1. Need for research

Our society has been increasingly interested in oral health due to the increase in the income of the people, the improvement of education, and the development of medical technology, and has recently changed to a prevention-oriented concept. Korea ranked second in major Da Vinci diseases (foreign) surveys in 2012 and 7th in tooth decay, and the number of people treated for “chi-eunitis” diseases increased 7.3% in 2011, compared to 2006, which requires measures to prevent periodontal diseases [1].

According to preventive dentistry, gingivitis is an early stage of periodontal disease with common inflammatory symptoms such as redness, bleeding and edema, This is reversible and can be improved or self-healed by continuous oral environment management, Periodontitis becomes more severe and when periodontic tissue is destroyed, periodontitis becomes more severe and the periodontic bone is severely destroyed, so periodontic sacs are formed and need to be treated [2]. Teethorexia refers to the phenomenon of tooth defects caused by the breakdown of the hemorrhoids such as enamel and ivory and the separation of minerals and organic substances, Dental disease is the most frequent chronic disease in humans, Once destroyed by tooth disease, tooth tissue is not regenerated [2]. Therefore, continuous oral health care is needed to prevent mouth disease, maintain and promote oral health. Therefore, the role of a dental hygienist in charge of professional work on oral disease prevention, education, and management is important.

Dental hygienists get rid of the hemp, Major tasks related to the prevention and hygiene of dental and oral diseases In addition, it requires comprehensive dental hygiene management capabilities with mastered skills along with scientific and professional knowledge related to oral disease prevention and oral health promotion [3]. Therefore, the dental hygienist department establishes a comprehensive dental hygiene curriculum, which can provide dental hygiene through a comprehensive systematic method, to remove plaque and prevent tooth decay. The comprehensive dental hygiene curriculum, an integrated curriculum with dental hygiene (department), is an integrated curriculum centered on curriculum that links knowledge, concepts, or principles related to subjects, and is considered to be an integrated design model belonging to Fogarty’s web [4].

Comprehensive dental hygiene management process refers to a systematic continuous management process performed by dental hygienists by providing not only treatment but also a management plan for comprehensive dental hygiene to the subjects [3]. Cho et al. [5] according to the section, the comprehensive dental hygiene management process systematically collects and documents the oral and overall health conditions and requirements of the subject It is divided into dental hygiene diagnosis stage to identify the current condition and potential oral health problems, dental hygiene plan stage to set the final goal for the target’s needs and expectations, dental hygiene performance stage to review and record the results of dental hygiene management process. Through this comprehensive dental hygiene process, patients and other subjects can receive a variety of oral health promotion services to prevent oral disease and improve and maintain oral health, thus satisfying their needs as medical consumers.

Therefore, this study aims to identify and evaluate the effects of dental hygiene activities by applying a comprehensive dental hygiene management process performed by dental hygienists to subjects and comparing and investigating oral hygiene status before and after work.

1. Research design

This study was conducted by experienced dental hygienists twice to perform the dental hygiene management process, and was used to determine the effectiveness of dental hygiene activities by comparing and analyzing oral odor changes and oral hygiene before and after the dental hygiene process.

2. Collection of research subjects and data

The subjects of this study were 72 patients who participated in the dental hygiene management process of one university located in A, who understood the purpose of this study and agreed in writing to participate. 72 of the 80 were used for final analysis, except for inappropriate surveys. The data collection period lasted from March to June 2019.

3. Research tools

In this study, a survey of patients who visited twice to perform dental hygiene management, a food experience permanent index (DMFT index), saliva secretion ratio test, oral hygiene change before and after dental hygiene management process, and oral hygiene status were analyzed.

As a survey tool, Whole body health, oral health, in the mouth.External examination, dental history, systemic disease, patient’s occupation, age, gender, social history, smoking, drinking, etc. were investigated. Before the dental hygiene management process, the number of toothbrushes, educational routes for toothbrushes, characteristics of toothbrushes, use of oral care products, and frequency of intake of sugary snacks were investigated.

Dental Hygiene Management Course Oral Examinations, The DMFT index, which analyzes how many permanent values a person has on average, The saliva secretion rate, which is closely related to the self-purification in the mouth, was tested with irritating saliva.

