Many preventive approaches in dentistry aim to improve oral health through behavioural instruction or intervention concerning oral health behaviour. However, it is still unknown which factors have the highest impact on oral health behaviours, such as toothbrushing or regular dental check-ups. Various external and internal individual factors such as education, experience with dentists or influence by parents could be relevant. Therefore, the present observational study investigated the influence of these factors on self-reported oral heath behaviour. One hundred and seventy participants completed standardized questionnaires about dental anxiety (Dental Anxiety Scale (DAS), and dental self-efficacy perceptions (dSEP)). They also answered newly composed questionnaires on oral hygiene behaviours and attitudes, current and childhood dental experiences as well as parental oral hygiene education and care. Four independent factors, namely attitude towards oral hygiene, attitude towards one’s teeth, sense of care and self-inspection of one’s teeth were extracted from these questionnaires by rotating factor analysis. The results of the questionnaires were correlated by means of linear regressions. Dental anxiety was related to current negative emotions when visiting a dentist and negative dental-related experiences during childhood. High DAS scores, infantile and current negative experiences showed significant negative correlations with the attitude towards oral hygiene and one’s teeth. Dental anxiety and current negative dental experiences reduced participants’ dental self-efficacy perceptions as well as the self-inspection of one’s teeth. While parental care positively influenced the attitude towards one’s teeth, dental self-efficacy perceptions significantly correlated with attitude towards oral hygiene, self-inspection of one’s teeth and parental care. Dental anxiety, dental experiences, parents’ care for their children’s oral hygiene and dental self-efficacy perceptions influence the attitude towards oral hygiene and one’s own oral cavity as well as the autonomous control of one’s own dental health. Therefore, oral hygiene instruction and the development of patient-centred preventive approaches should consider these factors.

Clinical studies on the efficacy of sonic toothbrushes show inconsistent results, most studies have been conducted without sufficient supervision of appropriate toothbrush usage. Aims of the explorative clinical trial were therefore to investigate whether the usage of an activated sonic toothbrush reduces plaque more effectively than an inactivated one used as a manual toothbrush, and to which extent the correct use of such toothbrush plays a role in its efficacy. The clinical trial was designed as a video-controlled interventional study. Thirty participants (mean (±SD) age 22.9 (±2.5) years) were included, areas of interest were the buccal surfaces of the upper premolars and the first molar (partial mouth recording). Toothbrushing was performed without toothpaste in a single brushing exercise under four different conditions: switched off, habitually used as manual toothbrush, no instruction; switched on, habitually used as powered toothbrush, no instruction; switched off, used as manual toothbrush, instruction in the Modified Bass Technique; switched on, used as powered toothbrush, instruction in a specific technique for sonic toothbrushes. Brushing performance was controlled by videotaping, plaque was assessed at baseline (after 4 days without toothbrushing) using the Rustogi modified Navy-Plaque-Index and planimetry. Main study results were that plaque decreased distinctly after habitual brushing regardless of using the sonic brush in ON or OFF mode (p for all comparisons < 0.001). After instruction, participants were able to use the sonic brush in ON mode as intended, with only minor impact on efficacy. Using the toothbrush in OFF mode with the Modified Bass Technique was significantly less effective than all other conditions (p for all comparisons < 0.001). Under the conditions used, the sonic toothbrush was not more effective when switched on than when switched off, and there was no evidence that the correct use of the toothbrush was more effective than the habitual use.

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