Association between motivation scale score and oral condition on receiving basic periodontal therapy

The purpose of this study was to evaluate the usefulness of the motivation scale score (MSS) for Japanese adults and investigate motivation related to the oral condition on receiving basic periodontal therapy using MSS.
The participants enrolled in this study were 221 patients with periodontal disease aged 20-64 years who visited a dental clinic in Shizuoka City, Japan for the first time. MSS was calculated using a 14-itemquestionnaire concerning the patients’ motivation assessment scale, and principal component analysis of MSS was performed. The associations among MSS, items of oral health behavior, periodontal conditions [Bleeding on probing (BOP) rate, Periodontal inflamed surface area (PISA)], and oral hygiene status [O’Leary’s Plaque control record (PCR)] were evaluated at the baseline and after basic periodontal treatment.
MSS was shown to be useful in terms of reliability and validity and was classified into five factors. MSS and MSS-Factor 1 (oral hygiene practices) of participants with BOP of less than 10% were significantly higher than in of participants with BOP of more than 10% at the baseline. In addition, MSS and MSS-F1 were significantly higher among participants who received regular dental check-ups within a year and used interdental cleaning tools. MSS-F1 was significantly higher in non-smokers. By binominal logistic regression analysis, the use of interdental cleaning tools was significantly correlated with BOP of less than 10% at the baseline. All items related to oral conditions and oral health behavior improved after basic periodontal therapy, except for current smoking status. After basic periodontal therapy, MSS was significantly higher in participants with PCR of less than 20%, and MSS-F1 was significantly higher in participants who used interdental cleaning tools or were non-smokers.
It was revealed that MSS used in this study was useful and associated with the periodontal condition and oral health behavior at the baseline. The values of MMS and MSS-F1 significantly increased after basic periodontal therapy. The use of interdental cleaning tools was associated with a good oral condition and higher MSS. Therefore, high motivation might lead to a good oral condition in patients with periodontal disease through the use of interdental cleaning tools by influencing patients’ compliance to improve their oral health behaviors.

本研究の目的は，日本の成人に対するモチベーションスケールスコア（MSS）の有用性を評価すること，および歯周基本治療における口腔状態に関連するモチベーションを，MSS を用いて検討することである．
　対象者は静岡市の歯科診療所に来院した20～64 歳の初診歯周病患者221 名である．MSS は患者のモチベーション評価尺度に関する 14 項目の質問紙を用いて算出し，MSS の主成分分析を行った．また，ベースライン時および歯周基本治療後の MSS と口腔保健行動項目，歯周状態（Bleeding on probing (BOP) 率，Periodontal inflamed surface area(PISA)）および口腔衛生状態（O’Leary のPlaque control record (PCR)）との関係を評価した．
　MSS は信頼性と妥当性の点からその有用性が示され，5 つの要素に分類された．ベースライン時BOP10% 未満の者はBOP10% 以上の者と比較してMSS およびMSS-F1（口腔衛生行動）が有意に高かった．また，年1 回の歯科健診受診，歯間部清掃用具の使用の者はMSS およびMSS-F1 が有意に高く，非喫煙者でMSS-F1 が有意に高かった．二項ロジスティック回帰分析において，ベースライン時BOP10% 以上と統計学的に有意な関連を認めた因子は歯間部清掃用具の使用であった．一方，歯周基本治療後，喫煙状況を除くすべての項目で良好な改善が認められた．このうち，歯周基本治療後のPCR20% 未満の者はMSS が有意に高く，歯間部清掃用具の使用および非喫煙者においてMSS-F1 が有意に高かった．
　本研究で用いたMSS は有用であり，ベースライン時の歯周組織状態および口腔保健行動と関連した．歯周基本治療介入後，MSS およびMSS-F1 の値は有意に上昇した．歯間部清掃用具の使用は良好な歯周組織状態と関連し，MSS の高値と関連した．それ故，高いモチベーションが，歯間部清掃用具の使用によって口腔保健行動の改善に対する患者のコンプライアンスに影響を与え，歯周病患者の良好な口腔状態を導いた可能性がある．

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本論文は，著者Ai Sakumaの学位論文として提出され，学位審査・授与の対象となっている。