World White Smile - SPOH-ARTS · Cross-cultural Communication, 1, 1-16. 31 . 11th National Congress of Associação Portuguesa de Higienistas Orais. 21 October 2011 Coimbra, Portugal

World White Smile

Determinants and promotion of oral hygiene behavior in diverse contexts

11th National Congress of Associação Portuguesa de Higienistas Orais. 21 October 2011 Coimbra, Portugal. 1

On behalf of the Dutch Association of Dental Hygienists

Congratulations!

A healthy mouth for a healthy life &

the promotion of preventive oral health care

11th National Congress of Associação Portuguesa de Higienistas Orais. 21 October 2011 Coimbra, Portugal.

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Flag carrier at IFDH 2010 in Glasgow

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President at FDI 2011 in Mexico

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PhD thesis 01-04-2010

Background

• The primary goal of oral hygiene care is the prevention of dental problems, a process in which the dental hygienist plays a central role

• Oral disease consequence of inadequate oral

hygiene behavior (OHB)

• Inadequate OHB very prevalent in all populations and cultures 6


Background • Important to establish the factors that influence

OHB (determinants)

• Determinants depend on context and culture

• “one size fits all‟” - approach will not be effective

• Identification and assessment important for developing oral health care interventions

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Primary focus

• Development of an

Index for Oral Hygiene Behavior

• Insight into determinants of OHB assessed with the

Theory of Planned Behavior (TPB)

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“brushing your teeth twice a day (once after breakfast and once before going to sleep), using a soft-bristled toothbrush and fluoride containing toothpaste brushing softly for at least two minutes; brushing stepwise by making small strokes –sort of massage– near the gum, along the inside and the outside, and on the jackdaw areas In addition to the tooth brushing, daily interdental cleaning (i.e., use of floss, tooth sticks, or interdental brushes) and tongue cleaning is also recommended.”

Oral Hygiene Behavior (OHB)

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Theory of Planned Behavior Attitude: „Evaluation of the advised oral hygiene behavior, on dimensions unimportant-important, unpleasant -pleasant, unhealthy-healthy, and painful-painless‟ Social norms: „My parents think that I should perform oral hygiene self-care as advised‟ Perceived behavior control: ‘Do you succeed in taking care of your teeth based on the daily OHB‟ Expected Social Outcomes: ‘In social contacts fresh breath is important‟ Oral Health Knowledge: „Gum bleeding is a sign of a periodontal disease‟

Differences in Oral Hygiene behavior

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Recruits in the Dutch Army Dental care seekers in the Caribbean

Dental care seekers in Nepal

Dental care seekers in the Dominican Republic

Dental patients in Uruguay Dental patients in Spain

Dutch Adults

Determinants in OHB - Dutch Adults

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Social Norms

Perceived Behavioral Control

Expected Social Outcomes

Oral Health Knowledge

Attitude

Oral Hygiene Behavior

Buunk-Werkhoven Y.A.B., Dijkstra A, van der Schans C.P. (2011). Determinants of oral hygiene behavior: A study based on the theory of planned behavior. Community Dentistry and Oral Epidemiology, 39, 250-259.

Determinants in OHB - Dutch Army

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Social Norms




Attitude

Intention to perform OHB

Buunk-Werkhoven Y.A.B., Dijkstra A, Van der Wal, H., Basic, N., Loomans, S.A., Van der Schans, C.P. & Van der Meer, R. Promoting Oral Hygiene Behavior in Recruits in the Dutch Army. Military Medicine, 2009; 174, 971-976.

OHB

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Determinants in OHB - Caribbean

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Social Norms




Attitude


Buunk-Werkhoven Y.A.B., Dijkstra A, Bink, P., Van Zanten, S. & Van der Schans, C.P. (2011). Determinants and promotion of oral . hygiene behaviour in the Caribbean and Nepal. International Dental Journal, 61, 267-273 DOI: 10.1111/j.1875-595X.2011.00071.x

Determinants in OHB - Nepal

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Social Norms




Attitude


Buunk-Werkhoven Y.A.B., Dijkstra A, Bink, P., Van Zanten, S. & Van der Schans, C.P. (2011). Determinants and promotion of oral hygiene behaviour in the Caribbean and Nepal. International Dental Journal, 61, 267-273 DOI: 10.1111/j.1875-595X.2011.00071.x

Determinants in OHB - Uruguay

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Social Norms


Attitude


Buunk-Werkhoven Y.A.B, Dijkstra A, Bink, P., Van der Schans C.P., Jaso, M.E., Acevedo, S., Parodi Estellano, G. 2008. Evaluación y promoción de la actitud .hacia la higiene oral en pacientes de la Facultad de Odontología de la Universidad Católica del Uruguay [Evaluation and promotion of patients‟ oral hygiene behavior in the faculty of Odontology of the Catolic University in Uruguay]. Actas Odontológicas Vol. V No. 2 Julio-Diciembre 13-20.

