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Zhan C, Qu W, Fok MR, Jin L, Lin Y. Motivational Interviewing on Periodontal Treatment Outcomes: A Meta-Analysis. Int Dent J 2024:S0020-6539(24)00005-4. [PMID: 38307831 DOI: 10.1016/j.identj.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/16/2023] [Accepted: 01/02/2024] [Indexed: 02/04/2024] Open
Abstract
OBJECTIVES This systematic review investigated the clinical efficacy of motivational interviewing (MI) in improving oral hygiene and periodontal health in patients with periodontal diseases. METHODS A comprehensive literature search was conducted across various databases up to May 2023. Randomised controlled trials (RCTs) evaluating the effects of MI on periodontal conditions in patients with gingivitis, periodontitis, and peri‑implantitis were included. After data screening, a risk-of-bias assessment was performed using the Cochrane risk of bias (RoB) tool. The meta-analysis was performed using random-effects models. RESULTS Out of 2108 records screened, 7 RCTs involving 474 patients were included in the qualitative synthesis, with 6 of these studies included in the meta-analysis. Amongst these, 5 studies had a high RoB and 2 had some concerns about bias. Although individual studies reported varied results regarding the effects of MI on different periodontal indices and parameters at different time points, the pooled results revealed no significant difference in the overall effect on plaque level, bleeding on probing, and gingival inflammation between the MI and control groups. In addition, there is insufficient evidence to suggest any significant effect on attachment loss or probing depth. CONCLUSIONS The current evidence is insufficient to support the effectiveness of MI as an adjunctive intervention for improving oral hygiene and periodontal outcomes. However, these results should be interpreted with caution. Additional high-quality studies with standardised MI interventions are required to derive definite conclusions.
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Affiliation(s)
- Chaoning Zhan
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Wanting Qu
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China
| | - Melissa Rachel Fok
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Lijian Jin
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Yifan Lin
- Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong SAR, China.
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Cartes-Velásquez R, Varnet-Pérez T, Martínez-Delgado CM, Villanueva-Vilchis MDC, Ramírez-Trujillo MDLÁ, Faustino-Silva DD. Motivational interviewing for preventing oral morbidities in adults: Systematic review and meta-analysis. Community Dent Oral Epidemiol 2024; 52:84-92. [PMID: 37668224 DOI: 10.1111/cdoe.12904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 07/11/2023] [Accepted: 07/31/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE This systematic review with meta-analysis was performed to assess whether motivational interviewing (MI) effectively prevents oral morbidities in adults. METHODS Studies considered were randomized controlled trials, cluster-randomized controlled trials and community-based randomized trials assessing interventions based on MI or indicating that a counselling technique based on the principles developed by Miller and Rollnick was used. Controls were any type of oral health education or negative controls. Participants were 18-60 years old. The main outcome was any oral morbidity. From 602 studies identified in MEDLINE, Scopus, Web of Science and LILACS databases, seven studies were included in the synthesis. RESULTS Studies included only evaluated periodontal outcomes, no studies were found for other oral morbidities. Patients' mean age was 43.7 years, and the follow-up time after MI or MI-based intervention varied between 1 month and 1 year. The total study population was 272 people with moderate-to-severe periodontitis; other groups analysed were pregnant women (n = 112) and patients with mental disorders and alcohol problems (n = 60). Meta-analysis for the plaque index (four studies, n = 267), bleeding on probing (two studies, n = 177) and gingival index (two studies, n = 166) were carried out. The summary effects for the random-effects model were estimated respectively as -3.59 percentage points (CI: [-11.44; 4.25] for plaque index, -6.41 percentage points (CI: [-12.18, -0.65]) for bleeding on probing and -0.70 (CI: [-1.87; 0.48]) for gingival index, marginally favouring the MI group. The reduced number of studies, the non-disclosure of some aspects of the data and the heterogeneity among them undermine the precision of the estimates. CONCLUSION The current evidence available is limited to periodontal outcomes, and it is not possible to determine whether MI effectively prevents oral morbidities in adults.
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3
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Vilar Doceda M, Petit C, Huck O. Behavioral Interventions on Periodontitis Patients to Improve Oral Hygiene: A Systematic Review. J Clin Med 2023; 12:jcm12062276. [PMID: 36983277 PMCID: PMC10058764 DOI: 10.3390/jcm12062276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/11/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023] Open
Abstract
This systematic review aimed to investigate the impact of different psychological models, strategies, and methods to improve plaque control and/or gingival inflammation in patients with periodontal diseases. Methods: The PubMed/MEDLINE, Cochrane Library, and Embase online databases were explored to identify relevant studies published before October 2022. Articles investigating the effects of different psychological approaches and intervention strategies on periodontitis patients’ oral hygiene (OH) behavioral change were screened. Results: 5460 articles were identified, and 21 fulfilled the inclusion criteria. In total, 2 studies tested audio-visual modalities, and the remaining 19 publications involved six psychological models of health-related behavioral interventions, including Social Cognitive Theory, the Theory of Planned Behavior, the Health Action Process Approach, Leventhal’s self-regulatory theory, Motivational Interviewing, and Cognitive Behavioral Therapy. A meta-analysis of the results was not carried out due to the high heterogeneity among the interventions. Conclusions: Considering the limitations of the available studies, psychological interventions based on social cognitive models that combine some of the techniques of this model (goal setting, planning, self-monitoring, and feedback) may improve OH in periodontitis patients, having a positive impact on periodontal clinical outcomes. Delivering cognitive behavioral therapy in combination with motivational interviewing may result in an improvement in OH as evaluated by decreasing plaque and bleeding scores.
