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Rogers AA, Halvari AEM, Johnsen JAK, Solbakk AK. Executive functioning as a moderator of flossing behaviour among young adults: a temporal self-regulation theory perspective. Health Psychol Behav Med 2023; 11:2249972. [PMID: 37645514 PMCID: PMC10461502 DOI: 10.1080/21642850.2023.2249972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023] Open
Abstract
Background Flossing among young adults is often infrequent and barriers not completely understood. One explanation concerns the capacity for executive functioning (EF) during the self-regulation of behaviour. Methods Using Temporal Self-Regulation Theory (TST) as a framework to explore EF, young adults from Norwegian universities completed a survey that measured monthly flossing frequency, flossing-related intentions and behavioural prepotency (BP), and EF using the Behaviour Rating Inventory of Executive Function - Adult Version (BRIEF-A). Results Data from 362 participants were analysed. The TST-model explained a substantial proportion of variance in monthly flossing (R2 = 0.74), and flossing was associated directly with intention and BP, and interactions between intention and both BP and global-EF. Sub-domains of EF were explored using the same model, revealing that behavioural regulation processes, specifically those related to emotional control and shifting between tasks, offered better fit. Simple slopes revealed that moderation effects were only present at lower levels of BP. Conclusion EF plays a role in moderating the translation of intentions into flossing behaviour. Specifically, emotional control and task-shifting appear to be influential, and this influence increases when habitual and environmental support (i.e. BP) is reduced. Overcoming EF-barriers may represent a key step in establishing flossing behaviours.
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Affiliation(s)
- Adam A. Rogers
- Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | | | - Jan-Are K. Johnsen
- Institute of Clinical Dentistry, UiT The Arctic University of Norway, Tromso, Norway
| | - Anne-Kristin Solbakk
- RITMO Centre for Interdisciplinary Studies in Rhythm, Time, and Motion, Department of Psychology, University of Oslo, Oslo, Norway
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Elkhodary HM, Abdelnabi MH, Swelem AA, Sabbagh HJ, El Meligy OAES, Talaat IM, Abdellatif EB, Khader Y, Al-Batayneh OB, Al-Khanati NM, Nurelhuda NM, Alhabli S, Mostafa MH, Qureshi S, Qureshi N, Yousaf MA, Taha D, Marafi YF, Al Harrasi SN, Al-Rai S, Gomaa N, Mattar H, Bakhaider HA, Samodien B, Lố H, El Tantawi M. Individual, familial and country-level factors associated with oral hygiene practices in children: an international survey. BMC Oral Health 2023; 23:50. [PMID: 36710323 PMCID: PMC9885580 DOI: 10.1186/s12903-023-02746-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Maintaining good oral hygiene is key to preventing dental caries and periodontal disease. Children and adolescents with good oral hygiene behaviours are likely to grow into adults with the same behaviours. This study assessed the frequency of using various oral hygiene methods among children and adolescents from different countries and individual, familial and country-level factors associated with the use of these methods. METHODS A multi-country online survey collected data from caregivers of children in 2020-21 about children's use of oral hygiene methods including toothbrush, fluoridated toothpaste, mouthwash, dental floss and miswak using self-administered, close-ended questions. Adjusted multilevel logistic regression models were used to assess the relationship between each of the five oral hygiene methods (dependent variables) and the independent factors: sex, age, and history of dental visits (individual factors), mother's education and area of residence (familial factors) as well as country income and region (country-level factors). RESULTS A total of 4766 parents/caregivers were included from 20 countries (77.4% Eastern Mediterranean-region and 41.6% lower middle income countries). The most frequent oral hygiene methods were using toothbrush and toothpaste (90% and 60.3%). The use of oral hygiene methods differed by age, sex and history of dental visits as well as mother's education and area of residence (P < 0.05). In addition, children from low income countries had significantly lower odds of using mouthwashes and dental floss than those from high income countries (AOR = 0.55, 95% CI 0.31, 0.98 and AOR = 0.34, 95% CI 0.12, 0.97) whereas children from the European region had higher odds of using mouthwash (AOR = 2.82, 95% CI 1.27, 6.26) and those from the region of the Americas had higher odds of using dental floss (AOR = 3.84, 95% CI 1.28, 11.52) than those from the Eastern Mediterranean region. CONCLUSIONS The use of various oral hygiene methods is associated with individual, familial and country-level factors. Oral health promotion programs should be developed taking into account these influences.
