Keywords
Dental students - Hiroshima University Dental Behavioural Inventory - medical students
- nursing students - oral health behavior
Introduction
Oral health is a vital part of general health and hence affects the total well-being.
The individual’s perception on oral health is reflected by their oral health attitudes
and behaviors.[[1]] Dental students, who will be our future dental care providers, are expected to
have good attitude and behavior toward their own oral health.[[2]],[[3]] Furthermore, as dentists, they will be role models for their patients, friends,
and family members.
The oral health conditions of the population are expected to be better when the dentists
themselves are motivated.[[4]],[[5]],[[6]] In addition, the quality of oral health-care services provided is greatly affected
by the attitude and behavior of the provider toward his or her own oral health.[[7]] Research on dental students in various parts of the world has shown that level
of clinical training also had an impact on the student’s attitude and behavior toward
oral health. Furthermore, students from different countries, ethnic origin, and course
of study demonstrated differences in their attitudes and behavior as well.[[8]],[[9]],[[10]]
Most studies evaluating the oral health attitudes and behaviors, conducted in different
parts of the world mainly focused on dental students.[[2]],[[3]],[[6]],[[8]],[[11]],[[12]],[[13]] Even though some studies also compared the attitudes and behavior of dental students
and students studying pharmacy,[[14]] medicine,[[5]] paramedical sciences,[[5]] and other professional courses [[10]] in various parts of the world. To the best of our knowledge, there was insufficient
data about the oral health attitudes of dental, medical, and nursing students from
this region of Malaysia.
Besides, dental students, students from the allied health streams are also supposed
to have better oral health knowledge and behavior.[[15]] It is well known that poor oral and periodontal health can lead to or worsen various
medical conditions, such as diabetes mellitus, respiratory disorders, cardiovascular
disease, and other systemic disorders.[[16]] Thus, by determining the oral health attitudes and behavior of various health-care
students, effective steps can be undertaken to improve or instil positive oral health
attitudes and behavior in all our future health-care providers. Thus, the aim of this
study was to determine and compare the oral health attitudes and behaviors of dental,
medical, and nursing students at Universiti Sains Malaysia (USM) Health Campus, Kelantan,
Malaysia.
Methods
The study was conducted at USM Health Campus. It was a cross-sectional survey involving
all students from dental, medical, and nursing schools that were attending the university
during the study. Ethical approval for carrying out the study was obtained from the
Human Research Ethics Committee USM (Ref.USM/JEPeM/16030106). A modified bilingual
(English and Bahasa Melayu) version of Hiroshima University– Dental Behavioral Inventory
(HU-DBI) questionnaire [Annexure 1] [SUPPORTING:1] was distributed to 1166 students
in dental, medical, and nursing schools. Participation was voluntary, and no personal
information was recorded. Demographic data such as gender, age, race, and school were
collected. Questionnaires that were unfilled or partly filled were excluded from the
study.
HU-DBI score was calculated using responses to 12 HU-DBI items in the questionnaire
[[Table 1]]. Items 4, 9, 11, 12, 16, and 19 with agree responses were given a point, whereas,
items 2, 6, 8, 10, 14, and 15 with disagree responses were given a point. Maximum
HU-DBI score that could be achieved was 12 while these 12 items appear to be directly
related to the oral health behavior, the remaining 8 statements were not included
in the analysis as they reflect general oral health-related attitude [[Table 1]].
