The effectiveness of an individually tailored oral health educational programme on oral hygiene behaviour in patients with periodontal disease: a blinded randomized‐controlled clinical trial (one‐year follow‐up)

Aim: To evaluate the effectiveness of an individually tailored oral health educational programme for oral hygiene self‐care in patients with chronic periodontitis compared with the standard treatment. Material and Method: A randomized, evaluator‐blinded, controlled trial with two different active treatments were used with 113 subjects (60 females and 53 males) randomly allocated to an experimental or a control group. The individually tailored oral health educational programme was based on cognitive behavioural principles and the individual tailoring for each participant was based on participants' thoughts, intermediate, and long‐term goals, and oral health status. The effect of the programmes on gingivitis [gingival index (GI)], oral hygiene [plaque indices (PlI) and self‐report], and participants' global rating of treatment was evaluated 3 and 12months after oral health education and non‐surgical treatment. Results: Between baseline and the 12‐month follow‐up, the experimental group improved both GI and PlI more than the control group. The mean gain‐score difference was 0.27 for global GI [99.2% confidence interval (CI): 0.16–0.39, p<0.001] and 0.40 for proximal GI (99.2% CI: 0.27–0.53, p<0.001). The mean gain‐score difference was 0.16 for global PlI (99.2% CI: 0.03–0.30, p=0.001), and 0.26 for proximal PlI (99.2% CI: 0.10–0.43, p<0.001). The subjects in the experimental group reported a higher frequency of daily inter‐dental cleaning and were more certain that they could maintain the attained level of behaviour change. Conclusion: The individually tailored oral health educational programme was efficacious in improving long‐term adherence to oral hygiene in periodontal treatment. The largest difference was for interproximal surfaces.     

The Cardiff Dental Survey: oral hygiene, gingival and periodontal health in relation to smoking in young adults

Abstract: Objective: To examine the relationship between tobacco smoking, oral hygiene, gingival and periodontal health in young adults. Study design: Cross‐sectional (conducted in the course of a cohort study). Setting: Cardiff, UK, 1989 and 2000. Methods: Plaque was recorded, as was presence or absence of bleeding on probing and loss of attachment (LA). Information concerning tobacco smoking was obtained from questionnaire data. Results: At age 19–20 years, smokers had statistically significantly (P < 0.01) higher whole mouth mean plaque scores than non‐smokers. Whole mouth mean bleeding scores, however, were similar in smokers and non‐smokers. The relationship of plaque to smoking was very similar at age 30–31, yet bleeding scores were approximately 25% lower in smokers than in non‐smokers (P < 0.01). Whole mouth LA scores showed small, statistically non‐significant differences between smokers and non‐smokers. At the age of 30–31 years, gender and social class had a negligible confounding effect on oral hygiene, gingival and periodontal health in smokers and non‐smokers. Conclusions: Smokers consistently demonstrated poorer oral hygiene than non‐smokers. The effect of smoking in reducing gingival bleeding was already apparent at age 19–20 years despite the fact that, at this time, subjects might be assumed to have been exposed to a relatively small dose of tobacco over a short period of time. In the follow‐up study conducted at the age of 30–31 years, the impact of smoking on the periodontal tissues was, as expected, more pronounced.     

A modified cognitive behavioural model as a method to improve adherence to oral hygiene instructions – a pilot study

To cite this article:
Int J Dent Hygiene 8, 2010; 178–182
DOI: 10.1111/j.1601‐5037.2010.00457.x
Fjellström M, Yakob M, Söder B. A modified cognitive behavioural model as a method to improve adherence to oral hygiene instructions – a pilot study. Abstract: Objective: The purpose of this project was to create a modified CBT model to determine the impact on increased adherence to oral hygiene instructions. In a pilot study test, this model was compared with traditional instructions. Method: Tools developed and tested in this pilot study were a self‐reporting questionnaire, a visual information consisting of pictures and a diary to document according to a modified CBT method. Four participants were divided into two groups, control group and CBT group. At the first visit, all participants answered a self‐reporting questionnaire. The clinical examination consisted of measuring the PI, GI and GBI. The same information and instructions were given. All received toothbrushes, dental floss and professional tooth cleaning. The CBT group was instructed to document their feelings and thoughts in a diary. After 3 weeks, the participants answered the same questionnaire, and the same clinical measurements were conducted at the re‐examination. The CBT group brought their diaries for evaluation. Result: At the end of the study, there was a difference in PI, GI and GBI between the groups. The levels of PI, GI and GBI had decreased more in the CBT group than in the control group. The questionnaire also showed that the CBT group had increased their knowledge and awareness about oral health. Conclusion: This pilot study shows that using a modified model of CBT, by keeping a diary, resulted in increased adherence to oral hygiene and knowledge about gingivitis, compared with traditional instructions.     

An intervention to reduce care‐resistant behavior in persons with dementia during oral hygiene: a pilot study

The primary purpose of this pilot study was to test the feasibility of an intervention designed to reduce care‐resistant behaviors (CRBs) in persons with moderate‐to‐severe dementia during oral hygiene activities. The intervention, Managing Oral Hygiene Using Threat Reduction (MOUTh), combined best oral hygiene practices with CRB reduction techniques. Oral health was operationalized as the total score obtained from the Oral Health Assessment Tool (OHAT). CRB was measured using a refinement of the Resistiveness to Care Scale. Seven nursing home residents with dementia received twice daily mouth care for 14 days. The baseline OHAT mean score of 7.29 (SD = 1.25) improved to 1.00 (SD = 1.26, p < .001); CRB improved from 2.43 CRBs/minute (SD = 4.26) to 1.09 CRBs/minute (SD = 1.56, t = 1.97, df 41, p= .06). The findings from this pilot study suggest that the MOUTh intervention is feasible and reduced CRBs, thus allowing more effective oral care.