Hiroshima University-Dental Behavioral Inventory Research Articles

Attitudes of dental and medical students in their first and final years of undergraduate study to oral health behaviour

To compare differences in attitude to oral health behaviour amongst medical and dental students when they were in years 1 and 5 of University study respectively. Medical and dental students of Peking University in Beijing, China were invited to take part in this study. The original version of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) was written in Japanese. After testing the validity of both English and Chinese versions, the revised Chinese version of the HU-DBI was administered to new medical and dental students. In their final year of University study, the same questionnaire was again administered. Significant differences were found for 13 of 21 items, reflecting an improvement in oral health attitudes and behaviour in final year dental students when compared with the time they were entrants. This difference was not found to be significant in the sample of medical students. There were significant differences in oral health attitudes and behaviours in dental students between entrance to University and the final year of their study. The same was not found to be true for medical students.

Smoking Prevalence and Its Effect on Dental Health Attitudes and Behavior among Dental Students

Objective: To determine smoking prevalence and its effect on dental health attitudes and behavior among dental students in Jordan. Subjects and Methods: A cross-sectional study of 314 dental students was conducted at Jordan University of Science and Technology. Subjects were surveyed using a modified version of the Hiroshima University Dental Behavior Inventory (HU-DBI) questionnaire. Multivariate logistic regression analyses were performed to study differences between male smokers and nonsmokers only. Results: The response rate was 83.7%, with 48% males and 52% females. The prevalence of smoking was 17.2%. Smoking was more prevalent among male students (31%) than female (4.3%). For male students, the multivariate logistic regression analysis showed 6 items that were different between smokers and nonsmokers. Nonsmokers tended to brush their teeth more often than smokers (OR 8.67, 95% CI 1.66–45.25); claimed that they had never been professionally taught how to brush their teeth (OR 11.15, 95% CI 1.89–65.67); believed that they spend too much time brushing their teeth (OR 12.24, 95% CI 2.0–75.05); were more concerned about having bad breath (OR 41.86, 95% CI 3.44–58.75) and were more concerned about the color of their gums (OR 8.04, 95% CI 1.55–41.84). Conclusions: Smoking prevalence among male dental students in Jordan was high, 7 times greater than for females. Male smokers and nonsmokers had different attitudes and oral health behaviors as indicated by the study survey.

The hierarchical cluster analysis of oral health attitudes and behaviour using the Hiroshima University - Dental Behavioural Inventory (HU-DBI) among final year dental students in 17 countries

The hierarchical cluster analysis of oral health attitudes and behaviour using the Hiroshima University - Dental Behavioural Inventory (HU-DBI) among final year dental students in 17 countries

Oral self‐care behaviours: comparing Greek and Japanese dental students

This study explored cross-cultural differences of self-reported oral health behaviours between Greek and Japanese dental students. The sample population included 877 dental students, 539 students registered at the University of Athens Dental School, and 338 registered at the Hiroshima University Dental School. Oral health behaviour was assessed using the Greek and Japanese versions of a 20-item questionnaire entitled Hiroshima University-Dental Behavioural Inventory (HU-DBI). The mean questionnaire score of the Japanese students (7.40) was significantly greater than that of the Greek peers (6.86, P = 0.001), indicating better oral self-care behaviour amongst the Japanese students; however, the overall difference was mainly attributed to their additional sixth study year. Greek and Japanese students provided significantly different answers to 14 of 20 HU-DBI items. Greeks significantly more often were required by their dentist to evaluate their brushing technique (OR = 14.4, P < 0.01), checked their teeth in the mirror after brushing (OR = 8.1, P < 0.01), worried about bad breath (OR = 6.7, P < 0.01), and believed that gum disease is preventable by tooth brushing alone (OR = 2.1, P < 0.05), whereas their Japanese peers significantly more often felt comfortable to clean their teeth without the use of a toothpaste (OR = 0.3, P < 0.01), believed that they take much time to brush their teeth (OR = 0.3, P < 0.01), used a child-sized toothbrush (OR = 0.2, P < 0.01), and put off going to the dentist until having toothache (OR = 0.4, P < 0.01). Considerable differences in dental health attitudes/behaviour exist amongst students in the two countries reflecting the different culture and the health education system of the students; moreover, it is possible to distinguish Greek dental students from Japanese peers with a probability of more than 89% by using the HU-DBI instrument.

