Abstract
BACKGROUND: Oral health is an essential component of overall well-being, and dentistry students are expected to model healthy behaviors. However, their lifestyle habits may not always reflect this role. This study explores the relationship between oral health status and health-promoting behaviors among fourth-year dental students. While the Health-Promoting Lifestyle Profile II (HPLP II) has been widely applied, its use alongside objective oral health indices in this population remains limited. METHODS: This cross-sectional study assessed health-promoting behaviors using the Health-Promoting Lifestyle Profile II (HPLP II) and evaluated oral health status using clinical indices, including Decayed, Missing, and Filled Teeth (DMFT) index, Gingival Index (GI), and Plaque Index (PI), among fourth-year dental students. RESULTS: Students with better gingival health exhibited higher overall health-promoting lifestyle scores, particularly in the domains of nutrition and health responsibility. Similarly, participants with better plaque control demonstrated more favorable stress management behaviors. In addition, weak inverse associations were observed between dental caries experience and spiritual growth, as well as between plaque accumulation and overall health-promoting lifestyle behaviors. CONCLUSION: This study revealed significant links between key health-promoting lifestyle domains—nutrition, stress management, and health responsibility—and oral health indicators. These findings underscore the need to integrate structured health promotion modules into dental curricula to improve students’ well-being and clinical competence. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-026-08591-3.