J Bagh College Dentistry Vol. 29(2), June 2017 Comparison Of Oral Health Oral and maxillofacial Surgery and Periodontics 71 Comparison Of Oral Health Status And Behaviorbetween First And Fifth Years Of Al-Mustansiriyah Dental Students Athraa A. Mahmood, B.D.S., M.Sc. (1) ABSTRACT Background:Periodontal diseases and dental caries are the most common oral diseases, but they can be adequately prevented by adopting a specific health behavior and plaque control.The study was carried out to determine and compare oral health status; it included both caries experience, gingival health and oral hygiene behavior betweenfirst and fifth yearsof Al-Mustansiriyahdental students. Materials and methods: Total sample of the study consisted of 50 students at first year (25 males, 25 females)and 60 students at fifth year (30 males, 30 females). Plaque andgingival indices,dental caries indices (DMFS and DMFT) wererecorded to evaluateoral health status for each student. Further questionnaires were given to evaluate different oral hygiene habits. Results: The mean values of plaque and gingival indicesin the first year were higher than fifth year for males and females with highly significant difference at (P ≤0.01);whereas the mean values of plaque index were (1.17, 0.83 for males of first and fifth years respectively and 1.02, 0.47 for femaleof first and fifth years respectively)and the mean values of gingival index were(0.89, 0.51 for males of first and fifth years respectively and 0.78, 0.31 for femalesof first and fifth years respectively). As well as, the mean of (DMFS and DMFT) were showed higher values among females than maleswhere (8.88, 6.48 for males and 10.16, 7.08 for females)in first year, while(11.90, 8.73for males and 13.33, 9.16 for females) infifth year. The percentagesof tooth brushing, mouthwash, dental floss, and tooth picks usingfor fifthyear students were higher than first year students. Conclusion: Differences of oral health statusand behavior rates between first and finalyearsstudents can be attributed to low level of dental education infirst year studentswhoseneed the improvements of oral hygiene education in futurewhich include the importance of proper tooth brushing and using of interdental aids to prevent the periodontal diseases and dental caries. Keywords:Tooth brushing,plaque index, gingival index, dental students. (J Bagh Coll Dentistry 2017; 29(2): 71-77 ) INTRODUCTION Oral hygiene is the practice of keeping the mouth healthy and clean by brushing and flossing to prevent tooth decay and gingival disease sothe purpose of oral hygiene is to prevent the buildup of bacterial plaque, whichis generally accepted as the predominant etiological factor in periodontal disease (PD) and is also regarded essential for the initiation of dental caries (DC) (1, 2). Consequently preventive programs of the (PD) and (DC) are based on plaque control (1, 3). Dental caries is a highly prevalent chronic oral infectious disease of microbiological origin affecting hard tissues of the tooth, characterized by alternating phases of demineralization and remineralization.(4,5)It can be arrested, restricted and potentially reversed in its early stages, but it is often not self-limiting and without proper care can be progress until the tooth is destroyed. (6), also it can affect either genders with all age groups with all socioeconomic conditions (7). Many studies were conducted to evaluate the decayed, missing and filled surfaces and teeth (DMFS) and (DMFT). The results showed that the caries prevalence was high and it increased with age and over time, especially since the relatively recent economic growth, which has resulted in an increased consumption of refined sugar, higher than other developing countries (8- 14). Lack of awareness about oral health practices has also contributed to increase dental caries(15, 16). One of the general objectives of teaching dentistry is to train experts to motivate patients to adopt good oral hygiene practices. They are more likely to be able to do this if they themselves are motivated(1, 13). Dental students are representative of the educated, urbanized, influential, and motivated class of individuals.They should