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Revista Portuguesa de Estomatologia,
Medicina Dentária e Cirurgia Maxilofacial
Portuguese Journal of Stomatology, Dental Medicine and Maxillofacial Surgery

rev port estomatol med dent cir maxilofac. 2026;67(1):11-20

Original Research

Oral health-related attitudes and behaviors
in Portuguese Air Force military personnel

Sónia Ferreira 1,2, * , Sónia Mendes 2,3 , Mário Bernardo 2,3
1 Portuguese Air Force, Lisbon, Portugal
2 Universidade de Lisboa, Faculdade de Medicina Dentária, Lisbon, Portugal
3 Unidade de Investigação e Ciências Orais e Biomédicas (UICOB), Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal

a r t i c l e i n f o a b s t r a c t

Article history: Objectives: The Armed Forces require ready and healthy military personnel with good oral
Received 31 July 2025 health to avoid medical and dental emergencies. This study aimed to investigate oral
Accepted 21 April 2026 health-related behaviors and attitudes among Portuguese Air Force personnel and identify
Available online 30 April 2026 areas for improvement.
Methods: A cross-sectional study was conducted on active-duty military personnel from the
Keywords: Portuguese Air Force. Participants voluntarily completed the study questionnaire sent via
Attitude to health email. The questionnaire gathered information on demographics, attitudes and behaviors
Health behavior related to oral health, as well as self-reported oral health issues. The study of attitudes and
Military personnel behaviors included the Portuguese version of the HUDBI (Hiroshima University Dental Be-
Mouth diseases havioral Inventory). Statistical analyses used Mann-Whitney and Kruskal-Wallis tests (α=0.05).
Oral health. Results: The sample included 360 participants, representing 11.2% of the entire target pop-
ulation. The mean HUDBI score was 6.82 (SD=1.61). Most military personnel reported brush-
ing their teeth at least twice a day with fluoride toothpaste. Only 12.8% reported using
dental floss on a daily basis. There was a significant association between HUDBI and age
group (p=0.045), military position (p=0.026), level of education (p=0.039), flossing (p<0.001),
and toothbrushing frequency (p=0.004).
Conclusions: HUDBI values were reasonable, and twice-daily toothbrushing was widely
adopted, but daily flossing was infrequent. Oral health attitudes and behaviors were better
among older individuals, those with higher military positions, a higher level of education,
and those who brushed and flossed more frequently. These relationships should be consid-
ered for improving the oral health of the population. (Rev Port Estomatol Med Dent Cir
Maxilofac. 2026;67(1):11-20)
© 2026 Sociedade Portuguesa de Estomatologia e Medicina Dentária.
Published by SPEMD. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).

* Corresponding author.
E-mail address: soniaferreira@campus.ul.pt (Sónia Ferreira).
http://doi.org/10.24873/j.rpemd.2026.04.1567
1646-2890/© 2026 Sociedade Portuguesa de Estomatologia e Medicina Dentária. Published by SPEMD.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).