Background
Methods
Participants and sampling
Measures
Data analysis
Results
Sample characteristics
Variable | Total group | DMFT = 0 | DMFT≥1 | OR (95% CI) | No or mild dental anxiety | Severe dental anxiety | OR (95% CI) |
---|---|---|---|---|---|---|---|
Gender % | |||||||
Boys | 619 (53.4) | 369 (57.9) | 250 (47.9)* | 1 | 546 (54.7) | 73 (45.9)* | 1 |
Girls | 540 (46.6) | 268 (42.1) | 272 (52.1)* | 1.50 (1.19–1.89) | 453 (45.3) | 86 (54.1)* | 1.42 (1.02–1.99) |
Father’s education level % | |||||||
Elementary school | 84 (7.8) | 39 (6.6) | 45 (9.3) | 1 | 68 (7.3) | 16 (10.5) | 1 |
High school | 741 (68.7) | 400 (67.3) | 341 (70.3) | 0.74 (0.47–1.16) | 634 (68.5) | 107 (69.9) | 0.72 (0.40–1.28) |
College or above | 254 (23.5) | 155 (26.1) | 99 (20.4)* | 0.55 (0.34–0.91) | 224 (24.2) | 30 (19.6) | 0.57 (0.29–1.11) |
Mother’s education level % | |||||||
Elementary school | 128 (11.7) | 54 (8.9) | 74 (15.0)* | 1 | 108 (11.5) | 20 (12.9) | 1 |
High school | 740 (67.5) | 410 (67.9) | 330 (66.9) | 0.59 (0.40–0.86) | 633 (67.2) | 107 (69.0) | 0.91 (0.54–1.53) |
College or above | 229 (20.9) | 140 (23.2) | 89 (18.1)* | 0.46 (0.30–0.72) | 201 (21.3) | 28 (18.1) | 0.75 (0.41–1.40) |
Monthly family income % | |||||||
HK$15,000 or below | 183 (18.1) | 91 (16.3) | 92 (20.3) | 1 | 147 (16.9) | 35 (24.6)* | 1 |
HK$15,001 -50,000 | 688 (67.9) | 383 (68.5) | 305 (67.2) | 0.79 (0.57–1.09) | 595 (68.4) | 93 (65.5) | 0.66 (0.43–1.01) |
HK$50,001 or above | 142 (14.0) | 85 (15.2) | 57 (12.6) | 0.66 (0.43–1.03) | 128 (14.7) | 14 (9.9) | 0.46 (0.24–0.89) |
Tooth brushing behaviors % | |||||||
Once a day or less often | 372 (32.1) | 201 (31.6) | 171 (32.8) | 1 | 310 (31.0) | 61 (38.4) | 1 |
Twice or more a day | 787 (67.9) | 436 (68.4) | 351 (67.2) | 0.95 (0.74–1.21) | 689 (69.0) | 98 (61.6) | 0.72 (0.51–1.02) |
Flossing behavior % | |||||||
Never or less than once a week | 924 (79.7) | 503 (79.0) | 421 (80.7) | 1 | 790 (79.2) | 132 (83.0) | 1 |
At least once a week | 235 (20.3) | 134 (21.0) | 101 (19.3) | 0.47 (0.67–1.20) | 208 (20.8) | 27 (17.0) | 0.78 (0.50–1.21) |
Sugar consumption % | |||||||
Rare or less than once a week | 212 (18.3) | 509 (79.9) | 438 (83.9) | 1 | 191 (19.1) | 20 (12.6)* | 1 |
Several times a week or daily | 947 (81.7) | 128 (20.1) | 84 (16.1) | 1.30 (0.97–1.78) | 807 (80.9) | 139 (87.4)* | 1.64 (1.00–2.70) |
Annual dental visit % | |||||||
No | 889 (76.7) | 478 (75.0) | 411 (78.7) | 1 | 724 (74.9) | 127 (82.5)* | 1 |
