Association Between Periodontal Health Knowledge and Oral Hygiene Practices in a National Cohort of Thai Adults

Periodontitis is a common oral disease that affects populations globally, however, awareness of periodontal disease prevention remains limited. Since periodontal health knowledge may influence oral hygiene behaviors, which are essential for disease prevention and long-term maintenance, this study aimed to assess periodontal health-related knowledge and its association with oral hygiene practices among an adult cohort in Thailand using the validated Adult Periodontal Health Knowledge and Belief Questionnaire.

A cross-sectional survey of Thai adults (≥ 18 years) was conducted from December 2023 to January 2024. The questionnaire captured demographics, oral hygiene practices (brushing and interdental cleaning), and periodontal health knowledge (ALPHA-K). Descriptive statistics, non-parametric tests, exploratory factor analysis, and multiple linear regression were used.

A total of 1770 participants completed the survey. The mean ALPHA-K score was 11.83 (2.88), which represents 59.2% of total score. While most recognized that plaque as the cause of gum disease, and smoking and diabetes as risk factors, misconceptions persisted (e.g., floss only removes food; tooth loss is inevitable with ageing; fluoride prevents gum disease). Higher periodontal health knowledge was associated with favorable flossing practices, brushing practices (longer brushing duration, extra-soft/soft bristles, manual toothbrush use) and higher education, higher income, and urban residence.

A significant knowledge deficit regarding periodontal health exists in this Thai cohort, particularly among rural residents, individuals with lower income, and those reporting inadequate brushing duration or preference for hard bristle brushes or electric toothbrushes in Thailand. Disseminating accurate information on periodontal health and disease is essential to enhance self-care practices and overall periodontal health outcomes.

Thai adults, particularly those with lower education levels and living in rural areas, demonstrated considerable gaps in periodontal health knowledge. Addressing these gaps through tailored educational interventions is important for improving population-level periodontal health outcomes.