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Journal of Peking University (Health Sciences) ›› 2026, Vol. 58 ›› Issue (4): 848-854. doi: 10.19723/j.issn.1671-167X.2026.04.023

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Report on oral health literacy of children and adolescents in Nagqu, Xizang

Zitong SHAN1, Shuhao WEI1, Jiahao HAN1, Yan SI1, Wensheng RONG1, Shuguo ZHENG1, Xiaomo LIU2,*(), Shanshan ZHANG1,*()   

  1. 1. Department of Preventive Health Care, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
    2. Department of Orthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing 100081, China
  • Received:2025-10-02 Online:2026-08-18 Published:2026-04-23
  • Contact: Xiaomo LIU, Shanshan ZHANG
  • Supported by:
    the Capital's Funds for Health Improvement and Research(2024-2G-4106); the Project Sponsored by the Innovative Development Research of People's Medical Publishing House(RWCY23DⅡ007007); the Education Research Project of Peking University School and Hospital of Stomatology in 2024(2024-ZC-07); the Beijing Research Ward Excellence Program, BRWEP(BRWEP2024W194100100); the Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology(PKUSSNCT-25B05); the Beijing Municipal Natural Science Foundation-Haidian Original Innovation Joint Fund(L222001)

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Abstract:

Objective: To understand the oral health literacy of children and adolescents in Nagqu City, and to evaluate the effect of a single online digital integrated media science popularization course on improving oral health literacy. Methods: A cluster sampling method was employed in which all students aged 9-15 years in the Seni District of Naqu City, Xizang Autonomous Region, 406 students were surveyed class-by-class using a paper questionnaire. After baseline data collection, the students received a single remote digital-multimedia oral-health education lesson; a follow-up questionnaire was administered one week later to evaluate whether the online course improved oral-health literacy. The instrument collected demographic information, basic oral-health knowledge, beliefs, self-care practices, and dental-service utilization. Data were analyzed with R 4.4.1 and SPSS 27.0. Results: The awareness rate of oral health knowledge among the children and adolescents in Xizang was less than 50%. More than half of the adolescents consumed high-sugar foods, such as desserts and sugary beverages daily. Only 15.98% of the adolescents brushed their teeth twice or more daily, 7.71% used dental floss daily before the course, and the usage rate of fluoride toothpaste was 45.45%. Oral health issues among the children and adolescents in Xizang severely impacted their daily lives, particularly in eating, pronunciation, and brushing. A single oral health education session showed no significant impact on the awareness rate or the conversion of knowledge into behavior. Conclusion: The awareness rate of oral health knowledge among the children and adolescents in Xizang is lower than the national average a decade ago, and a significant portion has yet to develop good personal oral hygiene habits. Targeted measures are needed to improve oral health awareness among the children and adolescents in Xizang. These may include utilizing interactive digital education tools and emphasizing oral disease prevention to enhance both the awareness rate of oral health knowledge and the conversion of knowledge into behavior.

Key words: Oral health literacy, Children and adolescents, Oral health education, Cross-sectional study, Xizang Autonomous Region

CLC Number: 

  • R780.1

Table 1

Questionnaire collection basic information"

Demographics Pre-education lesson，n(%) Post- education lesson, n(%) P
Age/years 9 3 (0.83) 3 (0.95) >0.999
10 20 (5.51) 18 (5.70) >0.999
11 22 (6.06) 21 (6.65) 0.877
12 104 (28.65) 91 (28.80) >0.999
13 165 (45.45) 147 (46.52) 0.841
14 47 (12.95) 35 (11.08) 0.804
15 2 (0.55) 1 (0.32) >0.999
Gender Boy 182 (50.14) — —
Girl 181 (49.86) — —
Only child Yes 17 (4.68) — —
No 346 (95.6) — —
Parent’s educational background Primary school or below 311 (85.67) — —
Middle school or high school 39 (10.74) — —
Secondary specialized school or associate degree 7 (1.93) — —
Bachelor’s degree or higher 6 (1.65) — —

Table 2

Awareness rate of oral health knowledge among children and adolescents in Xizang and the fourth oral health survey"

Table 3

Oral health attitudes among children and adolescents in Xizang and the fourth oral health survey"

Table 4

Dietary habits and personal oral hygiene practices among children and adolescents in Xizang and the fourth oral health survey"

Table 5

Self-reported incidence of various oral health issues among children and adolescents in Xizang"

Oral health status Pre-education，n(%) Post-education，n(%) P(pre-post)
Dental caries 115 (31.68) 88 (27.85) 0.32
Gingivitis 94 (25.90) 97 (30.70) 0.19
Periodontitis 82 (22.59) 73 (23.10) 0.95
Gum bleeding 147 (40.50) 120 (37.97) 0.55
Malocclusion 42 (11.57) 33 (10.44) 0.73
Mouth ulcer 98 (27.00) 86 (27.22) >0.99
Dental injure(off-campus) 106 (29.20) 74 (23.42) 0.11
Dental injure(on-campus) 34 (9.37) 39 (12.34) 0.26

Table 6

Impact of oral health related quality of lives of children and adolescents in Xizang and the fourth oral health survey"

The impact of oral health issues on daily life Pre-education lesson，n(%) Post-education lesson，n(%) P National data (ND)，n(%) P(pre-ND) P(post-ND)
Eating 193 (53.17) 166 (52.53) 0.929 4 33 683 (28.4) ＜0.001 ＜0.001
pronouncing 127 (34.99) 106 (33.54) 0.753 7 11 860 (10.0) ＜0.001 ＜0.001
Brushing 119 (32.78) 120 (37.97) 0.182 7 22 534 (19.0) ＜0.001 ＜0.001
Doing housework 86 (23.69) 83 (26.27) 0.493 4 4 270 (3.6) ＜0.001 ＜0.001
Going to school 106 (29.20) 91 (28.80) 0.975 4 10 081 (8.5) ＜0.001 ＜0.001
Sleeping 103 (28.37) 92 (29.11) 0.898 7 13 521 (11.4) ＜0.001 ＜0.001
Smiling 107 (29.48) 87 (27.53) 0.398 7 19 569 (16.5) ＜0.001 ＜0.001
Mood 118 (32.51) 85 (26.90) 0.131 5 - - -
Making friends 88 (24.24) 75 (23.73) 0.948 5 14 588 (12.3) ＜0.001 ＜0.001
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