Theory-based educational intervention on oral hygiene behavior among university students: a randomized controlled trial

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ObjectiveThe objective was to assess the effectiveness of the theory-based educational intervention tailored to the Theory of Planned Behavior (TPB) and behavior change techniques (BCTs) on oral hygiene behavior among university students through the oral hygiene behavior index and oral health outcomes.Materials and methodsA randomized controlled trial involving university students was conducted from November 2022 to March 2023 (n = 71). Participants were randomly assigned to a control group (n = 38) or an intervention group (n = 33). The control group received conventional dental health education, whereas the intervention group underwent a 21-day TPB-based educational intervention delivered through a three-minute video. Oral hygiene behavior index (OHBI) and oral health outcomes, including caries activity, salivary hemoglobin level, and total bacterial count, were assessed at baseline and three-month post-intervention.ResultsStatistically significant improvements were seen in the OHBI score between groups and within the intervention group at three-month follow-up, with higher scores indicating better oral hygiene behavior. In addition, caries activity and salivary hemoglobin level were also improved. The total bacterial count in the intervention group did not show any statistically significant difference, even though it was lower than that of the control group.ConclusionThis study indicates that theory-based educational intervention tailored to TPB and BCTs improves oral hygiene behavior and certain oral health outcomes. Future studies should examine the long-term effects and generalizability in diverse populations.Trial registrationThailand Clinical Trial TCTR20230105003.

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  • Cite Count Icon 1
  • 10.3389/froh.2023.1116717
Portrayal of oral hygiene and risk behaviours in animated movies
  • Jul 5, 2023
  • Frontiers in Oral Health
  • George Kitsaras + 1 more

BackgroundBehaviours depicted in movies and TV shows can significantly affect one's behaviour. Children are particularly susceptible to these effects as their habits are still forming. Oral hygiene behaviours play a crucial role in preventing or slowing down the progression of dental diseases, which are among the most common yet preventable diseases in the world. Therefore, it is important to understand if popular movies include oral hygiene behaviours or risk-related behaviours, which can in effect influence children's behaviour.AimThe aim of this study is to review the top grossing animated movies of all time to record and collect on screen portrayals of oral hygiene practices and risk behaviours related to oral health.MethodologyTop 30 highest grossing animated feature films (over 40 min duration) were coded using a structured coding instrument to capture oral hygiene and risk-related behaviours related to oral health. Two coders performed coding using the standardised instrument.ResultsOverall, 93% of behaviours were coded as a risk behaviour, with 7% coded as positive oral hygiene behaviour. Within the risk behaviour category, the majority (74%) were based around the consumption of sugar with risk behaviour occurring in 23 out of 30 movies (76%), while oral hygiene practices occurred in 6 out of 30 movies (20%); one movie depicted neither oral hygiene nor oral health risk behaviours. About 53% of behaviours were purely visual, 10% verbal, and 37% a combination of verbal and visual. Anthropomorphic characters and movie settings resulted in more behaviours related to oral health, either hygiene or mainly risk behaviours, depicted.ConclusionDespite their importance in shaping habits and attitudes, animated movies portrayed a significant number of risk behaviours related to oral health with depiction of beneficial behaviours remaining limited. Consideration should be given on how to best portray behaviours that promote and enhance optimal oral hygiene behaviours to achieve and sustain better oral health for children.

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  • 10.1007/978-981-13-3648-5_255
The Relationship of Oral Hygiene Behavior and Knowledge
  • Jan 1, 2019
  • Cheng Youeh Tsai + 3 more

In our country, there are no formal oral hygiene courses in senior high school. However, oral hygiene is a serious topic for students. This study is to survey the oral hygiene knowledge, oral hygiene behavior of college students. The aim of this study is discussing the relationship of oral hygiene knowledge and behavior by different schools and departments. The study sample was taken from the highest students in two different college schools. The questionnaire is used to data collect. The data was used to analysis for discussing oral hygiene knowledge, and oral hygiene behavior. The scores of oral hygiene knowledge are significant different in gender and department. The department is the most effect to oral hygiene behavior. The school and education of caregiver are second effects. The most important effect for oral hygiene knowledge, oral hygiene behavior is department. The relationship of oral hygiene knowledge behavior is not stronger.