The breath measurement was measured using a B&B Checker (mBA-21, Plustech, Korea) device for 15 seconds while inserting the measurement sense into the mouth and stopping breathing after collecting gas in the mouth for 3 minutes. The oral environmental management competency index (PHP Index), an index that measures and displays the amount of colored dental bacterial membranes, is an indicator of an individual’s ability to manage the oral cavity, The teeth subject to examination are targeted at the left and right sides of the maxilla, the right middle incisor of the maxilla, the left middle incisor of the mandible, and the left and right sides of the mandible.

The O’Leary index covers all teeth in the oral cavity and also evaluates fixative prostheses, Each tooth is divided into four parts: anxiety, centrifugal, narrow surface, and tongue surface to examine the gingival margin present in the gingival margin area [3].

4. Data analysis method

The statistical packages used in statistical analysis were analyzed using the IBM SPSS Win 21.0 program.

1) The general characteristics of the subjects were analyzed using frequency and percentage, mean and standard deviation.

2) The t-test and kayzegab of oral health according to gender of the experimental group are identified.

3) The t-test of oral health care according to the gender of the experimental group and kayzegub are identified.

4) The t-test for DMFT index and saliva secretion test according to age and gender of the experimental group is determined.

5) Prior to the comprehensive dental hygiene management process of the experimental group.The comparison of oral odor change, oral hygiene management ability (PHP index), and O’Leary index is determined t-test.

1. Typical characteristics of the target

If you look at the general characteristics of the subjects in this study, 83.3% (60 people) in their 20s, 4.1% (3%) in their 30s, 6.9% (5 people) in their 40s, and 5.5% (4 people) in their 50s and older, Gender was 54.1% (39) for women and 45.8% (33) for men, In terms of occupation, 73.6% (53 students) accounted for more than half. Office workers (6.9%), self-employed (6.9%), and others (12.5%), 40.3% (29 smokers) and 62.5% (45) drank alcohol (Table 1).

Table 1 . General characteristics of the target (N=72)

Variable		Experimental group n (or M) (%, SD)
Age	20-29	60 (83.3)
	30-39	3 (4.1)
	40-49	5 (6.9)
	50≤	4 (5.5)
Sex	F	39 (54.1)
	M	33 (45.8)
Job	Student	53 (73.6)
	Office worker	5 (6.9)
	Self-employment	5 (6.9)
	Other than that	9 (12.5)
Smoking	No	43 (59.7)
	Yes	29 (40.3)
Alcohol	No	27 (37.5)
	Yes	45 (62.5)

N (%)

72 (100.0)

2. Comparison of oral health conditions according to gender in experimental groups

If you look at the oral health conditions of the experimental group by gender, 27 (69.2%) women were found to have internal discomfort, The number of men was 27 (81.8%). According to the dental experience, 33 (84.6%) of women and 17 (51.5%) of men had dental experience. According to the experience of scaling, 9 (23.1%) of women had received experience, lower than 17 (51.5%) of men. In terms of anxiety and fear in dental treatment, women are average 15 (38.5%), 11 (28.2%), or 5 (12.8%), or 3 (7.7%), respectively. Men are average, 12 (36.4), 11 (33.3%), 7 (21.2%), 2 (6.1%), and 1 (3). Both women and men had the highest number of dental treatments, with 15 (20.8%) and 12 (16.7%). In oral health, women are average 27 (69.1%), bad 5 (12.8%), good 2 (5.1%), very good and zero. Men are average 20 (60.6%), bad 10 (30.3%), good 2 (6.1%), very good 1 (3.0%), and very bad 0 were shown (Table 2).

Table 2 . Gender-specific oral health conditions (N=72)