Table 1:
Items in Hiroshima University-Dental Behavioural Inventory Questionnaire (correct
answer, agree [A], disagree [D])
|
1. I don't worry about visiting the dentist
2. My gums tend to bleed when I brush my teeth (D)
3. I worry about the colour of my teeth
4. I have noticed some white sticky deposits on my teeth (A)
5. I use a child-sized toothbrush
6. I think that I cannot help having false teeth when I am old (D)
7. I am bothered by the colour of my gums
8. I think my teeth are getting worse despite my daily brushing (D)
9. I brush each of my teeth carefully (A)
10. I have never been taught professionally how to brush (D)
11. I think I can clean my teeth well without using toothpaste (A)
12. I often check my teeth in a mirror after brushing (A)
13. I worry about having bad breath
14. It is impossible to prevent gum disease with tooth brushing alone (D)
15. I put off going to the dentist until I have toothache (D)
16. I have used a dye to see how clean my teeth are (A)
17. I use a toothbrush which has hard bristles
18. I don't feel I've brushed well unless with strong strokes
19. I feel I sometimes take too much time to brush my teeth (A)
20. I have had my dentist tell me that I brush very well
|
Statistical analysis
HU-DBI scores of students from three schools were compared using one way ANOVA complemented
by Bonferroni test whereas comparison of HU-DBI scores of students based on their
clinical level was carried out using independent t-test. Chi-square test was carried out to evaluate the differences in distribution
of all items in the HU-DBI survey by school and clinical level. Statistical significance
level was set at P < 0.05.
Results
Out of 1166 students, 1053 students participated in this study (90.3% response rate).
Medical school students consisted of 62.3% of the respondents while students from
the dental and nursing schools were 24.0% and 13.7%, respectively. Out of all the
respondents, 553 were in their preclinical years (52.5%) whereas 500 students belonged
to clinical years (47.5%).
[[Table 2]] and [[Table 3]] summarize the comparison of HU-DBI scores between students based on their schools
and clinical levels. Dental students had the highest mean HU-DBI score (7.79 ± 1.58)
when compared to their nursing (6.99 ± 1.46) and medical (6.42 ± 1.58) counterparts.
Mean scores of students from each school were significantly different from the other
as summarized in [[Table 4]]. The mean HU-DBI score for clinical students from all 3 schools (7.04 ± 1.75) was
significantly higher than those in their preclinical years (6.64 ± 1.56). Comparison
of HU-DBI scores between preclinical students from the three schools using the post hoc Bonferroni test depicts a significant difference in HU-DBI score of preclinical medical
students as compared to dental and nursing students (P ≤ 0.05) whereas there are no significant differences in HU-DBI score between nursing
