A cross-country comparison of domains describing the general public's self-reported attitudes and experiences of prevention in oral healthcare

INTRODUCTION: Preventive oral healthcare is essential for overall well-being, yet its delivery varies significantly across Europe due to structural, cultural, and socioeconomic factors. Current dental systems often prioritise treatment over prevention, highlighting a need to understand public attitudes toward preventive care. This study uses the validated PAPOH questionnaire to explore the cross-country differences in 6 domains related to their attitudes and experiences of prevention in oral healthcare across six European countries. METHODS: Participants were recruited via a market research company to ensure demographic representativeness. The PAPOH questionnaire assessed 6 domains: cost, motivation, responsibility, advice received, whether personalised advice was given and knowledge. Data were analysed using linear and logistic regression models, adjusted for variables including age, income, and access to dental care. Ethical approvals were secured across participating institutions. RESULTS: There were 3,372 participants in six countries sampled by age and gender. Over half (54.8%) reported below-average incomes. The analysis on cost being a barrier showed this was a feature for Ireland (aOR 1.90) and Hungary (aOR 1.61), for Germany this was less of a feature (aOR 0.64). Motivation- Ireland (AMD 0.83) and Hungary (AMD 1.26) scored higher than the UK, while The Netherlands scored lower (AMD - 0.65). Hungary reported higher responsibility scores (aOR 1.58). Preventive advice was rated higher in Ireland (aOR 1.50) and Hungary (aOR 2.80), but lower in Denmark and The Netherlands. Personalised advice was noted more in Denmark (aOR 1.88) and The Netherlands (aOR 1.51). Knowledge scores were lower in all countries except Denmark which may have been due to practices around rinsing after brushing. CONCLUSION: Significant cross-country differences in attitudes and experiences highlight the role of socioeconomic and cultural factors in shaping preventive oral healthcare. Tailored public health strategies and improved cross-national messaging are essential to address disparities and enhance preventive care delivery.