Social support, oral health knowledge, attitudes, practice, self-efficacy and oral health-related quality of life in Chinese college students

Oral health literacy and behaviors among Chinese university students: a comparative study of medical and non-medical students

BACKGROUND

Oral health literacy (OHL) plays a crucial role in improving oral health outcomes. Due to their academic background, medical students are presumed to have higher OHL levels than students in other disciplines. However, few studies have directly compared OHL and oral health behaviors between medical and non-medical students.

METHODS

This cross-sectional study recruited undergraduate students from seven universities in Shandong, China. A total of 2,695 students completed an online survey between August and September 2024. The questionnaire collected information on demographic characteristics, OHL, and oral health-related behaviors. OHL was measured using the validated Chinese version of the short-form Dental Health Literacy Scale (HeLD-14). Data were analyzed using t-tests, chi-square tests, and mediation analysis conducted with the PROCESS macro in SPSS.

RESULTS

Among the participants, 1,572 (58.3%) were medical students. Medical students scored significantly higher on the HeLD-14 total score than non-medical students (56.96 ± 11.04 vs. 54.59 ± 11.24, P < 0.001), with consistently higher scores across all dimensions. In terms of oral health behaviors, medical students were more likely to brush after late-night snacks, use fluoride toothpaste, and floss regularly compared to non-medical students (all P < 0.05). Mediation analysis showed that OHL partially mediated the relationship between academic major and these oral health behaviors.

CONCLUSION

Medical students exhibit higher OHL and healthier oral health behaviors compared to non-medical students. Enhancing OHL among non-medical students may foster better oral health behaviors and improve overall oral health outcomes.

Evaluation of the psychometric properties of the Oral Health Behavior Social Support (OHBSS) Scales in English and Spanish for Mexican-origin young adults

BACKGROUND

Valid, reliable measures of psychosocial constructs are needed in oral health research. This study quantitatively evaluated the psychometric properties of nine new Oral Health Behavior Social Support (OHBSS) scales, which measured support for three oral health behaviors (brushing, flossing, dental care), queried for each of three sources (family, health providers, others/friends).

METHODS

Young Mexican-origin adults in the southwestern United States-Mexico border region completed an online survey, in English or Spanish (N = 502). Survey items included: OHBSS scales, general social support scales, oral health behaviors, self-rated oral health status, dental anxiety, acculturation and socio-demographics. Subsample 1 participants also completed a dental exam (N = 41). Subsample 2 participants also completed a repeat OHBSS survey two-to-six weeks later (N = 56). Psychometric properties were tabulated, overall and by language preference (English or Spanish). Convergent and divergent validity were evaluated via correlations between the dental-specific OHBSS social support scales, scores from three validated general social support scales, and scales expected to be largely unrelated (acculturation, dental anxiety). Correlations examined predictive validity between the OHBSS scales and oral health behaviors, and self-reported and clinical outcomes. Test-retest reliability was assessed via intraclass correlation coefficients in Subsample 2.

RESULTS

Of 502 participants, 60% preferred speaking English, 37% were single, and 21% were male. OHBSS scores indicated that health providers then family provided the most support for all three oral health behaviors, while others/friends did not provide much support. Spanish speakers tended to have higher OHBSS scores than English speakers. Correlations followed expected patterns and supported convergent and divergent validity, in the full sample and across languages. OHBSS scales exhibited many significant weak-moderate positive correlations (r = 0.10-0.38) with general social support scales. Few (11/108) significant correlations (< -0.16) were observed between OHBSS scales, acculturation, and dental anxiety. OHBSS scales exhibited some significant weak-moderate positive correlations with oral health-promoting behaviors. OHBSS scales were not associated with clinical outcomes. OHBSS scales exhibited good test-retest reliability overall and in Spanish.

CONCLUSION

Psychometric properties for the OHBSS scales were acceptable in both English and Spanish versions. The scales are valid and reliable tools for assessing social support for oral health-promoting behaviors from family, health providers, and others/friends.

TRIAL REGISTRATION

Not applicable.

The development and validation of a Korean version of the oral hygiene-related self-efficacy tool

PURPOSE

Self-efficacy is an important factor in the management of chronic oral diseases. This study aimed to develop a Korean version of a self-efficacy tool related to personal oral hygiene management, and verify its validity and reliability.

METHODS

This study evaluated the validity and reliability of a Korean version of the oral health-related self-efficacy measurement tool (OHSE-K). The sub-factors of this self-efficacy tool are tooth brushing, interdental hygiene management, and dental visits. The original items were translated into Korean, and their content validity was confirmed. Initially, a preliminary survey was conducted, followed by the main survey. The main survey comprised 19 content-verified items. The validity and reliability of the main survey were evaluated through repeated exploratory factor analyses. A randomly selected sample of Korean adults, aged 19 years or older, completed the OHSE-K online between May 10 and June 2, 2023. The study recruited 400 adults for the preliminary survey. Data were analyzed using PASW 25.0.