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Affiliation(s)
| | - Catherine Petit
- Dental Faculty, University of Strasbourg, 67000 Strasbourg, France
- Pole de Médecine et Chirurgie Bucco-Dentaire, Periodontology, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Olivier Huck
- Dental Faculty, University of Strasbourg, 67000 Strasbourg, France
- Pole de Médecine et Chirurgie Bucco-Dentaire, Periodontology, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
- Correspondence:
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Chunda R, Mossey P, Freeman R, Yuan S. Health Coaching-Based Interventions for Oral Health Promotion: A Scoping Review. Dent J (Basel) 2023; 11:dj11030073. [PMID: 36975570 PMCID: PMC10047453 DOI: 10.3390/dj11030073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/31/2023] [Accepted: 02/17/2023] [Indexed: 03/08/2023] Open
Abstract
Background: Health coaching-based interventions can support behaviour change to improve oral health. This scoping review aims to identify key characteristics of health coaching-based interventions for oral health promotion. Methods: The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist and the Joanna Briggs Institute manual for evidence synthesis were used in this review. A search strategy using medical subject heading terms and keywords was developed and applied to search the following databases: CINAHL, Ovid, PubMed, Cochrane Library and Scopus. Thematic analysis was used to synthesise the data. Results: Twenty-three studies met the inclusion criteria and were included in this review. These studies were predominantly based on health coaching and motivational interviewing interventions applied to oral health promotion. The following are the characteristics of health coaching-based interventions extracted from themes of the included studies: (a) Health professionals should be trained on the usage of motivational interviewing/health coaching interventions; (b) oral health professionals should acquire motivational techniques in their practice to engage patients and avoid criticisms during the behaviour change process; (c) routine brief motivational interviewing/health coaching intervention sessions should be introduced in dental clinics; (d) traditional oral health education methods should be supplemented with individually tailored communication; and (e) for cost-effectiveness purposes, motivational interviewing/health coaching strategies should be considered. Conclusions: This scoping review reveals that health coaching-based techniques of health coaching and motivational interviewing can significantly impact oral health outcomes and behaviour change and can improve oral health professional–patient communication. This calls for the use of health coaching-based techniques by dental teams in community and clinical settings. This review highlights gaps in the literature, suggesting the need for more research on health coaching-based intervention strategies for oral health promotion.
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Hagman J, Wide U, Werner H, Hakeberg M. A psychological intervention for caries active young adults, a randomized controlled trial. Clin Exp Dent Res 2021; 8:239-247. [PMID: 34792290 PMCID: PMC8874066 DOI: 10.1002/cre2.513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/21/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022] Open
Abstract
Objective The aim of the present study was to evaluate the effect of a brief version of the behavioral intervention Acceptance and Commitment Therapy (ACT) on reducing gingivitis and plaque levels after 18 weeks. Materials and methods One hundred thirty‐five caries‐active young adults (18–25 years of age), recruited from two public dental clinics, participated in this parallel group randomized control trial (RCT). Participants in the intervention (n = 67) received two ACT sessions in combination with standard information on oral health, and participants allocated to the control group (n = 68) received standard information only. Gingivitis and plaque levels were recorded at baseline and at the 9‐ and 18‐week follow‐ups. The effect of the intervention versus standard information alone was analyzed by intention‐to‐treat and per protocol, applying the General Linear Model (GLM). Exploratory analyses for the intervention and control groups were conducted to evaluate the effect of gender and smoking habits on the gingivitis and plaque outcome. The CONSORT guidelines for RCT were followed. Results A significant decrease in gingivitis and plaque levels was observed over time, irrespective of treatment allocation. However, the ACT intervention was not significantly more effective at reducing gingivitis and plaque scores than standard information alone, even though the intervention participants had maintained their improvement to a greater extent. The exploratory analysis revealed that females improved their gingivitis and plaque levels significantly more than the males in the intervention group (p = 0.025 for gingivitis and p = 0.013 for plaque). Conclusion A brief ACT intervention was not proven to be more effective than standard information alone at improving oral health in a sample of young adults with poor oral health. However, ACT seems to have a positive effect on oral health among females. (TRN ISRCTN15009620).
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Affiliation(s)
- Jennie Hagman
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulla Wide
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helene Werner
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Evensen KB, Bull VH, Ness L. A health promotion intervention to improve oral health of prisoners: results from a pilot study. Int J Prison Health 2021; 17:546-559. [PMID: 38902900 PMCID: PMC8753622 DOI: 10.1108/ijph-11-2020-0085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/03/2021] [Accepted: 04/09/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Prisoners have poorer oral health than the general population. Good oral health is essential for both social and physical well-being. For prisoners, poor oral health is also related to drug use after release, whereas good oral health is related to successful reintegration into society. The purpose of this study was twofold: to examine the effect of an intervention based on motivational interviewing (MI) on prisoners' oral health-related behavior and to assess if the intervention is a good fit for this population. DESIGN/METHODOLOGY/APPROACH In total, 16 prisoners in a Norwegian prison were offered a brief MI-based intervention focusing on changing their oral health-related behavior. An oral examination was also performed and the prisoners received a small package containing oral hygiene aids. Two weeks later, a second oral examination and a semi-structured interview were conducted to explore the effect of the intervention and examine the prisoners' responses to the intervention. Qualitative data analyzes were guided by thematic analysis. FINDINGS The findings indicate that the intervention had positive effects on both the prisoners' motivation to use oral health-related behavior and their performance of oral health-related behavior. The findings also indicate that the intervention was well adapted to the target population. ORIGINALITY/VALUE This is one of the first studies that explore the effect of an intervention in improving prisoners' oral health and bridges a knowledge gap in the literature. The findings may increase the understanding of how dental services should be organized and offered to provide dental health care to this vulnerable group.
