An analysis of factors affecting compliance with tooth-cleaning recommendations

A study was undertaken on a group of patients who have had periodontal treatment in an attempt to test some of the predictions of the "Health Belief Model" (Rosenstock et al. 1966). This present study set out to test whether (1) persons who knew they had periodontal disease (hence considered themselves susceptible) (2) thought the condition serious and (3) had a knowledge of how to prevent the disease (4) were effectively complying with a previously prescribed oral hygiene regimen. The study was conducted at a school of dental hygiene, providing a source of patients attending specifically for periodontal care and where the format of hygiene instruction and treatment is largely standardized. A questionnaire was designed to assess (1) attitudes and beliefs (2) knowledge of the disease (3) reported behavior. Gingival health was measured using Gingival Index (Löe & Silness 1963) and patients actual behavior was measured using the Plaque Index (Silness & Löe 1964). The majority of the highly motivated patients in the study were concerned with their susceptibility to, the seriousness of, and the benefits of treatment for periodontal disease. They were stimulated to take action by a cue, bleeding gums. These findings confirm the predictions made in the Health Belief Model. However, none of the factors in the Health Belief Model were significantly associated with the gingival health status of the patients, indicating that other factors were important for patients to clean their teeth effectively. It was also shown that information is not necessary followed by a change in behavior.