RESULTS

The OHSE-K demonstrated a high level of overall reliability (Cronbach's α=0.891). Exploratory factor analysis revealed 3 significant factors: tooth-brushing self-efficacy, interdental hygiene management self-efficacy, and dental visit self-efficacy, with a cumulative explanation rate of 65.114%. The criterion validity results indicated that oral healthcare awareness and behavior, as well as unmet dental treatment needs, were significant (P<0.05). Additionally, the OHSE-K scores showed significant correlations with all 3 sub-factors (P<0.05).

CONCLUSIONS

The OHSE-K is a reliable tool. Our results demonstrated its validity and reliability.

Comparative analysis of oral disorder burden in China and globally from 1990 to 2021 based on GBD data

Oral disorders are major global health issues, affecting 3.5 billion people and imposing significant economic burdens. This study analyzed the distribution and trends of oral disorder burden globally and in China from 1990 to 2021, aiming to inform resource allocation and prevention strategies. Data from the Global Burden of Disease (GBD) 2021 database were used to evaluate the incidence, prevalence, and years lived with disability (YLDs) of oral disorders. All statistical analyses and data visualizations were conducted using R. In 2021, the burden of oral disorders in China accounted for a significant proportion of the global burden. The incidence, prevalence, and YLDs increased by 15.49%, 52.44%, and 86.86% respectively compared with 1990. The global burden also showed an upward trend during the same period. The relevant indicators in China are at a relatively low level, and disparities were observed among regions with different sociodemographic indices (SDI). Oral disorder burden is on the rise globally, with females, children, adolescents, and the elderly being the key affected groups. Regions with middle SDI bear a heavier burden. This study provides a scientific basis for the formulation of relevant policies and emphasizes the necessity of interventions for specific groups.

The relationship between dental anxiety and oral health literacy with oral health-related quality of life

BACKGROUND AND AIM

Dental anxiety is a prevalent issue in society, characterized by an uneasy sensation and anticipation of negative experiences in dental settings. In essence, dental anxiety, oral health literacy, and quality of life may have a relationship with each other, however, there is a shortage of evidence examining the interplay between these factors. Therefore, this study aimed to assess the relationship between dental anxiety and oral health literacy (OHL) with oral health-related quality of life (OHRQOL).

METHODS

This is an analytical cross-sectional study conducted on 155 patients referred to the Department of Oromaxillofacial Diseases. Three questionnaires consisting of dental anxiety scale, oral health impact profile- 14, and oral health literacy adult questionnaire were used to measure anxiety, health literacy, and the quality of life-related to oral health. Scores were recorded and analyzed by IBM SPSS 24 software using independent samples T-test and ANOVA. Besides, the confirmatory modeling through the goodness of fit index of the model was applied.

RESULTS

This study involved 155 participants, with a mean age of 38.44 ± 14 years. The majority were females, comprising 99 individuals (63.9%). In this study, 89 patients (57.4%) had dental anxiety. The mean OHL score in the examined participants was 9.88 ± 3.97. Both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on the OHRQOL. There was no significant difference in the mean OHRQOL among the three categories of OHL (p = 0.085). The confirmatory modeling showed that only the fourth (p = 0.065) and fifth (p = 0.146) questions of the OHL questionnaire had no significant effect on the total score of OHL. Besides, both factors of anxiety (p < 0.001) and OHL (p = 0.012) had a significant effect on OHRQOL. With an increase of one unit in anxiety, the OHRQOL score increases by 0.31 and for a one-unit increase in the OHL score, the OHRQOL score decreases by 0.66 units.

CONCLUSION

In conclusion, it seems that considering various dimensions of oral and dental health can help patients to have reduced psychological anxiety. Notably, further multicenter studies assessing diverse variables related to dental anxiety, OHL, and OHRQOL, and considering more comprehensive study designs with longitudinal follow-up could help provide insights into how changes in dental anxiety and OHL over time affect OHRQOL.

Relationship between risk of oral frailty and awareness of oral frailty among community-dwelling adults: a cross-sectional study

We aimed to investigate the relationship between the risk of oral frailty and awareness of oral frailty among Japanese adults in an adult dental health field study conducted in Kanagawa Prefecture. Questionnaire data from a total of 5051 individuals (1907 males, 3144 females; mean age; 59.9 years) were used. The risk of oral frailty was assessed using the Oral Frailty Index-8. Of the participants, 1418 (28.1%) had a high risk of oral frailty and 1495 (29.6%) had knowledge of oral frailty. Logistic regression analysis indicated that the risk of oral frailty was significantly associated with awareness of oral frailty. We further found that awareness of oral frailty was significantly related to gender (female), age (20-39 compared to 70-79, ≥ 80), residential areas (Yokohama compared to Kawasaki, Sagamihara), exercise habits (yes), eating a balanced diet (yes), consciousness of oral health (yes), risk of oral frailty (low) and outpatient category (hospital visit). For groups with low levels of awareness obtained from the results of this study, it is necessary to consider the means of accessibility and increase awareness further.