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Affiliation(s)
- Heba Mohamed Elkhodary
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.411303.40000 0001 2155 6022Department of Pedodontics and Oral Health, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
| | - Mohamed Hussein Abdelnabi
- grid.412125.10000 0001 0619 1117Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.411806.a0000 0000 8999 4945Department of Removable Prosthodontics, Faculty of Dentistry, Minia University, Minia, Egypt
| | - Amal Ali Swelem
- grid.7776.10000 0004 0639 9286Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Heba Jafar Sabbagh
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Omar Abd El Sadek El Meligy
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.7155.60000 0001 2260 6941Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Iman Mamdouh Talaat
- grid.412789.10000 0004 4686 5317Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE ,grid.7155.60000 0001 2260 6941Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Enas B. Abdellatif
- grid.7155.60000 0001 2260 6941Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Yousef Khader
- grid.37553.370000 0001 0097 5797Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ola B. Al-Batayneh
- grid.37553.370000 0001 0097 5797Preventive Dentistry Department, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Nuraldeen Maher Al-Khanati
- grid.449576.d0000 0004 5895 8692Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Nazik M. Nurelhuda
- grid.9763.b0000 0001 0674 6207Dental Public Health Division, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Sara Alhabli
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohamed Hassan Mostafa
- grid.411303.40000 0001 2155 6022Department of Pedodontics and Oral Health, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
| | - Shabnum Qureshi
- grid.412997.00000 0001 2294 5433Department of Education, University of Kashmir, Srinagar, India
| | - Nafeesa Qureshi
- grid.412273.10000 0001 0304 3856NHS Tayside Scotland, Dundee, DD2 2RZ UK
| | - Muhammad Abrar Yousaf
- grid.444943.a0000 0004 0609 0887Department of Biology, Faculty of Science and Technology, Virtual University of Pakistan, Lahore, Pakistan
| | - Dunia Taha
- grid.8192.20000 0001 2353 3326Department of Pediatric Dentistry, Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Yousef Falah Marafi
- grid.7155.60000 0001 2260 6941Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Sarah Al-Rai
- grid.444919.50000 0004 1777 7537Department of Conservative and Preventive Dentistry, Faculty of Dentistry, Saba University, Sana’a, Yemen
| | - Noha Gomaa
- grid.39381.300000 0004 1936 8884Oral Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON Canada ,grid.413953.90000 0004 5906 3102Department of Oral Medicine, Children’s Health Research Institute, London, ON Canada
| | - Hala Mattar
- grid.7155.60000 0001 2260 6941Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Hanin A. Bakhaider
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Bahia Samodien
- Western Cape Education Department, Cape Town, South Africa
| | - Hanane Lố
- Department of Pediatric Dentistry, Clinique Dentaire D’Agadir, Agadir, Morocco
| | - Maha El Tantawi
- grid.7155.60000 0001 2260 6941Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Bashirian S, Seyedzadeh-Sabounchi S, Shirahmadi S, Karimi-Shahanjarini A, Soltanian AR, Vahdatinia F. Predictors of oral health promotion behaviors among elementary school children: Examination of an extended social cognitive theory. Int J Paediatr Dent 2021; 31:191-203. [PMID: 32339312 DOI: 10.1111/ipd.12659] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Brushing teeth with fluoride-containing toothpaste and flossing are considered as effective solutions for preventing dental caries and periodontal diseases. AIM The aim of this study was to use the promoted social cognitive theory (SCT) to investigate factors influencing adherence to oral hygiene behaviors by elementary school children. DESIGN In this cross-sectional study, 988 elementary school children were chosen using the multistage cluster sampling method. Data were collected using the SCT scale, and its validity and reliability were confirmed. Theoretical models were examined using the structural equation modeling. RESULTS The SCT explained 50% of the variance in brushing with fluoridated toothpaste and 55.6% of the variance in flossing behaviors. The total effect of family environment (β = .60, P < .05), self-efficacy in overcoming impediments (β = .50, P < .05), and emotional coping (β = .40, P < .05) variables in the conceptual model had significantly influenced tooth brushing behavior. The total effect of self-efficacy (β = .79, P < .05), family environment (β = .41, P < .05), and situational perception (β = .35, P < .05) variables of the conceptual model significantly influenced the flossing behavior. CONCLUSIONS The SCT, self-efficacy, and family environment were strongly associated with brushing and flossing behaviors. Therefore, supportive family environments should be considered as one of the top contributors to successful oral health promotion.
