Relationship Between Stress Level, Fatigue Symptoms, and Sleep Quality with Oral Health Behavior among Preclinical Student Faculty of Pharmacy, Indonesia

Rini Pratiwi, Fuad Husain Akbar, Nur Hidayat Muhiddin


Objective: To determine the association of the stress level, fatigue symptoms, and sleep quality with oral health behavior of preclinical pharmacy students. Material and Methods: Observational analytic study surveyed the students of the Faculty of Pharmacy of Hasanuddin University. From the total 205 sample of pharmacy students, 77 students drawn from the 2017 year of study, 68 students from the 2016 year of study, and 60 students from the 2015 year of study. The study consisted of 4 questionnaires, which are Perceived Stress Scale, Fatigue Assessment Scale, Karolinska Sleep Questionnaire and questions that assess oral health behaviors reported per individual. Data were collected and analyzed statistically using Chi-square test and Fisher's exact test. The level of significance was set at 5%. Results: The percentage of oral health behaviors in terms of the frequency of tooth brushing, use of dental floss, use of tongue cleaner and use of mouthwash increase as the year of study. In contrast to the percentage of stress level, awakening difficulties symptoms, sleep disturbance symptoms, daytime sleepiness symptoms and fatigue symptoms tended to decrease according to the year of study. Significant associations found among students who are under stress with the frequency of dental floss (p<0.05). However, no significant association was found between the fatigue symptoms, awakening difficulties symptoms, sleep disturbance symptoms, and daytime sleepiness symptoms with oral health behavior (p>0.05). Conclusion: There is an association between stress levels with the use of dental floss.


Stress, Psychological; Health Behavior; Sleep; Students, Pharmacy

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Peltzer K, Pengpid S. Dental health status and oral health behavior among university students from five Asean countries. Nagoya J Med Sci 2017; 79(2):123-33. doi: 10.18999/nagjms.79.2.123.

Vasiliou A, Shankardass K, Nisenbaum R, Quinonez C. Current stress and poor oral health. BMC Oral Health 2016; 16:88. doi: 10.1186/s12903-016-0284-y.

Arman K, Petruninaite A, Grigalauskiene R, Slabsinskiene E. Stress experience and effect on self-perceived oral health status among high school students. Stomatologija 2016; 18(3):75-9.

Asawa K, Sen N, N Bhat, Tak M, Sultane P, Mandal A. Influence of sleep disturbance, fatigue, vitality on oral health and academic performance in indian dental students. Clujul Medical 2017; 90(3):333-43. doi: 10.15386/cjmed-749.

Rahman B, Al Kawas S. The relationship between dental health behavior, oral hygiene and gingival status of dental students in the United Arab Emirates. Eur J Dent 2013; 7(1):22-7.

Baseer MA, Mehkari MA, Al-Marek FA, OA Bajahzar. Oral health knowledge, attitude, and self-care practices among pharmacists in Riyadh, Riyadh province, Saudi Arabia. Available at: [Acessed November 22, 2017]. doi: 10.4103/2231-0762.178739.

Opoku-Acheampong A, Kretchy IA, Acheampong F, Afrane BA, Ashong S, Tamakloe B, Nyarko AK. Perceived stress and quality of life of pharmacy students in university of Ghana. BMC Res Notes 2017; 10(1):115. doi: 10.1186/s13104-017-2439-6.

Rovas A, Staniulyte A, Puriene A. Associations between stress, fatigue, sleep disturbances and dental students' oral health-related Behaviors: Changes throughout an academic year. Med Dent Probl 2017; 54(2):149-54. doi: 10.17219/dmp/68782.

Elani HW, Allison PJ, Kumar RA, Mancini L, Lambrou A, Bedos C. A systematic review of stress in dental students. J Dental Educ 2014; 78(2):226-42.

Hershner SD, Chervin RD. Causes and consequences of sleepiness among college students. Nat Sci Sleep 2014; 6:73-84. doi: 10.2147/NSS.S62907.

Eun-Hyun L. Review of the psychometric evidence of the perceived stress scale. Asian Nurs Res 2012; 6(4):121-7. doi: 10.1016/j.anr.2012.08.004.

Kaunang WP, Wowor V, Arisanty AD. The behavior of dental and oral health care of pregnant women at health centers Manado shoulder. E-Dental J 2013; 1(2):1-11.

Marcora BC, Staino W, Manning V. Mental fatigue impairs physical performance in humans. J Appl Physiol 2009; 106(3):857-64. doi: 10.1152/japplphysiol.91324.2008.