be convinced that (DC) and (PD) are preventable, and should possess the knowledge and conviction of preventive principles in planning and implementation of programmers and possess leadership in this aspect(17, 18). Reports on the impact of education on the oral hygiene of dental students are different. Lang et al, in1977was studied oral hygiene of Danish dental students, whileCavaillon et al,in 1982wasstudied oral hygiene of French dental students at the University of Paris; where both (1) Assi stance Lecturer, Depart ment of Periodontal Dentistry, College of Dentistry, University of Al-Mustansiriyah. J Bagh College Dentistry Vol. 29(2), June 2017 Comparison Of Oral Health Oral and maxillofacial Surgery and Periodontics 72 authors noted a clear improvement in the oral hygiene practices of students during their studies. On the other hand, Meister et al,in 1980did not showany improvement in the oral hygiene of students, in spite of having received information and education in a study at the University of Marquette (Michigan) in United States of America (19, 20, 21). The aim of the present study was to determine and compare oral health status (DC and gingivitis) and oral hygiene behavior among first (1st) and fifth (5th)years of Al-Mustansiriyah dental students to find out if they are practicing the dental health regimes effectively during their studying period and to assess the import of dental study on improvement of oral health status. MATERIALS AND METHODS The sample of the study consisted of 110 dental students;50 students at 1styear (25 males and 25 females) and 60 students at 5thyear (30 males and 30 females) of Al-Mustansiriyah dental college, theywere randomly recruited and enrolled voluntarily in the study after a well explanation of purpose of the investigation. In this study, all students were systemically healthy, cooperative and not taking any antibiotics during the last three months (22).Any pregnant and in menstrual cycle females, student had history of chronic systemic diseases with known associations with (PD) (e.g. diabetes mellitus) and any student with retentive factor of plaque (e.g. orthodontic appliance) were excluded from this study. Oral examinations of students were carried out at the dental clinics teaching hospital department of periodontics of Al-Mustansiriyah University, under standard conditions, using plane mouth mirrors, William's periodontal probes and artificial light. All teeth were examined with the exception of third molars.Oral health status was evaluated by measurement the plaque index (PLI) (23), gingival index (GI)(24),(DMFS)index and (DMFT)index(25).Radiographs were not taken for any of the participants because of practical limitations. Further questionnaires were given to evaluate different oral hygiene behavior that includes:  How often do you clean your teeth daily?  Are you use dental floss, mouthwash and tooth picks? Statistical methods for analysis of the results of the study were performed using (IBM® SPSS® Statistics version 21, 2012). RESULTS The study sample was composed of 110 dental students;50 students at 1st year aged (17-19 years) divided into (25 males and 25 females) and 60 students at 5thyear aged (21-23 years) divided into (30 males and 30 females), this was shown in Table (1). The means of (PLI) and(GI) were higher in the 1st year students than in the 5thyear students for males and females (means of PLI were 1.17, 0.83 for males and 1.02, 0.47 for females while means of GI were 0.89, 0.51 for males and 0.78, 0.31 for females at 1stand 5th years respectively) as shown in Table (2) and Figure (1) Caries experience by gender was shown in Table (3); wherethe means of(DMFT) and (DMFS) indices showed higher values among females than males(8.88, 6.48 for malesand 10.16, 7.08 for females in 1st year students, while 11.90, 8.73 for males and 13.33, 9.16 for females in 5th year students). For comparisons among students, ANOVA test was used; the results showed that there was high significant (HS) difference at P-value ≤ 0.01 among and within students for both (PLI) and (GI), as shown in Table (4).While, the least significant difference (LSD)test was performed for multiple