An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students

To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students. Cross-cultural survey of dental students. 18 cultural areas. 904 first-year dental students completed the Hiroshima University-Dental Behavioural Inventory (HU-DBI) translated into their own languages. Individual areas were clustered by similarity in responses to the questions. The first group displayed an 'occidental-culture orientation' with the exception of Brazil (Cluster 1 comprised: Australia, United Kingdom, Ireland, Belgium and Brazil, Cluster 2: Germany, Italy, Finland and France). The second group displayed an 'oriental-cultural orientation' with the exception of Greece and Israel (Cluster 3 comprised: China and Indonesia, and Cluster 4: Japan, Korea, Israel, Hong Kong, Malaysia, Thailand and Greece). Australia and United Kingdom were the countries that were most alike. Ireland was the 'neighbour' to these countries. Greece and Malaysia had similar patterns of oral health behaviour although geographic conditions are very different. Although it was considered that in Hong Kong, occidental nations have affected the development of education, it remained in the oriental-culture group. Comparison with the data from the occidentals indicates that a higher percentage of the orientals put off going to the dentist until they have toothache (p < 0.001). Only a small proportion of the occidentals (8%) reported a perception of inevitability in having false teeth, whereas 33% of the orientals held this fatalistic belief (p = 0.001). Grouping the countries into key cultural orientations and international clusters yielded plausible results, using the HU-DBI.

A comparative study of oral health attitudes and behaviour using the Hiroshima University-Dental Behavioural Inventory (HU-DBI) between dental students in Britain and China

The aim of this study was to compare oral health attitudes and behaviour between British and Chinese dental students. A cross-national survey using the Hiroshima University - Dental Behavioural Inventory (HU-DBI) was completed at the University of Leeds in Britain and West China University of Medical Sciences in China. In Britain and China, 192 of 266 and 180 of 303 dental students answered English and Chinese versions of the HU-DBI questionnaire, respectively. Data were statistically analyzed by logistic regression and the following results were obtained: 1) Self-reported gingival bleeding was more prevalent in Chinese students than in British students, although the number of students who had professional oral hygiene instruction was higher in China than in Britain; 2) 29% of Chinese students believed wearing dentures in old age was inevitable, whereas 7% of British students believed so; 3) Chinese students were substantially more concerned about the appearance of their teeth, gums and halitosis; and 4) 54% of Chinese students seek dental care only when symptoms arise, as compared to 13% of British students. In conclusion, bilateral comparison of countries using HU-DBI revealed interesting differences in oral health attitudes and behaviour, while the logistic regression model made it possible to differentiate British from Chinese students with a probability of nearly 95%.

Gender-Specific Oral Health Attitudes and Behavior among Dental Students in Jordan

The aim of this study was to determine the difference in oral health attitudes and behavior between male and female dental students at Jordan University of Science and Technology (JUST). A self-administered questionnaire based on a modified version of the Hiroshima University Dental Behavior Inventory (HU-DBI) was distributed among 375 dental students. The response rate was 83.7% with 48% males and 52% females responding. Female students reported brushing their teeth more frequently than male students (P<0.001). Approximately 47% of the male students brushed their teeth less than twice daily compared to 21% of the female students. Also, female students believed in the necessity of using toothpaste during brushing more often than male students (P<0.01). On the other hand, smoking was much more frequent among males than among females (31% vs. 4%) (P<0.001). Male students indicated they had been smoking for longer periods of time than female students. This survey shows male students visit the dentist only when they have dental pain. While this was more than their female peers, it was not statistically significant (P= 0.056). In general the present study showed dental students in Jordan had poor oral health. Further research is needed to examine the students clinically for periodontal and caries conditions. Students should be encouraged to be a model for oral health for their families, friends, and patients.

