DISCUSSION
This study involved a sample of Greek dental patients, who
visited a dentist for a check-up, dental restoration, or management
of dental pain. A novel feature of our sample was
that it consisted of patients drawn from a population known
to have poor oral health. Our study sought to apply an extended
HBM to the understanding of factors underlying oral
hygiene behaviors, and oral health status. Since the first hypothesis
concerned the role of oral hygiene beliefs, the structure
of oral hygiene perceptions was investigated too. Our
factor analysis of the Greek oral hygiene beliefs questionnaire
yielded five factors. Thus, the present findings provide
support for our notion that health beliefs about toothbrushing
have a multidimensional structure, involving susceptibility,
severity, barriers, benefits and self-efficacy perceptions. In
path analyses, the study findings partially supported our first
hypothesis that oral hygiene beliefs would be associated with
dental hygiene behavior. More specifically, self-efficacy beliefs
emerged as significant predictors of toothbrushing behavior.
Patients with confidence in their ability to brush regularly,
and who considered that toothbrushing could be performed
successfully, reported more frequent toothbrushing,
and had higher oral health status. These results are similar to
those of previous studies that emphasize that greater oral hygiene
self-efficacy is associated with better outcomes such as
better timing, method, and duration of toothbrushing, as well
as less plaque and bleeding,36 and a decreased risk of loss to
follow-up in long-term periodontal treatment.37 As long as
perceptions of self-efficacy may determine whether a given
oral health-related behavior is initiated and for how long
the behavior may continue against any obstacles that are encountered,
effective interventions should target self-efficacy
beliefs.38 Regarding perceived severity, this also emerged
as a significant predictor of toothbrushing behavior. Dental
diseases might be considered serious enough to move
DISCUSSION
This study involved a sample of Greek dental patients, who
visited a dentist for a check-up, dental restoration, or management
of dental pain. A novel feature of our sample was
that it consisted of patients drawn from a population known
to have poor oral health. Our study sought to apply an extended
HBM to the understanding of factors underlying oral
hygiene behaviors, and oral health status. Since the first hypothesis
concerned the role of oral hygiene beliefs, the structure
of oral hygiene perceptions was investigated too. Our
factor analysis of the Greek oral hygiene beliefs questionnaire
yielded five factors. Thus, the present findings provide
support for our notion that health beliefs about toothbrushing
have a multidimensional structure, involving susceptibility,
severity, barriers, benefits and self-efficacy perceptions. In
path analyses, the study findings partially supported our first
hypothesis that oral hygiene beliefs would be associated with
dental hygiene behavior. More specifically, self-efficacy beliefs
emerged as significant predictors of toothbrushing behavior.
Patients with confidence in their ability to brush regularly,
and who considered that toothbrushing could be performed
successfully, reported more frequent toothbrushing,
and had higher oral health status. These results are similar to
those of previous studies that emphasize that greater oral hygiene
self-efficacy is associated with better outcomes such as
better timing, method, and duration of toothbrushing, as well
as less plaque and bleeding,36 and a decreased risk of loss to
follow-up in long-term periodontal treatment.37 As long as
perceptions of self-efficacy may determine whether a given
oral health-related behavior is initiated and for how long
the behavior may continue against any obstacles that are encountered,
effective interventions should target self-efficacy
beliefs.38 Regarding perceived severity, this also emerged
as a significant predictor of toothbrushing behavior. Dental
diseases might be considered serious enough to move
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