Associations between Perceived Self-Efficacy and Oral Health Behaviours in Adolescents

Factors associated with toothbrushing performance among children: An observational cohort study

BACKGROUND

Effective removal of dental plaque is essential factor for prevention of caries, gingival, and periodontal diseases in children and adults.

AIM

To evaluate factors associated with improving toothbrushing performance (TB-P) among children.

DESIGN

An observational cohort study analyzed all paediatric patients receiving regular examinations in a single dental clinic between 2009 and 2017 and regularly brushing their teeth with a triple-headed toothbrush (TH-TB). At every periodic follow-up, the TB-P of the child/parent was evaluated using the TB-P Skill Index (TB-PS-I); that is, did the child reach all five teeth segments within each arch and did he/she perform 10 back-and-forth stocks in each segment. When not optimal, they received instructions for improving TB-P and subsequently were asked to re-demonstrate. TB-PS-I was calculated and analyzed for correlation with other explanatory variables.

RESULTS

A total of 1737 children with 7399 follow-up appointments were analyzed. Older age, female gender, higher number of follow-up appointments, and compliance with twice-daily toothbrushing significantly improved TB-P. The most typical mistakes in their performance were not reaching the canine segments and not performing enough strokes in each segment. Instructions given after imperfect TB-P significantly improved the TB-P. The magnitude of improvement, however, did not correlate with the performers' age, gender, or the number of follow-up visits.

CONCLUSIONS

A significant percentage of children >8 years did not perform optimal toothbrushing even when using TH-TB.

Perceived racial discrimination, resilience, and oral health behaviours of adolescents with immigrant backgrounds

INTRODUCTION

Unmet oral health needs remain a significant issue among immigrant adolescents, often exacerbated by experiences of racial discrimination. This study aimed to examine the associations between perceived discrimination and oral health behaviours in adolescents with immigrant backgrounds and explore the potential moderating role of resilience on this association.

METHODS

Ethical approval for this cross-sectional study was obtained from the University of Alberta Research Ethics Board. Participants were 12 to 18-year-old adolescents from immigrant backgrounds. Participants were recruited through nine community organizations using a snowball sampling technique. After obtaining active parental consent and assent from the adolescent, the participants completed a questionnaire covering demographics, oral health behaviours, and perceived racial discrimination and resilience. Perceived racial discrimination and resilience were measured using validated scales. Descriptive statistics summarized variables. Logistic regression assessed associations, controlling for confounding factors. Resilience's moderating impact was analyzed via the interaction model of regression analysis.

RESULTS

In this cross-sectional study of 316 participants, average age of 15.3 (SD = 1.9) years, and a median age of 15 years (Inter Quartile Range-12-18), 76% reported discrimination experiences. Adjusted analysis showed that an increase of one unit in the total discrimination distress score was associated with 51% less likelihood of categorizing self-rated oral health as good (OR = 0.49, 95% CI: 0.29-0.81). The odds of brushing teeth more than twice a day, as opposed to once a day, decreased by 58% with one unit increase in the total discrimination distress score (OR = 0.42, 95% CI: 0.25-0.71). The odds of visiting the dentist for an urgent procedure instead of a regular check-up were 2.3 times higher with a unit increase in the total discrimination distress score (OR = 2.3: 95% CI:1.3-4.0) Resilience did not moderate the observed association.

CONCLUSION

Perceived racial discrimination was associated with the pattern for dental attendance, tooth brushing frequency, and self-rated oral health. Resilience did not moderate the observed association.

Association between orthodontic treatment and psychosocial factors in adolescents: a cross-sectional study

BACKGROUND

Orthodontic treatment is one of the longest and most common medical interventions in adolescence. There are certain inequalities in care leading to risk factors associated with higher rates of untreated tooth malocclusion, resulting in a significant burden on oral health. Little is known about that certain psychosocial and personal risk factors influence the uptake of orthodontic treatment. Therefore, the aim was to explore factors that might influence orthodontic treatment and psychosocial and personal factors in a representative sample in Germany.

METHODS

The data are based on the KiGGS Survey Wave 2, a representative cross-sectional study of children and adolescents in Germany. Sociodemographic data, uptake of orthodontic treatment, parental socioeconomic status, social support, self-efficacy, and perceived health status were collected through a self-reported questionnaire.

RESULTS

A total of 6599 children and adolescents between 11 and 17 years were included in the analysis. Girls, non-immigrants, children, and adolescents with higher levels of social support, and children and adolescents who have visited a dentist or orthodontist more often in the past 12 months are more likely to have received orthodontic treatment. Among 14- to 17-year-olds, the likelihood of seeking orthodontic treatment is also associated with an increasing parental socioeconomic status (odds ratio 1.07 [95% CI 1.02; 1.14] P = .013).