comparisons between each two groups; the results showed that there wasnon- significant (NS) difference at P-value ≥ 0.05 between 1st year-males and 1st year-femalesfor both (PLI) and (GI), whilethere was significant (S) difference at P-value <0.05between 5th year- males and 5th year-females for (GI), whereas there was(HS) difference at P-value ≤ 0.01 between1st year-males and 5th year-males; 1st year-males and5th year-females; 1st year females and 5th year-males; 1styear-females and 5th year- femalesfor both (PLI) and (GI), and5th year- maleswith5th year-females for (PLI),as shown in Table (5). Also, ANOVA test was showed that there was(HS) difference at P-value ≤ 0.01 among and within groups for both (DMFS) and (DMFT) indices, as shown in Table (6). While, LSD test was showed that there was(NS) difference at P- value ≥ 0.05 between 1st year-males and 1st year females; 5th year-males and 5th year-females for both(DMFS) and (DMFT) indices,and 1st year- females with 5th year-males for (DMFS) index, whilethere was significant (S) difference at P- value < 0.05 between 1st year-males and 5th year- males for (DMFS) index, and1st year females with 5th year-males for (DMFT) index,whereas there was (HS) difference at P-value ≤ 0.01 between 1st year-males and5th year-females; 1styear-females and 5th year-femalesfor J Bagh College Dentistry Vol. 29(2), June 2017 Comparison Of Oral Health Oral and maxillofacial Surgery and Periodontics 73 both(DMFS) and (DMFT) indices, and1st year- males with 5th year-males for (DMFT) index,as shown in Table (7). The percentagesfor once, twice and more than twice per day of tooth brushing in5thyear students were(43%, 40%, 16% respectively for males) and (33%, 56%, 10%respectively for females),while the percentages in1st year students were (48%, 44%, 8% respectively for males) and (40%, 48%, 12% respectively for females), as shown in Table (8). The rates of mouthwashusing in1st year students were(16%, 20%) andin 5th year were(20%, 23%) for males and females respectively. While, of dental floss using in 1st year studentswere(20%, 24%) and in5th year students were(43%, 63%) for males and females respectively. Whereas, of tooth picksusing in1st year studentswere (28%, 24%) and in5th yearstudents were(30%, 6.7%) for males and femalesrespectively, as shown in Table (9). DISCUSSION This study was performed on dental students only;50 dental students at 1st year aged (17-19 years) divided into (25 males and 25 females) and 60 dental students at 5th year aged (21-23 years)to determine and compare oral health status and oral hygiene behavior among them. One might expect that dental students have good oralhygiene and periodontal health than other subjects in the community, butfrom the presented results of this study it's clearthat most of dental students didn't demonstrate an effective oral hygienethis could be due to differences in oral hygiene habits and oral hygiene practice among different subjects (26, 27).This resultwas agreed with Christopher et al, in1994;waliin 2002; Al-Jubouryin 2006; AL- Muhamadawyin2009. (3, 27, 28, 29) Our findings were showed that females students had lower means of (PLI) and (GI)than males students; which were in agreement with Howat et al,in 1979; Locker et al,in 2000; Al- Jubouryin 2006;AL-Muhamadawyin2009(3, 27, 30, 31). This result may be possiblydue to the fact that females take care of their teeth and oral health better than males as a result ofgreater social pressure on females to be physically attractive (32).A statistically significant improvementin oral hygiene and periodontal health status (PLI) and (GI) were found between 1stand 5th year students, this may be attributed tothat5th year students were more successful for removing plaque than 1st yearstudents due toentirely devoted to comprehensive dental care,also the awareness andthe knowledge of the presence of disease and its management was poor in the 1st year students(1, 18).This was in agreement with some other studies Howat et al. in 1979;Lang et al,in 1977; Cavaillon et al,in 1982; AL-Muhamadawyin2009(3, 19, 20, 30), whileElmostehv et al,in 1969 ; Meisterin 1980and Tenenbaumin 1980 were not showed any improvement of either