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Psychosocial correlates of oral hygiene behaviour in people aged 9 to 19: a systematic review with meta-analysis

Author: Scheerman, J.F.M. · Loveren, C. van · Meijel, B. van · Dusseldorp, E. · Wartewig, E. · Verrips, G.H.W. · Ket, J.C.F. · Empelen, P. van
Source:Community Dentistry and Oral Epidemiology, 4, 44, 331-341
Identifier: 533647
doi: DOI:10.1111/cdoe.12224
Keywords: Health · Behavioral science · Dental health perceptions · Oral hygiene; · Pediatric dentistry; · Psychosocial aspects of oral health · Healthy for Life · Healthy Living · Life · CH - Child Health · ELSS - Earth, Life and Social Sciences


Objectives. This systematic and meta-analytic review aimed to quantify the association of psychosocial correlates with oral hygiene behaviour among 9- to 19-year olds. Methods. A systematic search up to August 2015 was carried out using the following databases: PubMed, PsycInfo, Embase, CINAHL and Web of Science. If necessary, authors of studies were contacted to obtain unpublished statistical information. A study was eligible for inclusion when it evaluated the association between the psychosocial correlates and oral hygiene behaviour varying from self-reports to clinical measurements, including plaque and bleeding scores. A modified New Castle Ottawa Scale was applied to examine the quality of the included studies. Results. Twenty-seven data sets (k) presented in 22 publications, addressing nine psychosocial correlates, were found to be eligible for the meta-analysis. For both tooth brushing and oral hygiene behaviour, random effect models revealed significant weighted average correlation (r+) for the psychosocial factors: ‘intention’, ‘self-efficacy’, ‘attitude’ (not significant for tooth brushing), ‘social influence’, ‘coping planning’ and ‘action planning’ (r+ ranging from 0.18 to 0.57). Little or no associations were found for ‘locus of control’, ‘self-esteem’ and ‘sense of coherence’ (r+ ranges from 0.01 to 0.08). Conclusions. The data at present indicates that ‘self-efficacy’, ‘intention’, ‘social influences’, ‘coping planning’ and ‘action planning’ are potential psychosocial determinants of oral health behaviour. Future studies should consider a range of psychological factors that have not been studied, but have shown to be important psychosocial determinants of health behaviours, such as ‘self-determination’, ‘anticipated regret’, ‘action control’ and ‘self-identity’. Effectiveness of addressing these potential determinants to induce behaviour change should be further examined by intervention trials.