Yes | 270 (23.3) | 159 (25.0) | 111 (21.3) | 0.81 (0.62–1.08) | 243 (25.1) | 27 (17.5)* | 0.63 (0.41–0.98) |
Variable | Total group | DMFT = 0 | DMFT ≥1 | p | No or mild dental anxiety | Severe dental anxiety | p |
Perceived susceptibility (Mean ± SD)a | 2.7 ± 0.9 | 2.5 ± 0.9 | 2.8 ± 0.9 | < 0.001 | 2.6 ± 0.9 | 2.9 ± 0.9 | < 0.01 |
Perceived severity (Mean ± SD)a | 3.7 ± 0.9 | 3.7 ± 0.9 | 3.7 ± 0.9 | 0.24 | 3.7 ± 0.9 | 3.8 ± 0.8 | 0.03 |
Perceived benefits (Mean ± SD)a | 3.7 ± 0.6 | 3.7 ± 0.6 | 3.7 ± 0.6 | 0.54 | 3.7 ± 0.6 | 3.7 ± 0.6 | 0.65 |
Perceived barriers (Mean ± SD)a | 2.3 ± 0.8 | 2.2 ± 0.8 | 2.4 ± 0.8 | 0.001 | 2.2 ± 0.8 | 2.4 ± 0.8 | 0.02 |
Cues to action (Mean ± SD)a | 2.1 ± 0.9 | 2.1 ± 0.9 | 2.1 ± 0.9 | 0.90 | 2.1 ± 0.9 | 2.0 ± 0.9 | 0.22 |
Self-efficacy (Mean ± SD)a | 3.5 ± 1.0 | 3.5 ± 1.0 | 3.4 ± 1.0 | 0.27 | 3.5 ± 1.0 | 3.3 ± 1.0 | < 0.05 |
General anxiety score (Mean ± SD)a | 4.8 ± 5.2 | – | – | – | 4.4 ± 5.0 | 7.4 ± 5.5 | < 0.001 |
Variable | Total group | DMFT = 0 | DMFT ≥1 | OR (95% CI) | No dental anxiety | Dental anxiety | OR (95% CI) |
Oral health (DMFT) % | |||||||
DMFT = 0 | 637 (55.0) | – | – | – | 569 (57.0) | 67 (42.1)* | 1 |
DMFT ≥1 | 522 (45.0) | – | – | – | 439 (43.0) | 92 (57.9)* | 1.82 (1.30–2.56) |
Model 1 (POR, 95% CI) | Model 2 (POR, 95% CI) | Model 3 (POR, 95% CI) | Model 4 | Model 5 (POR, 95% CI) | |
---|---|---|---|---|---|
Perceived susceptibility | 1.44 (1.25–1.65)* | 1.36 (1.16–1.59)* | 1.39 (1.21–1.61)* | 1.42 (1.24–1.63)* | 1.31 (1.12–1.54)* |
Perceived severity | 1.00 (0.87–1.15) | 0.94 (0.80–1.11) | 1.01 (0.87–1.16) | 0.98 (0.85–1.14) | 0.92 (0.78–1.09) |
Perceived benefits | 0.98 (0.79–1.20) | 1.05 (0.83–1.33) | 0.97 (0.79–1.20) | 0.98 (0.79–1.20) | 1.05 (0.83–1.33) |
Perceived barriers | 1.16 (0.97–1.39) | 1.16 (0.95–1.42) | 1.15 (0.95–1.39) | 1.13 (0.95–1.36) | 1.16 (0.93–1.44) |
Cues to action | 0.96 (0.84–1.10) | 1.00 (0.86–1.17) | 0.98 (0.85–1.13) | 0.97 (0.85–1.12) | 1.02 (0.87–1.19) |
Self-efficacy | 1.02 (0.89–1.15) | 1.00 (0.87–1.16) | 1.01 (0.88–1.16) | 1.02 (0.90–1.16) | 1.00 (0.86–1.17) |
Sex | |||||
Boy | – | 1 | – | 1 | |
Girl | – | 1.63 (1.25–2.12)* | – | 1.64 (1.24–2.17)* | |
Father’s education level | |||||
Elementary school | – | 1 | – | 1 | |
High school | – | 0.76 (0.46–1.25) | – | 0.73 (0.44–1.21) | |
College or above | – | 0.66 (0.37–1.21) | – | 0.64 (0.35–1.17) | |
Mother’s education level | |||||
Elementary school | – | 1 | – | 1 | |
