Modelling health belief predictors of oral health and dental anxiety among adolescents based on the Health Belief Model: a cross-sectional study

Abstract

Background: A vicious cycle exists between dental anxiety, oral health behaviors and oral health status. Based on previous research, psychological factors of the Health Belief Model (HBM) are associated with oral health behaviors and oral health, and are likely involved in this cycle. However, little is known about the relationship between HBM factors and dental anxiety of adolescents. The purpose of this cross-sectional study was to investigate the relationship between health belief factors, oral health and dental anxiety based on the constructs of the HBM.Methods: 1207 Grade 2 students from 12 secondary schools in Hong Kong were randomly selected and measured for the decayed, missing and filled permanent teeth (DMFT) index. Data for oral health behaviors, HBM constructs and dental anxiety were collected using questionnaires. The hierarchical entry of explanatory variables into logistic regression models estimating prevalence odds ratios (POR) were analyzed and 95% confidence intervals (95% CI) for DMFT and dental anxiety were generated. Path analysis was used to evaluate the appropriateness of the HBM as predictors for oral health behaviors, DMFT and dental anxiety.Results: Based on the full model analysis, individuals with higher perceived susceptibility of oral diseases (POR: 1.33, 95% CI: 1.14-1.56) or girls or whose mother received higher education level were likelier to have a DMFT≥1, while those with higher perceived severity (POR: 1.31, 95%CI: 1.09-1.57), flossing weekly, DMFT≥1 or higher general anxiety level statistically increases the possibility of dental anxiety. The results from path analysis indicated that stronger perceived susceptibility, greater severity of oral diseases, less performing of oral health behaviors and a higher score of DMFT were directly related to increased dental anxiety level. Other HBM variables, such as perceived susceptibility, self-efficacy beliefs, cues to action and perceived barriers, might influence dental anxiety through oral health behaviors and caries status.Conclusions: Clarifying the propositional structures of the HBM may help the future design of theory-based interventions in reducing dental anxiety and preventing dental caries.

Effect of training based on health belief model and behavioral intention on improving dental and oral self-care behavior in 9–12-year-old Iranian female students

“…There was a significant relationship between the variable of family size and Father's education with the structure of behavioral intention, and the variable of Father's education with the structures of perceived severity, which was in line with the results of Dumitrescu(2014) [ 54 ]، Xiang (2022) [ 55 ] studies. According to what was discussed, a health behavior in the health belief model depends on two issues: first, the person's perception of the risk threatening him/her, and second, the perceived barriers and benefits of behavior.…”