Oral health condition		Gender		The entire
		Woman N (%)	Man N (%)	t or χ2 (p)
Inconvenient area in the mouth	To exist	27 (69.2)	27 (81.8)	1.510 (0.279)
	To have none	12 (30.8)	6 (18.2)
	Sum	39 (100)	33 (100)
Dental Visiting Experience	To exist	33 (84.6)	17 (51.5)	6.230 (0.004)**
	To have none	6 (15.4)	16 (48.5)
	Sum	39 (100)	33 (100)
Skelling Experience	To exist	9 (23.1)	17 (51.5)	6.266 (0.015)*
	To have none	30 (76.9)	16 (48.5)
	Sum	39 (100)	33 (100)
Anxiety and fear in dental treatment	Very much so	3 (7.7)	1 (3)	2.470 (0.650)
	That’s right	5 (12.8)	2 (6.1)
	Normal	15 (38.5)	12 (36.4)
	I don’t think so	5 (12.8)	7 (21.2)
	It’s not like that at all	11 (28.2)	11 (33.3)
	Sum	39 (100)	33 (100)
Dental treatment experienced	Tooth decay treatment	15 (20.8)	12 (16.7)	19.37 (0.197)
	Neurotherapy	2 (2.8)	1 (1.4)
	Prosthetic therapy	1 (1.4)
	Extraction	1 (1.4)	1 (1.4)
	Gum treatment		1 (1.4)
	Remedial treatment		2 (2.8)
	Implant	3 (4.2)	7 (9.7)
	Chin surgery	3 (4.2)
	Blend	20 (27.8)	9 (12.5)
Oral health condition	Very much so	0	1 (3.0)	6.540 (0.162)
	That’s right	5 (12.8)	2 (6.1)
	Normal	27 (69.2)	20 (60.6)
	I don’t think so	5 (12.8)	10 (30.3)
	It’s not like that at all	2 (5.1)	0
	Sum	39 (100)	33 (100)

*p<0.05, **p<0.01.

3. Comparison of oral health care according to gender of experimental group

If we look at oral health care by gender in the experimental group, The average number of toothbrushes was 3.13 for women, higher than 2.48 for men. From the experience of brushing teeth, 33 (84.6%) of women were found to be in the same class. Men were 17 (51.5%). For the type of toothbrush, the average toothbrush was 22 (56.4%), the highest. Soft toothbrush bristles were 13 (33.3%) and stiff toothbrush bristles were 4 (10.2%). Men had the highest average toothbrush bristles at 18 or 54.5%. Soft toothbrush bristles showed 11 (33.3%) and stiff toothbrush bristles 4 (12.1%). When it comes to not using oral hygiene products, 33 (84.6%) for women and 31 (93.9%) for men. Among the types of oral hygiene products, women’s dental floss 16 (41.0%), dental floss 6 (15.3%), tongue washing 3 (7.6%), tooth brushing solution and water dispenser 1 (2.6%), respectively. Men flossed 24 (72.7%), toothbrush 4 (12.1%), and toothbrush 3 (9%). The frequency of eating snacks was the highest for women at 11 (28.2%) per day. One intake per two to three days was 8 (20.5%), almost none was 6 (15.3%), and three intake per day (7.7%). Men had the highest intake of 13 (39.4%) per day, It was found that 6 (18.2%) were consumed once every two to three days, 5 (15.2%) were consumed twice a day, and 4 (12.2%) were consumed twice a day (Table 3).

Table 3 . Mouth health care behavior according to gender (N=72)

Oral health care activities		Gender		The entire
		Woman n (or M) (%, SD)	Man n (or M) (%, SD)	t or χ2 (p)
Average number of toothbrushes	Average number of times	3.13 (0.656)	2.48 (0.712)	−3.986 (0.000)**
Toothbrush Learning Experience	To exist	33 (84.6)	17 (51.5)	6.230 (0.004)**
	To have none	6 (15.4)	16 (48.5)
	Sum	39 (100)	33 (100)
Toothbrush type	Softness	13 (33.3)	11 (33.3)	0.067 (0.967)
	Norma	22 (56.4)	18 (54.5)
	Stiffness	4 (10.2)	4 (12.1)
	Sum	39 (100)	33 (100)
Use of oral hygiene products or not	To exist	33 (84.6)	31 (93.9)	3.108 (0.78)
	To have none	6 (15.4)	2 (6)
	Sum	39 (100)	33 (100)
Types of oral hygiene products	Dental floss	16 (41.0)	24 (72.7)	15.076 (0.010)*
	Interdental toothbrush	6 (15.3)	4 (12.1)
	Brushing solution	1 (2.6)	3 (9)
	Tongue washing machine	3 (7.6)	-
	Water dispenser	1 (2.6)	-
Frequency of snack intake	Hardly	6 (15.3)	5 (15.2)	3.837 (0.429)
	1/2-3 Days	8 (20.5)	6 (18.2)
	1/day	11 (28.2)	13 (39.4)
	2/day	11 (28.2)	4 (12.1)
	3/day	3 (7.7)	5 (15.2)
	Sum	39 (100)	33 (100)

*p<0.05, **p<0.01.