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Affiliation(s)
| | | | - Linda Ness
- Oral Health Centre of Expertise-Rogaland, Stavanger, Norway
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7
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Gunpinar S, Meraci B. Periodontal health education session can improve oral hygiene in patients with gingivitis: A masked randomized controlled clinical study. J Periodontol 2021; 93:218-228. [PMID: 34048073 DOI: 10.1002/jper.21-0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The aim of this clinical trial was to evaluate the effect of a periodontal health education session (PHES), which included education on the pathogenesis and consequences of periodontal diseases on oral hygiene motivation in patients with gingivitis. METHODS A randomized controlled clinical trial was conducted on 50 (26 females and 24 males) patients with gingivitis who underwent periodontal treatment. Subjects were randomly allocated into the PHES group (experimental group) and standard oral hygiene education group (control group). The Rustogi Modified Navy Plaque Index (RMNPI) and Papillary Bleeding Index (PBI) were used to evaluate oral hygiene at baseline and were repeated after 1, 3, and 6 months. Knowledge about periodontal disease was measured and the participants' motivation was determined using the Oral Hygiene Motivation Scale. RESULTS Although baseline knowledge levels and motivation scores were not different between the groups, following the educational motivational interviewing (MI) session, levels were higher in the experimental compared with the control group. The subjects' RMNPI and PBI scores at the 1-, 3-, and 6- month re-examinations were statistically higher in the control group than the experimental group. Furthermore, the level of knowledge and intrinsic and total motivation scores were moderately positively correlated with a reduction in clinical indices at 6 months compared with baseline. CONCLUSIONS The results of this study indicated that increased knowledge and awareness about periodontal diseases and its consequences, including systemic effects, via educational MI session increased intrinsic motivation and improved oral hygiene of patients with gingivitis, especially regarding interproximal surfaces.
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Affiliation(s)
- Sadiye Gunpinar
- Department of Periodontology, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Bilge Meraci
- Department of Periodontology, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
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8
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Carra MC, Detzen L, Kitzmann J, Woelber JP, Ramseier CA, Bouchard P. Promoting behavioural changes to improve oral hygiene in patients with periodontal diseases: A systematic review. J Clin Periodontol 2021; 47 Suppl 22:72-89. [PMID: 31912530 DOI: 10.1111/jcpe.13234] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 12/13/2019] [Accepted: 12/14/2019] [Indexed: 12/20/2022]
Abstract
AIM This systematic review investigates the impact of specific interventions aiming at promoting behavioural changes to improve oral hygiene (OH) in patients with periodontal diseases. METHODS A literature search was performed on different databases up to March 2019. Randomized and non-randomized controlled trials evaluating the effects of behavioural interventions on plaque and bleeding scores in patients with gingivitis or periodontitis were considered. Pooled data analysis was conducted by estimating standardized mean difference between groups. RESULTS Of 288 articles screened, 14 were included as follows: 4 studies evaluated the effect of motivational interviewing (MI) associated with OH instructions, 7 the impact of oral health educational programmes based on cognitive behavioural therapies, and 3 the use of self-inspections/videotapes. Studies were heterogeneous and reported contrasting results. Meta-analyses for psychological interventions showed no significant group difference for both plaque and bleeding scores. No effect was observed in studies applying self-inspection/videotapes. CONCLUSIONS Within the limitations of the current evidence, OH may be reinforced in patients with periodontal diseases by psychological interventions based on cognitive constructs and MI principles provided by oral health professionals. However, no conclusion can be drawn on their specific clinical efficacy as measured by reduction of plaque and bleeding scores over time.
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Affiliation(s)
- Maria Clotilde Carra
- Department of Periodontology, U.F.R. of Odontology, Université de Paris, Paris, France.,Department of Periodontology, Service d'Odontologie, AP-HP, Rothschild Hospital, Paris, France.,Inserm, Population-based Epidemiologic Cohorts Unit, UMS 011, Villejuif, France
| | - Laurent Detzen
- Department of Periodontology, U.F.R. of Odontology, Université de Paris, Paris, France.,Department of Periodontology, Service d'Odontologie, AP-HP, Rothschild Hospital, Paris, France
| | - Julia Kitzmann
- Private Practice, Hamburg, Germany.,Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Johan P Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Philippe Bouchard
- Department of Periodontology, U.F.R. of Odontology, Université de Paris, Paris, France.,Department of Periodontology, Service d'Odontologie, AP-HP, Rothschild Hospital, Paris, France.,EA 2496, U.F.R. of Odontology, University of Paris, Paris, France
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The Effect of a Personalized Oral Health Education Program on Periodontal Health in an At-Risk Population: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020846. [PMID: 33478179 PMCID: PMC7844619 DOI: 10.3390/ijerph18020846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/02/2021] [Accepted: 01/12/2021] [Indexed: 01/03/2023]
Abstract
While periodontal disease is associated with many risk factors, socioeconomically disadvantaged communities experience the highest disease burden. The aim of this study was to evaluate the effectiveness of a personalized oral health education program, in combination with routine dental treatment, in participants from a low socioeconomic community. We used a randomized, controlled, examiner-blinded clinical trial. A total of 579 participants (aged 18–60 years) were randomly grouped: the intervention group (n = 292) received a personalized oral health education program in combination with routine dental care and the control group (n = 287) received routine dental care. All participants were assessed for improvement in oral health care behaviors, dental plaque, and periodontal status at baseline, 12 months, and 24 months. We found a significant drop (p < 0.001) in the plaque indices, Periodontal Probing Depths (PPD) and Bleeding on Probing (BOP) between baseline and the 12-month follow-up for both groups. For BOP, the number of sites positive was significantly different between baseline and the 24-month follow-up (p = 0.037). No differences were found between the two groups for any evaluated clinical outcome. The personalized oral health education program used in the current study did not appear to add significant improvement to clinical outcomes of periodontal health compared with routine restorative dental care per se.