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Affiliation(s)
- Saeed Bashirian
- Department of Public Health, Social Determinants of Health Research Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | | | - Samane Shirahmadi
- Dental Research Center, School of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Akram Karimi-Shahanjarini
- Department of Public Health, Social Determinants of Health Research Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Ali Reza Soltanian
- Communicable Disease Research Center, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Farshid Vahdatinia
- Dental Implants Research Center, School of Dentistry, Hamedan University of Medical Sciences, Hamedan, Iran
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Marchesan JT, Byrd KM, Moss K, Preisser JS, Morelli T, Zandona AF, Jiao Y, Beck J. Flossing Is Associated with Improved Oral Health in Older Adults. J Dent Res 2020; 99:1047-1053. [PMID: 32321349 DOI: 10.1177/0022034520916151] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The effect of preventive oral habits is largely unexplored in older individuals. The purpose of this study was to evaluate the associations between home use of flossing and prevalence of periodontal disease and caries in older adults. Five-year incident tooth loss was also evaluated. Data on 686 individuals ≥65 y-old from the Piedmont 65+ Dental Study were examined including: 1) interproximal clinical attachment level (iCAL), 2) interproximal probing depth (iPD), 3) numbers of caries, and 4) missing teeth. Flossing behavior was evaluated according to the Periodontal Profile Class (PPC) system. Five-year follow-up data (n = 375) was evaluated for incident tooth loss. Dichotomous and categorical variables were analyzed using Pearson chi-square tests as well as covariate-adjusted Cochran-Mantel-Haenszel tests. Multiple linear regression compared clinical parameters based on flossing behavior. Elderly flossers had lower (mean, SE) %iCAL≥3 mm (38.2, 2.38 vs. 48.8, 1.56) and %iPD≥4 mm (8.70, 1.41 vs. 14.4, 0.93) compared to nonflossers (P ≤ 0.005). Flossers showed less coronal caries compared to nonflossers (P = 0.02). Baseline number of missing teeth (mean, SE) was 11.5 (0.35) in nonflossers compared to 8.6 (0.53) in flossers (P < 0.0001). Regular dental visitors had lower oral disease levels compared to episodic dental users. The majority of flossers classified into PPC-Stage I (health) whereas nonflossers classified as PPC-Stages V, VI, and VII (disease). At the 5-y follow-up visit, the average tooth loss for flossers was ~1 tooth compared to ~4 teeth lost for nonflossers (P < 0.0001). Among all teeth, molars showed the highest benefit (>40%) for flossing behavior (P = 0.0005). In conclusion, the extent of oral disease for older individuals was significantly less in flossers than in nonflossers. Flossers showed less periodontal disease, fewer dental caries, and loss of fewer teeth over a 5-y period. These findings further support flossing as an important oral hygiene behavior to prevent oral disease progression in older adults.
