Understanding oral health behaviour – psychological predictors of systematic toothbrushing behaviour


  • S. Ebel
  • H. Blaettermann
  • D. Harnacke
  • U. Weik
  • J. Margraf-Stiksrud
  • R. Deinzer


Background: Toothbrushing is an important health behaviour which is necessary to prevent not only caries but also gum diseases such as gingivitis and periodontitis. Although most people brush their teeth regularly, there is a high prevalence of gum diseases in western countries. Previous research revealed that systematic toothbrushing best predicts oral cleanliness. In this study, psychological variables are investigated as potential predictors of systematic toothbrushing behaviour. This approach might help to generate hypotheses how to target interventions more successful and to identify groups with special treatment needs. Methods: N=96 18-year olds filled out questionnaires regarding toothbrushing self-efficacy, decisional balance (pros and cons), dental anxiety and knowledge regarding periodontal diseases. The criterion variable was systematic toothbrushing behaviour operationalized by the degree of evenness of brushing time across the different brushing locations. This variable has been derived from the same study group and shown to be a significant predictor of oral cleanliness. Backward regression analysis was performed to assess the predictive values of the psychological variables. Findings: The final regression model explained 17% of the variance of systematic toothbrushing behaviour (F=6.291; p=.001). In particular, dental anxiety (β = −0.301), self-efficacy (β = 0.184) and knowledge of risk factors for developing a periodontitis (β = 0.169) were included as predictors. Discussion: Results indicate that future oral hygiene interventions should focus especially on anxious individuals and those with lacking self-efficacy. Additionally, educating patients regarding gum diseases such as periodontitis should be included in future interventions.





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