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  • Cite Count Icon 27
  • 10.7205/milmed-d-05-0408
Promoting Oral Hygiene Behavior in Recruits in the Dutch Army
  • Sep 1, 2009
  • Military Medicine
  • Yvonne A B Buunk-Werkhoven + 7 more

To make practical recommendations for improving oral hygiene behavior (OHB) potential predictors based on the Theory of Planned Behavior (TPB) were assessed. Measurements of oral health knowledge (OHK) and the expected social effect for having healthy teeth were included. 216 recruits in the Dutch Army ground forces completed a questionnaire about oral hygiene behavior, attitudes, social norms, perceived behavioral control (PBC), intention to perform optimal OHB, OHK, and expected social outcomes. The multivariate regression analysis revealed that attitude and PBC explained 37.2% of the variance in intention to perform optimal oral hygiene behavior, which is a substantial proportion. Furthermore, actual oral hygiene behavior was only predicted by attitude, explaining 7.1% of the variance. The present findings suggest that recruits' oral hygiene behavior may be improved by promoting a more positive attitude and especially by enhancing perceived behavior control.

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  • 10.1111/idj.12413
Determinants of oral hygiene behaviour among patients with moderate and severe chronic periodontitis based on the theory of planned behaviour
  • Feb 1, 2019
  • International Dental Journal
  • Jenisha Patel + 5 more

Determinants of oral hygiene behaviour among patients with moderate and severe chronic periodontitis based on the theory of planned behaviour

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  • 10.1111/j.1365-263x.2010.01048.x
Modelling the factors influencing general and oral hygiene behaviours in adolescents
  • Jun 2, 2010
  • International Journal of Paediatric Dentistry
  • Mojtaba Dorri + 2 more

Health behaviour models have been mainly used to explain indicators and the development of hygiene behaviours. However, health behaviour models do not explain and predict general and oral hygiene behaviours. To develop and test a theoretical model of the factors influencing oral and general hygiene behaviours in male and female adolescents in Mashhad, Iran. A representative stratified random sample of 1132 6th grade Iranian students in Mashhad, with an average age of 12.4 (SD = 0.8) years, answered a 37-item questionnaire. The questionnaire had items on socio-demographic characteristics, education achievement and future aspiration, Sense of Coherence, toothbrushing frequency, frequency of showering and changing underwear, and peer social networks. Confirmatory structural equation modelling was used to test the validity of the model in the whole sample and among two sexes separately. All measurement models fitted the data. Significant correlations among latent variables were observed. Fit indices indicated good representation of the data in the whole sample. Goodness-of-fit statistics were significant among the two sexes. The proposed theoretical model of the factors influencing general and oral hygiene behaviours in adolescents was valid. Further studies should further investigate the properties of this model in different populations.

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  • Cite Count Icon 2
  • 10.1111/idh.12666
Oral hygiene behaviour and its determinants among preparatory school students in Gondar city, Northwest Ethiopia: A cross-sectional study.
  • Jan 20, 2023
  • International Journal of Dental Hygiene
  • Kegnie Shitu + 2 more

This study aimed to evaluate oral hygiene behaviour and its determinants among preparatory school students in Gondar city, Northwest Ethiopia. Institutional-based cross-sectional study was conducted among 423 students to evaluate their oral hygiene behaviour and determinant factors (sociodemographic attributes, oral hygiene knowledge, and attitude to oral hygiene behaviours). Linear regression was employed to identify factors associated with oral hygiene behaviour. A p-value of <0.05 and a 95% confidence interval were used to declare statistical significance. A total of 407 students participated with a response rate of 96.2%. The mean age of the participants was 18 (SD ±1.3). The mean oral hygiene behaviour (OHB) score was about 7.89 ± 3.43. Only 9.2%, 21.4%, and 5.7% were brushing their teeth at least twice a day, cleaning their tongue, and flossing at least once a day respectively. Father's educational status (able to read and write (β=1.99, 95% CI: 0.62, 3.38), completed secondary school (β=1.68, 95% CI: 0.18, 3.18), and diploma and higher (β=1.75, 95% CI: 0.33, 3.18)), being from private school (β=3.25, 95%CI: 2.30, 4.19), knowledge about OHB (β=0.16, 95% CI: 0.01, 0.30), and attitude towards OHB (β=0.11, 95% CI: 0.08, 0.14) were significant factors positively associated with better oral hygiene behaviour. Oral hygiene behaviour was poor among preparatory school students in Gondar city. Father's educational status, students' oral hygiene knowledge, and attitude were found to be significant factors affecting students' oral hygiene behaviour. Thus, tailored school-based oral health communication programs are highly required to improve students' oral hygiene behaviour.

