Motivation for Maintaining Oral Hygiene and Its Association with Debris Index Scores Among the Elderly

Abstract

Poor oral hygiene remains a persistent problem among older adults, with debris accumulation on the tooth surface serving as a key clinical indicator of inadequate self‑care. Motivation; both intrinsic and extrinsic is widely recognized as a behavioral driver of oral hygiene practices. However, empirical evidence linking motivation directly to debris index scores among Indonesian elderly populations is still limited. Understanding this relationship is essential for designing effective community‑based oral health interventions. This study aimed to analyze the association between oral hygiene maintenance motivation and debris index scores among older adults. A cross‑sectional observational‑analytic design was employed, involving 54 elderly respondents selected through simple random sampling from the population of Posyandu Lansia (Elderly Integrated Health Service Post) of RT 02 RW 06, Gayungan. Motivation was assessed using a Likert‑scale questionnaire consisting of favorable and unfavorable items. Debris index scores were obtained through direct clinical examination of six index teeth using disclosing solution. Data analysis was conducted using the Spearman rank correlation test with a significance level of α = 0.05. More than half of the respondents (55.56%) demonstrated moderate motivation, while 44.44% exhibited strong motivation. Most participants (59.26%) had poor debris index scores, and only 16.67% were categorized as having good oral hygiene. A statistically significant and strong negative correlation was identified between motivation and debris index scores (p = 0.000; r = −0.806), indicating that higher motivation corresponds to lower debris accumulation. Respondents with moderate motivation were substantially more likely to fall into the poor debris category compared to those with strong motivation, suggesting that motivation must reach a certain threshold before it meaningfully improves oral hygiene outcomes. In conclusion, motivation plays a significant role in determining debris index scores among older adults and represents a modifiable behavioral factor.

Keywords: elderly; motivation; behavioral determinants; oral hygiene; debris index