and dental preclinical students (P > 0.05). On the other hand, clinical dental students had a significantly higher mean
HU-DBI score when compared to their medical and nursing counterparts (P ≤ 0.05). However, the mean HU-DBI scores of medical and nursing clinical students
were not significantly different from each other (P > 0.05). These results are tabulated in [[Table 5]] and [[Table 6]].
Table 2:
Post hoc Bonferroni test comparing Hiroshima University-Dental Behavioural Inventory scores
of all students from medical, dental and nursing schools
|
Course (I)
|
Course (J)
|
Mean difference (I-J)
|
SE
|
P
|
95%, CI
|
|
|
|
|
|
Lower bound
|
Upper bound
|
|
Medical
|
Dental
|
–1.373[*]
|
0.116
|
<0.001[*]
|
-1.65
|
-1.09
|
|
Nursing
|
–0.575[*]
|
0.144
|
<0.001[*]
|
-0.92
|
-0.23
|
|
Dental
|
Nursing
|
0.797[*]
|
0.164
|
<0.001[*]
|
0.40
|
1.19
|
* Statistically significant (P < 0.05). SE – Standard error, CI – Confidence interval
Table 3:
Independent t-test comparing the mean Hiroshima University-Dental Behavioural Inventory scores
of participants based on their clinical years
|
Clinical level
|
|
HU-DBI score
|
|
Mean±SD
|
Mean difference (95% CI)
|
t statistics (df)
|
P
|
|
Preclinical
|
6.64±1.563
|
–0.399 (−0.600–0.199)
|
–3.904 (1051)
|
<0.001[*]
|
|
Clinical
|
7.04±1.758
|
|
|
|
* Statistically significant (P < 0.05). SD – Standard deviation, HU-DBI – Hiroshima University-Dental Behavioural
Inventory
Table 4:
Results of one-way ANOVA test comparing the mean Hiroshima University-Dental Behavioural
Inventory scores of participants from all three schools
|
School
|
Mean±SD
|
F
|
P
|
|
Medical
|
6.42±1.58
|
70.90
|
<0.001[*]
|
|
Dental
|
7.79±1.58
|
|
|
|
Nursing
|
6.99±1.46
|
|
|
* Statistically significant (P < 0.05). SD – Standard deviation
Table 5:
Post hoc Bonferroni test comparing Hiroshima University-Dental Behavioural Inventory scores
of preclinical students from medical, dental and nursing schools
|
School (I)
|
School (J)
|
Mean difference (I–J)
|
SE
|
P
|
95% CI
|
|
|
|
|
|
Lower bound
|
Upper bound
|
|
Medical
|
Dental
|
–0.651[*]
|
0.175
|
0.001[*]
|
–1.07
|
–0.23
|
|
Nursing
|
–0.646[*]
|
0.191
|
0.002[*]
|
–1.10
|
–0.19
|
|
Dental
|
Nursing
|
0.006
|
0.234
|
1.000
|
–0.56
|
0.57
|
* Statistically significant (P < 0.05). SE – Standard error, CI – Confidence interval
Table 6:
Post hoc Bonferroni test comparing Hiroshima University-Dental Behavioural Inventory scores
of clinical students from medical, dental and nursing school
|
School (I)
|
School (J)
|
Mean difference (I–J)
|
SE
|
P
|
95% CI
|
|
|
|
|
|
Lower bound
|
Upper bound
|
|
Medical
|
Dental
|
–1.831[*]
|
0.156
|
<0.001[*]
|
–2.21
|
–1.46
|
|
Nursing
|
–0.495
|
0.213
|
0.062
|
–1.01
|
0.02
|
|
Dental
|
Nursing
|
1.337[*]
|
0.229
|
<0.001[*]
|
0.79
|
1.89
|