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10
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Özyemişci N, Turgut Çankaya Z. Effect of a motivational video on flossing behaviour: A pilot study. Int J Dent Hyg 2020; 19:201-208. [PMID: 33215814 DOI: 10.1111/idh.12480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 10/11/2020] [Accepted: 10/23/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Motivational interviews used for health behavioural change requires several sessions and expert consultations. A practical method is needed to promote oral hygiene habits. The aim of the study was to develop a video as a new motivational intervention method combining several health behaviour change theories to improve flossing behaviour. METHODS A questionnaire about individual psychosocial characteristics was conducted to 30 volunteer dental patients. Plaque index (PI) scores were calculated and a video about flossing was shown the patients. The second PI measurements were performed after 2 months. The video including flossing instructions and expressions of performers acting dental patients was produced to test as a motivational method. Cues used in the video were generated according to health behaviour change theories and models under the supervision of an expert team. Content validity ratio (CVR) and content validity index (I-CVI) of the video and reliability of the questionnaire was determined. First and second PI scores were compared to assess the effect of the video. Correlation between answers of the questionnaire and PI changes were tested. RESULTS The average I-CVIs of the video was 0.93, CVR of video items was 1, I-CVIs of 5 items was 80% and of 10 was 100%. Cronbach's alpha of the questionnaire was 0.93. PI scores significantly decreased after 2 months (p < 0.001). CONCLUSION A single session motivational intervention via a video based on health psychological models and theories was efficacious in improving oral hygiene and flossing behaviour in the short term.
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Affiliation(s)
- Nuran Özyemişci
- Dental Prosthesis Technology Program, Vocational School of Health Services, Hacettepe University, Ankara, Turkey
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11
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Bray KK, Bennett K, Catley D. Fidelity of motivational interviewing training for dental hygiene students. J Dent Educ 2020; 85:287-292. [PMID: 33075849 DOI: 10.1002/jdd.12448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 08/29/2020] [Accepted: 09/19/2020] [Indexed: 11/09/2022]
Abstract
Use of Motivational Interviewing (MI), a patient centered counseling strategy in the health professions, has demonstrated efficacy. Given the varied training associated with the delivery of health interventions, it is essential adherence and competence are equivocally assured. Motivational Interviewing Treatment Integrity (MITI) coding evaluated our recorded standardized patient oral assessment and planning sessions to identify the skills in which MI-trained students (n = 26) performed compared to student counterparts (n = 24) not trained in the MI curriculum. The full integration of MI in those receiving the MI curriculum resulted in the dental hygiene students with higher ratings for all global ratings, behavioral counts, and summary scores. MI-trained mean scores for evocation, collaboration, autonomy support, empathy, and direction ranged from 4.16(±0.43) to 3.85 (±0.67). All students receiving MI training reached competence in all 5 of the referenced MITI global variables: evocation, collaboration, autonomy support, empathy, and direction. The most substantial improvements for MITI behavioral and summary variables were in Giving Information, MI Adherence, and proportion of Open-Ended Questions. Complex Reflections, and subsequently Ratios of Complex Reflections to Open-Ended Questions were notably below proficiency in the MI group. Knowing which elements were adhered to well and which were lacking helps inform student MI learning outcomes. Results inform the design of MI training curricula to address areas of weakness and maximize performance across all MI fidelity domains.
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Affiliation(s)
- Kimberly Krust Bray
- Division of Dental Hygiene, University of Missouri-Kansas City School of Dentistry, Kansas City, Missouri, USA
| | - Kymberly Bennett
- Undergraduate Psychology Program and Psychology Advising, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, Kansas City, Missouri, USA.,Department of Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri, USA.,University of Kansas School of Medicine, Kansas City, Missouri, USA
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12
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Donos N, Suvan JE, Calciolari E, Nibali L, Rollnick S. The effect of a behavioural management tool in adults with mild to moderate periodontitis. A single-blind, randomized controlled trial. J Periodontal Res 2020; 56:46-57. [PMID: 32959898 DOI: 10.1111/jre.12790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To compare a behavioural management program (test) to a standard communication approach (control) to reduce plaque, improve clinical outcomes and patient's compliance with oral self-care. BACKGROUND Since psychological factors affect oral health-related behaviours, approaches directed at changing behaviours and improving compliance might improve the effect of oral health education. MATERIALS AND METHODS This was a randomized, single-blind, parallel-design trial involving 71 patients with mild to moderate periodontitis. During a run-in period, all participants began using a power toothbrush. Two sessions of non-surgical periodontal therapy were performed post-baseline, along with one of the two oral healthcare communication approaches. Plaque and bleeding scores, probing pocket depth (PPD) and clinical attachment level (CAL) were recorded at the screening visit, baseline visit and at 8 and 14 weeks post-baseline. Patients were asked to fill in oral self-care diaries. Experience questionnaires were administered to both clinicians and patients to assess subjective experience of the clinician-patient interactions during the visits. RESULTS In both groups, a significant reduction in plaque and bleeding scores was observed from baseline to 8 weeks after baseline, which then remained stable at week 14, but no differences between the groups were noted. An improvement in CAL and PPD was recorded at week 8 post-baseline in the test compared to the control group. No inter-group differences in the clinician's and subject's experience questionnaires were observed. CONCLUSION Both approaches significantly promoted periodontal health. However, changing lifestyle requires repeated communication/engagement over time and a behavioural management program based upon two visits did not provide additional benefit compared to a standard approach.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jeanie E Suvan
- Unit of Periodontology, Eastman Dental Institute, University College London (UCL), London, UK
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Department of Medicine and Surgery, School of Dental Medicine, University of Parma, Parma, Italy
| | - Luigi Nibali
- Centre for Oral Immunobiology & Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Centre for Host-Microbiome Interactions, Guy's Hospital, Kings College London, London, UK
| | - Stephen Rollnick
- Cochrane School of Primary Care & Public Health, Cardiff University, Cardiff, UK
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13
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Ramseier CA, Woelber JP, Kitzmann J, Detzen L, Carra MC, Bouchard P. Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: A systematic review. J Clin Periodontol 2020; 47 Suppl 22:90-106. [DOI: 10.1111/jcpe.13240] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Christoph A. Ramseier
