September 2013 ■ Journal of Dental Education 1171 Oral Health Attitudes and Behavior of Dental Students at the University of Zagreb, Croatia Ana Badovinac, D.M.D.; Darko Božic ´, D.M.D., M.S., Ph.D.; Ivana Vuc ˇinac; Jasna Vešligaj; Domagoj Vražic ´, D.M.D.; Darije Planc ˇak, D.M.D., M.S., Ph.D. Abstract: The aim of this study was to investigate oral health behavior and attitudes of dental students in years 1 to 6 at the University of Zagreb, Croatia. The Croatian version of the Hiroshima University-Dental Behavioral Inventory (HU-DBI) was administered to predoctoral dental students, and collected data were analyzed. A total of 503 students (22.3±2.6 mean age) com- pleted the questionnaire. The response rate was 85.1 percent, and 72.4 percent of the respondents were female. These dental stu- dents’ answers to eleven out of twenty HU-DBI items differed signiicantly by academic year. The mean questionnaire score was 6.62±1.54, and the highest value of the HU-DBI score was in the fourth year (7.24±1.54). First-year students were most likely to have a toothbrush with hard bristles and felt they had not brushed well unless done with hard strokes. Students in the sixth year were least worried about visiting a dentist and most frequently put off going to a dentist until having a toothache, indicating that rise of knowledge contributes to higher self-conidence. The mean HU-DBI score for these students showed average value, point- ing out the need for a comprehensive oral hygiene and preventive program from the start of dental school. Dr. Badovinac is Research Assistant, Department of Periodontology, School of Dental Medicine, University of Zagreb, Croatia; Dr. Božić is Assistant Professor, Department of Periodontology, School of Dental Medicine, University of Zagreb, Croatia; Ms. Vučinac is a dental student, School of Dental Medicine, University of Zagreb, Croatia; Ms. Vešligaj is a dental student, School of Dental Medicine, University of Zagreb, Croatia; Dr. Vražić is Research Assistant, Department of Periodontology, School of Dental Medicine, University of Zagreb, Croatia; and Dr. Plančak is Professor, Department of Periodontology, School of Dental Medicine, University of Zagreb, Croatia. Direct correspondence and requests for reprints to Dr. Ana Badovinac, University of Zagreb, School of Dental Medicine, Department of Periodontology, Gundulićeva 5, Zagreb 10 000, Croatia; badovinac@sfzg.hr. Keywords: dental education, dental students, oral health attitudes, oral health behavior, Croatia Submitted for publication 1/26/12; accepted 6/7/12 O ral health is now widely recognized as an important part of overall health. Although there are more and more dental hygiene products available and awareness is rising every day, oral diseases are still one of the most prevalent prob- lems in countries around the world. 1 Oral self-care such as toothbrushing and lossing are important for preserving oral health and preventing oral diseases as they remove microbial plaque, preventing it from accumulating on teeth and gingiva. 2 Studies have demonstrated that dental plaque is an important fac- tor in the onset of hard and soft tissue diseases and that plaque reduction decreases the prevalence of dental caries, gingivitis, and periodontal diseases. 3-6 The most effective and widespread way to control plaque at home is toothbrushing. 7 In Western soci- eties, brushing twice a day with luoride toothpaste is now an integral part of most people’s daily oral hygiene routine. 8,9 However, many factors such as brushing technique, frequency, duration, pressure, characteristics of toothbrush bristles, lossing, use of toothpaste, and training inluence the effectiveness and safety of dental hygiene products. 10,11 Inadequate toothbrushing techniques may be ineffective in plaque removal and may cause hard tissue abrasions or gingival recessions. 12,13 Therefore, knowledge about oral hygiene products, procedures, and behav- ior are important factors in preventing oral disease and achieving good oral health. Prevention of oral disease is the most accepted and effective method for ensuring oral health. Modi- ications of patients’ habits regarding oral hygiene maintenance and constant emphasis on prevention are two challenges confronting the modern dental practitioner. 14 Dentists’ attitudes, proiciency, and knowledge are playing an important role not only in improving oral health of their patients but also in determining oral health of the population. 15 Dental practitioners are competent to counsel on oral health and the most suitable daily oral hygiene procedures. 16 Furthermore, they can induce and reinforce long- term motivation for self-prevention and may provide preventive care. Dental students, as future oral health provid- ers, are an important group to observe and follow through their academic years. Since knowledge and