* Statistically significant (P < 0.05). SE – Standard error, CI – Confidence interval
The percentage and analysis of yes/no response to HU-DBI items are listed according
to schools as shown in [[Table 7]] and according to clinical levels as shown in [[Table 8]]. Among the 12 HU-DBI items that were used to calculate the HU-DBI scores, items
number 2,6,8,9,10,15,16, and 19 shows a significant difference between the distributions
of responses for the three schools (P ≤ 0.05). As for the distributions of responses between preclinical and clinical group,
a significant difference (P ≤ 0.05) was seen for items number 2, 4, 8, 11, 15, and 16.
Table 7:
Percentage and analysis of yes-no responses according to schools (n = 1053)
|
Item number
|
HU-DBI
|
Medical, n (%)
|
Dental, n (%)
|
Nursing, n (%)
|
P
|
|
1
|
Agree
|
514 (78.3)#
|
220 (86.9)
|
115 (79.8)
|
0.013
|
|
Disagree
|
142 (21.7)
|
33 (13.1)
|
29 (20.2)
|
|
|
2
|
Agree
|
183 (27.8)#
|
37 (14.6)s
|
37 (25.6)
|
<0.001
|
|
Disagree
|
473 (72.2)
|
216 (85.4)
|
107 (74.4)
|
|
|
3
|
Agree
|
469 (71.5)#
|
150 (59.2)s
|
119 (82.6)##
|
<0.001
|
|
Disagree
|
187 (28.5)
|
103 (40.8)
|
25 (17.4)
|
|
|
4
|
Agree
|
310 (47.2)
|
119 (47.0)
|
74 (51.3)
|
0.644
|
|
Disagree
|
346 (52.8)
|
134 (53.0)
|
70 (48.7)
|
|
|
5
|
Agree
|
44 (6.7)
|
8 (3.1)
|
9 (6.2)
|
0.118
|
|
Disagree
|
612 (93.3)
|
245 (96.9)
|
135 (93.8)
|
|
|
6
|
Agree
|
230 (35.0)#
|
55 (21.7)s
|
47 (32.6)
|
<0.001
|
|
Disagree
|
426 (65.0)
|
198 (78.3)
|
97 (67.4)
|
|
|
7
|
Agree
|
223 (33.9)#
|
59 (23.3)
|
43 (29.8)
|
0.007
|
|
Disagree
|
433 (66.1)
|
194 (76.7)
|
101 (70.2)
|
|
|
8
|
Agree
|
150 (22.8)#
|
20 (7.9)$
|
32 (22.2)
|
<0.001
|
|
Disagree
|
506 (77.2)
|
233 (92.1)
|
112 (77.8)
|
|
|
9
|
Agree
|
507 (77.2)#
|
227 (89.7)
|
124 (86.2)##
|
<0.001
|
|
Disagree
|
149 (22.8)
|
26 (10.3)
|
20 (13.8)
|
|
|
10
|
Agree
|
145 (22.1)#
|
16 (6.3)s
|
20 (13.8)##
|
<0.001
|
|
Disagree
|
511 (77.9)
|
237 (93.7)
|
124 (86.2)
|
|
|
11
|
Agree
|
74 (11.2)
|
18 (7.1)
|
11 (7.6)
|
0.108
|
|
Disagree
|
582 (88.8)
|
235 (92.9)
|
133 (92.4)
|
|
|
12
|
Agree
|
517 (78.8)
|
213 (84.1)
|
123 (85.4)
|
0.063
|
|
Disagree
|
139 (21.2)
|
40 (15.9)
|
21 (14.6)
|
|
|
13
|
Agree
|
520 (79.2)
|
211 (83.3)
|
123 (85.4)
|
0.131
|
|
Disagree
|
136 (20.8)
|
42 (16.7)
|
21 (14.6)
|
|
|
14
|
Agree
|
482 (73.4)
|
179 (70.7)
|
111 (77.0)
|
0.386
|
|
Disagree
|
174 (26.6)
|
74 (29.3)
|
33 (23.0)
|
|
|
15
|
Agree
|
358 (54.5)#
|
43 (16.9)s
|
66 (45.8)
|
<0.001
|
|
Disagree
|
298 (45.5)
|
210 (83.1)
|
78 (54.2)
|
|
|
16
|
Agree
|
110 (16.7)#
|
115 (45.4)s
|
31 (21.5)
|
<0.001
|
|
Disagree
|
546 (83.3)
|
138 (54.5)
|
113 (78.5)
|
|
|
17
|
Agree
|
117 (17.8)#
|
6 (2.3)$
|
24 (16.6)
|
<0.001
|
|
Disagree
|
539 (82.2)
|
247 (97.7)
|
120 (83.4)
|
|
|
18
|
Agree
|
257 (39.1)#
|
26 (10.2)'
|
51 (35.4)
|
<0.001
|
|
Disagree
|
399 (60.9)
|
227 (89.8)
|
93 (64.6)
|
|
|
19
|
Agree
|
280 (42.6)
|
100 (39.5)s
