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

**Authors:** Lujain Alchalabi, Emmanuel Schaffner, Yaman Maani-Abuzahra, Julia Dötzer, Ayoung Jeong, Nicola U. Zitzmann, Sonja Merten, Gianfranco Lovison, Nicole Probst-Hensch

PMC · DOI: 10.3389/ijph.2026.1609334 · International Journal of Public Health · 2026-02-23

## TL;DR

This study explores how health beliefs influence oral hygiene behaviors among asylum seekers and refugees in Switzerland.

## Contribution

The study identifies specific health belief model factors influencing oral hygiene behaviors in a population of asylum seekers and refugees.

## Key findings

- Inadequate oral hygiene behaviors were common, with 47% inadequate toothbrushing and 65% inadequate interdental cleaning.
- Higher self-efficacy and autonomy were linked to better oral hygiene behaviors.
- Barriers like lack of time and limited knowledge reduced the likelihood of adequate oral hygiene practices.

## Abstract

This study examined oral hygiene behavior (OHB) and Health Belief Model-based (HBM) determinants among asylum seekers and refugees (ASR).

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.

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)).

Self-efficacy, autonomy, barriers and benefits may be key OHB determinants among ASRs, but need testing in intervention studies.

## Full-text entities

- **Genes:** HBM (hemoglobin subunit mu) [NCBI Gene 3042] {aka HBAP2, HBK}
- **Diseases:** trauma (MESH:D014947), caries (MESH:D003731), tooth loss (MESH:D016388), pain (MESH:D010146), tooth breakage (MESH:D019457), gum diseases (MESH:C537732), infections (MESH:D007239), calculus (MESH:D002137), OHB (MESH:D001523), OH (OMIM:603663), bleed (MESH:D006470), OH diseases (MESH:D009059), cardio-vascular and other non-communicable diseases (MESH:D000073296), periodontal disease (MESH:D010510), impaired nutrition (MESH:D009748)
- **Chemicals:** OHB (-), pc1 (MESH:C013992), sugar (MESH:D000073893)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## References

62 references — full list in the complete paper: https://tomesphere.com/paper/PMC12968041/full.md

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Source: https://tomesphere.com/paper/PMC12968041