effective personaloral hygiene or gingival health between pre-clinical and final-year dental students due to the absence of improvement of the oral hygiene practices in students, in spite of having received information and education(1, 21, 26). The evaluation of (DC) is important. It gives an opportunity to improve hygiene, diet, and implement preventive measures in a population. The overall prevalence of (DC) in this study(DMFS and DMFT) among females was higher than males; this could be attributed to the earlier eruption of teeth in females than males which enhance longer exposure to the cariogenic oral environmental factors or may be easier to food supplies by females and frequent snacking during food preparation(33). This result wasin agreementwith Al-Azawi in 2000; Eugenio et al,in 2005; Hala in 2006;Abdullah in 2009;Rashid et al,in 2010;Shaikhet al,in 2014(11, 16, 27, 34, 35, 36).Also the means of (DMFS and DMFT) indices were higher in 5th year studentsthan 1st year studentscaries prevalence was high and it increased with age(9, 10). These results are attributed to the irreversibility of caries process and accumulative nature of the disease on the one hand, and the paucity of planned preventive programmers in Iraq (including different methods of fluoride application) on the other hand (16, 37). So the people are verysusceptible to (DC) throughout their lifetime. (38).This result was in agreement withMaatouk et al,in 2006(13)and Al- Huwaiziand Khamisin 2010(14). The mean of (DS) component for 1styear students was found to be higher than 5th year students; this result was opposite to the result of 5th year students, which showed that the mean of (FS) component had higher than 1st year students, and this result was reflected the low care about dental health among dental students in 1styear in comparison with 5th year students, in addition greater motivation and ease of access to dental consultation of 5th year students.This result was in agreement with Maatouk et al, in2006(13). Many students in 1styear were brushing their teeth at least once a day but lack the knowledge of proper tooth brushing techniques, also, this study was reported that very few students were J Bagh College Dentistry Vol. 29(2), June 2017 Comparison Of Oral Health Oral and maxillofacial Surgery and Periodontics 74 used practice flossing and at least some students were used mouthwash and toothpicks(39, 40) ,while large proportion of the students in 5th year were brushed their teeth twice daily with the knowledge of proper tooth brushing techniques and interdental cleaning aids such as flossing,which indicate that their training appear to have influenced their oral hygiene effectively.This result was in agreement with Maatouk et al,in 2006(13). CONCLUSION The results of this study confirmed the need for extensive and continual exposure of dental students towards plaque control and prevention proceduresand starting from the 1styear and continued throughout their courses in order that the graduated dentist having ample knowledge and are capable of implementing and maintaining thorough preventive measures for their patients. REFERENCES 1. Tenenbaum H.Impact of a periodontal course on oral hygiene and gingival health among senior dental students. Dental Health Education. 1980; 8(7):335-338. 2. Emmanuel A, Chang'endo E.Oral health related behaviour, knowledge, attitudes and beliefs among secondary school students in Iringa Municipality. Dar Es Salaam Medical Students' Journal. 2010; 17(1):24-30. 3. AL-muhamadawy A.Periodontal health status and treatment needs among Iraqi dental students. J Fac Med Baghdad. 2009; 51(4): 378-381. 4. Pakshir HR. Dental reduction and dentistry system in Iran. 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The influence of academic stress on gingival inflammation. Int J Dent Hy. 2010; 8(1):22-27. 23. Silness J, Loe H. Periodontal disease in pregnancy II Correlation between oral hygiene and periodontal condition. Acta Odont Scand. 1964; 22:121-35. 24. Loe H, Silness J. Periodontal disease in pregnancy 1. Prevalence and severity. Acta Odont Scand. 1963; 21:533-51. 25. Jackson D. The clinical diagnosis of dental caries. Br Dent J. 1950; 88:207. 