Gender variations in determinants of oral hygiene behavior:A secondary analysis based on the theory of planned behavior

Objectives: The aim of this secondary analysis was to investigate gender variations related to oral hygiene behavior (OHB), i.e., gender differences in the level of OHB, gender differences in the psychological factors as defined by the expanded Theory of Planned Behavior (expanded TPB), and gender differences in the relationships between the psychological factors and OHB. Methods: Using questionnaires in seven populations, 955 adult participants-274 males and 681 females-were asked about their OHB, and the determinants of OHB, including attitudes (ATT), social norms (SN), perceived behavioral control (PBC), oral health knowledge (OHK), and expected social outcomes for having healthy teeth (ESO). Results: No significant differences were found. In some samples, females reported a better OHB, and in one sample a more positive attitude than males. No interaction effects between gender and the determinants on OHB were found. Exploratory regression analyses revealed only a few variations in predictors of OHB between males and females, in that for males SN, ESO and PBC are relatively important determinants of OHB, whereas among females attitude and OHK are relevant. Conclusions: All analyses considered, no consistent pattern was found and no decisive factor emerged. However, gender variations in OHB and in the determinants should be considered when designing practical recommendations for improving OHB. Insight in gender variations is relevant to refine preventive approaches to modify OHB for male and female in the desired direction. There is a need of further experimental research in this area for the development of tailored oral hygiene interventions.