

NURSING IMPLICATION:

Nursing Education:

Oil pulling was found effective in reducing the level of oral health among college students. Educational institutions should play a proactive role by creating interdisciplinary opportunities that will serve as the impetus for change in health care delivery, so a new curriculum incorporating basics related to oral hygiene should be included for nursing students.

 

Nursing administration:

The nurse administrator can draw written policies regarding oil pulling to reduce the fair oral health among college students. A check list can be prepared and practiced by health care personnel. Periodical surveillance can be helpful on reduction of fair oral health among college students.

 

Nursing Practice:

Oil pulling does not cost students extra time and is effective in reducing fair oral health among college students.

 

 

 

CONCLUSION:

Good oral health is not only essential to good overall health and freedom from pain and suffering associated with oral diseases. Inter professional and collaborative education between medicine/nursing and dentistry is important. There exists a critical relationship between oral and general health , it also affects self-esteem, quality of life, and performance at college therefore, the professional educators must view oral health as essential. Oil pulling is observed to bring improvement in oral health hygiene when practiced correctly and regularly, based on this research it can be concluded that oil pulling can be safely used as an adjunct to maintain good oral hygiene and health along with the routine tooth brushing and flossing with promising positive results.

 

REFERENCES:

1.     Asokan S, Emmadi P, Chamundeswari R. Effect of Oil pulling on plaque induced gingivitis, A randomized, controlled, triple - blind study -2009

2.     Asokan S, Rathan J, Muthu MS, Rathna PV, Emmadi P, Raghuraman R, et al. Effect of oil pulling on streptococcus mutans count in plaque and saliva using Dentocult SM strip mutans test, A randomized, controlled, triple- blind study- 2008

3.     Oil pulling a wonderful therapy. Available from: http://www.oilpulling.com ( Last accessed on 2013 sep 20)

4.     The Oil pulling Natural Healing Treatment of Dr. Karach. Available from: http://www.oilpulling.org /wpcontent/ uploads /2009/09/Oil_Pulling_A_Universal_RemedyTKRao.pdf. (Last accessed on 2013 sep 19)

5.     Modified from Kayser-Jones et al (1995) by chalmers(2004), Best Practice Guideline- The Oral Assessment Tool Available from: http://www.healthcare.uiowa.edu/igec/e-learnlic/ dentistry/ default.asp

6.     National Institute of health and the US National Library of Medicine. PMID: 21911944 [Pub Med- indexed from MEDLINE]. Originally published at http://www. ncbi.nlm.nih. gov/pubmed/21911944 and appeared there on December 19, 2013.

 

 

 

Received on 12.01.2018        Modified on 17.04.2018

Accepted on 29.05.2018       ©A&V Publications All right reserved

Int.  J. of Advances in Nur. Management. 2018; 6(3): 199-204.

DOI: 10.5958/2454-2652.2018.00044.6