The relationship between self-efficacy and oral health status of older adults

Abstract

Objectives: The objectives of this study were to determine the relationship between reported self-efficacy and dental status in older adults, identify factors which might influence self-efficacy and, their willingness to pay (WTP) for preventive care.

Methods: Participants aged 60-90 years of age living in Singapore were recruited. All participants completed an oral health questionnaire and a clinical examination. Details of participants' socio-economic status and educational attainment were collected, and participants also answered a range of questions related to self-efficacy, oral health attitudes, beliefs and dental attendance patterns. Participants were asked to indicate their willingness to pay for preventive care using contingent valuation. The clinical examination recorded decayed, missing and filled teeth [DMFT], root caries, periodontal attachment loss, bleeding on probing index, occlusal status and, denture wearing status. Associations between self-efficacy, self-report and clinical variables were assessed using Kendall's Tau B coefficient.

Results: 614 participants [mean age 68.07 (5.99) years] were recruited. There was a high level of dental awareness and nearly 70% of the participants reported visiting a dentist once or twice a year. Self-efficacy was associated with levels of bleeding on probing and self-reported satisfaction with oral health. Nearly 60% of participants were not willing to pay for preventive advice from an oral healthcare professional.

Conclusion: Older adults with a high level of self-efficacy had good gingival health, with low reported levels of bleeding on probing. Participants with low reported self-efficacy had higher disease levels and were less satisfied with their oral health.

Clinical significance: Self-efficacy in relation to oral hygiene practices is variable, and participants with low self-efficacy had higher gingival bleeding scores. However, willingness to pay for preventive advice is low, and further work is required to increase the value proposition of preventive care to older adults.

Keywords: Attitudes; Geriatric; Oral health; Self-efficacy; Willingness to pay.