Self-Reported Gum Bleeding, Perception, Knowledge, and Behavior in Working-Age Hong Kong Chinese—A Cross-Sectional Study

Abstract

Gingivitis and periodontitis are highly prevalent in Hong Kong, where the provision of oral health services is predominantly private. This cross-sectional study aimed to investigate the association between the oral symptoms of gum bleeding and self-reported behavioral factors, beliefs, and knowledge among Hong Kong Chinese. The research team commissioned the Public Opinion Programme of The University of Hong Kong to conduct a structured, population-based, computer-assisted telephone interview (CATI), which covered questions related to the demography, perception, and knowledge (including traditional Cantonese beliefs) of gum health, dental attendance, oral health behavior, and dental anxiety. A total of 1,265 individuals aged 25–60 years old were successfully contacted, and 704 (55.7%) reported prior gum bleeding experience. A total of 516 individuals (64.9% females, median 55–60 years) completed the CATI satisfactorily, and 321 (62.2%) experienced gum bleeding in the past 12 months. The factors that were significantly associated with reports of gum bleeding in the past 12 months include having periodontitis, sensitive teeth, having tertiary or higher education, flossing/interdental cleaning, not cleaning teeth well enough, lack of sleep, consuming too much ‘heaty’ food, avoiding going to the dentist when gums are bleeding, and waiting for gum bleeding to subside (p < 0.05, r2 =0.198; forward stepwise logistic regression). Within the limitations of this study, approximately half of the Hong Kong working-age adults surveyed reported experiencing gum bleeding, and 62.2% of the participants experienced it within the past 12 months. Members of Hong Kong’s working-age population who reported having higher levels of education appeared more readily aware of their gum problems. Those with bleeding gums, especially those who have discernable periodontitis, poor dental awareness/behaviors, and/or a poor lifestyle should be targeted to receive education and encouragement, which will allow them to take action and improve their own gum health.

Oral health behavior and oral health service utilization among cancer patients in China: A multicenter cross-sectional study

“…More than half of the patients (56.2%) experienced gums bleeding when brushing their teeth. The prevalence of self-reported gingival bleeding is consistent with previous studies, with a survey of adults in Hong Kong (15) showing a prevalence of 62.2% and a survey of adolescents aged 12-15 years in Jiangxi showing an incidence of 66.5% (40). However, most patients (60.5%) believe that bleeding gums or swollen gums do not need to be treated, nearly one-fifth (19.1%) of the patients chose to delay medical treatment, and 12.3% of them chose to take their medication or other, only 8% of patients would seek immediate medical care.…”

“…The "Chinese Residents' Guide to Oral Health Behavior" manual for health care professionals recommends the use of comprehensive oral cleaning behaviors including brushing, rinsing, and flossing to maximize plaque removal and control plaque growth [15]. The awareness and utilization of oral health care products, except for the most basic toothbrush and toothpaste, the behaviors of rinsing the mouth, using mouthwash, flossing, and using fluoride toothpaste are limited.…”

“…The maintenance of good oral health care is essential for nutrition, recovery, and well-being in cancer patients ( 13 ). The impact of oral health on the quality of life of cancer patients has received increasing attention in recent years ( 14 ), and it has been demonstrated in numerous studies that oral health is influenced by oral health behaviors and the use of oral health care services ( 11 , 15 , 16 ). To achieve and maintain good oral hygiene, tooth brushing, flossing, and the use of fluoride toothpaste are recommended ( 17 ).…”

Theory-based behavioral change interventions to improve periodontal health

“…For dental patients, external opportunities could include having a physical space to perform oral care, such as a bathroom with adequate lighting and a mirror to visualize and evaluate one's performance. Social opportunities stem from cultural or social norms; in Hong Kong, the traditional Chinese medicine belief that “heat” (“yeet-hay”) causes gingival inflammation may direct attention away from the necessity of plaque control ( 74 ). Motivation has both an automatic component stemming from impulses, habits and emotions, as well as a reflective component involving planning, decision making and self-reflection.…”