A comparative study of oral health attitudes and behaviour using the Hiroshima University - Dental Behavioural Inventory (HU-DBI) between dental students in Britain and China.

A comparative study of oral health attitudes and behaviour using the Hiroshima University - Dental Behavioural Inventory (HU-DBI) between dental students in Britain and China.

The Relationship Between Dental Caries Status and Oral Health Attitudes and Behavior in Young Israeli Adults

The aim of this study was to investigate the epidemiologic relationship between oral health attitudes and behavior as measured by the Hiroshima University-Dental Behavioral Inventory (HU-DBI) and dental caries status using the DMF in a sample of young Israeli adults. The HU-DBI (in Hebrew) was used to survey 123 young Israeli army recruits (eighteen and nineteen years old). All participants submitted to a clinical and radiographic dental examination. Dental caries status was evaluated using the World Health Organization (WHO) caries diagnostic criteria for decayed, missing, and filled teeth and surfaces (DMFT and DMFS, respectively). Data were statistically analyzed. DMFT and DMFS scores, which measure dental disease, ranged from 0 to 24 (average 6.77) and from 0 to 48 (average 10.95), respectively. There were sixteen (13 percent) caries free (DMF=0) participants. When relating the different DMF values to the HU-DBI responses, a statistically significant relation was found between seven items and DMF scores or their components and indices. The HU-DBI score ranged from 2 to 9 (mean 5.8, SD=1.5). Low DS and DT values significantly correlated with a high total HU-DBI score (p<0.05); that is, subjects with low levels of dental disease had more positive oral health attitudes and behavior. In young Israeli adults, dental disease, as measured by DMF scores or their components, were related to HU-DBI, which demonstrate the relationship of dental caries status with oral health behavior. Special emphasis should be given to improving patients' oral health attitudes and behaviors by providing patient education during treatment.

Differences in self-reported oral health behavior between dental students and dental technology/dental hygiene students in Jordan

The aim of this study was to compare differences in oral health behavior between dental students and dental technology/dental hygiene students in Jordan. One hundred and five dental students and seventy-eight dental technology/dental hygiene students were recruited into this study. All subjects were recruited from the students who were receiving training at the clinics and laboratories that belong to the Faculty of Dentistry, Jordan University of Science and Technology. The Hiroshima University-Dental Behavioral Inventory (HU-DBI) was used to assess the oral heath behavior of the subjects. Significant differences were found between students from different disciplines. Dental students were found to worry more about visiting their dentist, to be less aware of bleeding gums when brushing and were less bothered by the color of their gums compared with dental technology and dental hygiene (DT/DH) students (P < 0.05, P < 0.001 and P < 0.05, respectively). Dental students tended to be more professionally educated about brushing and to have a belief that they cannot clean their teeth well without using toothpaste (P < 0.01 and P < 0.001, respectively). Most of them did not feel they have brushed well unless they brush with strong strokes (P < 0.05). A logistic regression model showed that it might be possible to distinguish dental students from DT/DH students by using three items of the HU-DBI and the level of dental education. The difference in the HU-DBI scores was not a major feature. There were significant differences in oral health attitudes/behavior between dental students and DT/DH students. The findings might reflect differences in students' training experience and education between different specialties.

Comparison of United States and Korean dental hygiene students using the Hiroshima University-Dental Behavioural Inventory (HU-DBI)

To compare cross-national differences of dental health behaviour among dental hygiene students. Cross-cultural differences. United States (USA) and Korea. One hundred and twenty-six dental hygiene students in USA and 246 in Korea were surveyed using the Hiroshima University-Dental Behavioural Inventory (HU-DBI) (in English and Korean versions respectively). There were considerable differences in oral health behaviour between USA and Korean dental hygiene students. Of great significance were findings that while only a small proportion of the USA students (1%) reported gum bleeding when they brushed their teeth, 37% of the Korean students did so (P<0.001). Furthermore, only 19% of the Korean students had been told by their dentist that they were performing a high level of plaque control, contrasted with 76% of the USA students. Logistic regression model showed that it was possible to distinguish USA students from Korean peers with a probability of more than 90% by using the HU-DBI. There were considerable differences in dental health attitudes/behaviour among dental hygiene students in the two countries. The variation in the favourable attitudes/behaviour toward oral health appeared to reflect the students' clinical training experience in Korea.

