AUTHOR=Chan Charlotte C. K. , Chan Alice K.Y. , Chu C.H. , Tsang Y. C. 

TITLE=Theory-based behavioral change interventions to improve periodontal health

JOURNAL=Frontiers in Oral Health

VOLUME=Volume 4 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2023.1067092

DOI=10.3389/froh.2023.1067092

ISSN=2673-4842

ABSTRACT=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 behavioural 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, behavioural models have been adopted in the design of oral hygiene interventions from individual to population levels.
Despite the growing focus on behavioural 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 behaviours. 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 some selected literatures on the use of behavioural models to improve periodontal outcomes. A search was performed on existing behavioural 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 behavioural principles); stages of readiness to change (precaution adoption process model and transtheoretical model); planning behavioural change (health action process approach model, theory of planned behaviour 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. 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 behavioural model-based interventions.