Theory-based behavioral change interventions to improve periodontal health

Periodontal disease is a significant global health burden affecting half of the world's population. Given that plaque and inflammation control are essential to the attainment of periodontal health, recent trends in preventive dentistry have focused on the use of behavioral models to understand...

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Main Authors: Charlotte C. K. Chan, Alice K.Y. Chan, C.H. Chu, Y. C. Tsang
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-01-01
Series:Frontiers in Oral Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/froh.2023.1067092/full
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author Charlotte C. K. Chan
Alice K.Y. Chan
C.H. Chu
Y. C. Tsang
author_facet Charlotte C. K. Chan
Alice K.Y. Chan
C.H. Chu
Y. C. Tsang
author_sort Charlotte C. K. Chan
collection DOAJ
description Periodontal disease is a significant global health burden affecting half of the world's population. Given that plaque and inflammation control are essential to the attainment of periodontal health, recent trends in preventive dentistry have focused on the use of behavioral models to understand patient psychology and promote self-care and treatment compliance. In addition to their uses in classifying, explaining and predicting oral hygiene practices, behavioral models have been adopted in the design of oral hygiene interventions from individual to population levels. Despite the growing focus on behavioral modification in dentistry, the currently available evidence in the field of periodontology is scarce, and interventions have primarily measured changes in patient beliefs or performance in oral hygiene behaviors. Few studies have measured their impact on clinical outcomes, such as plaque levels, gingival bleeding and periodontal pocket reduction, which serve as indicators of the patient's disease status and quality of oral self-care. The present narrative review aims to summarize selected literature on the use of behavioral models to improve periodontal outcomes. A search was performed on existing behavioral models used to guide dental interventions to identify their use in interventions measuring periodontal parameters. The main models were identified and subsequently grouped by their underlying theoretical area of focus: patient beliefs (health belief model and cognitive behavioral principles); stages of readiness to change (precaution adoption process model and transtheoretical model); planning behavioral change (health action process approach model, theory of planned behavior and client self-care commitment model); and self-monitoring (self-regulation theory). Key constructs of each model and the findings of associated interventions were described. The COM-B model, a newer behavioral change system that has been increasingly used to guide interventions and policy changes, is discussed with reference to its use in oral health settings. Within the limitations of the available evidence, interventions addressing patient beliefs, motivation, intention and self-regulation could lead to improved outcomes in periodontal health. Direct comparisons between interventions could not be made due to differences in protocol design, research populations and follow-up periods. The conclusions of this review assist clinicians with implementing psychological interventions for oral hygiene promotion and highlight the need for additional studies on the clinical effects of behavioral model-based interventions.
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spelling doaj.art-105d59d1ea8c4095a18dbea0ae1830302023-01-25T09:56:00ZengFrontiers Media S.A.Frontiers in Oral Health2673-48422023-01-01410.3389/froh.2023.10670921067092Theory-based behavioral change interventions to improve periodontal healthCharlotte C. K. ChanAlice K.Y. ChanC.H. ChuY. C. TsangPeriodontal disease is a significant global health burden affecting half of the world's population. Given that plaque and inflammation control are essential to the attainment of periodontal health, recent trends in preventive dentistry have focused on the use of behavioral models to understand patient psychology and promote self-care and treatment compliance. In addition to their uses in classifying, explaining and predicting oral hygiene practices, behavioral models have been adopted in the design of oral hygiene interventions from individual to population levels. Despite the growing focus on behavioral modification in dentistry, the currently available evidence in the field of periodontology is scarce, and interventions have primarily measured changes in patient beliefs or performance in oral hygiene behaviors. Few studies have measured their impact on clinical outcomes, such as plaque levels, gingival bleeding and periodontal pocket reduction, which serve as indicators of the patient's disease status and quality of oral self-care. The present narrative review aims to summarize selected literature on the use of behavioral models to improve periodontal outcomes. A search was performed on existing behavioral models used to guide dental interventions to identify their use in interventions measuring periodontal parameters. The main models were identified and subsequently grouped by their underlying theoretical area of focus: patient beliefs (health belief model and cognitive behavioral principles); stages of readiness to change (precaution adoption process model and transtheoretical model); planning behavioral change (health action process approach model, theory of planned behavior and client self-care commitment model); and self-monitoring (self-regulation theory). Key constructs of each model and the findings of associated interventions were described. The COM-B model, a newer behavioral change system that has been increasingly used to guide interventions and policy changes, is discussed with reference to its use in oral health settings. Within the limitations of the available evidence, interventions addressing patient beliefs, motivation, intention and self-regulation could lead to improved outcomes in periodontal health. Direct comparisons between interventions could not be made due to differences in protocol design, research populations and follow-up periods. The conclusions of this review assist clinicians with implementing psychological interventions for oral hygiene promotion and highlight the need for additional studies on the clinical effects of behavioral model-based interventions.https://www.frontiersin.org/articles/10.3389/froh.2023.1067092/fullbehavioral changebehavioral interventionperiodontal healthoral hygiene instructionpreventive dentistry
spellingShingle Charlotte C. K. Chan
Alice K.Y. Chan
C.H. Chu
Y. C. Tsang
Theory-based behavioral change interventions to improve periodontal health
Frontiers in Oral Health
behavioral change
behavioral intervention
periodontal health
oral hygiene instruction
preventive dentistry
title Theory-based behavioral change interventions to improve periodontal health
title_full Theory-based behavioral change interventions to improve periodontal health
title_fullStr Theory-based behavioral change interventions to improve periodontal health
title_full_unstemmed Theory-based behavioral change interventions to improve periodontal health
title_short Theory-based behavioral change interventions to improve periodontal health
title_sort theory based behavioral change interventions to improve periodontal health
topic behavioral change
behavioral intervention
periodontal health
oral hygiene instruction
preventive dentistry
url https://www.frontiersin.org/articles/10.3389/froh.2023.1067092/full
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