CONCLUSIONS

Certain protective and risk factors as well as personal and psychosocial factors are associated with orthodontic treatment. This knowledge can be used to determine which individuals should be targeted for need-based care to ensure that health care is provided without over- or undertreatment.

Associations of Social Psychological Factors and OHRQoL in Periodontitis Patients: A Structural Equation Modeling Study

Background and Purpose

Periodontitis is the leading cause of tooth loss in adults worldwide. The functional loss, nutritional deficiencies, and psychological barriers it causes, as well as its impact on overall health and quality of life, are all significant. The prevalence of periodontal disease is high in China. Our study aimed to determine the intricate relationship between periodontal disease status, dental anxiety, self-rated oral health (SROH), self-efficacy for oral care, perceived social support, socioeconomic status (SES), and the oral health-related quality of life (OHRQoL) among periodontitis patients.

Methods

This cross-sectional study used purposive sampling to identify 247 patients with periodontitis who entered the First Affiliated Hospital of Bengbu Medical University between October 2022 and October 2023. 247 participants underwent a periodontal clinical examination combined with imaging, adhering to the "2018 world new classification of periodontal and peri⁃implant diseases and conditions". Participants also completed a detailed questionnaire in paper format, which included OHRQoL, sociodemographic details, dental anxiety, SROH, self-efficacy in oral care, perceived social support, and subjective SES.

Results

Dental anxiety, self-efficacy for oral care, and SROH all had a direct and significant effect on OHRQoL. OHRQoL was indirectly related to SROH mediated by dental anxiety and subjective SES, perceived social support and self-efficacy for oral care, respectively. SROH was directly related to subjective SES, and at the same time, they had a direct effect on dental anxiety. Furthermore, patient's age, gender, annual household income, and education level were significantly associated with the degree of periodontal disease.

Conclusion

OHRQoL and periodontal status was influenced by socio-demographics characteristics, dental anxiety, SROH, self-efficacy for oral care, perceived social support, subjective SES in periodontitis patients. These insights underscore the importance of adopting a holistic approach in the management and treatment of periodontal diseases.

Predicting oral hygiene practices through health behavior, perceived stress and self-efficacy in undergraduate dental students of Pakistan: a national survey

BACKGROUND

Dental students face the rigorous demands of coursework, which can lead to feelings of inadequacy and stress. These pressures can negatively influence self-efficacy and cause neglect in practicing healthy behaviors that encompass oral health. Identifying the associations of these variables with oral hygiene practices can help in the formulation of interventions tailored toward supporting young students. Therefore, this study aimed to investigate the impact of health behaviors, perceived stress and self-efficacy on oral hygiene practices among undergraduate dental students in Pakistan.

METHODS

A national online survey was carried out among 904 students across the dental colleges of Pakistan. The survey assessed general health behaviors such as tobacco use, sleep, and exercise, among other demographic variables. Perceived stress was evaluated via the Perceived Stress Scale (PSS-10), and self-efficacy was evaluated via the General Self-Efficacy Scale (GSES). Twice daily brushing, brushing for 2 min, and changing toothbrushes after 3 months informed oral hygiene practice of the participants.

RESULTS

The students experienced moderate perceived stress (20.82 ± 5.92) and high self-efficacy (29.19 ± 5.43). The majority of participants were in their third year (31.9%), were female (65.9%), and resided in home during their studies (64.4%). Perceived stress was observed to have no significant effect on the oral practice of participants. Female gender, non tobacco user, regular exercise, frequent dental visits and higher self-efficacy were associated with good oral hygiene practices.

CONCLUSIONS

The results highlight the importance of addressing stress, enhancing self-efficacy and encouraging healthy behaviors among dental students to improve their oral health, which could be reflected in their professional practice and personal well-being. This study contributes to the understanding of behavioral determinants and emphasizes the need for supportive measures to foster better health behaviors in future dental professionals.

Influencing factors of health screening among retirees: an extended TPB approach

Background

Health screenings are promoted worldwide as they help detect and prevent overall health issues. Despite expanding coverage, the participation rate among the retired population has not significantly increased. Given the special role of health screenings in promoting health and healthy aging, understanding the behavioral intentions, and influencing factors of retirees' voluntary participation in health screenings is crucial. This study aims to explore the participation intentions in health screenings among the Chinese retired population by integrating the Theory of Planned Behavior (TPB) and Self-Efficacy (SE).

Methods

This study used a cross-sectional design to conduct an online questionnaire among 311 retirees in 2023. The questionnaire, tailored for the Chinese retired population, combines the TPB theory and Self-Efficacy theory, including demographic structure, the basic structure of TPB, and SE.