  • Research Article
  • Cite Count Icon 118
  • 10.1111/j.1600-0528.2010.00589.x
Determinants of oral hygiene behavior: a study based on the theory of planned behavior
  • Nov 10, 2010
  • Community Dentistry and Oral Epidemiology
  • Yvonne A.B Buunk-Werkhoven + 2 more

The aim of this study was to develop an index for oral hygiene behavior (OHB) and to examine potential predictors of this actual behavior based on the theory of planned behavior (TPB). Measures of oral health knowledge (OHK) and the expected effect of having healthy teeth on social relationships were included too. Using an Internet questionnaire, 487 participants were asked about actual OHB, attitudes (ATT), social norms (SN), perceived behavioral control (PBC), OHK, and expected social outcomes (ESO). Based on a Delphi method involving oral health professionals, a new index for OHB was developed, including tooth brushing, interdental cleaning, and tongue cleaning. Regression analysis revealed that the TPB variables (ATT, SN, and PBC) and OHK explained 32.3% of the variance in self-reported OHB. The present findings indicate that socio-psychological consequences play a role in oral health care.

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  • Cite Count Icon 9
  • 10.1371/journal.pone.0247069
Determinants of intention to improve oral hygiene behavior among students based on the theory of planned behavior: A structural equation modelling analysis.
  • Feb 25, 2021
  • PLOS ONE
  • Kegnie Shitu + 3 more

The prevalence of oral hygiene behaviors (OHB) is very low among school children in Ethiopia. However, the determinants of student's readiness/intention to perform those behaviors have been remained unstudied. This study aimed to identify the determinants of oral hygiene behavioral intention (OHBI) among preparatory school students based on the theory of planned behavior (TPB). An institution-based cross-sectional study was conducted among 393 students. A 98-item self-administered questionnaire was used to evaluate oral hygiene knowledge (OHK), oral hygiene behavior (OHB), and OHBI based on TPB variables [attitude (ATT), subjective norms (SN) and perceived behavioral control (PBC)]. Descriptive statistics and structural equation modeling analysis (SEM) were employed to confirm relationships and associations among study variables. A p-value of less than 0.05 and a 95% confidence interval were used to declare statistical significance. A total of 393 students were participated with a response rate of 97.5%. The mean age of the participants (54% females) was 18 (± 1.3) with an age range of 16 to 24. The TPB model was well fitted to the data and explained 66% of the variance in intention. ATT (β = 0.38; 95% CI, (0.21, 0.64)), SN (β = 0.33; 95% CI, (0.05, 0.83)) and PBC (β = 0.29; 95% CI, (0.13, 0.64)) were significant predictors of OHBI, where ATT was the strongest predictor of OHBI. The TPB model explained a large variance in the intention of students to improve their OHB. All TPB variables were significantly and positively linked to stronger intent, as the theory suggests. Furthermore, these results suggest that the model could provide a framework for oral hygiene promotion interventions in the study area. Indeed, these interventions should focus on changing the attitudes of students towards OHB, creation of positive social pressure, and enabling students to control over OHB barriers.

