Investigating the relationship between stress and oral health-related behaviors changes in final year of high school students prior to university entrance exam

Today, academic stress and subsequent test anxiety is one of the most important problems for the last year of high school students. In addition to systemic effects, stress can affect the level of oral health by disrupting oral health behaviors. The aim of this study was to investigate the relationship between stress and variables related to oral health in the final year of high school students prior to University entrance exam.

In this descriptive-analytical study, the level of stress and variables related to oral health in 180 students of the final year of high school in Tehran, in three time periods during the academic year 2018-2019, were measured by a questionnaire and one clinical examination. Data were analyzed by Friedman, Bonferroni and Generalized Estimating Equations using SPSS software.

As the exam approaches, some variables related to the oral health, such as toothbrush usage pattern, daily sleep, fast food frequency, and sweet snack consumption, changed (P<0.05). Daily sleep changes were significantly associated with the stress changes (P=0.022). According to the results of the Repeated Measures Analysis, significant changes were observed between the average score of the "Cognitive Error" aspect of three times (P<0.001). Also, according to the results of the Bonferroni Test, significant changes related to the difference in the average score of "cognitive error" 6 months and 3 months before the entrance exam (P<0.001), 6 months and 1 month before the entrance exam (P<0.001), and 3 months and 1 month before the entrance exam (P<0.001) were observed. In all three cases, as the time of the entrance exam approaches, the score of "cognitive error" had decreased significantly. Considering that the lower score in this index indicates a higher level of test anxiety, the closer we get to the entrance exam, the higher the level of test anxiety in the "cognitive error" dimension

The academic stress of the national university entrance exam can affect some oral health variables such as daily sleep, however, it is not related to other variables.