Determinants and Consequences of Oral Health Behavior

Objectives: The aim of the first study was to develop an index of desirable oral health behavior (OHB), and to examine the relevant predictors of this behavior. Variables of the Theory of Planned Behavior (TPB), measures of oral health knowledge and of expected social outcomes (ESO) of having healthy teeth were used as predictors. Assuming that quality of life is an important outcome of OHB, the second study aimed to examine how OHB was related to quality of life, as assessed with the translated Dutch version of the Oral Health Impact Profile-14 (OHIP-14). Methods: For the first study, 487 participants filled in a questionnaire via Internet, which assessed one's dental history and status, personal oral (home)care practices, dietary behavior, oral health knowledge (16 items), attitudes (9 items, alpha=0.83), social norms (5 items, alpha=0.92), perceived behavioral control (PBC) (3 items, alpha=0.71) and expected social outcomes (6 items, alpha=0.82). Based upon a Delphi method involving dental professionals, an index for OHB was developed, including toothbrushing, interdental- and tongue cleaning (10 items). For the second study 234 participants filled in a questionnaire, including OHIP-14, ESO, OHB and clinical criteria. Results: Regression analysis in the first study revealed that attitude, PBC, knowledge and expected outcomes (not social norms) predicted 26.2% of the variance in self-reported OHB. Similar analyses in the second study showed that OHB was related to quality of life as assessed with the OHIP-14. Conclusions: The results provide important clues for the prevention of oral health problems. Besides the more well-known predictors of behavior such as attitude and PBC, the two studies indicate that social consequences of oral health play a role in oral health care. Moreover, findings of the second study provide preliminary evidence for the validity of the OHIP-14, even for the importance of OHB for perceived quality of life.