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  • Cite Count Icon 5
  • 10.1371/journal.pone.0247069.r004
Determinants of intention to improve oral hygiene behavior among students based on the theory of planned behavior: A structural equation modelling analysis
  • Feb 25, 2021
  • PLoS ONE
  • Kegnie Shitu + 4 more

IntroductionThe prevalence of oral hygiene behaviors (OHB) is very low among school children in Ethiopia. However, the determinants of student’s readiness/intention to perform those behaviors have been remained unstudied.ObjectiveThis study aimed to identify the determinants of oral hygiene behavioral intention (OHBI) among preparatory school students based on the theory of planned behavior (TPB).Methods and materialsAn institution-based cross-sectional study was conducted among 393 students. A 98-item self-administered questionnaire was used to evaluate oral hygiene knowledge (OHK), oral hygiene behavior (OHB), and OHBI based on TPB variables [attitude (ATT), subjective norms (SN) and perceived behavioral control (PBC)]. Descriptive statistics and structural equation modeling analysis (SEM) were employed to confirm relationships and associations among study variables. A p-value of less than 0.05 and a 95% confidence interval were used to declare statistical significance.ResultsA total of 393 students were participated with a response rate of 97.5%. The mean age of the participants (54% females) was 18 (± 1.3) with an age range of 16 to 24. The TPB model was well fitted to the data and explained 66% of the variance in intention. ATT (β = 0.38; 95% CI, (0.21, 0.64)), SN (β = 0.33; 95% CI, (0.05, 0.83)) and PBC (β = 0.29; 95% CI, (0.13, 0.64)) were significant predictors of OHBI, where ATT was the strongest predictor of OHBI.ConclusionThe TPB model explained a large variance in the intention of students to improve their OHB. All TPB variables were significantly and positively linked to stronger intent, as the theory suggests. Furthermore, these results suggest that the model could provide a framework for oral hygiene promotion interventions in the study area. Indeed, these interventions should focus on changing the attitudes of students towards OHB, creation of positive social pressure, and enabling students to control over OHB barriers.

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  • 10.4103/jispcd.jispcd_182_24
Impact of the COVID-19 Pandemic on Oral Health Perception, Hygiene Behaviors, and Oral Health-Related Quality of Life in Myanmar.
  • Nov 1, 2024
  • Journal of International Society of Preventive & Community Dentistry
  • Kaung Myat Thwin + 4 more

The COVID-19 pandemic has significantly impacted various aspects of daily life, including oral health. However, limited research has explored the effects of the pandemic on oral health perceptions, hygiene behaviors, and their subsequent influence on oral health-related quality of life (OHRQoL) in underserved settings. This study aims to assess changes in oral health perceptions and behaviors during the pandemic and their impact on OHRQoL in Myanmar. A cross-sectional study was conducted in 2023 at a township health center in Yangon, Myanmar. A total of 158 participants were included in the study. Clinical oral assessments were performed alongside face-to-face interviews, which collected data on sociodemographic characteristics, oral health perceptions and behaviors, psychological factors, and OHRQoL. Descriptive statistics, chi-square tests, Mann-Whitney U tests, Kruskal-Wallis tests, and regression analyses were used to explore associations and predictors of OHRQoL. Among the 158 participants, 30.4% reported a decline in oral health perception, and 27.8% reported negative changes in oral hygiene behaviors during the COVID-19 pandemic. These changes were significantly associated with a history of COVID-19 infection, depressive symptoms, and bleeding on probing during oral examinations. Regression analysis revealed that worsened oral health perception (B = -2.59; 95% confidence interval [CI] = -5.00, -0.18) and negative changes in hygiene behaviors (B = -2.27; 95% CI = -4.57, -0.02) were associated with poorer OHRQoL. However, these associations became nonsignificant after adjusting for confounding factors. Notably, a history of COVID-19 infection requiring hospitalization remained a statistically significant predictor of poorer OHRQoL in all models. A significant proportion of participants reported worsened oral health perception and negative changes in oral hygiene behaviors during the COVID-19 pandemic, which contributed to a decline in OHRQoL. However, the influence of other confounding factors, such as psychological and socioeconomic variables, needs to be carefully considered. Clinically, these findings highlight the importance of integrating psychological support and targeted oral health interventions in the post-pandemic recovery phase, particularly in underserved settings. Public health initiatives should address the long-term impacts of the pandemic on oral health behaviors and perceptions to improve OHRQoL in affected populations.