- Department of Periodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Johan P. Woelber
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
| | - Julia Kitzmann
- Department of Operative Dentistry and Periodontology Faculty of Medicine University of Freiburg Freiburg Germany
- Private Practice Hamburg Germany
| | - Laurent Detzen
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
| | - Maria Clotilde Carra
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
- Population‐based Epidemiologic Cohorts Unit INSERM UMS 011 Villejuif France
| | - Philippe Bouchard
- Service of Odontology Department of Periodontology Rothschild Hospital AP‐HP Université de Paris U.F.R. of Odontology Paris France
- EA 2496 Université de Paris U.F.R. of Odontology Paris France
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Diet and Oral Health Coaching Methods and Models for the Independent Elderly. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10114021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Health-related behavior based on diet is an important determinant of oral health in independent elderly. Aging impairs senses, mastication, oral status, and function, causing nutritional needs and diet insufficiencies that contribute to a vicious circle of impairment. But the present needs of independent older adults suggest that health research and oral health care should shift from disease management and therapy to integral customized and personal treatment plans, including lifestyle, psychological, nutritional, and oral health coaching approaches. In this paper health coaching approaches in medical and dental settings are valued as to their effectiveness for older adults. Furthermore, coaching approaches for seniors are discussed and coaching models for better senior patient-dentist cooperation on the diet issue are suggested. Diet and oral health coaching is proven to be a modern senior patient-centered approach that needs to be incorporated at all relevant settings. It should aim to empower older adults in co-management of their oral diseases or bad diet habits affecting their oral health. This can be carried out through an incorporated educational plan for dentists either at the postgraduate or professional level since advantages seem to enhance the quality of life of the independent elderly.
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Zabolypour S, Alishapour M, Behnammoghadam M, Abbasi Larki R, Zoladl M. A Comparison of the Effects of Teach-Back and Motivational Interviewing on the Adherence to Medical Regimen in Patients with Hypertension. Patient Prefer Adherence 2020; 14:401-410. [PMID: 32161450 PMCID: PMC7049851 DOI: 10.2147/ppa.s231716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/22/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Arterial hypertension is considered a chronic medical problem and also a challenging condition. The present study aimed to compare the effects of motivational interviewing and teach-back on people with hypertension. MATERIALS AND METHODS In this clinical trial conducted in Yasuj in 2018 a total of 81 patients with essential hypertension were selected in terms of the inclusion criteria. Then, they were randomly divided into three groups: teach-back (Group 1), motivational interviewing (Group 2), and control (Group 3). Three teach-back sessions were held for the teach-back group, five sessions of motivational interviewing for the motivational interviewing group, and the routine care was provided for the control group. In addition, data were collected by the demographic form and scale of Adherence to Systemic Hypertension Treatment, which were completed by participants of all three groups at baseline and also two months from the intervention. Data were analyzed using SPSS 21 by applying descriptive statistics, one-way ANOVA, chi-squared test, Fisher's exact test, and Bonferroni test. FINDINGS Two months from the interventions, in Group 1, the score of adherence to the hypertension treatment regimen significantly increased by 816.38 points compared to the control group, in Group 2 by 1228.9 points compared to the control group, and in Group 2 by 412.6 points compared to Group 1 (p >0.05). CONCLUSION Both teach-back and motivational interviewing increased the adherence to the hypertension treatment regimen; however, motivational interviewing was more effective compared to teach-back in boosting adherence to the hypertension treatment regimen.
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Affiliation(s)
- Soheila Zabolypour
- Medical Surgical Nursing Department, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Maryam Alishapour
- Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
| | | | - Rozina Abbasi Larki
- Urology Department, Medicine Faculty, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Mohammad Zoladl
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
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Garyga V, Pochelu F, Thivichon-Prince B, Aouini W, Santamaria J, Lambert F, Maucort-Boulch D, Gueyffier F, Gritsch K, Grosgogeat B. GoPerio - impact of a personalized video and an automated two-way text-messaging system in oral hygiene motivation: study protocol for a randomized controlled trial. Trials 2019; 20:699. [PMID: 31823812 PMCID: PMC6905095 DOI: 10.1186/s13063-019-3738-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 09/21/2019] [Indexed: 12/30/2022] Open
Abstract
Background Oral hygiene is of paramount importance for the preservation of oral health, and for patients affected by periodontal disease establishing an effective oral hygiene routine is the first step of therapy. Several clinical frameworks have been developed to foster behavior change, such as motivational interviewing. However, two obstacles can be identified. First, patients tend to forget the advice they were given during the consultation. Second, it is hard to maintain motivation in the long term, thus leading to relapse. An innovative eHealth solution was designed with the aim to tackle both obstacles and supplement the current clinical standard of care. The primary objective is to compare the full mouth plaque scores of study groups (eHealth plus standard of care versus standard of care only) at 8 weeks of follow up. The main secondary objective is to compare the full mouth bleeding score at 8 weeks of follow up. Methods/design The “GoPerio” study is a multicenter, randomized, controlled trial assessing the impact of a novel eHealth concept for oral hygiene motivation (personalized video of oral hygiene routine available for the patient via a cloud server plus interactive text messages) in addition to the current standard of care (motivational interviewing plus tooth scaling and polishing). The minimum sample size required is 86 patients. Participants will be randomized (allocation ratio 1:1): test group (eHealth plus standard of care) versus control group (standard of care only). The primary outcome is oral hygiene as measured by the full mouth (six sites per tooth) plaque control record (PCR) index. The main secondary outcome is gingival inflammation as measured by the full mouth (six sites per tooth) bleeding on probing (BOP) index. Both the primary and the main secondary outcomes are evaluated by blinded and calibrated examiners at 8 weeks of follow up. The other secondary outcomes are patient satisfaction and patient behavior change and motivation. Discussion The study will investigate the value of an innovative eHealth approach to strengthen patient motivation for oral hygiene. If proven effective, such an approach would supplement the current clinical standard of care, resulting in improved clinical outcomes with negligible impact on productivity in a dental practice. Trial registration ClinicalTrials.gov, NCT03109808. Registered on 12 April 2017. Sponsor: Hospices Civils de Lyon. BP 2251, 3 quai des Célestins, 69,229 Lyon cedex 02. Protocol version: 1.0 as of 21 September 2016.
