The role of self-efficacy in dental patients' brushing and flossing: testing an extended Health Belief Model

Patient Educ Couns. 2010 Feb;78(2):269-72. doi: 10.1016/j.pec.2009.06.014. Epub 2009 Jul 28.


Objective: In an effort to examine the decreasing oral health trend of Australian dental patients, the Health Belief Model (HBM) was utilised to understand the beliefs underlying brushing and flossing self-care. The HBM states that perception of severity and susceptibility to inaction and an estimate of the barriers and benefits of behavioural performance influence people's health behaviours. Self-efficacy, confidence in one's ability to perform oral self-care, was also examined.

Methods: In dental waiting rooms, a community sample (N=92) of dental patients completed a questionnaire assessing HBM variables and self-efficacy, as well as their performance of the oral hygiene behaviours of brushing and flossing.

Results: Partial support only was found for the HBM with barriers emerging as the sole HBM factor influencing brushing and flossing behaviours. Self-efficacy significantly predicted both oral hygiene behaviours also.

Conclusion: Support was found for the control factors, specifically a consideration of barriers and self-efficacy, in the context of understanding dental patients' oral hygiene decisions.

Practice implications: Dental professionals should encourage patients' self-confidence to brush and floss at recommended levels and discuss strategies that combat barriers to performance, rather than emphasising the risks of inaction or the benefits of oral self-care.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Australia
  • Dental Devices, Home Care*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Oral Hygiene / psychology*
  • Patient Acceptance of Health Care
  • Patient Compliance / psychology*
  • Self Efficacy*
  • Surveys and Questionnaires
  • Toothbrushing*
  • Young Adult