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Updated: Aug 15, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year)
M Kawamura1, F A C Wright, D Declerck
1Preventive Dentistry, Hiroshima University Hospital, Japan. makoto@hiroshima-u.ac.jp
Objective:
To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students.
Design:
Cross-cultural survey of dental students.
Setting:
18 cultural areas.
Participants And Methods:
904 first-year dental students completed the Hiroshima University-Dental Behavioural Inventory (HU-DBI) translated into their own languages. Individual areas were clustered by similarity in responses to the questions.
Results:
The first group displayed an 'occidental-culture orientation' with the exception of Brazil (Cluster 1 comprised: Australia, United Kingdom, Ireland, Belgium and Brazil, Cluster 2: Germany, Italy, Finland and France). The second group displayed an 'oriental-cultural orientation' with the exception of Greece and Israel (Cluster 3 comprised: China and Indonesia, and Cluster 4: Japan, Korea, Israel, Hong Kong, Malaysia, Thailand and Greece). Australia and United Kingdom were the countries that were most alike. Ireland was the 'neighbour' to these countries. Greece and Malaysia had similar patterns of oral health behaviour although geographic conditions are very different. Although it was considered that in Hong Kong, occidental nations have affected the development of education, it remained in the oriental-culture group. Comparison with the data from the occidentals indicates that a higher percentage of the orientals put off going to the dentist until they have toothache (p < 0.001). Only a small proportion of the occidentals (8%) reported a perception of inevitability in having false teeth, whereas 33% of the orientals held this fatalistic belief (p = 0.001).
Conclusions:
Grouping the countries into key cultural orientations and international clusters yielded plausible results, using the HU-DBI.
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