Patients’ awareness regarding the quality of their oral hygiene: development and validation of a new measurement instrument

Abstract

Background The present research aimed to develop and validate a standardised survey instrument for the assessment of patients' awareness of the quality of their oral hygiene performance. Methods A digital questionnaire was developed that assesses both patients' naïve self-perceptions of oral cleanliness (SPOCn) after tooth brushing and patients' perceptions after being informed how oral cleanliness may be captured in dentistry (SPOCd). Three studies (N = 56 adults, N = 66 adolescents and one of their parents, N = 24 university students) assessed the instrument’s feasibility (patient reports), reliability (internal consistency), validity (correlation with other constructs; sensitivity to manipulation of actual tooth brushing), and the correlation with actual oral cleanliness after tooth brushing. Results All study groups accepted the questionnaire well; average answering times were less than 5 min. Cronbach’s α exceeds 0.90; correlational analyses support the discriminant validity regarding oral hygiene related self-efficacy expectations and stages of change; manipulation of oral hygiene behaviour results in the expected changes of SPOC scores. Patients’ SPOC correlate only moderately with actual oral cleanliness. The comparison between SPOCd scores and actual oral cleanliness indicate that they considerably overestimate their oral hygiene performance. Conclusions The SPOC questionnaire is an easy-to-use, well-accepted, reliable and valid instrument for the assessment of patients’ awareness of the quality of their oral hygiene for research and clinical purposes. The results of the questionnaire may help to reveal unrealistic self-perceptions of patients regarding their oral hygiene. It can raise their awareness of the need to improve their skills and/or efforts in this regard. Trial registration The third study was an interventional study and was registered in the appropriate national register (www.drks.de; ID: DRKS00018781; date of registration: 12/09/2019).

It is the habit not the handle that affects tooth brushing. Results of a randomised counterbalanced cross over study

“…Firstly, individuals signi cantly overestimate their oral cleanliness. They believe that they have cleaned 70─80% of the sites measured at the gingival margins [25,38]. In fact, they only achieve a cleanliness of 30─40% ─ regardless of whether they brush to the best of their abilities or as usually [28, 29,38,39].…”

“…Finally, participants were asked to answer some questions on the tablet. First, they had to assess their self-perceived oral cleanliness by a visual analogue scale ranging from not at all clean to totally clean (SPOC n , [25]). Then, questions were presented about the toothbrush they had just used compared to the one they used at home in terms of handling, stiffness of the bristles and weight, and nally, age and gender were asked.…”

“…Then the participants had to compare the toothbrush they had just used with the toothbrush used at the rst appointment (again in terms of handling, bristle stiffness and weight). Subsequently, the participants answered in more detail the self-perceived cleanliness after they had been informed about the way a dentist would assess it (SPOC d , [25]). The questionnaire ended with some open questions about the BV1, in which positive and negative aspects of the toothbrush itself and the head frame were to be mentioned.…”

“…At the end of the second appointment they also answered items directly comparing both brushes (the questions of these questionnaires are shown in the Appendix). Additionally, self-perceived oral cleanliness (SPOC) was assessed by a validated questionnaire [25]. Participants provided their naïve SPOC-estimation (SPOC n )…”

Assessing sugar intake rapidly – a short form of the Marburg Sugar Index (MSI)

“…To assess the convergent validity of the short form with the long form and its further psychometric properties (internal consistency and item characteristics), an online survey was conducted where the short and the long form were presented in a counterbalanced cross-over design. Between the two forms, two distracting questionnaires (decisional balance [ 16 , 17 ] and self-efficacy expectations regarding oral hygiene behavior [ 18 ] were presented, to minimize recall of the answers given first when answering the second form. These questionnaires were also used to assess the discriminant validity of the sugar index questionnaire (see below).…”