|
88 (61.1)##
|
<0.001
|
|
Disagree
|
376 (57.4)
|
153 (60.5)
|
56 (38.9)
|
|
|
20
|
Agree
|
283 (43.1)#
|
162 (64.0)
|
90 (62.5)##
|
<0.001
|
|
Disagree
|
373 (56.9)
|
91 (36.0)
|
54 (37.5)
|
|
Pearson Chi-square test was done to compare responses between medical and dental,
medical and nursing and dental and nursing. ##Statistically significant difference
with medical school (P < 0.05), #Statistically significant difference with dental school (P < 0.05), 'Statistically significant difference with nursing school (P < 0.05). HU-DBI – Hiroshima University-Dental Behavioural Inventory
Table 8:
Percentage and analysis of yes-no responses according to clinical levels (n = 1053)
|
Item number
|
HU-DBI
|
Preclinical, n (%)
|
Clinical, n (%)
|
P
|
|
1
|
Agree
|
451 (81.5)
|
398 (79.6)
|
0.423
|
|
Disagree
|
102 (18.5)
|
102 (20.4)
|
|
|
2
|
Agree
|
121 (21.8)
|
136 (27.2)
|
0.045*
|
|
Disagree
|
432 (78.2)
|
364 (72.8)
|
|
|
3
|
Agree
|
402 (72.6)
|
336 (67.2)
|
0.052
|
|
Disagree
|
151 (27.4)
|
164 (32.8)
|
|
|
4
|
Agree
|
239 (43.2)
|
264 (52.8)
|
0.002*
|
|
Disagree
|
314 (56.8)
|
236 (47.2)
|
|
|
5
|
Agree
|
22 (3.9)
|
39 (7.8)
|
0.008*
|
|
Disagree
|
531 (96.1)
|
461 (92.2)
|
|
|
6
|
Agree
|
169 (30.5)
|
163 (32.6)
|
0.477
|
|
Disagree
|
384 (69.5)
|
337 (67.4)
|
|
|
7
|
Agree
|
162 (29.2)
|
163 (32.6)
|
0.246
|
|
Disagree
|
391 (70.8)
|
337 (67.4)
|
|
|
8
|
Agree
|
87 (15.7)
|
115 (23.0)
|
0.003*
|
|
Disagree
|
466 (84.3)
|
385 (77.0)
|
|
|
9
|
Agree
|
444 (80.2)
|
414 (82.8)
|
0.295
|
|
Disagree
|
109 (19.8)
|
86 (17.2)
|
|
|
10
|
Agree
|
96 (17.3)
|
85 (17.0)
|
0.877
|
|
Disagree
|
457 (82.7)
|
415 (83.0)
|
|
|
11
|
Agree
|
37 (6.6)
|
66 (13.2)
|
<0.001*
|
|
Disagree
|
516 (93.4)
|
434 (86.8)
|
|
|
12
|
Agree
|
460 (83.1)
|
393 (78.6)
|
0.058
|
|
Disagree
|
93 (16.9)
|
107 (21.4)
|
|
|
13
|
Agree
|
442 (79.9)
|
412 (82.4)
|
0.306
|
|
Disagree
|
111 (20.1)
|
88 (17.6)
|
|
|
14
|
Agree
|
413 (74.6)
|
359 (71.8)
|
0.291
|
|
Disagree
|
140 (25.4)
|
141 (28.2)
|
|
|
15
|
Agree
|
279 (50.4)
|
188 (37.6)
|
<0.001*
|
|
Disagree
|
274 (49.6)
|
312 (62.4)
|
|
|
16
|
Agree
|
69 (12.4)
|
187 (37.4)
|
<0.001*
|
|
Disagree
|
484 (87.6)
|
313 (62.6)
|
|
|
17
|
Agree
|
73 (13.2)
|
74 (14.8)
|
0.455
|
|
Disagree
|
480 (86.8)
|
426 (85.2)
|
|
|
18
|
Agree
|
196 (35.4)
|
138 (27.6)
|
0.006*
|
|
Disagree
|
357 (64.6)
|
362 (72.4)
|
|
|
19
|
Agree
|
251 (45.3)
|
217 (43.4)
|
0.517
|
|
Disagree
|
302 (54.7)
|
283 (56.6)
|
|
|
20
|
Agree
|
258 (46.6)
|
277 (55.4)
|
0.005*
|
|
Disagree
|
295 (53.4)
|
223 (44.6)
|
|
Pearson Chi-square test was done. *P < 0.05, statistically significant. HU-DBI - Hiroshima University-Dental Behavioural
Inventory
Discussion
HU-DBI scores of individuals are directly related to their oral health behavior and
attitude.[[8]] Higher scores can be associated with better oral health-related attitude and behavior.
