Reliability of self-reported toothbrushing frequency as an indicator for the assessment of oral hygiene in epidemiological research on caries in adolescents: a cross-sectional study

Abstract

BackgroundIn the present state of knowledge regarding the etiology of dental caries, it is unacceptable for studies addressing factors associated with this outcome to disregard oral hygiene. Simple, valid methods are needed for the assessment of oral hygiene in adolescents to allow this condition to be properly investigated in epidemiological studies on caries and assist in the establishment of health promotion measures. The aim of the present study was to test the hypothesis that the self-reported toothbrushing frequency can be used as a proxy measure for clinical oral hygiene indices in epidemiological studies on dental caries in adolescents.MethodsA cross-sectional study was conducted with a representative sample (n = 589) of 12-year-old school children in a medium-sized city in southern Brazil. A detailed questionnaire addressing socio-demographic and economic characteristics was sent to primary caregivers. Adolescents answered a brief self-administered questionnaire on behavioral characteristics, including toothbrushing frequency and sugar intake. Samples of stimulated saliva were collected from the adolescents and evaluated for levels of mutans streptococci and lactobacilli using Dentacult kits I and II, respectively. Examiners who had undergone a training and calibration exercise (kappa > 0.81) performed the clinical examination of the adolescents. Caries experience was assessed using the decayed, missing and filled teeth index. Oral hygiene was determined using the Simplified Oral Hygiene Index and the Visible Plaque Index.ResultsWhen the oral hygiene variables were used alone in the multiple models, significant associations with dental caries were found. When Simplified Oral Hygiene Index and/or Plaque Index were used together with toothbrushing frequency in the same model, only the latter was significantly associated with dental caries. A significant association was also found between self-reported toothbrushing frequency and the clinical indices.ConclusionBased on the present findings, self-reported toothbrushing frequency can be used as a proxy measure for clinical oral hygiene indices, which facilitates data collection in epidemiological studies addressing dental caries in adolescents.

A new complementary approach for oral health and diabetes management: health coaching

“…The HC group participants were motivated and supported to explore and to activate their potential to attain multiple healthy behaviours in their self-management routines, and thus may lead to improvement in periodontal health and glycaemic control; this is in line with earlier studies that showed that taking part in an intervention focusing on empowerment for diabetes self-management had a positive and sustainable impact on the management of health behaviours and glycaemic control 48,49 . Studies have shown that the coaching groups compared with the control groups significantly reduced the body-weight and fat and coronary heart disease factors including BMI 50,51 . In line with these studies, the Turkish HC group significantly reduced body fat percentage and improved the lean mass.…”

“…Assessment of the prevalence of health behaviours as part of research is vitally important and often requires the use of self-report measures. There is an inherent error risk in self-reported measures, however, if this error were constant over time, it could still be used as a good comparison criterion among epidemiological studies 16,51 . The present study could have minimised this limitation; self-reported measures were assessed over time and also analysed along with clinical measures.…”

“…Studies have shown that the coaching groups compared with the control groups significantly reduced the body-weight and fat and coronary heart disease factors including BMI 50,51 . In line with these studies, the Turkish HC group significantly reduced body fat percentage and improved the lean mass.…”

Toothbrushing behaviour and periodontal pocketing: An 11‐year longitudinal study

“…Second, periodontal status was assessed as pocket depth, which T A B L E 2 Brushing twice a day or more often at baseline (2000) and follow-up (2011), by baseline characteristics (n = 1,025) Third, information on toothbrushing behaviour was collected through self-reports. Although some might argue that dental plaque indices provide a stronger assessment of oral cleanliness, there is evidence of good correlation between self-reported toothbrushing frequency and oral hygiene indices (Gil et al, 2015;Harnacke et al, 2015). More importantly, current recommendations on plaque control and oral hygiene maintenance are based on habitual toothbrushing behaviour, not clinical levels of dental plaque.…”

Design and content validation of the Oral Hygiene Habits Scale.

“…Educational interventions aimed at controlling plaque and improving oral health often have only a shortterm effect. Flossing after brushing and not before, and a positive attitude promote better oral hygiene habits [3][4][5][6][7][8][9][10][11][12][13][14][15] .…”