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Affiliation(s)
- J T Marchesan
- Department of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - K M Byrd
- Department of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - K Moss
- Department of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J S Preisser
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - T Morelli
- Department of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A F Zandona
- Department of Comprehensive Care, School of Dental Medicine, Tufts University, Boston, MA, USA
| | - Y Jiao
- Department of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - J Beck
- Department of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Vernon LT, Seacat JD, Demko CA, Paes B da Silva A, Zyzanski SJ. A provider-observed tool to assess Oral Hygiene Skill Mastery (OHSIM) in human immunodeficiency virus-positive (HIV+) adults. SPECIAL CARE IN DENTISTRY 2019; 39:147-157. [PMID: 30758061 DOI: 10.1111/scd.12355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 12/21/2018] [Accepted: 12/26/2018] [Indexed: 11/30/2022]
Abstract
AIMS Periodontal diseases (PDs) affect nearly half of Americans ≥30 years old and are common in human immunodeficiency virus-positive (HIV+) adults. A validated measure of oral hygiene skill could improve tailored prevention-focused health communication. METHODS We developed Oral Hygiene Skill Mastery (OHSIM), a provider-observed measure of toothbrushing and flossing ability. We examined OHSIM's inter-rater reliability (IRR) and concurrent validity using a blinded, cross-sectional study design with a convenience sample of HIV+/- adults. Clinical outcome measures included bleeding on probing (BOP) and abbreviated plaque and gingival indices. Analyses included IRR and, after identifying relevant predictor variables for each outcome, backward elimination regression and structural equation modeling (SEM) were used to demonstrate concurrent validity. RESULTS We saw 173 research participants (reliability: n = 61; validity: n = 112). The average IRR was α = 0.73 for toothbrushing and α = 0.84 for flossing. Toothbrushing and flossing skill were moderately correlated (r = 0.49, P < 0.001). SEM analyses demonstrated that OHSIM toothbrushing significantly and independently predicted variance in plaque and gingival indices and BOP, while OHSIM flossing skill significantly and independently predicted plaque index and BOP. CONCLUSION OHSIM is a provisionally reliable and valid provider-observed measure of toothbrushing and flossing skill. Most predictors of clinical outcomes were modifiable behaviors. Toothbrushing quality is a critical component of oral health.
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Affiliation(s)
- Lance T Vernon
- Department of Pediatric Dentistry and Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio.,VA Quality Scholars Fellowship Program, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
| | - Jason D Seacat
- Department of Psychology, Western New England University, Springfield, Massachusetts
| | - Catherine A Demko
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio
| | - Andre Paes B da Silva
- Department of Periodontology, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio
| | - Stephen J Zyzanski
- Department of Family Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio
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Bernabé E, Knuuttila M, Suominen AL. Interdental cleaning and periodontal pocketing among finnish adults. J Clin Periodontol 2019; 46:310-320. [PMID: 30734957 DOI: 10.1111/jcpe.13081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 01/29/2019] [Accepted: 02/02/2019] [Indexed: 11/30/2022]
Abstract
AIM To investigate the relationship between frequency of interdental cleaning and 11-year change in teeth with periodontal pocketing in Finnish adults. METHODS Data from 1667 dentate adults, aged 30 to 82 years, who participated in the Health 2000 survey and were re-examined in 2004 and/or 2011 were analysed. Participants reported their frequency of interdental cleaning (either dental floss or interdental brush) at baseline. Teeth with periodontal pocketing (PD) ≥4 mm were counted in every survey and treated as a repeated outcome. The association between the frequency of interdental cleaning and the number of teeth with PD ≥4 mm was evaluated in linear mixed effects models, controlling for demographic factors, socioeconomic position, diabetes, smoking status, toothbrushing frequency, dental attendance and number of teeth. RESULTS Twelve per cent of adults reported daily interdental cleaning. Significant inverse linear trends in the number of teeth with PD ≥4 mm were found in every survey according to the frequency of interdental cleaning. However, this association was completely attenuated after adjustment for the full set of confounders. Contrarily, toothbrushing frequency was negatively associated with the baseline number of teeth with PD ≥4 mm and its rate of change over time. CONCLUSION Interdental cleaning was not associated with 11-year change in periodontal pocketing after accounting for other established risk factors for periodontal disease.
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Affiliation(s)
- Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Matti Knuuttila
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Anna L Suominen
- Department of Oral Public Health, Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.,Public Health Evaluation and Projection Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
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