Training of Health Behavior Skills: Clinical and Psychological Effects of a Tooth-brushing Training

Abstract

Background: Albeit oral hygiene is a widespread health behavior prevalence of diseases due to insufficient oral hygiene is high. Deficits in oral hygiene skills might be responsible. Skills have been rarely included in health behavior modelling. This interventional study focusses on skills and how they are associated with psychological variables. Methods: 70 participants were randomized to a standardized training of one of two tooth brushing techniques (Fones, Bass) or of basics of tooth brushing alone (control group). Skills (plaque after thorough hygiene) and gingivitis were assessed 6, 12 and 28 weeks after the training. Self-efficacy, decisional balance and adherence were assessed and brushing behavior was video recorded after 28 weeks. Findings: Fones group differed significantly from the control group after 6 (p=0.030) and 12 weeks (p=0.006) with respect to skills. The control group showed less gingivitis. Groups did not differ with respect to self-reported adherence. Multiple associations were observed with psychological parameters and observed brushing behavior. Discussion: Data indicate complex relationships between behavior complexity, behavioral skills and maintenance.