High school | – | 0.58 (0.38–0.89)* | – | 0.58 (0.38–0.91)* | |
College or above | – | 0.56 (0.32–0.98)* | – | 0.54 (0.31–0.96)* | |
Family income per month | |||||
HK$15,000 or below | – | 1 | – | 1 | |
HK$15,001 -50,000 | – | 1.00 (0.69–1.43) | – | 1.02 (0.71–1.49) | |
HK$50,001 or above | – | 1.01 (0.61–1.68) | – | 1.07 (0.64–1.79) | |
Tooth brushing behavior | |||||
Once a day or less often | – | – | 1 | 1 | |
Twice or more a day | – | – | 0.96 (0.73–1.28) | 0.94 (0.68–1.30) | |
Flossing behavior | |||||
Never or less than once a week | – | – | 1 | 1 | |
At least once a week | – | – | 0.99 (0.73–1.35) | 1.01 (0.71–1.42) | |
Sugar consumption | |||||
Rare or less than once a week | – | – | 1 | 1 | |
Several times a week or daily | – | – | 1.23 (0.69–1.26) | 1.09 (0.75–1.57) | |
Annual dental visit | |||||
No | – | – | 1 | 1.08 (0.76–1.53) | |
Yes | – | – | 0.93 (0.69–1.26) | ||
Dental anxiety level | |||||
No or mild | 1 | 1 | |||
Severe | 1.66 (1.17–2.35)* | 1.51 (1.03–2.21)* | |||
−2 Log likelihood | 1558 | 1261 | 1508 | 1549 | 1218 |
Nagelkerke R2 | 0.042 | 0.072 | 0.042 | 0.051 | 0.080 |
Model 1 (POR, 95% CI) | Model 2 (POR, 95% CI) | Model 3 (POR, 95% CI) | Model 4 (POR, 95% CI) | Model 5 (POR, 95% CI) | Model 6 (POR, 95% CI) | |
---|---|---|---|---|---|---|
Perceived susceptibility | 1.31 (1.07–1.59)* | 1.38 (1.11–1.72)* | 1.27 (1.04–1.56)* | 1.25 (1.02–1.53)* | 1.26 (1.03–1.54)* | 1.27 (1.01–1.60)* |
Perceived severity | 1.34 (1.08–1.66)* | 1.40 (1.09–1.78)* | 1.39 (1.11–1.73)* | 1.35 (1.08–1.68)* | 1.25 (1.00–1.56)* | 1.38 (1.07–1.78)* |
Perceived benefits | 1.02 (0.76–1.37) | 1.00 (0.73–1.38) | 0.97 (0.72–1.32) | 1.02 (0.75–1.37) | 1.01 (0.74–1.37) | 0.93 (0.66–1.30) |
Perceived barriers | 1.36 (1.06–1.73)* | 1.29 (0.98–1.70) | 1.30 (0.99–1.70) | 1.34 (1.04–1.71)* | 1.33 (1.04–1.71)* | 1.17 (0.86–1.59) |
Cues to action | 0.85 (0.70–1.05) | 0.92 (0.74–1.15) | 0.89 (0.72–1.10) | 0.86 (0.70–1.05) | 0.88 (0.72–1.09) | 0.97 (0.77–1.22) |
Self-efficacy | 0.89 (0.74–1.06) | 0.88 (0.72–1.08) | 0.95 (0.77–1.16) | 0.89 (0.74–1.06) | 0.95 (0.79–1.14) | 1.06 (0.84–1.33) |
Sex | ||||||
Boy | – | 1 | – | – | – | 1 |
Girl | – | 1.30 (0.89–1.89) | – | – | – | 1.14 (0.76–1.70) |
Father’s education level | ||||||
Elementary school | – | 1 | – | – | – | 1 |
High school | – | 0.79 (0.42–1.50) | – | – | – | 0.87 (0.45–1.68) |
College or above | – | 0.76 (0.34–1.69) | – | – | – | 0.80 (0.35–1.81) |
Mother’s education level | ||||||
Elementary school | – | 1 | – | – | – | 1 |