Results

A Structural Equation Modeling (SEM) approach was used to identify factors related to health screening behaviors. Of the respondents, 311 completed the survey (88.9% response rate). The most crucial determinant of health examination behavior was behavioral intention, with a correlation score of (1.524, p < 0.001). Significant correlates of behavioral intention included Subjective Norms (SN) and Self-Efficacy (SE), followed by Perceived Behavioral Control (PBC) and Attitude (AT), with correlation scores of (0.401, p < 0.001), (0.339, p < 0.001), (0.082, p < 0.001), and (0.060, p < 0.05), respectively.

Conclusion

This study provides insights for enhancing the willingness and behavior of retirees to participate in health screenings.

Effectiveness of theory-based educational interventions of promoting oral health among elementary school students

BACKGROUND

The aim of the present study was to determine the effect of oral health education programs on the oral health of primary school students.

METHODS

In this randomized controlled trial study, 190 elementary fifth-grade female students were chosen using the multistage cluster sampling method. In this study, the Plaque Index (PI), Simplified Oral Hygiene Index (OHI-S), Community Periodontal Index (CPI), tooth brushing using fluoride toothpaste, dental flossing frequency and factors affecting them were determined according to social cognitive theory (SCT). Interventions were implemented using the play method and with the help of three pamphlets, five posters, a celebration of oral health, and the creation of a Telegram group. Data were analyzed using descriptive statistics indexes, t tests, paired sample t tests, chi-square tests, and Pearson correlation tests.

RESULTS

The results showed that 3 months after the intervention, compared to before the intervention, the percentage of participants in the intervention group who brushed their teeth twice or more per day increased by 48.5%, and the percentage of participants who used dental floss at least once per day increased by 64.2%. The rate of gum bleeding decreased by 6.3%. The good OHI-S rate increased by 44.4%. Dental plaque decreased by 38.1%.

CONCLUSION

The results demonstrated that a gamification design can be effective and useful in promoting the oral health of students.

TRIAL REGISTRATION

registration timing: retrospective, registration date: 18/10/2022, registration number: IRCT20141128020129N2.

Factors predicting oral health behaviors among students age 13-15 years in Shushtar city, Iran

BACKGROUND

Tooth decay and other oral health (periodontal) diseases are highly prevalent worldwide and present a significant economic burden. Oral health is particularly important for adolescents, as the World Health Organization has identified tooth decay as one of the most pressing global health issues. This study aims to identify predictors of oral health behaviors among students aged 13-15 years in the city of Shushtar, Iran.

METHODS

The present research is a cross-sectional study that was conducted during the summer of 2022 on 415 adolescents from the first secondary school in Shushtar. Two standard questionnaires were used to collect data, consisting of demographic information and questions related to measuring awareness, attitude, performance, and self-efficacy regarding oral health behaviors among adolescents. The collected data was analyzed using SPSS 22 statistical software through descriptive statistics, Pearson correlation, and regression analysis.

RESULTS

The average scores for awareness, attitude, self-efficacy in brushing teeth, self-efficacy in flossing, self-efficacy in going to the dentist, and adolescents' performance on oral health behaviors are 5.72 ± 2.06, 36.40 ± 6.36, 25.40 ± 7.49, 14.15 ± 6.06, 15.80 ± 5.59, and 14.01 ± 4.02, respectively.

CONCLUSION

Based on the results of this study, it can be concluded that adolescents have low levels of awareness, performance, self-efficacy, and a positive attitude towards oral health. Considering the significance of adolescence as a stage for shaping oral health behaviors and their impact on adulthood, it is recommended to increase awareness among adolescents and improve their health behaviors by conducting educational classes in schools.

Effect of Teacher Support on Adolescents' Positive Academic Emotion in China: Mediating Role of Psychological Suzhi and General Self-Efficacy

Positive academic emotions can promote good academic performance and development in students. Therefore, how teachers stimulate students to produce more positive academic emotions is particularly important. This study aimed to reveal the underlying mechanism of teacher support and adolescents' positive academic emotions. A total of 854 students from western China participated in this survey, which included the Students' Perception of the Teacher's Behavioural Support Questionnaire, the Psychological Suzhi Questionnaire for Middle School Students, the General Self-Efficacy Scale, and the Achievement Emotions Questionnaire (396 boys; 12 to 20 years old, Mage = 15.3, SD = 2.04). Results showed that (1) teacher support, psychological suzhi, and general self-efficacy were positively correlated with students' positive academic emotion; (2) psychological suzhi and general self-efficacy played a separate mediating role between teacher support and adolescents' positive academic emotion; and (3) teacher support also influenced adolescents' positive academic emotion through the serial mediation of psychological suzhi and general self-efficacy.