4. T-test for DMFT index and saliva secretion by age and gender of experimental group

If you look at the DMFT index by gender in the experi-mental group, The woman’s DMFT index was 80.0±4.26. It was higher than the men’s DMFT index 7.47±5.07. The saliva secretion test showed that women had 10.13±2.10, higher than men’s saliva secretion ratio of 9.94±1.95.

If you look at DMFT index and saliva secretion test by age. For those in their 20s, DMFT index was 7.78±4.61, and the saliva ratio was 10.51±2.03. In their 30s, DMFT index was 7.67±3.05 and the saliva ratio was 8.00±1.73. In their 40s, DMFT index was 8.80±3.03 and the saliva ratio was 8.60± 1.34. The DMFT index for those in their fifties was 7.50±4.42, and the saliva ratio was 7.00±1.41 (Table 4).

Table 4 . DMFT index and saliva secretion test according to age of the experimental group (N=72)

Variable		Experimental group n (or M) (%, SD)	DMFT index	Saline secretion test
Sex	F	39	80.0±4.26	10.13±2.10
	M	33	7.47±5.07	9.94±1.95
Age	20-29	60 (83.3)	7.78±4.61	10.51±2.03
	30-39	3 (4.1)	7.67±3.05	8.00±1.73
	40-49	5 (6.9)	8.80±3.03	8.60±1.34
	50≤	4 (5.5)	7.50±4.42	7.00±1.41

5. T-test for the comparison of oral hygiene management capability (PHP index) and O’Leary index before and after the comprehensive dental hygiene management process of the experimental group

Before and after the comprehensive hygiene management process of the experimental group, The oral change was 80.92 (15.010) prior to the performance, After performing, it was shown as 65.92 (12.565). The oral hygiene management capability (PHP Index) was showed up as 2.57 before the mission, After performing, it was shown as 1.89 (0.543). O’Leary index was showed up as 51.99 (41.58) before the mission, After performing, it was shown as 41.58 (12.925) (Table 5).

Table 5 . Changes in oral odor, oral hygiene management ability, O’Leary index before and after the comprehensive dental hygiene management process of the experimental group (N=72)

Variables	Pre		Post		Pre experiment-Post experiment	t (p)
	M±SD		M±SD		M±SD
Change halitosis	80.92 (15.010)		65.92 (12.565)		−15.000 (14.007)	−9.087 (0.000)*
PHP Index	2.57 (0.643)		1.89 (0.543)		−0.678 (0.041)	−16.482 (0.000)*
O’leary index	51.99 (41.58)		41.58 (12.925)		−10.413 (7.901)	−11.182 (0.000)*

*p<0.01.

Recently, as the demand for medical care increases, the public’s awareness of early detection and prevention of oral diseases has increased, and preventive oral health activities are more active in the dental field than in treatment. Because the causes of oral disease also vary from person to person, it is necessary to identify the causes and take various preventive measures from person to person.

This study attempted to understand the effectiveness of dental hygiene activities by examining oral health and oral management status of subjects who participated in the comprehensive dental hygiene management process and applying the comprehensive dental hygiene management process.

If you look at the general characteristics of the subjects in this study, 83.3% (60 people) in their 20s, 4.1% (3 people) in their 30s, 6.9% (5 people) in their 40s, and 5.5% (4 people) in their 50s and older. Gender was 54.1% (39) for women and 45.8% (33) for men. In terms of occupation, 73.6% (53 students) accounted for more than half. Office workers (6.9%), self-employed (6.9%), and others (12.5%), 40.3% (29 smokers) and 62.5 percent (45) drank alcohol (Table 1).