High school | – | 1.36 (0.75–2.48) | – | – | – | 1.50 (0.80–2.80) |
College or above | – | 1.30 (0.58–2.87) | – | – | – | 1.75 (0.77–4.01) |
Family income per month | ||||||
HK$15,000 or below | – | 1 | – | – | – | 1 |
HK$15,001 -50,000 | – | 1.09 (0.76–1.57) | – | – | – | 0.76 (0.47–1.22) |
HK$50,001 or above | – | 1.02 (0.62–1.70) | – | – | – | 0.51 (0.24–1.09) |
Tooth brushing behavior | ||||||
Once a day or less often | – | – | 1 | – | – | 1 |
Twice or more a day | – | – | 0.76 (0.51–1.13) | – | – | 0.63 (0.40–0.99)* |
Flossing behavior | ||||||
Never or less than once a week | – | – | 1 | – | – | 1 |
At least once a week | – | – | 0.97 (0.62–1.54) | – | – | 0.97 (0.58–1.61) |
Sugar consumption | ||||||
Rare or less than once a week | – | – | 1 | – | – | 1 |
Several times a week or daily | – | – | 1.64 (0.98–2.75) | – | – | 1.53 (0.86–2.74) |
Annual dental visit | ||||||
No | – | – | 1 | – | – | 1 |
Yes | – | – | 0.77 (0.48–1.23) | – | – | 0.76 (0.44–1.29) |
Oral health | ||||||
DMFT = 0 | – | – | – | 1 | – | 1 |
DMFT≥1 | – | – | – | 1.66 (1.17–2.35)* | – | 1.58 (1.07–2.35)* |
General anxiety | – | – | – | – | 1.09 (1.06–1.12)* | 1.07 (1.04–1.11)* |
−2 Log likelihood | 899 | 757 | 864 | 890 | 1441 | 1151 |
Nagelkerke R2 | 0.043 | 0.065 | 0.053 | 0.056 | 0.090 | 0.113 |
Path analysis modeling
Effects | Standardized path coefficient (β) | Unstandardized path coefficient | SE | 95% CI | Bootstrapping p | R2 |
---|---|---|---|---|---|---|
Oral health behaviors | ||||||
Perceived susceptibility | −0.07 | −0.07 | 0.03 | −0.12 to −0.00 | 0.04 | 0.14 |
Perceived severity | −0.01 | −0.01 | 0.03 | − 0.08 to 0.05 | 0.72 | |
Perceived benefits | 0.06 | 0.09 | 0.05 | −0.01 to 0.17 | 0.08 | |
Perceived barriers | −0.21 | −0.25 | 0.04 | −0.33 to − 0.17 | < 0.01 | |
Cues to action | 0.08 | 0.08 | 0.03 | 0.02 to 0.13 | 0.01 | |
Self-efficacy | 0.23 | 0.20 | 0.03 | 0.15 to 0.25 | < 0.01 | |
Oral health (DMFT) | ||||||
Oral health behaviors | −0.05 | −0.08 | 0.06 | −0.20 to 0.04 | 0.09 | 0.04 |
Perceived susceptibility | 0.17 | 0.30 | 0.18 | −0.06 to 0.66 | 0.16 | |
Dental anxiety | ||||||
Perceived susceptibility | 0.07 | 0.56 | 0.24 | 0.05 to 1.03 | 0.03 | 0.14 |
Perceived severity | 0.09 | 0.72 | 0.23 | 0.31 to 1.18 | < 0.01 | |
General anxiety | 0.32 | 0.44 | 0.04 | 0.36 to 0.52 | < 0.01 | |
Oral health (DMFT) | 0.07 | 0.28 | 0.13 | 0.04 to 0.54 | 0.02 | |
Oral health behaviors | −0.09 | −0.74 | 0.23 | −1.18 to −0.30 | < 0.01 |