Determinants in OHB - Spain

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Social Norms


Attitude


Buunk-Werkhoven Y.A.B., Dijkstra A, & Van Palenstein Helderman, W.H. Gender differences in determinants of oral hygiene behavior. (manuscript in preparation upon invitation of) International Journal of Dental Hygiene.

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Determinants in OHB – Dominican Republic

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Social Norms




Attitude


Buunk-Werkhoven Y.A.B., Burrekers, S.Y., Jongboer, A., Quant, D. & Van Maanen-Schakel, N. Determinants of oral hygiene behavior in the Dominican Republic. (manuscript submitted for publication)

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* in general Dutch population: attitude towards dental hygiene, social norms, perceived behavior control, and knowledge about dental care * among Dutch military soldiers: attitude and perceived behavior control

* among dental-care seekers in the Caribbean and among dental patients in Uruguay: attitude and social norms * among dental-care seekers in Nepal: perceived behavior control

* among dental patients in Spain and among dental-care seekers in the Dominican Republic: attitude

Summary primary focus

Second focus

• concerned the psychological factors related to Oral Health-Quality of Life (OH-QoL)

as assessed by the Dutch version of the Oral

Health Impact Profile-14 (OHIP-14-NL)

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Determinants in OH-QoL – Imprisoned forensic psychiatric patients

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Dental Anxiety

General Health Perception


OHB

Oral Health- Quality of life

Buunk-Werkhoven Y.A.B., Dijkstra, A. Schaub, R.M.H., Van der Schans, C.P. & Spreen, M. (2010). Oral health-related quality of life among imprisoned Dutch forensic psychiatric patients. Journal of Forensic Nursing, 6,137-143

Dentition Characteristics

Determinants in OH-QoL - Students

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Dental Anxiety



OHB


Buunk-Werkhoven Y.A.B., Dijkstra, A. & Van der Schans, C.P. (2009). Oral health-quality of life predictors depend on population. Applied Research Quality of Life, 4(3) 283-293.

Determinants in OH-QoL - Patients

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Dental Anxiety



OHB


Buunk-Werkhoven Y.A.B., Dijkstra, A. & Van der Schans, C.P. (2009). Oral health-quality of life predictors depend on population. Applied Research Quality of Life, 4(3) 283-293.

Dentition Characteristics

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* among forensic psychiatric patients: OH-QoL was related primarily to fear of dental anxiety and unhealthy dentition * among patients from a regular dental care clinic: OH-QoL was related primarily to fear of dental anxiety * among undergraduate students: fear was not related to OH-QoL Although not all relations could be interpreted unequivocally, the pattern of findings illustrated that differences between the samples influenced the psychological processes involved in OH-QoL

Summary second focus

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Overall process model of the determinants of OHB and OH-QoL with Context and Country as moderators

Intention Social Norms

Perceived Behavior Control


Oral Health Knowledge Attitude


Oral Disease versus Oral Health

Oral Health-related Quality of Life


Dental Anxiety

Context and Country

Forensic Psychiatric Centre

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Third focus • concerned the effects of interventions aimed at

improving OHB and OH-QoL - the effect of oral health care by a dental hygienist in a

forensic psychiatric centre Buunk-Werkhoven Y.A.B., Dijkstra, A. & Van der Schans, C.P. (2009). Oral health-quality of life predictors depend on population. Applied

Research Quality of Life, 4(3) 283-293

- case report, demonstrated a short-time „effect‟ of a

tailored oral hygiene self-care intervention on an imprisoned forensic psychiatric patient‟s OH-QoL

Buunk-Werkhoven Y.A.B., Dijkstra-le Clercq, M., Verheggen-Udding, E.L., De Jong, N. & Spreen, M. (2011). Halitosis and Oral health-related Quality of Life: A Case Report. International Journal of Dental Hygiene. DOI: 10.1111/j.1601-5037.2011.00512.x 29


Third focus • Experimental study, examined the effect of two

different persuasive oral health messages in promoting OHB

In Spain and Uruguay: the effectiveness of presenting

individuals with a positive, encouraging message depended on the country of residence, level of education and the importance individuals attached to their health

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Buunk-Werkhoven, Y.A.B., Dijkstra, A., Jaso, M.E., Acevedo, S., Parodi Estellano, G. & Almerich Silla, J.M. (2011). Persuasive oral hygiene communications in Uruguay and Spain. Cross-cultural Communication, 1, 1-16

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Oral hygiene related interventions, whether aimed at improving OHB or

OH-QoL, need to be specifically adjusted to or

designed for the population under target

Conclusion

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Practical implications

The identified and mapped factors in the process model can be used for

the development of tailored oral hygiene self-care interventions for

influencing OHB and OH-QoL

Obrigada! Questions?

Documents

World White Smile - SPOH-ARTS · Cross-cultural Communication, 1, 1-16. 31 . 11th National Congress of Associação Portuguesa de Higienistas Orais. 21 October 2011 Coimbra, Portugal