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This study evaluated the effect of dental education on oral health-related attitudes and behavior of students in a five-year dental program in Peru. A survey using the Hiroshima University-Dental Behavioral Inventory (HU-DBI), which consists of twenty dichotomous responses (agree-disagree) regarding oral health behavior and attitudes, was completed by Year 1 and Year 5 dental students at the Universidad Inca Garcilaso de la Vega in Lima, Peru. A total of 153 Year 1 students and 120 Year 5 students responded to the Spanish version of the HU-DBI questionnaire. The data were analyzed using chi-square tests and logistic regression analyses. Compared to the Year 1 students, the Year 5 dental students were more likely to agree with questions such as "I think I can clean my teeth well without using toothpaste" (OR=0.24, 95% CI: 0.10-0.58); "I have used a dye to see how clean my teeth are" (OR=0.19, 95% CI: 0.10-0.36); and "I have had my dentist tell me that I brush very well" (OR=0.34, 95% CI: 0.17-0.69). Overall, the data showed that the curriculum in this dental school in Peru resulted in more positive oral health-related attitudes and behavior among Year 5 dental students compared to those of Year 1 dental students.

The aim of this study was to use the Hiroshima University - Dental Behavioral Inventory (HU-DBI) to compare oral health attitudes and behavior of dental and civil engineering students in Colombia. The HU-DBI's survey consisting of twenty dichotomous responses (agree-disagree) regarding tooth brushing, was completed at University Antonio Narino for the dental students and the University of Cauca for the civil engineering students. The Spanish version of the HU-DBI questionnaire was taken by 182 of 247 dental students and 411 of 762 engineering students. The data was-statistically analyzed by the chi-square test and backward logistic regression. Compared to the engineering students, the dental students were more likely to agree with questions such as "I am bothered by the color of my gums"(OR = 2.2, 95% CI: 1.3-3.7),"I think I can clean my teeth well without using toothpaste" (OR = 3.0, 95% CI: 1.5-5.9), "I have used a dye to see how clean my teeth are" (OR = 2.9, 95% CI: 1.9-4.3), and "I have had my dentist tell me that I brush very well" (OR = 2.0, 95% CI: 1.3-3.1). The dental education curriculum in a dental school compared to a civil engineering school in Colombia indicated that a three-phase curriculum in didactics and clinics increased oral health attitudes and behavior from entry to graduation.

Purpose: The PRECEDE-PROCEED (P-P) model is a framework for designing health education/promotion programmes. While the P-P model has been used to design community-based oral health programmes, outcome assessments of the model are seldom reported. The aim of the present study was to explore whether pathways in the P-P model accurately reflect the current status of environmental/behavioural assessment in a Japanese community and to examine whether using the linear structural relations (LISREL) programme would improve the model., Materials and Methods: In a community health centre in Japan, a questionnaire with 29 items regarding oral health was distributed to 824 mothers with 3-year-old children. The items were compiled into eight variables that were tested using the LISREL programme. Goodness-of-fit index (GFI), adjusted goodness-of-fit index (AGFI) and root mean square error of approximation (RMSEA) were statistically analysed before and after P-P model modification., Results: The GFI, AGFI and RMSEA were 0.913, 0.776 and 0.161 before, and 0.975, 0.939 and 0.075 after P-P model modification, respectively. Indirect effects on the quality of life from the predisposing, reinforcing and enabling factors became stronger than those in the initial P-P model. The overall fit of the modified P-P model was significantly better than that of the P-P model without modification, which did not accurately reflect the status of environmental/behavioural assessment in the community., Conclusions: The modified P-P model reflected the current status of environmental/behavioural assessment in the community. Health education models should be tested rigorously to ensure that they fit the reality of people's behaviour.

Objective: To explore and describe international oral health attitudes/ behaviours among final year dental students., Methods: Validated translated versions of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) questionnaire were administered to 1,096 final-year dental students in 17 countries. Hierarchical cluster analysis was conducted within the data to detect patterns and groupings., Results: The overall response rate was 72%. The cluster analysis identified two main groups among the countries. Group 1 consisted of twelve countries: one Oceanic (Australia), one Middle-Eastern (Israel), seven European (Northern Ireland, England, Finland, Greece, Germany, Italy, and France) and three Asian (Korea, Thailand and Malaysia) countries. Group 2 consisted of five countries: one South American (Brazil), one European (Belgium) and three Asian (China, Indonesia and Japan) countries. The percentages of 'agree' responses in three HU-DBI questionnaire items were significantly higher in Group 2 than in Group 1. They include: "I worry about the colour of my teeth."; "I have noticed some white sticky deposits on my teeth."; and "I am bothered by the colour of my gums.", Conclusion: Grouping the countries into international clusters yielded useful information for dentistry and dental education.

Objective: To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students., Design: Cross-cultural survey of dental students., Setting: 18 cultural areas., Participants and Methods: 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., Results: 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)., Conclusions: Grouping the countries into key cultural orientations and international clusters yielded plausible results, using the HU-DBI.

Objective: To compare cross-national differences of dental health behaviour among dental hygiene students., Design: Cross-cultural differences., Setting: United States (USA) and Korea., Subjects and Methods: 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)., Results: 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., Conclusions: 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.

Objective: To clarify the differences in dental health attitudes/behaviour among freshman dental students., Design: Cross-cultural differences., Setting: Japan, Hong Kong and West China., Participants and Methods: 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., Results: 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)., Conclusions: There were considerable differences in dental health attitudes/behaviour among freshman dental students in the three cultural groups.

The purpose of this study was to examine oral health attitudes/behavior and gingival self-care levels of Korean dental hygiene students (n = 271). A questionnaire known as HU-DBI (Korean version) was administered to each class. Higher scores of the HU-DBI indicate better oral health attitudes/behavior. The student's gingival self-care level was scored as excellent (+2), good (+1), questionable (0), poor (-1), or very poor (-2) according to the criteria of the Oral Rating Index (ORI) for youth. The mean score of the HU-DBI was 6.40, and that of the ORI was +0.12. Most samples scored 0 or +1. The mean HU-DBI scores of year-2 and year-3 students (7.06, and 7.61 respectively) were significantly greater than that of year-1 students (5.23) (P<0.001). Twenty-three percent of the students reported a belief that they may eventually require false teeth. Half stated that they put off going to the dentist until they had toothache. Year-1 students were more likely to have this attitude compared to year-3 students. HU-DBI scores were significantly associated with ORI scores (r = 0.315; P<0.001). The differences in the HU-DBI and ORI scores across the level of education were highly significant.