Social cognitive correlates of oral hygiene behaviour in periodontal disease

Objective: To determine which social cognitive constructs most strongly correlate with brushing and flossing intention, self-reported oral hygiene behaviour and clinical markers of periodontal disease in patients with periodontal disease.

Methods: Cross sectional survey of 101 patients with periodontal disease. Social cognition measures, oral hygiene intentions and behaviour were assessed by questionnaire. Clinical indices of periodontal disease (pocket depths, bleeding on probing and plaque score) were assessed through clinical examination.

Results: Self-reported tooth brushing was correlated with an internal locus of control (rho=-0.26); Self-reported flossing was related to the belief that good oral hygiene reduces the progression of periodontal disease (outcome expectancy, rho=0.27) and that the individual had time available to floss (rho=0.25). Intentions had no relationship to self-reported behaviours. Severity of periodontal disease (as assessed by the proportion of teeth with pocketing of 5mm or more) was correlated with risk perception (rho=0.28), knowledge of periodontal disease (rho=-0.33), outcome expectancies (flossing prevents progression rho=-0.22; flossing reduces the risk, rho=-0.26) and a powerful others locus of control (rho=0.25).

Conclusions: The social cognitions which were most consistently correlated with intention, self-reports and clinical measures were barriers, outcome expectancy and locus of control beliefs. The one construct which was consistently not correlated with any of the included outcome variables was social norm. A different set of constructs correlated with flossing in comparison to tooth brushing intention. It is possible that no single social cognition model predicts all oral hygiene related behaviours.