Relationship between dental experiences, oral hygiene education and self-reported oral hygiene behaviour

Abstract

Many preventive approaches in dentistry aim to improve oral health through behavioural instruction or intervention concerning oral health behaviour. However, it is still unknown which factors have the highest impact on oral health behaviours, such as toothbrushing or regular dental check-ups. Various external and internal individual factors such as education, experience with dentists or influence by parents could be relevant. Therefore, the present observational study investigated the influence of these factors on self-reported oral heath behaviour. One hundred and seventy participants completed standardized questionnaires about dental anxiety (Dental Anxiety Scale (DAS), and dental self-efficacy perceptions (dSEP)). They also answered newly composed questionnaires on oral hygiene behaviours and attitudes, current and childhood dental experiences as well as parental oral hygiene education and care. Four independent factors, namely attitude towards oral hygiene, attitude towards one's teeth, sense of care and self-inspection of one's teeth were extracted from these questionnaires by rotating factor analysis. The results of the questionnaires were correlated by means of linear regressions. Dental anxiety was related to current negative emotions when visiting a dentist and negative dental-related experiences during childhood. High DAS scores, infantile and current negative experiences showed significant negative correlations with the attitude towards oral hygiene and one's teeth. Dental anxiety and current negative dental experiences reduced participants' dental self-efficacy perceptions as well as the self-inspection of one's teeth. While parental care positively influenced the attitude towards one's teeth, dental self-efficacy perceptions significantly correlated with attitude towards oral hygiene, self-inspection of one's teeth and parental care. Dental anxiety, dental experiences, parents' care for their children's oral hygiene and dental self-efficacy perceptions influence the attitude towards oral hygiene and one's own oral cavity as well as the autonomous control of one's own dental health. Therefore, oral hygiene instruction and the development of patient-centred preventive approaches should consider these factors.

Fig 1. Flow-chart of number and reasons for inclusion or exclusion of participants prior to and during the study.

Reasons and number (in brackets) of included or excluded participants.

Fig 2. Preferred time point of brushing.

Percentage of participants who brushed their teeth a certain points during the day (dark grey) or did not (light grey).

Fig 3. Significant correlations (r-value) between environmental factors and the independent factors of oral hygiene behaviour.

Significant (p ≤ 0.01) positive (full line) and negative (dotted line) correlations between environmental factors (parental care; negative experiences / feelings at / with dentists currently and during childhood; dental anxiety) and the 4 independent oral hygiene behaviour factors (factor 1 “attitude towards oral hygiene” (including sensations towards and during oral hygiene); factor 2 “attitude towards one’s teeth” (including perception of one’s own teeth); factor 4 “self-inspection of one’s teeth” (including actions for controlling one’s own teeth and the use of professional help). Only those results are presented exceeding the threshold of effect size (r² > 5%).