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  • Cite Count Icon 27
  • 10.1111/j.1600-0722.2009.00657.x
Relationship between general hygiene behaviours and oral hygiene behaviours in Iranian adolescents
  • Jul 14, 2009
  • European Journal of Oral Sciences
  • Mojtaba Dorri + 2 more

The objective of the present study was to investigate the relationship between oral hygiene behaviours and general hygiene behaviours among Iranian adolescents living in Mashhad. A representative stratified random sample of 1,054 Iranian adolescents, in the sixth grade of school, answered a 37-item questionnaire on socio-demographic characteristics, frequency of toothbrushing behaviours, frequency of taking showers, and frequency of changing underwear, as measures of general hygiene behaviours. Binary logistic-regression analysis was employed to test the association between toothbrushing behaviours and general hygiene behaviours. The results showed that toothbrushing frequency was significantly associated with the frequency of taking showers (odds ratio: 2.40; 95% confidence interval: 1.86, 3.09) and the frequency of changing underwear (odds ratio: 2.14; 95% confidence interval: 1.65, 2.78). These associations were significant for girls and boys when tested separately and remained significant after adjusting for gender and father's education level. Girls were significantly more likely than boys to practice oral hygiene and general hygiene behaviours. In conclusion, there was a positive association between general hygiene and oral hygiene behaviours among Iranian adolescents. This association has important applications for planning health and hygiene-promoting programmes.

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  • Cite Count Icon 17
  • 10.1371/journal.pone.0236259
Relationship between oral hygiene knowledge, source of oral hygiene knowledge and oral hygiene behavior in Japanese university students: A prospective cohort study.
  • Jul 23, 2020
  • PLOS ONE
  • Daiki Fukuhara + 11 more

The aim of this prospective cohort study was to examine whether oral hygiene knowledge, and the source of that knowledge, affect oral hygiene behavior in university students in Japan. An oral exam and questionnaire survey developed to evaluate oral hygiene knowledge, the source of that knowledge, and oral hygiene behavior, such as the frequency of tooth brushing and regular dental checkups and the use of dental floss, was conducted on university student volunteers. In total, 310 students with poor tooth brushing behavior (frequency of tooth brushing per day [≤ once]), 1,963 who did not use dental floss, and 1,882 who did not receive regular dental checkup during the past year were selected. Among these students, 50, 364, and 343 in each respective category were analyzed in over the 3-year study period (follow-up rates: 16.1%, 18.5%, and 18.2%, respectively). The odds ratios (ORs) and 95% confidence intervals (CIs) for oral hygiene behavior were calculated based on oral hygiene knowledge and the source of that knowledge using logistic regression models. The results showed that dental clinics were the most common (> 50%) source of oral hygiene knowledge, and that a more frequent use of dental floss was significantly associated with dental clinics being a source of oral hygiene knowledge (OR, 4.11; 95%CI, 1.871–9.029; p < 0.001). In addition, a significant association was seen between dental clinics being a source of oral hygiene knowledge and more frequent regular dental checkups (OR, 13.626; 95%CI, 5.971–31.095; p < 0.001). These findings suggest the existence of a relationship between dental clinics being the most common source of oral hygiene knowledge and improved oral hygiene behavior in Japanese university students.

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  • Cite Count Icon 12
  • 10.1186/s12903-020-1036-6
Socioeconomic-related inequalities in oral hygiene behaviors: a cross-sectional analysis of the PERSIAN cohort study
  • Feb 28, 2020
  • BMC Oral Health
  • Moslem Soofi + 30 more

BackgroundSocioeconomic-related inequality in oral hygiene behaviors in Iran is poorly understood. This study aims to measure and decompose socioeconomic-related inequalities in oral hygiene behaviors among middle-aged and elderly adults in Iran.MethodsA cross-sectional analysis was performed using data from the Prospective Epidemiological Research Studies in IrAN (PERSIAN), a large national cohort study. A total of 130,016 individuals aged 35 years and above from 17 cohort centers in Iran were included in the study. The normalized concentration index (Cn) was used to measure the magnitude of inequality in oral hygiene behaviors, i.e. brushing at least twice and flossing once daily, among middle-aged and elderly Iranian adults included in the cohort centers. Decomposition analysis was performed to quantify the contribution of each determinant to the observed inequality in oral hygiene behaviors.ResultsTotally, 65.5% of middle-aged and elderly adults brushed their teeth twice a day or more, 7.6% flossed at least once a day and 3.48% had both habits. The estimated Cn of the two habits combined, i.e. tooth brushing and dental flossing, for all provinces taken part in the PERSIAN cohort study was 0.399 (95% confidence interval [CI]: 0.383 to 0.417), indicating that the prevalence of the two habits combined is more concentrated among individuals with higher socioeconomic status. Inequality in oral hygiene behaviors was pro-rich in all cohort centers. The decomposition results suggested socioeconomic status as the main factor contributing to the overall inequality, followed by the level of education, and the province of residence.ConclusionA low prevalence of oral hygiene behaviors among middle-aged and elderly Iranian adults was observed. There was also a pro-rich inequality in oral hygiene behaviors among middle-aged and elderly adults in all cohort centers. These results suggest an urgent need for targeted policy interventions to increase the prevalence of preventive oral hygiene behaviors among the poor and less-educated middle-aged and elderly adults in Iran.