If you look at the oral health conditions of the experimental group by gender, 27 (69.2%) women were found to have internal discomfort. The number of men was 27 (81.8%). According to the dental experience, 33 (84.6%) of women and 17 (51.5%) of men had dental experience. According to the experience of scaling, 9 (23.1%) of women had received experience, lower than 17 (51.5%) of men. In contrast to Ahn’s study [6], 52.2% of women were higher than 42.1% of men, the study found that men had some experience. This supports the fact that the DMFT index results in men are lower in this study (Table 2). According to Kim et al. [3], it is necessary to educate oral health care that materials that are firmly attached, such as dental floss, should be treated professionally only by those with special skills or knowledge. In terms of anxiety and fear in dental treatment, women are average 15 (38.5%), 11 (28.2%), or 5 (12.8%), or 3 (7.7%), respectively. Men are average, 12 (36.4), 11 (33.3%), 7 (21.2%), 2 (6.1%), and 1 (3). Both women and men had the highest number of dental treatments, with 15 (20.8%) and 12 (16.7%). In oral health, women are average 27 (69.1%), bad 5 (12.8%), good 2 (5.1%), very good and zero. Men are average 20 (60.6%), bad 10 (30.3%), good 2 (6.1%), very good 1 (3.0%), and very bad 0 were shown (Table 2). According to Kim’s study [7], 45.2% of respondents had received oral health education, less than half of them. According to Park’s study [8], oral health education experience shows that 70.3% of male students and 60.5% of female students did not receive it, indicating the need for oral health education as it has a significant impact on oral health.

If we look at oral health care by gender in the experimental group, The average number of toothbrushes is 3.13 for women, higher than 2.48 for men, indicating that women brush more than men. According to Ahn’s research [6], 81.4 percent of the second time, Won’s [9] findings showed similar results of 90.3% over two times. According to the experience of brushing teeth, 33 (84.6%) were found to be women and 17 (51.5%) were men. Personal oral care is very important in preventing and managing oral diseases in addition to specialist treatment. Kim et al. [10] and Park [11] argued that brushing teeth is the most basic and effective prevention method in domestic oral health care. For the type of toothbrush, the average toothbrush was 22 (56.4%), the highest. Soft toothbrush bristles were 13 (33.3%) and stiff toothbrush bristles were 4 (10.2%). Men had the highest average toothbrush bristles at 18 or 54.5%. Soft toothbrush bristles showed 11 (33.3%) and stiff toothbrush bristles 4 (12.1%). When it comes to not using oral hygiene products, 33 (84.6%) for women and 31 (93.9%) for men. Among the types of oral hygiene products, women’s dental floss 16 (41.0%), dental floss 6 (15.3%), tongue washing 3 (7.6%), tooth brushing solution and water dispenser 1 (2.6%), respectively. Men flossed 24 (72.7%), toothbrush 4 (12.1%), and toothbrush 3 (9%) (Table 3). Both men and women flossed high in oral hygiene. The man was higher than the woman. This can prove that men had higher experience in scaling than women in this study (Table 4). The number of people in their 20s is 60 (83.3 percent), and education on how to use dental floss is needed in their 20s. The frequency of eating snacks was the highest for women at 11 (28.2%) per day. One intake per two to three days was 8 (20.5%), almost none was 6 (15.3%), and three intake per day (7.7%). Men had the highest intake of 13 (39.4%) per day. It was found that 6 (18.2%) were consumed once every two to three days, 5 (15.2%) were consumed twice a day, and 4 (12.2%) were consumed twice a day (Table 3). According to Kim et al. [3], dietary control should be controlled to prevent tooth decay by reducing the number and amount of fermentation sugars and supplying nutrients ideally.

If you look at the DMFT index by gender in the experi-mental group. For women, DMFT index was 80.0±4.26, higher than for men DMFT index 7.47±5.07. According to Choi’s research [12], women’s first codfish health level was lower than that of men. According to Glickmam [13] Women become pregnant before and after the age of 30 and pregnant women are more likely to develop gingivitis due to the accumulation of plaque and food residue than non-pregnant women. According to Samant et al. [14] the inflammatory area that had pre-existing gingivitis deteriorates due to pregnancy. The saliva secretion test showed that women had 10.13±2.10, higher than men’s saliva secretion ratio of 9.94±1.95. DMFT index and saliva secretion tests by age, DMFT index in their 20s was 7.78±4.61, the second highest after those in their 40s. The saliva secretion ratio was 10.51±2.03, the highest. DMFT index in their 40s was the highest at 8.80±3.03. The saliva secretion ratio was 8.60±1.34, the second highest after those in their 20s (Table 4). By age, DMFT index ranked the highest in the 40s, followed by those in their 20s. In the saliva secretion test, people in their 20s were the highest, and those in their 50s or older were the lowest, indicating differences in oral health care.