Influence of parents' oral health behaviour on oral health status of their school children: an exploratory study employing a causal modelling technique.

The aim of this study was to examine the simultaneous interrelationships between parents' oral health behaviour and the oral health status of their school children. Subjects comprised 296 pairs of parents (mother or father) and their children at an elementary school in Hiroshima. The child's dental examination was performed using the World Health Organization (WHO) caries diagnostic criteria for decayed teeth (DT) and filled teeth (FT). The Oral Rating Index for Children (ORI-C) was used for the child's gingival health examination. Hiroshima University Dental Behavioural Inventory (HU-DBI) was used for the assessment of the parents' oral health behaviour. A parent-child behavioural model was tested by the linear structural relations (LISREL) programme. There was a significant correlation between DT and ORI-C (r = - 0.168; P < 0.01). Correlation was found between ORI-C and oral health behaviour in children (OHB-C) (r = 0.182; P < 0.01). OHB-C was significantly associated with the HU-DBI (r = 0.251; P < 0.001). The hypothesized model after some revisions was found to be consistent with the data (chi(2) = 1.3, d.f. = 6, P = 0.97; Goodness of Fit Index = 0.999). Parents' oral health behaviour affected their children's oral health behaviour (P < 0.001). Children's oral health behaviour affected their DT through its effect on gingival health level. Parents' oral health behaviour also had a significant direct effect on their children's DT (P < 0.05). Children's grade affected both DT and their oral health behaviour. Parents' oral health behaviour could influence their children's gingival health and dental caries directly and/or indirectly through its effect on children's oral health behaviour.

Comparison of United States and Korean dental hygiene students using the Hiroshima University-Dental Behavioural Inventory (HU-DBI)

Comparison of United States and Korean dental hygiene students using the Hiroshima University-Dental Behavioural Inventory (HU-DBI)

A cross-cultural comparison of dental health attitudes and behaviour among freshman dental students in Japan, Hong Kong and West China

To clarify the differences in dental health attitudes/behaviour among freshman dental students. Cross-cultural differences. Japan, Hong Kong and West China. The original version of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) was written in Japanese. After testing the validity of both English and Chinese versions, the original version of the HU-DBI was administered to 58 freshman Japanese dental students, the English version to 43 Hong Kong Chinese peers and the Chinese version to 39 West Chinese peers. Significant cultural differences were found for 16 items out of 20. The most striking result was that the Japanese students were more likely to have used a dye to see how clean their teeth were, compared to their Chinese peers (P<0.001). The Chinese students were less likely to have a belief that they could clean their teeth well without using toothpaste (P<0.001), whereas higher percentages of the Chinese students worried about having bad breath (P<0.001). A higher percentage of the Hong Kong students reported that they regularly checked their teeth in a mirror than did their West Chinese or Japanese peers (P<0.05). There were considerable differences in dental health attitudes/behaviour among freshman dental students in the three cultural groups.

An assessment of oral self-care level among Japanese dental hygiene students and general nursing students using the Hiroshima University--Dental Behavioural Inventory (HU-DBI): surveys in 1990/1999.