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Affiliation(s)
- Valentin Garyga
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | - Florian Pochelu
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | - Béatrice Thivichon-Prince
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France.,Université de Lyon, IGFL UMR 5242, Lyon, France
| | - Walid Aouini
- Université de Monastir, Monastir, Tunisia.,CHU de Liège, Liège, Belgium
| | - Julie Santamaria
- Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Lyon, France
| | - France Lambert
- CHU de Liège, Liège, Belgium.,Université de Liège, Liège, Belgium.,Dental Biomaterials Research Unit, Liège, Belgium
| | - Delphine Maucort-Boulch
- Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Biostatistique-Bioinformatique, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, Département Biostatistiques et Modélisation pour la Santé et l'environnement, Université de Lyon, CNRS UMR 5558, Villeurbanne, France
| | - Francois Gueyffier
- Université de Lyon, Université Lyon 1, Lyon, France.,Laboratoire de Biométrie et Biologie Évolutive, Département Biostatistiques et Modélisation pour la Santé et l'environnement, Université de Lyon, CNRS UMR 5558, Villeurbanne, France
| | - Kerstin Gritsch
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France.,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Lyon, France.,Université de Lyon, LMI UMR CNRS 5615, Lyon, France
| | - Brigitte Grosgogeat
- Faculté d'odontologie, Université de Lyon, Université Lyon 1, Lyon, France. .,Hospices Civils de Lyon, Service de Consultations et de Traitements Dentaires, Lyon, France. .,Université de Lyon, LMI UMR CNRS 5615, Lyon, France.
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Lee CY, Chang CH, Teng NC, Chang HM, Huang WT, Huang YK. Associations between the phenotype and genotype of MnSOD and catalase in periodontal disease. BMC Oral Health 2019; 19:201. [PMID: 31470840 PMCID: PMC6717336 DOI: 10.1186/s12903-019-0877-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2019] [Indexed: 12/14/2022] Open
Abstract
Background Periodontal disease is an inflammatory disease in which pathogenic infections trigger a series of inflammatory responses and redox regulation. The hypothesis of this study was that a host’s redox regulation, as modified by genetic polymorphisms, may affect periodontal disease activities (including the plaque index (PlI), bleeding on probing (BOP), and pocket depth (PD)) during periodontal therapy. Methods In total, 175 patients diagnosed with periodontitis were recruited from the Department of Periodontology, Taipei Medical University Hospital. Both saliva samples and clinical measurements (PlI, BOP, and PD) were taken at the baseline and at 1 month after completing treatment. Salivary manganese superoxide dismutase (MnSOD) and catalase, and corresponding genetic polymorphisms (MnSOD, T47C, rs4880 and Catalase, C-262 T, rs1001179) were determined. The extent of change (Δ) of MnSOD or catalase was calculated by subtracting the concentration after completing treatment from that at the baseline. Results Subjects who carried the Catalase CC genotype had significantly higher salivary MnSOD or catalase levels. The MnSOD genotype had a significant effect on the percentage of PDs of 4~9 mm (p = 0.02), and salivary ΔMnSOD had a significant effect on the PlI (p = 0.03). The Catalase genotype had a significant effect on the PlI (p = 0.01~0.04), but the effect was not found for the mean PlI or PD. There was a significant interaction between the MnSOD genotype and salivary ΔMnSOD on PDs of 4~9 mm. After adjusting for gender, years of schooling, smoking status, and alcohol consumption, subjects with ΔMnSOD of < 0 μg/ml or Δcatalase of < 0 μg/ml had significantly higher 5.58- or 5.17-fold responses to scaling and root planing treatment. Conclusions The MnSOD T47C genotype interferes with the phenotype of salivary antioxidant level, alters MnSOD levels, and influences the PD recovery. MnSOD and catalase gene polymorphism associated with phenotype expression and susceptibility in periodontal root planing treatment responses. Electronic supplementary material The online version of this article (10.1186/s12903-019-0877-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chang-Yu Lee
- Division of Periodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, 11031, Taiwan
| | - Chia-Huang Chang
- College of Public Health and Nutrition, Taipei Medical University, Taipei, 11031, Taiwan
| | - Nai-Chia Teng
- Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, 11031, Taiwan
| | - Hung-Ming Chang
- Department of Anatomy and Cell Biology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan
| | - Wan-Ting Huang
- Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, 11031, Taiwan
| | - Yung-Kai Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan. .,School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan.
