Knowledge, attitude, and practice toward oral health management among orthodontic patients: a cross-sectional study

BACKGROUND: This study aimed to investigate the knowledge, attitude, and practice (KAP) toward oral health management among orthodontic patients. METHODS: A cross-sectional study on orthodontic patients was conducted at Suzhou Dushu Lake Hospital from December 20, 2023, to March 19, 2024. Demographic data and KAP scores were collected using self-designed questionnaires. The cutoff for adequate KAP dimension scores was 70%. RESULTS: The study included 418 orthodontic patients, of whom 274 (65.55%) were female, and 144 (34.45%) were male. The average age was 32.70 ± 8.47 years (33.72 ± 8.46 in females and 32.17 ± 8.44 in males). The mean knowledge, attitude, and practice scores were 11.80 ± 4.06 (possible range: 0-16), 27.00 ± 3.18 (possible range: 6-30), and 31.13 ± 6.01 (possible range: 8-40), respectively. The proportions of participants who scored above a cutoff of 70% were 247 (59.09%) for knowledge, 403 (96.41%) for attitude, and 290 (69.38%) for practice. Multivariate logistic regression showed that knowledge score (OR = 1.243, 95% CI: [1.152-1.342], P < 0.001), attitude score (OR = 1.255, 95% CI: [1.140-1.381], P < 0.001), and wearing an appliance for 3 to 6 months (OR = 4.309, 95% CI: [1.565-11.861], P = 0.005) were independently linked to proactive practice. Structural equation modeling demonstrated that knowledge directly influenced attitude (β = 0.684, P < 0.001) and practice (β = 0.527, P < 0.001), while attitude had a direct impact on practice (β = 0.587, P < 0.001). CONCLUSIONS: The majority of orthodontic patients demonstrated adequate knowledge, positive attitudes, and proactive practices toward oral health management. Nonetheless, continuous education is still essential for certain groups, such as recently fitted orthodontic patients, to ensure sustained improvement in oral health outcomes.