Association Of Oral Health Status In Relation To BMI, Screen Time, And Physical Activity Among Students Using WHO Oral Health Assessment Form And IPAQ: A Cross-Sectional Study

Oral health is a fundamental component of overall health and well-being, influencing not only mastication and speech but also psychosocial aspects such as self-esteem and quality of life. In recent decades, rapid urbanization and technological advancements have significantly altered lifestyle patterns, especially among young adults and students. These changes have led to increased sedentary behavior, unhealthy dietary habits, and reduced engagement in physical activity.

One of the major concerns in modern lifestyle is the rising prevalence of overweight and obesity, commonly assessed using Body Mass Index (BMI). Increased BMI has been associated with metabolic disturbances and dietary patterns rich in sugars and processed foods, which are well-established risk factors for dental caries and periodontal diseases. However, the relationship between BMI and oral health remains complex and multifactorial, requiring further exploration (1);(2).

Screen time, defined as the duration spent using electronic devices such as smartphones, computers, and televisions, has dramatically increased among students. Prolonged screen exposure is often associated with frequent snacking, especially consumption of cariogenic foods and beverages. Additionally, excessive screen time may lead to neglect of oral hygiene practices such as brushing and flossing, thereby increasing the risk of oral diseases(3),(4).

Physical activity plays a crucial role in maintaining systemic and oral health. Regular physical activity improves immune function, reduces inflammation, and promotes healthier lifestyle behaviors. Conversely, low levels of physical activity are often linked to sedentary habits, poor dietary choices, and increased risk of chronic diseases, all of which can indirectly impact oral health(5),(6).

Despite growing evidence on individual lifestyle factors, there is limited research assessing the combined effect of BMI, screen time, and physical activity on oral health using standardized tools like the WHO Oral Health Assessment Form and IPAQ. Therefore, this study aims to bridge this gap by evaluating these associations among students.

AIM AND OBJECTIVES

Aim:

To evaluate the association between oral health status and BMI, screen time, and physical activity among students.

Objectives:

To assess oral health status using WHO criteria

To calculate BMI of participants

To evaluate screen time and physical activity levels

To determine associations between these variables

Materials and Methods

Study Design:

Cross-sectional study

Study Population:

150 undergraduate students aged 18–25 years

Inclusion Criteria:

Students willing to participate

Age 18–25 years

Exclusion Criteria:

Systemic illness

Ongoing orthodontic treatment

Ethical Approval:

Obtained from Institutional Ethical Committee

Data Collection

Oral Health: WHO Oral Health Assessment Form

BMI Calculation: Height and weight measured

Physical Activity: IPAQ (categorized as Low, Moderate, High)

Screen Time: Self-reported daily hours

Variables

BMI: Underweight, Normal, Overweight, Obese

Screen Time: <2 hrs, 2–4 hrs, >4 hrs

Physical Activity: Low, Moderate, High

Oral Health: DMFT index, Oral hygiene status

Statistical Analysis

Chi-square test

Pearson correlation

Significance level: p < 0.05

RESULTS

The demographic distribution showed a slightly higher proportion of female participants (54.7%) compared to males (45.3%), indicating a balanced representation of both genders.

BMI distribution revealed that nearly half of the participants (48%) had normal BMI, while a considerable proportion fell into overweight (25.3%) and obese (14.7%) categories, highlighting the growing prevalence of unhealthy weight among students.

Screen time analysis indicated that a majority of students (80%) spent more than 2 hours daily on electronic devices, with 36.7% exceeding 4 hours. This reflects a high level of sedentary behavior in the study population.

Physical activity assessment showed that only 20% of participants engaged in high levels of activity, whereas a significant proportion had low (38.7%) or moderate (41.3%) activity levels.

Oral health findings demonstrated that 64% of students had dental caries, and 46.7% exhibited poor oral hygiene, indicating a high burden of oral diseases.

Association analysis revealed that:

Higher BMI was significantly linked with increased dental caries prevalence(p = 0.03).

Students with screen time greater than 4 hours had notably higher caries rates(72%).

Low physical activity was associated with higher DMFT scores and poorer oral hygiene (72%).

These findings suggest a strong relationship between sedentary lifestyle factors and oral health outcomes.

DISCUSSION

The present study highlights a significant association between lifestyle factors such as BMI, screen time, and physical activity with oral health status among students. These findings are consistent with existing literature emphasizing the role of sedentary behaviors and unhealthy lifestyle patterns in the development of oral diseases.

The association between higher BMI and increased dental caries observed in this study is in agreement with previous research (1,2,15). This relationship can be explained by shared risk factors such as increased consumption of sugar-rich diets, frequent snacking, and poor nutritional habits. Additionally, obesity-related metabolic alterations may influence salivary flow and composition, thereby promoting cariogenic activity and changes in oral microbiota.

Screen time emerged as an important determinant of oral health in this study. Students with prolonged screen exposure showed higher prevalence of dental caries, which is consistent with earlier findings (3,4,7,10,12). Increased screen time is often associated with sedentary behavior, irregular eating patterns, and higher intake of cariogenic snacks and beverages. Furthermore, excessive use of digital devices may reduce the time spent on maintaining oral hygiene practices, leading to plaque accumulation and poor oral health outcomes.

Physical activity demonstrated a protective effect against dental caries and poor oral hygiene in the present study. Participants with higher levels of physical activity had better oral health outcomes, supporting previous studies (5,6,8,11,13). Regular physical activity is associated with improved immune response, reduced systemic inflammation, and healthier lifestyle behaviors, which collectively contribute to better oral health. Conversely, low physical activity is often linked to sedentary habits and unhealthy dietary choices, increasing the risk of oral diseases.

The combined effect of BMI, screen time, and physical activity observed in this study is supported by recent research (9,12,14). These studies suggest that lifestyle factors do not act independently but interact synergistically to influence oral health outcomes. For instance, individuals with high screen time and low physical activity are more likely to adopt unhealthy dietary habits, further increasing the risk of dental caries and periodontal diseases.

Overall, the findings of this study reinforce the importance of adopting a holistic approach to oral health promotion. Addressing only oral hygiene practices may not be sufficient; instead, interventions should also focus on modifying lifestyle behaviors such as maintaining healthy body weight, reducing screen time, and promoting regular physical activity

LIMITATIONS

Although this study offers valuable insights, several limitations should be taken into account:

The cross-sectional design restricts the ability to determine causal relationships.Self-reported data for screen time and physical activity may be subject to recall bias.

The sample size was relatively small and limited to a specific population, which may affect generalizability.

Dietary habits, which play a crucial role in oral health, were not assessed in detail.

Future studies should incorporate longitudinal designs, larger sample sizes, and additional variables such as diet and socioeconomic status.

CONCLUSION

The findings of this study clearly indicate that lifestyle factors such as BMI, screen time, and physical activity are significantly associated with oral health status among students. Increased BMI and prolonged screen time contribute to a higher prevalence of dental caries and poor oral hygiene, while physical activity appears to have a protective role.

These findings highlight the importance of integrated health promotion strategies targeting both general and oral health.Encouraging healthy lifestyle behaviors can play a crucial role in reducing the burden of oral diseases among young adults.

RECOMMENDATIONS

Implement educational programs focusing on the impact of lifestyle on oral health

Encourage regular physical activity among students

Promote reduced screen time through awareness campaigns

Integrate oral health counseling with general health programs

Conduct periodic oral health screenings in educational institutions

Develop multidisciplinary approaches involving dentists, nutritionists, and fitness experts

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