Predicting Tooth Brushing Behavior among Students in Guilan, North of Iran: An Application of the Theory of Planned Behavior

Background Oral health is one of the key elements of quality of life and welfare. The aim of this study was to investigate the role of the Theory of Planned Behavior (TPB) as predictors of dental brushing behavior among Iranian adolescents. Materials and Methods: This cross-sectional study was carried out on 791 students in Guilan province, Iran, during the year 2018. The participants were selected through the multi-stage random sampling method. The data collection tool was a self-administered questionnaire designed based on TPB. The validity and reliability of the scale were assessed and confirmed. The data were analyzed using linear and logistic regression models in SPSS software version 21.0. Results: Nearly half of the assessed students were girls (49.6%, n=392/791). In total, 363 students (45.9%) brushed their teeth once or more daily. The TPB constructs accounted for 28% of the variance of intention to teeth brushing. Multiple logistic regression showed that one-point increase in scores of attitude, perceived behavioral control (PBC), and subjective norms, led to 10%, 12%, and 3% increase in the odds of daily teeth brushing respectively. Moreover, one-point increase in behavioral intention increased the odds of daily teeth brushing 2.24 fold. Conclusion Based on the results, the level of oral health practice was unfavorable among most of Guilan high school students compared to similar studies in the world. It seems designing and implementing educational interventions based on TPB constructs especially variables of perceived behavioral control and attitude, could result in optimal activities regarding oral health care among students.