An application of the Health Action Process Approach model to oral hygiene behaviour and dental plaque in adolescents with fixed orthodontic appliances.
BACKGROUND
The Health Action Process Approach (HAPA) model addresses health behaviours, but it has never been applied to model adolescents' oral hygiene behaviour during fixed orthodontic treatment.


OBJECTIVE
This study aimed to apply the HAPA model to explain adolescents' oral hygiene behaviour and dental plaque during orthodontic treatment with fixed appliances.


METHODS
In this cross-sectional study, 116 adolescents with fixed appliances from an orthodontic clinic situated in Almere (the Netherlands) completed a questionnaire assessing oral health behaviours and the psychosocial factors of the HAPA model. Linear regression analyses were performed to examine the factors associated with dental plaque, toothbrushing, and the use of a proxy brush.


RESULTS
Stepwise regression analysis showed that lower amounts of plaque were significantly associated with higher frequency of the use of a proxy brush (R2= 45%), higher intention of the use of a proxy brush (R2= 5%), female gender (R2= 2%), and older age (R2= 2%). The multiple regression analyses revealed that higher action self-efficacy, intention, maintenance self-efficacy, and a higher education were significantly associated with the use of a proxy brush (R2= 45%).


CONCLUSIONS
Decreased levels of dental plaque are mainly associated with increased use of a proxy brush that is subsequently associated with a higher intention and self-efficacy to use the proxy brush.
Department of Preventive Dentistry, Academic Centre of Dentistry Amsterdam, Amsterdam, The Netherlands.|Department of Oral Hygiene, Inholland University, Amsterdam, The Netherlands.|Research Group Child Health, TNO, Leiden, The Netherlands.
Janneke F M
JFM
Scheerman
Research Group Child Health, TNO, Leiden, The Netherlands.
Pepijn
P
van Empelen
Department of Preventive Dentistry, Academic Centre of Dentistry Amsterdam, Amsterdam, The Netherlands.
Cor
C
van Loveren
Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
Amir H
AH
Pakpour
Department of Health, Sports and Welfare/Cluster Nursing, Inholland University of Applied Sciences, Amsterdam, The Netherlands.|Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.|Parnassia Psychiatric Institute, Parnassia Academy, The Hague, The Netherlands.
Berno
B
van Meijel
Department of Health Psychology, Freie Universität Berlin, Berlin, Germany.
Maryam
M
Gholami
Department of Oral Hygiene, Inholland University, Amsterdam, The Netherlands.
Zaher
Z
Mierzaie
Department of Preventive Dentistry, Academic Centre of Dentistry Amsterdam, Amsterdam, The Netherlands.
Matheus C T
MCT
van den Braak
Research Group Child Health, TNO, Leiden, The Netherlands.
Gijsbert H W
GHW
Verrips
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000066949:Biobehavioral Sciences; D002648:Child; D003430:Cross-Sectional Studies; D003742:Dental Devices, Home Care / Q000706:statistics & numerical data; D003773:Dental Plaque; D003774:Dental Plaque Index; D005260:Female; D015438:Health Behavior; D006801:Humans; D016014:Linear Models; D008297:Male; D009426:Netherlands; D009910:Oral Hygiene / Q000523:psychology / Q000706:statistics & numerical data*; D009967:Orthodontic Appliances; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000523:psychology / Q000706:statistics & numerical data