The purpose of this study was to determine the differences in oral self-care levels between Japanese dental hygiene students and general nursing students in 1999, and compare them with a similar study in 1990. The examination was mainly based upon responses to a questionnaire titled "Hiroshima University--Dental Behavioural Inventory (HU-DBI)". Higher scores of the HU-DBI indicate better oral health attitudes/behaviour. The mean HU-DBI score of the 2nd-year dental hygiene students was significantly greater than that of the 2nd-year nursing students (9.56 and 6.65, respectively; p<0.001), and much higher than those of the 1st-year students at each course (dental hygiene course; 6.30, nursing course; 5.88). Except for the 2nd-year dental hygiene class, there were no significant differences in the HU-DBI score between the 1990 and 1999 subgroups of each class. About 1/3 of the 2nd-year nursing students reported a belief that they may eventually require false teeth, while 6% of the 2nd-year dental hygiene students held this belief. More than 60% of this study sample stated that they put off going to the dentist until they had toothache. The 2nd-year dental hygiene students were more likely to have this attitude than their 1990 peers. Flossing was not popular among the nursing students in either 1990 or 1999. Although the difference in the HU-DBI score across time was not major, the variation in HU-DBI and the favourable attitudes/behaviour toward oral health appeared to reflect the differences in schooling between student hygienists and student nurses.

Cross-cultural differences of self-reported oral health behaviour in Japanese and Finnish dental students

To determine whether any differences existed in dental health behaviour between Japanese and Finnish dental students. Hiroshima University School of Dentistry and the University of Helsinki. Comparison of cross-cultural differences of self-reported oral health behaviour. Dental students, 337 in Japan and 113 in Finland. Subjects were surveyed using the Japanese and Finnish versions of a 20-item questionnaire entitled Hiroshima University--Dental Behavioural Inventory (HU-DBI). Only 2 per cent of Finnish students reported that they put off going to the dentist until they had toothache, compared to 56 per cent of Japanese students. Similarly, significantly more Japanese students thought that their teeth were getting worse despite their daily brushing, compared to their Finnish peers. The mean HU-DBI score of Year 1 Finnish students was higher than that of their Japanese peers, which suggested a higher level of dental health awareness in Finnish students upon entry into dental school. The mean scores of the Japanese students were lower than those of their Finnish peers until Year 3. The mean scores of Year 5 and Year 6 Japanese students were higher than that of Year 1 students, indicating raised self-care levels influenced by the course in preventive dentistry. The gender difference of the HU-DBI score was not a major feature in either country. Self-reported oral health behaviours seemed to be very different between the two countries, which reflected different culture and/or health education systems of the students.

Behavioral dental science: the relationship between tooth-brushing angle and plaque removal at the lingual surfaces of the posterior teeth in the mandible.

The aim of this study was to investigate the relationship between tooth-brushing angle and efficacy of plaque removal. The subjects in this study were 72 students (18-21 yrs.) from paramedical schools. They answered the questionnaire of the Hiroshima University-Dental Behavioral Inventory (HU-DBI) to assess dental health behavior, and then received examinations of tooth-brushing angle, efficacy of plaque removal and gingival condition. The examination sites of tooth-brushing angle and the efficacy of plaque removal were the lingual surfaces of the posterior teeth in the mandible. The tooth-brushing angle, efficacy of plaque removal, gingival condition and dental health behavior were significantly associated with each other. The subjects who directed the bristles of the toothbrush vertically toward the tooth surfaces had a high efficacy of plaque removal, good gingival condition and good dental health behavior. Thus, it is important to direct the bristles vertically toward the tooth surfaces for effective plaque removal. In addition, knowledge related to good dental health might be necessary to carry out effective tooth brushing.

A comparison of self‐reported dental health attitudes and behavior between selected Japanese and Australian students

To compare cross-cultural differences of dental health behavior, 376 dental students in Japan and 213 in Australia were surveyed using a twenty-item Hiroshima University-Dental Behavior Inventory (HU-DBI) questionnaire (in Japanese and English versions respectively). The mean DBI score of Year 1 Australian students was significantly greater than that of their Japanese peers (Australian 6.56, Japanese 5.57; P < 0.001), which suggested a higher level of dental health awareness in Australian students on entry. Only 7 percent of the Japanese students had been told by their dentist that they were performing a high level of plaque control, as contrasted with 50 percent of the Australian students. Furthermore, while only a small proportion of the Australian students (8 percent) reported a belief that they may eventually require dentures, 37 percent of the Japanese students held this belief (P < 0.001). The mean HU-DBI score of the Japanese students was lower than that of the Australian students until Year 4. Differences between the genders were not a major feature.