26. ELmostehy M., Zaki H., Stallard R. The dental student's attitude toward the profession as reflected on his oral cavity. Egypt. Dent. J. 1969; 15: 104- 109. 27. Al-juboury HA. Oral health status among a group of dental students in Yemen. J Bagh College of Dentistry. 2006; 18(3):60-62. 28. Christopher H., Fox L., Alan M, Sheila M. periodontal disease among new England Elders. Jof. Periodontal. 1994; 65: 676-684. 29. Wali ZH. Effect of cigarette smoking on periodontal health status among the fifth year dental students. Master thesis, Baghdad University. Periodontics. 2002. J Bagh College Dentistry Vol. 29(2), June 2017 Comparison Of Oral Health Oral and maxillofacial Surgery and Periodontics 75 30. Howat A, Trabelsi I, Bradnock G. Oral hygiene levels and behavior in pre-clinical and final-year dental students. J ClinPeriodontol. 1979;6(3):177- 85. 31. Locker D, Slade GD, Murray H. Epidemiology of periodontal disease among older adults: a review.Periodontol 2000. 1998; 16:16-33. 32. Qasim AA. Risk factors influence on the prevalence and severity of root caries in Mosul (rural and urban). Al-Rafidain Dent J. 2010; 10(2):1-10. 33. Lukacs JR, LargaespadaLL. Explaining sex differences in dental caries prevalence: Saliva, hormones, and ‘‘Life-History’’ etiologies.American journal of human biology. 2006; 18:540–555. 34. Eugenio DB, Laurie KB, Maria Teresa C, et al. “Surveillance for dental caries, dental sealants retention, Edentulism and Enamel Fluorosis in United States, 1988-1994 and 1999-2002”, Surveillance summaries. 2005; 1-44. 35. Rashid AA, Kanaan SB, Abdullah OM.Caries experience and treatment need among students of health and medical technologies college.Journal of Kerbala University. 2010; 8(1):206-212. 36. Shaikh IA, Kalhoro FA, Pirzado MS, et al. Prevalence of dental caries among students of khairpur district. Pakistan oral & dental journal. 2014; 34(4):680-683. 37. Petersen P, Razanamihaj N. Oral health status of children and adults in Madagascar. Int Dent J. 1996; 46: 41-47. 38. Hingorjo MR, Jaleel F, Mehdi A. Oral Health Aspects In Primary School Children Of Three Major Cities Of Pakistan. J Pak Dent Assoc. 2010; 19 (4):211-55. 39. Mwangosi IE, Nyandindi U. Oral health related knowledge, behavior, attitude and self-assessed status of primary school teachers in Tanzania. Int Dent j. 2002; 52(3):130-613. 40. MwakatobeAJ,MumghambaEGS,Oral health behavior and prevalence of dental caries among 12- year-old schoolchildren in Dar es Salaam, Tanzania. Tanz Dent J. 2007; 14(1):1-7. Table 1: Descriptive statistical resultsof student's ages. Groups Gender No. Mean S.D 1st year students Males 25 18.04 0.53 Females 25 18.12 0.52 5th year students Males 30 22.13 0.57 Females 30 22.06 0.44 Table 2: Descriptive statistical results of (PLI) and (GI) for each group. Groups Index Gender Mean S.D 1st year students PLI Males 1.17 0.32 Females 1.02 0.33 GI Males 0.89 0.41 Females 0.78 0.46 5th year students PLI Males 0.83 0.28 Females 0.47 0.27 GI Males 0.51 0.29 Females 0.31 0.19 Table 3: Descriptive statistical results of dental caries for each group. DS MS FS DMFS DT FS FT DMFT 1st year Males Mean 5.96 1.40 1.52 8.88 5.08 0.28 1.12 6.48 S.D 2.79 2.70 1.44 3.52 2.46 0.54 1.05 2.41 Females Mean 6.52 1.60 1.84 10.16 5.16 0.32 1.52 7.08 S.D 3.74 2.78 1.65 5.18 2.67 0.55 1.22 2.78 5th year Males Mean 5.63 2.66 3.76 11.90 4.86 0.53 3.33 8.73 S.D 3.01 4.09 3.69 5.58 2.51 0.81 3.27 3.25 Females Mean 4.53 2.00 6.90 13.33 3.63 0.40 5.13 9.16 S.D 2.35 2.81 4.26 4.18 1.97 0.56 3.38 2.87 J Bagh College Dentistry Vol. 29(2), June 2017 Comparison Of Oral Health Oral and maxillofacial Surgery and Periodontics 76 Figure (1): Bar chart graph for means of (PLI) and (GI) for each for each group. Table 4: ANOVA test for plaque and gingival indices. Index ANOVA SS df MS F-test P-value Sig. PLI Among groups 7.65 3 2.55 27.85 0.000 ** Within groups 9.70 106 0.09 Total 17.35 109 GI Among groups 5.69 3 1.89 15.49 0.000 ** Within groups 12.98 106 0.12 Total 18.67 109 Table 5: LSD test to compare the means of (PLI) and (GI) among groups. Index Groups MD SE P-value Sig. PLI 1st year-males 1st year females 0.14 0.08 0.093 NS 5th year-males 0.34 0.08 