The change in oral odor before and after the comprehensive hygiene management process of the experimental group was shown as 80.92 (15.010) before and after the performance was shown as 65.92 (12.565), indicating that it decreased after the performance (Table 5). Decreases after performance can be seen. According to Kim et al. [3], the cause of oral odor is about 10% of the causes of endogenous disease and 90% of the total causes are presumed to be caused by oral conditions such as periodontitis and tooth decay, but it is effective if managed by a dentist. The oral hygiene management capability (PHP index) was shown as 2.57 (0.643) before performing and 1.89 (0.543) after performing, indicating a decrease in Table 5. According to Kim et al. [3], oral hygiene management capability (PHP Index) is a material that measures and displays the amount of battered bacteria membranes with individual’s ability to manage oral cavity, and when treated by experts, the amount of bacteria can be reduced. O’Leary index was shown as 51.99 (41.58) before performing and decreased to 41.58 (12.925) after performing (Table 5). O’Leary index measures and assesses the amount of bacterial membranes in all teeth of the subject, especially as a known indicator of fixed prosthesis and periodontal surgery management, which can be seen as decreasing after expert performance.

According to Park’s study [15], the number of patients with a periodontic depth of 4 mm or more decreased by 40% after the periodontic care process was performed. It was found that the dental hygiene process affected the depth and odor of the periodontal sac by decreasing after the dental hygiene process, resulting in an overall increase in the low group.

Therefore, this study is thought to be intended to identify and evaluate the effects of dental hygiene activities by comparing and investigating oral hygiene before and after performing work by applying a comprehensive dental hygiene management process to subjects.

Since this study was conveniently extracted and measured by residents of some regions, there is a limitation in expanding the overall interpretation of the research results, but it is expected to be useful data for the effective application of the dental hygiene process.

This study attempted to identify the effectiveness of dental hygiene activities by examining oral health and management status of subjects who participated in the comprehensive dental hygiene management process and applying dental hygiene management process to compare dental hygiene conditions before and after performing their duties.

The general characteristics of the subjects in this study are as follows.

1. 83.3% (60 people) in their 20s, 4.1% (3 people) in their 30s, 6.9% (5 people) in their 40s, and 5.5% (4 people) in their 50s and older. Gender was 54.1% (39) for women and 45.8% (33) for men. In terms of occupation, 73.6% (53 students) accounted for more than half. Office workers (6.9 percent), self-employed (6.9 percent), and others (12.5 percent), 40.3 percent (29 smokers) and 62.5 percent (45) drank alcohol (Table 1).

2. If you look at the oral health conditions of the experi-mental group by gender. According to dental experience, 33 (84.6%) were women and 17 (51.5%) were men. According to his experience with scalping, women were 9 (23.1%) experienced, men were 17 (51.5%), and men were 17 (51.5%). Dental treatment was the highest among women and men, with 15 (20.8%) and 12 (16.7%) (Table 2).

3. If we look at oral health care by gender in the experi-mental group. The average number of toothbrushes was 3.13 for women, higher than 2.48 for men. Toothbrush experience is higher than 33 (84.6%) for women and 17 (51.5%) for men. Oral hygiene products oil.As for radishes, 33 (84.6%) for women and 31 (93.9%) for men. Both women and men had 16 (41.0%) and 24 (72.7%) dental floss (Table 3).

4. If you look at the DMFT index by gender in the experimental group. For women, DMFT index was 80.0±4.26, higher than for men DMFT index 7.47±5.07. The saliva secretion test showed that women had 10.13±2.10, higher than men’s saliva secretion ratio of 9.94±1.95 (Table 4).

5. Changes in oral odor before and after the comprehensive hygiene management process of the experimental group were shown as 80.92 (15.010) before and 65.92 (12.565) after the performance. The oral hygiene management capability (PHP index) was shown as 2.57 (6.643) before performing and 1.89 (0.543) after performing. O’Leary index was 51.99 before performing (41.58) and 41.58 (12.925) after performing (Table 5).

This study shows that the comprehensive dental hygiene management process performed by dental hygienists has a positive effect on dental health education, the use of oral hygiene products, and regular oral examinations. Therefore, repeated studies targeting various fields and classes are suggested.

No potential conflict of interest relevant to this article was reported.