Oral Hygiene Behavior Among Asylum Seekers and Refugees Using Health Beliefs Model: A Cross-Sectional Study

Objectives: This study examined oral hygiene behavior (OHB) and Health Belief Model-based (HBM) determinants among asylum seekers and refugees (ASR). Methods: Cross-sectional survey data from 300 Arabic-speaking ASRs in Switzerland were analyzed for associations of two OHB outcomes (Adequate: toothbrushing twice a day; interdental cleaning at least each other day) with HBM-based explanatory variables. Mixed logistic regression models were used, adjusting for age, sex, education, and household. Results: Inadequate-OHB was common (toothbrushing: 47%; interdental cleaning: 65%). ASRs reporting higher self-efficacy under stress, more likely reported adequate-OHB (toothbrushing: odds ratio (95% confidence interval) 2.93 (0.68,12.70); interdental cleaning: 3.10 (2.28,4.22). Barriers (anticipating pain or breakage, lack of time, limited knowledge) were associated with reduced likelihood of adequate-OHB (interdental cleaning: don't know how: 0.76 (0.61, 0.95)). Benefits were associated with adequate interdental cleaning (making mouth feel better: 1.61 (1.14, 2.27); saving money later: 1.36 (1.01; 1.82)). The likelihood of adequate toothbrushing increased with autonomy (control of decisions on one's dental health: 1.40 (0.91, 2.17)). Conclusion: Self-efficacy, autonomy, barriers and benefits may be key OHB determinants among ASRs, but need testing in intervention studies.