Oral Health Self-Management Ability and Its Influencing Factors among Adolescents with Fixed Orthodontics in China: A Mixed Methods Study

OBJECTIVE: To understand the oral health self-management ability status and influencing factors among adolescent patients with fixed orthodontics in Nanjing and to provide a reference for formulating targeted intervention measures. METHODS: A mixed research method was used. First, the convenience sampling method was used to select adolescent patients with fixed orthodontics admitted to the orthodontic department of a dental hospital in Nanjing from November 2021 to March 2022. The oral health self-management ability questionnaire was used for the investigation; then, 15 children with poor oral health management ability were selected for in-depth interviews. RESULTS: The total score of oral health self-management ability of 290 adolescent children with fixed orthodontics was 45.6-90.8 points, with an average score of 69.63 ± 7.40 of which knowledge, belief, and behavior dimension scores were 72.09 ± 10.47, 68.50 ± 10.13, and 67.63 ± 8.67, respectively, and the environmental score was 69.91 ± 12.50. Multiple regression analysis showed that sex, age, bracket wearing time, grade, and place of residence were related to the scores of each dimension of self-management. Qualitative research shows that the main reasons for the poor oral health self-management ability of adolescents with fixed orthodontics are the lack of awareness during fixed orthodontics, lack of knowledge channels, low compliance, inability to solve oral problems during treatment, difficulty in adhering to oral care behaviors, and lack of motivation to treat. CONCLUSION: The oral health self-management ability of adolescent children with fixed orthodontics needs improvement, and a precise health intervention plan should be formulated.