0.000 ** 5th year-females 0.69 0.08 0.000 ** 1st year-females 5th year-males 0.19 0.08 0.017 ** 5th year-females 0.55 0.08 0.000 ** 5th year-males 5th year-females 0.35 0.07 0.000 ** GI 1st year-males 1st year females 0.11 0.09 0.264 NS 5th year-males 0.38 0.09 0.000 ** 5th year-females 0.58 0.09 0.000 ** 1st year-females 5th year-males 0.27 0.09 0.005 ** 5th year-females 0.46 0.09 0.000 ** 5th year-males 5th year-females 0.19 0.09 0.030 * Table 6: ANOVA test for DMFS and DMFT. ANOVA SS df MS F-test P-value Sig. DMFS Among groups 312.82 3 104.27 4.68 0.004 ** Within groups 2357.36 106 22.23 Total 2670.19 109 DMFT Among groups 135.74 3 45.24 5.48 0.002 ** Within groups 874.11 106 8.24 Total 1009.85 109 0 0.2 0.4 0.6 0.8 1 1.2 PLI GI Means of (PLI) and (GI) for each male and female at 1st and 5th year's dental students 5th male 5th female 1st male 1st female J Bagh College Dentistry Vol. 29(2), June 2017 Comparison Of Oral Health Oral and maxillofacial Surgery and Periodontics 77 Table 7: LSD test to compare the means of DMFS and DMFTamong groups. Groups MD SE P-value Sig. DMFS 1st year-males 1st year females -1.28 1.33 0.339 NS 5th year-males -3.02 1.27 0.020 * 5th year-females -4.45 1.27 0.001 ** 1st year-females 5th year-males -1.74 1.27 0.176 NS 5th year-females -3.17 1.27 0.015 ** 5th year-males 5th year-females -1.43 1.21 0.242 NS DMFT 1st year-males 1st year females -0.60 0.81 0.462 NS 5th year-males -2.25 0.77 0.005 ** 5th year-females -2.68 0.77 0.001 ** 1st year-females 5th year-males -1.65 0.77 0.036 * 5th year-females -2.08 0.77 0.008 ** 5th year-males 5th year-females -0.43 0.74 0.560 NS Table 8: Frequency of brushing in students. z Gender Brushing Once daily Twice daily ≥ 3 times daily No. % No. % No. % 1st year students Males 12 48 11 44 2 8 Females 10 40 12 48 3 12 5th year students Males 13 43.3 12 40 5 16.7 Females 10 33.3 17 56 3 10 Table 9: Frequency of flossing, mouth wash, and tooth picks in students. Groups Gender Flossing Mouth wash Tooth picks Yes No Yes No Yes No No. % No. % No. % No. % No. % No. % 1st year students Males 5 20 20 80 4 16 21 84 7 28 18 72 Females 6 24 19 76 5 20 20 80 6 24 19 76 5th year students Males 13 43.3 17 56.7 6 20 24 80 9 30 21 70 Females 19 63.3 11 36.7 7 23.3 23 76.7 2 6.7 28 93 المستخلص الخلفیة:تعتبر امراض اللثھ وتسوس االسنان من امراض الفم الشائعھ، لكن یمكن ان نتجنبھا بشكل تام من خالل التعود على سلوك صحي محدد وسیطرة على البالك. تم عمل ھذه الدراسھ لتحدید ومقارنة الحالھ الصحیھ للفم والتي تتضمن كالً من تسوس االسنان وصحة اللثھ المستنصریھ.- السلوك الصحي للفم بین طالب المرحلة االولى والخامسھ في كلیة طب االسنان وكذلك 30طالبا في المرحلة الخامسھ ( 50اناث) و 25ذكور، 25طالبا في المرحلة االولى ( 50المواد والطرق:یتكون النموذج الكلي للدراسھمن لتقدیرالحالة الصحیة لفم كل طالب وقد تم DMFS and DMFT)سوس االسنان (اناث) وقد تم عمل مؤشرات البالك واللثة وت 30ذكور، اعطاء اسئلھ اخرى للطالب لتقدیر العادات الصحیة المختلفھ للفم. النتائج:كانت قیم معدالت مؤشرات البالك واللثھ عند طالب المرحلة االولى اعلى من المرحلة الخامسة لكال من الذكور واالناث مع وجود للذكور عند المرحلتین االولى والخامسھ بالتتابع و 0,83، 1,17؛ بحیث كانت قیم معدالت مؤشر البالك ((P ≤0.01)معنوي عالي عندفرق قیم عالیة بین (DMFS and DMFT)لالناثعند المرحلتین االولى والخامسھ بالتتابع) وكذلك اظھرت قیم معدالت مؤشري 0,47، 1,02 8,73، 11,90لالناث) عند المرحلة االولى بینما كانت ( 7,08، 10,16للذكور و 6,20، 8,88حیث كانت (االناث اكثر من الذكور ب لالناث) عند المرحلة الخامسة وكانت نسبة تنظیف االسنان، استخدام غسیل الفم، خیط االسنان، وعیدان االسنان 9,16، 13,33للذكور و .رحلة االولىعند طالب المرحلة الخامسھ اعلى من طالب الم االستنتاج:ان اختالفات الحالة الصحیة والمعدالت السلوكیةللفم بین طالب المرحلتین االولى والخامسة قد یكون راجع الى انخفاض مستوى نان تعلیم طب االسنان عند طالب المرحلة االولى والذین یحتاجون الى التثقیف الصحي للفم في المستقبل والذي یتضمن اھمیة تنظیف االس الصحیح واستخدام وسائل التنظیف بین االسنان لمنع امراض اللثھ وتسوس االسنان. .الكلمات الرئیسیة:تنظیف االسنان، مؤشر البالك، مؤشر اللثھ، طالب كلیة طب االسنان J Bagh College Dentistry Vol. 29(2), June 2017 Comparison Of Oral Health Oral and maxillofacial Surgery and Periodontics 78 J Bagh College Dentistry Vol. 29(2), June 2017 Comparison Of Oral Health Oral and maxillofacial Surgery and Periodontics 79 .