Professional Documents
Culture Documents
The determinants of
dental health attitudes
and behaviours
Ruth Freeman1
The development and evolution of health attitudes and behaviours throughout a persons life
has been called a health career. A health career
provides the health professional with:
...a description of the ways in which an individuals attitudes to a health issue develop
over time.7
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PRACTICE
16
The importance of school based health education, nevertheless, has been recognised as a
means of helping children develop their own
health care attitudes and behaviours. The
importance placed upon peers as advocates in
this regard has been successfully used in childto-child teaching programmes.11 These programmes recognise the value of peers as a
means of providing dental health information
to other, usually younger children. In the peer
group teaching scenario the older child not
only gains a greater understanding of the needs
of younger children but also develops his/her
own dental health care skills
As time progresses the child enters preadolescence and adolescence.13 During preadolescence and adolescence more and more
friendships are made with people outside the
home. The shift from parents and family to
friends and peers is mirrored by a change in
dental health care attitudes and behaviours.
Difficulties arise when the adolescents wishes
are opposed by those of the parent. Recent
research examining non-compliance with
orthodontic care has clearly shown that it is the
conflict between parent and adolescent which
influences the success of continuing orthodontic treatment.12
Case 3 illustrates how conflict between a
mother and her son affected compliance.What
can be learnt from Ms Hs experience with
Keith? First, Keith had not chosen to return to
complete his orthodontic treatment that
had been mothers decision. Secondly, he was
PRACTICE
17
PRACTICE
During an oral examination, the dentist commented that the student hygienist had a
localised area of gingivitis. The young
woman became upset and stated, This is
dreadful! Gingivitis in my mouth, where is it!
I must see! It must be attended to immediately,I cant be brushing properly.
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The third process associated with professionalisation affects society at large. It does
this through its power and influence. The
power is also connected to the knowledge and
training on which the work of the profession is
based. Dentistry has gained a monopoly over
an area of expertise and the right to self-determination. The recognition of this expertise
and knowledge by society affords members of
the profession a place within society which
influences their dental health attitudes and
behaviour.
Tertiary socialisation and social norms
Societal attitudes or social norms affect attitudes towards dental health. At a society level,
for instance, public attitudes towards water fluoridation, has effectively reduced the availability of fluoride in the public water supplies.
Social norms, can be considered as expressions of the beliefs and attitudes of people who
belong to a particular social group. In this sense
social norms not only afford a cohesiveness to
the group but also permit it to have a sense of
identity. It is this identity which gives the group
its characteristics. Dental health promotion
strategies which are targeted at groups of people,
in what has been termed the settings approach,
acknowledges the importance of social norms as
a salient element in behaviour change.
It has been suggested that social norms have a
tenacity of their own. Nevertheless, they may be
gradually modified with time and between generations or change abruptly with social mobility. For example, social norms can be gradually
modified within a three generation family with
the attitudes of grandparents being quite different to those of their grandchildren. Social
mobility, in terms of movement through socioeconomic groups, has been shown to affect
dental health attitudes and behaviour in an
abrupt way. Social mobility via marriage has
been shown to provide the impetus for changes
in dental health care actions being associated
with changing social norms.15
Conclusions