  • Research Article
  • 10.1186/s12889-024-21158-5
The association between cognitive impairment and oral health or oral hygiene behaviors among multiethnic older adults in Western China: a cross-sectional multicenter study
  • Jan 21, 2025
  • BMC Public Health
  • Yuqing Xie + 8 more

BackgroundOlder adults with cognitive impairment tend to experience deteriorating oral health and inadequate oral hygiene behaviors, but few studies have addressed interethnic variability. This study aimed to explore the associations between cognitive impairment and oral health or oral hygiene behaviors in multiethnic older adults in Western China.MethodsWe conducted a cross-sectional multicenter study from four provinces of Western China, recruiting multiethnic older adults aged 50 years and older between July and December 2018. Oral health and oral hygiene behaviors were evaluated through an oral examination and a self-made questionnaire, whereas cognitive condition was assessed via the Chinese version of the Short Portable Mental Status Questionnaire (SPMSQ). Three multiple regression models were used to examine the associations between cognitive impairment and oral health or oral hygiene behaviors, with adjustments for relevant variables.ResultsA total of 6529 participants with a median age (interquartile range) of 62.4 (55, 68) years were included. The prevalence of cognitive impairment was 15.4%, with the Yi group having the highest prevalence (28.9%), followed by the Tibetan (19.1%) and Qiang (15.4%) groups. Poorer self-rated oral health, fewer residual teeth, less frequent use of toothbrushes and toothpaste, and irregular dental care were associated with a risk of cognitive impairment (p < 0.05). The SPMSQ scores and correlations between cognitive impairment and oral health or oral hygiene behaviors were heterogeneous among the multiethnic groups.ConclusionInadequate oral hygiene behaviors and deteriorating oral health may be associated with a higher risk of cognitive impairment. Advancing oral health and oral hygiene behaviors is essential for preventing cognitive impairment among multiethnic older adults.

  • Research Article
  • 10.35882/ijahst.v4i5.411
The Influence of the Story DONI AND GIGINYA on Oral Hygiene Behavior in Preschool Children Banyuwangi
  • Oct 27, 2024
  • International Journal of Advanced Health Science and Technology
  • Haswita Haswita + 2 more

Oral hygiene problems that cause damage to the oral cavity in children in Indonesia are still high, reaching 57.6%. So it is very important to pay attention because this is an important growth stage. Damaged teeth can cause delayed tooth development in later life. The method of oral hygiene that attracts the attention of preschool children is the storytelling method. The aim of this research is to determine the effect of stories on oral hygiene behavior in preschool children. This method is quantitative research using a quasi-experimental design (one group pre-test and posttest). The population consisted of 50 individuals, and the sampling technique used was total sampling, using an observation checklist sheet to measure how to brush teeth. Statistical tests use the Wilcoxon Test. The results of the research showed that after the story was given, there was an increase, namely 30 children behaved good, 18 children behaved enough, and 2 children behaved poorly. Wilcoxon Signed Rank Test results with a value of p=000&lt;0.05, the analysis shows that the story "Doni and Giginya" influences the oral hygiene behavior of preschool children. The story "Doni and Giginya" has been proven to affect increasing children's oral hygiene knowledge and behavior. Therefore, parents or guardians of children can utilize audio-visual media in other forms that have moral messages so that children's knowledge and behavior regarding oral hygiene in particular and health, in general, can increase. Keywords: Stories, Oral Hygiene Behavior, Preschool

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