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Kitzmann J, Ratka‐Krueger P, Vach K, Woelber JP. The impact of motivational interviewing on communication of patients undergoing periodontal therapy. J Clin Periodontol 2019; 46:740-750. [DOI: 10.1111/jcpe.13132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 04/02/2019] [Accepted: 05/05/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Julia Kitzmann
- Private Practice Hamburg Germany
- Department of Operative Dentistry and Periodontology, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Petra Ratka‐Krueger
- Department of Operative Dentistry and Periodontology, Faculty of Medicine University of Freiburg Freiburg Germany
| | - Kirstin Vach
- Faculty of Medicine, Institute for Medical Biometry and Statistics Medical Center – University of Freiburg Freiburg Germany
| | - Johan P. Woelber
- Department of Operative Dentistry and Periodontology, Faculty of Medicine University of Freiburg Freiburg Germany
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Christofoli BR, Silva NC, Oliveira JAP, Fernandes MI, Haas AN. Predictors of dental plaque and gingivitis in patients receiving integrated dental treatment—a longitudinal retrospective study. Clin Oral Investig 2019; 23:651-659. [DOI: 10.1007/s00784-018-2485-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/02/2018] [Indexed: 11/24/2022]
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20
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Soldani FA, Lamont T, Jones K, Young L, Walsh T, Lala R, Clarkson JE. One-to-one oral hygiene advice provided in a dental setting for oral health. Cochrane Database Syst Rev 2018; 10:CD007447. [PMID: 30380139 PMCID: PMC6516798 DOI: 10.1002/14651858.cd007447.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Effective oral hygiene measures carried out on a regular basis are vital to maintain good oral health. One-to-one oral hygiene advice (OHA) within the dental setting is often provided as a means to motivate individuals and to help achieve improved levels of oral health. However, it is unclear if one-to-one OHA in a dental setting is effective in improving oral health and what method(s) might be most effective and efficient. OBJECTIVES To assess the effects of one-to-one OHA, provided by a member of the dental team within the dental setting, on patients' oral health, hygiene, behaviour, and attitudes compared to no advice or advice in a different format. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 10 November 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 10) in the Cochrane Library (searched 10 November 2017); MEDLINE Ovid (1946 to 10 November 2017); and Embase Ovid (1980 to 10 November 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials (10 November 2017). No restrictions were placed on the language or date of publication when searching the electronic databases. Reference lists of relevant articles and previously published systematic reviews were handsearched. The authors of eligible trials were contacted, where feasible, to identify any unpublished work. SELECTION CRITERIA We included randomised controlled trials assessing the effects of one-to-one OHA delivered by a dental care professional in a dental care setting with a minimum of 8 weeks follow-up. We included healthy participants or participants who had a well-defined medical condition. DATA COLLECTION AND ANALYSIS At least two review authors carried out selection of studies, data extraction and risk of bias independently and in duplicate. Consensus was achieved by discussion, or involvement of a third review author if required. MAIN RESULTS Nineteen studies met the criteria for inclusion in the review with data available for a total of 4232 participants. The included studies reported a wide variety of interventions, study populations, clinical outcomes and outcome measures. There was substantial clinical heterogeneity amongst the studies and it was not deemed appropriate to pool data in a meta-analysis. We summarised data by categorising similar interventions into comparison groups.Comparison 1: Any form of one-to-one OHA versus no OHAFour studies compared any form of one-to-one OHA versus no OHA.Two studies reported the outcome of gingivitis. Although one small study had contradictory results at 3 months and 6 months, the other study showed very low-quality evidence of a benefit for OHA at all time points (very low-quality evidence).The same two studies reported the outcome of plaque. There was low-quality evidence that these interventions showed a benefit for OHA in plaque reduction at all time points.Two studies reported the outcome of dental caries at 6 months and 12 months respectively. There was very low-quality evidence of a benefit for OHA at 12 months.Comparison 2: Personalised one-to-one OHA versus routine one-to-one OHAFour studies compared personalised OHA versus routine OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis, plaque or dental caries (very low quality).Comparison 3: Self-management versus professional OHAFive trials compared some form of self-management with some form of professional OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis or plaque (very low quality). None of the studies measured dental caries.Comparison 4: Enhanced one-to-one OHA versus one-to-one OHASeven trials compared some form of enhanced OHA with some form of routine OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis, plaque or dental caries (very low quality). AUTHORS' CONCLUSIONS There was insufficient high-quality evidence to recommend any specific one-to-one OHA method as being effective in improving oral health or being more effective than any other method. Further high-quality randomised controlled trials are required to determine the most effective, efficient method of one-to-one OHA for oral health maintenance and improvement. The design of such trials should be cognisant of the limitations of the available evidence presented in this Cochrane Review.
