The understanding of actual practices in keeping the oral health at standard based on patient's perceptions of oral health care is vital. Oral hygiene is intimated in the health of all parts of the body. Oral health is generally a neglected aspect of health in developing countries. Oral health is about more than shining white teeth and sweet breath. The practices and perceived access barriers have been related to oral health. Several studies have been conducted, which were questionnaire-based, exploring different aspects of oral health. Some studies have shown that the gender differences were pronounced in female being more concerned about oral hygiene and their practices were optimum compared to men. A survey from Steele showed that 19-28% of all subjects were dental non-attendees. A perception that no need to seek clinical dental care was the commonest reason given by non-attendees. Patients' perception of the quality of oral hygiene depends on their regular practices.
Garbin proved that ninety-eight percent (98%) patients knew about educative and preventive practices regarding oral health. However, in developing countries this knowledge, practice and perceptions have been very poor. The major perceived barrier is the willingness to visit general and specialty dentists for treatment. The financial concerns of the patients and/or family are main reasons for not caring about oral hygiene. As low resources are available in urban facilities, but substantial barriers to care are uniformly perceived. Dental involvements in policy development from schools, provision of consultation and service have been limited in Pakistan. Priority given to oral health has been low because of low finances allocated and preferences in dealing with the multitude of other health problems. The failure to provide quality oral health care has been further aggregated by lack of or, limited, access to oral health care to the public by public sector hospitals. Currently, global dental caries and periodontal disease comprise a considerable public health problem in the majority of countries. There have been wide disparities among developed and developing countries observed in epidemiologic indicators of oral disease. The prevalence rates of tooth loss and experience of oral problems vary according to income. Oral hygiene has the mandatory role in overall body health and keeps them away from illness. Experience of oral problems was high in low income countries and access to health care was poor in rural areas, and they have never visited any dentist for any dental problem. Tooth brushing is the most popular oral hygiene practice across the world. The traditional oral self-care is prevalent in several countries of Africa and Asia. While fluoride. toothpaste is widely used in developed countries Oral health services are available in developed countries; however, the use of such services is low among the older people. According to the country reports, health promotion programmes reflects the lack of oral health policies. Worldwide, there are few population-oriented preventive or curative activities currently implemented in developed high income countries. Therefore, in developing countries, like Pakistan, lack of financial support from government has rendered oral health services unaffordable to patients. Reasons for avoiding dental examination are cost, time and fear. Other barriers are weak national health policy, the impact of poor oral health, and lack of trained dentist and institutes in oral health. An integration of oral health into national health programmes and availability of standard oral health services needs to be addressed on priority basis, starting from school-based service. The National Health Programmes for diabetes, hypertension and liver diseases should be integrated with oral health to be effective to improve the oral hygiene in our population. Frazo conducted an interventional study through health -care workers counseling to patients in the community, and reported that health careworker can play a pivotal role in modifying practices and perceptions for oral hygiene. Good oral health outcomes for patients are defined as the primary purpose of dental practice and, therefore, an essential dimension of success. The link between positive patient perceptions of general care and his/her own oral health to practice success is explored. Current evidence highlights the importance of maintaining good oral health during pregnancy. Most women are unaware of link between oral health and maternal child health. Oral health practices and perception vary based-on age group and gender. The poor resources for dental care,common malpractices and the nonavailability of professional care are the main barriers in seeking optimum care.
