title: The theory of reasoned action in describing tooth brushing, dental caries and diabetes adherence among diabetic patients.
abstract: OBJECTIVE
  Preventive oral health behaviour is important among diabetic patients, as it has been found that dental diseases and insulin-dependent diabetes mellitus (IDDM) have some psychological and biological factors in common. The aim here was to analyze the variables of Ajzen and Fishbein's theory of reasoned action to explain the reported frequency of tooth brushing, dental caries, HbA1c level and diabetes adherence.
  
  
  METHODS
  Cross-sectional data were gathered from 149 IDDM patients by means of a quantitative questionnaire, clinical examination and patient records.
  
  
  RESULTS
  The results showed that a firmer intention to brush the teeth was related to a higher reported frequency of tooth brushing (p < 0.001). The attitude to and the subjective norm of tooth brushing were related to the intention to brush(p < 0.001) and to the reported frequency of tooth brushing. A better dental attitude was related to better diabetes adherence (p = 0.002) and fewer decayed surfaces (p = 0.01), and a firmer intention to brush the teeth was related to a lower HbA1c level (p = 0.015).
  
  
  CONCLUSIONS
  Our results suggest that in oral health promotion among diabetic patients, both subjective norm and attitude are important and that diabetes adherence may be influenced by promoting dental attitude.
authors.affiliation: Department of Periodontology, Institute of Dentistry, University of Oulu, Oulu, Finland. Anna-Maija.Syrjala@oulu.fi
authors.forename: Anna-Maija H
authors.initials: AM
authors.lastname: Syrjälä
authors.forename: Mirka C
authors.initials: MC
authors.lastname: Niskanen
authors.forename: Matti L E
authors.initials: ML
authors.lastname: Knuuttila
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000517:prevention & control* / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000517:prevention & control* / Q000523:psychology; D004522:Educational Status; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010808:Physical Examination; D010865:Pilot Projects; D012189:Retrospective Studies; D012737:Sex Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000523:psychology*
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin