title: Relationship between attitudes toward oral health at initial office visit and compliance with supportive periodontal treatment.
abstract: OBJECTIVE
  The objectives of the present study include investigation of the relationship between attitudes and desires with respect to oral health at initial office visit and compliance with supportive periodontal treatment (SPT) and identification of prognostic factors with respect to low-compliance with SPT.
  
  
  METHODS
  Four hundred thirty-one patients were evaluated. Subjects completed a questionnaire concerning attitude and desire with respect to oral health and subjective symptoms prior to periodontal treatment. Survival probabilities of SPT were estimated by the Kaplan-Meier method and compared between answers for each item of the questionnaire via the Cox-Mantel test. Finally, a multivariate Cox proportional hazards regression model was constructed, which included age and gender.
  
  
  RESULTS
  Greater than 95% of participants desired toothbrushing proficiency and lifelong retention of teeth at the initial office visit; however, the overall survival probabilities of SPT were only 52.7% after about 5 years. Patients exhibiting unfavourable attitudes toward oral health at the initial office visit, in comparison with those displaying favourable attitudes, exhibited greater tendency to abandon SPT. A Cox regression model revealed that lack of brushing on the gingival margin, non-use of an inter-dental brush or dental floss, non-use of fluoride toothpaste and frequent consumption of sugar-containing drinks were significant independent prognostic factors for low-compliance with SPT (p<0.05; Hazard ratios=2.27, 2.00, 2.56 and 2.06, respectively).
  
  
  CONCLUSIONS
  Desire for satisfactory oral health is not related consistently to continuation of SPT. Unfavourable attitudes toward oral health were correlated to low-compliance with SPT. Clinicians may wish to establish methods for improvement of patient compliance employing behavioural approaches applicable to the attitudes of potential low-compliance individuals.
authors.affiliation: Department of Preventive Dentistry, Graduate School of Dentistry, Osaka University, Osaka, Japan. ojima@dent.osaka-u.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Ojima
authors.forename: H
authors.initials: H
authors.lastname: Kanagawa
authors.forename: N
authors.initials: N
authors.lastname: Nishida
authors.forename: H
authors.initials: H
authors.lastname: Nagata
authors.forename: T
authors.initials: T
authors.lastname: Hanioka
authors.forename: S
authors.initials: S
authors.lastname: Shizukuishi
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003777:Dental Prophylaxis / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D016016:Proportional Hazards Models; D011795:Surveys and Questionnaires; D016019:Survival Analysis