College Students' Dental Health Survey: Half Dissatisfied with Their Teeth, Misalignment and Cavities Most Common

As the saying goes, “Poor dental care invites systemic disease.” Teeth serve as the first line of defense in disease prevention and are crucial to overall health. With changes in young people’s dietary habits—particularly increased consumption of high-sugar and refined foods—dental health has become a growing concern among college students. What are the primary dental health issues faced by college students? How can these problems be addressed? Have they had any prior experiences with dental treatment?

As National Love Your Teeth Day on September 20 approaches, the Campus News Agency of China Youth Network conducted a questionnaire survey among 663 university students across China on the topic of dental health. The results showed that half of the university students were dissatisfied with their teeth, and more than half had experienced dental treatment. Malocclusion, dental caries, and gingival bleeding were identified as the primary dental problems among university students. Over 80% of students would choose public hospitals for dental care, and more than 90% prioritized the qualifications and technical expertise of dentists when seeking treatment. Exorbitant costs emerged as the main factor deterring university students from receiving dental care.

Zhao Yu, a student at Weifang University, often felt drowsy during her evening study sessions and would frequently drink a cup of strong tea to refresh herself and stay alert. Over time, this developed into a habitual practice. “Although tea consumption offers many benefits, it can erode tooth enamel, causing teeth to gradually turn yellow and even black.” These changes in her teeth made Zhao Yu feel somewhat self-conscious; she often hesitated to engage in conversations or smile at others, fearing that she might give the impression of being unclean.

Beautiful, white teeth and a “perfect smile” can showcase an individual’s charm and confidence. Survey results indicate that 92.61% of college students believe dental health issues affect their overall appearance, with many stating that “dental problems can ruin one’s entire face as soon as they open their mouth.” Many students consider dental health to have the greatest impact on their image in situations such as job interviews (84.01%), important performances or presentations (74.81%), encounters with romantic interests (71.64%), and taking photos with friends (70.59%). Furthermore, 50.23% of college students are dissatisfied with their dental health, and 51.89% have undergone dental treatment.

Wang Tianwen, a student at Anhui Normal University, has congenital buck teeth and was often called “Bugs Bunny” by his classmates. This had long been a source of significant distress for him. “I once learned that misaligned teeth can even lead to facial skeletal deformities, which significantly affect one’s appearance.” He finally decided to undergo orthodontic treatment. Wearing braces has brought considerable inconvenience to his daily life, requiring monthly hospital visits to replace the archwires and regular dental cleanings. “However, I believe that by following my doctor’s advice and consistently wearing the braces, my misaligned teeth will gradually improve.”

Liu Haolin, a student at Shandong University of Finance and Economics, has recently been deeply troubled. “My postgraduate entrance exam review has reached a critical stage, yet dental caries have emerged to disrupt my preparations.” He explained that due to poor habits in the past, such as frequently eating at night and neglecting to brush his teeth afterward, he developed two cavities. “Usually, it doesn’t cause any issues, but whenever I feel stressed or agitated, the pain persists for a while.” With time running short for his exam preparation, seeking treatment would be too time-consuming, so he has had to rely on painkillers to “tough it out” for now.

There is no shortage of college students who share Liu Haolin’s concerns. According to a survey conducted by China Youth Daily reporters, misaligned teeth, dental caries, and gingival bleeding have now become the primary dental issues, accounting for 44.34%, 40.57%, and 36.35% respectively. These are followed by problems such as tooth stains, bad breath, wide interdental spaces, and gum recession.

Wang Yadong, a student at Henan Institute of Science and Technology, frequently noticed gum bleeding while brushing his teeth in the morning. Switching to several different types of toothpaste yielded no improvement. A subsequent hospital examination revealed that his gum bleeding was linked to a vitamin C deficiency. He candidly admitted, “I really need to correct my bad habit of not eating enough fruits and vegetables.”

Nie Feng, a student at Liupanshui Normal University, recently had an unpleasant experience receiving dental treatment at a private dental clinic. He chose the nearby private facility because public hospitals were too far from his university. However, during the treatment, the dentist repeatedly recommended high-priced and unreasonable products, making Nie feel very uncomfortable. After learning about the experiences of several classmates who received dental care at public hospitals, he resolved, “Next time, I will definitely seek treatment at a public hospital. The treatment is standardized and guaranteed, the pricing is reasonable, and expenses can be reimbursed through medical insurance.”