The mean HU-DBI scores of dental, medical, and nursing students from USM were higher
as compared to students from respective schools in the previous studies with mean
scores ranging from 4.74–7.33.[[6]],[[12]],[[13]],[[14]],[[17]],[[18]] However, within the three schools, dental students were the best in terms of mean
HU-DBI score as compared to their medical and nursing counterparts. Similarly, other
studies have also shown that dental students demonstrate higher mean HU-DBI scores
than students from other schools.[[5]],[[10]],[[14]] This is most likely attributed to the wide range of preventive dentistry and periodontics
lectures given to dental students during their studies. Furthermore, clinical students
in this study reported a better dental health attitude and behavior as compared to
preclinical students. Various studies have proposed that the students’ personal dental
health attitude and behavior are related intimately with their academic progression.[[2]],[[19]],[[20]]
In general, most of the students from all three schools in USM are not worried about
visiting the dentist. These results are similar to students from India and China.[[6]],[[13]] Despite that, it is notable that majority of dental students in this study reported
that they regularly visit the dentist as compared to their medical and nursing counterparts,
where only 45%–55% reported regular dental visit. This is consistent with a study
conducted on dental students in Croatia.[[12]] Dental students have more exposure to the dental clinics and dentists in general
as compared to their medical and nursing counterparts, thus experiencing less treatment
anxiety. A study conducted in Israel found that treatment anxiety is one of the main
factors of delayed dental visits until symptoms arise and could also be the reason
for the delayed visits by medical and nursing students.[[21]]
Surprisingly, fewer dental students are worried about the color of their teeth as
compared to their medical and nursing counterparts. This depicts that medical and
nursing students demonstrate a behavior which is similar to the general population,
wherein the presence of symptoms and/or concern for esthetics drive their dental behavior.[[22]] However, dental students are well versed with the agents used in tooth whitening
(bleaching) and understand the risks and benefits associated with various esthetic
treatments. Furthermore, clinical students are also less worried about the color of
their teeth as is reported in some studies.[[19]],[[23]] In addition, in this study, plaque deposits on their teeth were noticed by significantly
more number of clinical students than their preclinical counterparts. As expected,
clinical students have a higher awareness toward the microbial dental plaque due to
their education and clinical training experiences. This result was in contrast to
a study in Turkey,[[18]] where the clinical students fared worse than preclinical students. However, there
may have been a misinterpretation that this question was about cleanliness of teeth
rather than the awareness of plaque.
Regarding tooth brushing techniques, significantly higher number of dental and nursing
students reported that they brush each of their teeth carefully as compared to the
medical students. Likewise, almost all (93.7%) dental students agreed that the correct
brushing technique has been professionally taught to them, which is significantly
higher than students from the other two schools. Other studies have also observed
similar results.[[12]],[[17]] Moreover, when compared to dental students, significantly higher numbers of medical
and nursing students use a hard bristled toothbrush. This is in accordance to the
study done in China and Kingdom of Saudi Arabia.[[14]],[[24]] Again, this result can be attributed to dental health education, particularly the
periodontology and dental public health subjects which emphasize on toothbrush selection
and tooth brushing techniques for good oral hygiene.
Strength and limitations
The strength of this study includes the large sample size of health-care students
and the rigor of survey and questions which addresses in breadth various aspects of
oral health attitudes and behavior.
There are several limitations in this study. First, because this is a cross-sectional
study, any changes in HU-DBI scores cannot be attributed entirely toward the curricular
level. Furthermore, dental students are well versed with the correct dental health
behaviors and attitudes. Therefore, a bias may occur as these dental students may
not practice these behaviors in real life yet answer the questions correctly.
Implications for practice
The oral health of a patient is closely linked to their general health. Evidence suggests
that diabetes mellitus and periodontal disease have an adverse bidirectional interrelationship.[[16]] Furthermore, dental plaque can also serve as a reservoir of infection in hospital
inpatients.[[25]] These are among a few examples that highlight the importance of oral health status
relating to general health. This study shows that medical and nursing students did
not demonstrate good attitude and behavior toward their oral health. Therefore, there
needs to be an improvement in the oral health awareness for the medical and nursing
schools. It is crucial that these students improve their own awareness and thus can
provide comprehensive health-care services to their patients in the future. Furthermore,
when our future health-care providers are aware of the oral health-related problems
and its effects on the general health, they will refer patients to dentists in an
appropriate and timely manner.
