title: What is the best predictor for oral cleanliness after brushing? Results from an observational cohort study.
abstract: BACKGROUND
  Brushing performance is an important factor for brushing success. Thus, observing brushing performance might help to explain deficits in oral hygiene. However, it is unknown how brushing behavior observed at one time relates to brushing capabilities observed at another time. The authors assessed the predictive validity of video-observed habitual brushing behavior for the capability to achieve oral cleanliness several weeks later.
  
  
  METHODS
  Study participants (N = 101) were video-recorded while cleaning their teeth. Two independent, calibrated examiners assessed brushing duration, evenness of distribution of brushing time across areas of the mouth as one indicator of brushing systematics, and duration of specific brushing movements. Weeks later (mean: 6.4 weeks; range: 1 to 24 weeks), 70 participants were asked to remove plaque to the best of their ability, and degree of oral cleanliness was assessed immediately afterward. A forward regression analysis was performed to assess the predictive values of brushing parameters.
  
  
  RESULTS
  Regression analysis revealed that evenness of distribution of brushing time and duration of circling movements explained 20.8% of variance of oral cleanliness (P < 0.001).
  
  
  CONCLUSIONS
  Evenness of distribution of brushing time and duration of circling movements are aspects of observed habitual brushing behavior that predict brushing capabilities in terms of oral cleanliness.
authors.affiliation: Institute for Medical Psychology, Justus-Liebig-University, Giessen, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Harnacke
authors.forename: Tobias
authors.initials: T
authors.lastname: Winterfeld
authors.forename: Jörg
authors.initials: J
authors.lastname: Erhardt
authors.forename: Nadine
authors.initials: N
authors.lastname: Schlueter
authors.forename: Carolina
authors.initials: C
authors.lastname: Ganss
authors.forename: Jutta
authors.initials: J
authors.lastname: Margraf-Stiksrud
authors.forename: Renate
authors.initials: R
authors.lastname: Deinzer
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D003773:Dental Plaque / Q000628:therapy; D003774:Dental Plaque Index; D005260:Female; D005544:Forecasting; D015438:Health Behavior; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009910:Oral Hygiene / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D013997:Time Factors; D014099:Toothbrushing / Q000379:methods* / Q000706:statistics & numerical data; D014741:Video Recording; D055815:Young Adult
keywords: Adherence; dental plaque; observation; oral hygiene; toothbrushing; video recording