When dental health issues arise, which channels do college students primarily choose for treatment? A survey conducted by the China Youth Network’s Campus News Agency found that 85.52% of college students opt to address their dental health problems at public hospitals. Among respondents with prior experience in dental care, 91.55% stated that they prioritize the qualifications and technical expertise of dentists, followed by factors such as the environment of hospitals and clinics, service quality, and pricing.

Jiang Lele, a student at Lanzhou University, recently experienced a flare-up of periodontitis. She sought advice from numerous classmates with prior dental treatment experience through her university’s mutual-aid group and WeChat Moments. She noted that although this approach is more cumbersome than directly registering for an appointment at a hospital, it is well worth the effort to identify a healthcare facility with highly qualified physicians, superior technical expertise, and an excellent environment.

“Treating one tooth requires extracting two, doubling the cost, which is simply too expensive.” He Zhiwen, a student at Guangxi Normal University, recently visited a hospital for treatment of dental caries. The doctor informed her that the pulp in the affected tooth had become necrotic and recommended extraction followed by prosthetic replacement. “It was only an issue with one tooth, but the doctor stated that placing a prosthetic crown would damage the pulp of the adjacent tooth, suggesting the extraction of an additional tooth.” He Zhiwen remained skeptical about the doctor’s advice. Extracting an extra tooth entails additional risks, and she indeed could not afford the cost of replacing two teeth. She indicated that she planned to visit several other hospitals in the coming days to seek further opinions from different dentists.

In the survey, many students indicated that factors such as difficulty in finding reliable dentists, high costs, long travel distances, and time-consuming follow-up visits have affected their access to dental care. Among these, “the high cost of dental treatment” was the primary factor, accounting for 70.29% of all respondents.

Dental caries had long plagued Zhong Zirui, a student at Jiangxi University of Finance and Economics. During the summer vacation after her college entrance examination, she underwent comprehensive treatment at a hospital: root canal therapy for four teeth, followed by the fabrication of four porcelain-fused-to-metal crowns. “It cost me a total of 5,800 yuan—enough to buy a laptop computer,” she said regretfully. “From now on, I will definitely take better care of my teeth. Shifting focus from treating dental problems to preventing them is the most cost-effective ‘investment’ in life!”

When respondents ask how to choose a medical institution for dental health issues and how to address the challenge of high costs, Nan Zhe, a Ph.D. in Stomatology from Peking University, chief writer of “Mr. Nan,” and founder of “Weishimei,” believes that the core of selecting a hospital lies in finding a reliable dentist. In China, whether seeking dental care or general medical treatment, people generally prefer public hospitals as their first choice. After choosing a hospital, it is essential to verify whether the doctor holds valid medical practice qualifications. “The official website of the National Health Commission allows anyone to check whether a doctor is qualified to practice medicine.”

Secondly, regarding treatment costs, Nan Zhe stated that most dental treatments are out-of-pocket expenses, and public hospitals are not necessarily more affordable. On one hand, the overall professional standards of tertiary specialized hospitals are indeed higher than the industry average, leading to naturally higher fees. On the other hand, the purchase prices and cost structures for high-value consumables in public hospitals are generally higher than those in typical private clinics, which is a currently widespread phenomenon. “A model combining dentists with public hospital training backgrounds and private clinic settings may be a favorable option.”

Addressing the prevalence of dental issues among college students, such as misaligned teeth, cavities, and gum bleeding, Zhou Lei, a master’s candidate in oral implantology at the Chinese PLA General Hospital, noted that this is not surprising. “These are common oral diseases prevalent among individuals around the age of 20.”

Zhou Lei suggests that college students are the primary demographic for orthodontic treatment. However, it is crucial to wear retainers diligently after completing orthodontic therapy; many patients lose the benefits of their treatment due to inadequate retention. Dental caries, commonly known as cavities, primarily present with food impaction and subsequent pain. The appropriate management for dental caries is timely restoration. Unilateral chewing caused by dental caries can lead to facial asymmetry, affecting aesthetic appearance. Gingival bleeding is perhaps the most common symptom and is indicative of gingivitis. This condition is easily treatable, typically resolved through thorough professional dental cleaning. However, patients must maintain consistent and proper oral hygiene practices and develop good oral health habits.

“Another issue that cannot be overlooked is wisdom teeth. The age of 18–20 is when wisdom teeth typically erupt. Impacted wisdom teeth are easily neglected in the absence of pericoronitis symptoms, but they may cause problems such as resorption of the second molars and dental crowding. Students should pay close attention and seek early intervention,” said Zhou Lei. (At the request of the interviewees, Wang Tianwen, Nie Feng, He Zhiwen, and Zhong Zirui are pseudonyms used in this article.)