Further studies can be implemented on the same students to properly determine the
impact of increased educational experience by correlating their dental health attitudes
and behaviors with their actual oral health status. In addition, further studies emphasizing
on gender and cultural differences of students in Malaysia regarding dental health
attitudes and behaviors can also be carried out.
Conclusion
Dental students demonstrated better oral health attitudes as compared to their medical
and nursing counterparts, which indicate the positive impact of dental health education
on these students. It is well known that oral health is closely related to general
health, thus, when our future health-care providers are aware of the effects of oral
health-related problems on general health, they will refer patients to dentists in
an appropriate and timely manner. Hence, comprehensive oral health awareness programs
need to be incorporated to all health-care students starting from their preclinical
years to improve the oral health attitudes of all our future health-care providers.
Annexure 1: A modified bilingual (English and Bahasa Melayu) version of Hiroshima
University – Dental Behavioral Inventory (HU-DBI) questionnaire
Hiroshima University-Dental Behavioral Inventory Inventori Tingkah Laku Pergigian
Universiti Hiroshima
|
Statement/ Penyata
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
1
|
I don't worry about visiting the dentist
Saya tidak bimbang untuk berjumpa doktor gigi
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
2
|
My gums bleed when I brush my teeth
Gusi saya berdarah apabila saya memberus gigi
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
3
|
I worry about the color of my teeth Saya risau tentang warna gigi saya
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
4
|
I have noticed some white sticky deposits on my teeth
Saya telah menjumpai beberapa deposit putih melekat pada gigi saya
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
5
|
I use a child-sized toothbrush
Saya mengguna berus gigi saiz kanak-kanak
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
6
|
I think I cannot help having false teeth when I am old
Saya berasa tidak dapat mengelakkan diri daripada memakai gigi palsu
apabila saya berumur
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
7
|
I am bothered by the color of my gums
Saya berasa terganggu dengan warna gusi saya
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
8
|
I think my teeth are getting worse despite my daily brushing
Saya berasa gigi saya menjadi semakin teruk walaupun memberus gigi
setiap hari.
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
9
|
I brush each of my teeth carefully Saya memberus setiap gigi dengan teliti
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
10
|
I have never been taught professionally how to brush
Saya tidak pernah diajar cara memberus gigi secara profesional
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
11
|
I think I can clean my teeth well without using toothpaste
Saya berasa bahawa saya boleh membersihkan gigi dengan baik tanpa
menggunakan ubat gigi
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
12
|
I often check my teeth in a mirror after brushing
Saya selalu memeriksa gigi dengan cermin selepas memberus gigi
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
13
|
I worry about having bad breath
Saya berasa bimbang tentang nafas berbau
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
14
|
It is impossible to prevent gum disease with toothbrushing alone
Ia adalah mustahil untuk mencegah penyakit gusi dengan memberus gigi
sahaja
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
15
|
I put off going to a dentist until I have a toothache
Saya melengahkan perjumpaan dengan doktor gigi sehingga saya
mengalami sakit gigi
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
16
|
I have used a dye to see how clean my teeth are
Saya pernah mengguna pewarna untuk lihat kebersihan gigi saya
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
17
|
I use a toothbrush with hard bristles
Saya menggunakan berus gigi berbulu keras
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
18
|
I don't feel I have brushed unless I brush with strong strokes Saya tidak berasa bahawa
saya telah memberus gigi sehingga saya memberus dengan gerakan memberus yang kuat
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
19
|
I feel I sometimes take too much time to brush my teeth
Saya berasa bahawa kadang kala saya mengambil masa yang terlalu
panj ang untuk memberus gigi
|
Agree Setuju
|
Disagree Tidak Setuju
|
|
20
|
I have had my dentist tell me that I brush very well
Doktor gigi pernah memberitahu saya bahawa saya memberus gigi
dengan baik
|
Agree Setuju
|
Disagree Tidak Setuju
|