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Affiliation(s)
- Francesca A Soldani
- Bradford District Care NHS Foundation TrustCommunity Dental ServiceBradfordUK
| | - Thomas Lamont
- University of Dundee, Dental School & HospitalPark PlaceDundeeTaysideUKDD1 4HN
| | | | - Linda Young
- NHS Education for ScotlandScottish Dental Clinical Effectiveness ProgrammeDundee Dental Education CentreSmall's WyndDundeeUKDD1 4HN
| | - Tanya Walsh
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Rizwana Lala
- School of Clinical Dentistry, University of SheffieldUnit of Dental Public HealthClaremont CrescentSheffieldUKS10 2TA
| | - Janet E Clarkson
- Dundee Dental School, University of DundeeDivision of Oral Health SciencesPark PlaceDundeeScotlandUKDD1 4HR
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Jaedicke KM, Bissett SM, Finch T, Thornton J, Preshaw PM. Exploring changes in oral hygiene behaviour in patients with diabetes and periodontal disease: A feasibility study. Int J Dent Hyg 2018; 17:55-63. [PMID: 30184336 PMCID: PMC7379549 DOI: 10.1111/idh.12365] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/06/2018] [Accepted: 09/01/2018] [Indexed: 11/30/2022]
Abstract
Objective Exploring the feasibility to understand changes in oral hygiene behaviour using the Health Action Process Approach (HAPA) model applied to qualitative research interviews in patients with diabetes and periodontitis undergoing standard periodontitis treatment. Methods Patients with type 1/2 diabetes and chronic periodontitis (n = 8) received standard non‐surgical periodontal treatment accompanied with personalized oral hygiene instructions by a dental hygienist. Clinical indices (% bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), % of sites with PD ≥ 5 mm, periodontal epithelial surface area (PESA) and periodontal inflammatory surface area (PISA) were recorded pre‐ and post‐treatment. At 3 months post‐treatment, patients were interviewed using a topic guide relating to oral health. A behaviour change framework was constructed from elements of the HAPA model and used directly to map interview data to evaluate oral hygiene behaviour in these patients. Results Data from this feasibility study suggest a clinical improvement in periodontal status, albeit only monitored for 3 months. Application of the HAPA model highlighted the behavioural change pathway that diabetes patients undertake before, during and after periodontal treatment. The data suggest that patients move through all elements of the motivation phase and all elements of the volition phase except for the recovery self‐efficacy element. Conclusion The novel approach of applying the HAPA model to qualitative research data allowed for the collection of richer data compared to quantitative analysis only. Findings suggest that, in general, patients with periodontitis and diabetes successfully manage to incorporate new oral hygiene behaviours into their daily routine.
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Affiliation(s)
- Katrin M Jaedicke
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK
| | - Susan M Bissett
- Centre for Oral Health Research, School of Dental Sciences and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery & Health, Northumbria University, Coach Lane Campus West, Newcastle upon Tyne, UK
| | - Jared Thornton
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Philip M Preshaw
- Centre for Oral Health Research, School of Dental Sciences and Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
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Wide U, Hagman J, Werner H, Hakeberg M. Can a brief psychological intervention improve oral health behaviour? A randomised controlled trial. BMC Oral Health 2018; 18:163. [PMID: 30285814 PMCID: PMC6171315 DOI: 10.1186/s12903-018-0627-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/24/2018] [Indexed: 12/18/2022] Open
Abstract
Background Dental caries is a major public health issue affecting a large proportion of the general population. The disease is associated with behavioural factors and is thus preventable to a high degree. Individuals may need assistance to be able to change their oral health behaviour. There is a lack of such interventions for adults affected by severe caries. The aim of the study was to evaluate the effect of Acceptance and Commitment Therapy (ACT), a form of cognitive behavioural therapy, on oral health behaviour in young adults with poor oral health. Methods The study included a two group parallel randomised controlled trial at general dental clinics, with young adults, 18–25 years of age, ≥ two manifest proximal dental caries lesions (n = 135); 67 were treated with ACT and 68 with standard disease information only, respectively. Primary outcomes: oral health behaviours (tooth-brushing, flossing, use of toothpicks, and additional fluoride use). The CONSORT principles for RCTs were used, including intention-to-treat and per protocol analyses. The Chi-square, Mann-Whitney, and Wilcoxon Signed Rank tests were applied, including effect sizes. Results The study groups did not differ with regard to oral health behaviour variables at baseline. The intervention group improved all their oral health behaviours significantly over time (effect sizes, 0.26–0.32), while the control group showed improved behaviours on two measures (flossing and additional use of fluoride, effect sizes, 0.22–0.23). Conclusions By testing a psychological intervention on young adults (18–25 years of age) with a high prevalence of caries, we found an immediate positive effect with improved oral health behaviours. Trial registration TRN ISRCTN15009620, retrospectively registered 14/03/2018.
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Affiliation(s)
- U Wide
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, SE-40530, Gothenburg, Sweden.
| | - J Hagman
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, SE-40530, Gothenburg, Sweden
| | - H Werner
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, SE-40530, Gothenburg, Sweden
| | - M Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, SE-40530, Gothenburg, Sweden
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Rigau-Gay MM, Claver-Garrido E, Benet M, Lusilla-Palacios P, Ustrell-Torrent JM. Effectiveness of motivational interviewing to improve oral hygiene in orthodontic patients: A randomized controlled trial. J Health Psychol 2018; 25:2362-2373. [DOI: 10.1177/1359105318793719] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Maintaining good oral hygiene in patients wearing fixed appliances is a challenge for orthodontics. Conventional education has been demonstrated to be insufficient for the promotion of good oral habits, while motivational interviewing has the potential to facilitate health behavior change. The present randomized controlled trial with 130 patients aimed to evaluate the effectiveness of a single session of motivational interviewing in enhancing oral hygiene in orthodontic patients compared with conventional education alone. Results revealed an immediate improvement in oral hygiene which remained stable throughout the 6-month follow-up.
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Affiliation(s)
| | | | - Marta Benet
- Global Health Institute Barcelona (ISGlobal), Spain
- Universitat Pompeu Fabra (UPF), Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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Newton JT, Asimakopoulou K. Behavioral models for periodontal health and disease. Periodontol 2000 2018; 78:201-211. [DOI: 10.1111/prd.12236] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jonathon T. Newton
- Unit of Social and Behavioural Sciences; Population & Patient Health; King's College London; Guy's Hospital; London UK
| | - Koula Asimakopoulou
- Unit of Social and Behavioural Sciences; Population & Patient Health; King's College London; Guy's Hospital; London UK
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Chang CH, Han ML, Teng NC, Lee CY, Huang WT, Lin CT, Huang YK. Cigarette Smoking Aggravates the Activity of Periodontal Disease by Disrupting Redox Homeostasis- An Observational Study. Sci Rep 2018; 8:11055. [PMID: 30038248 PMCID: PMC6056417 DOI: 10.1038/s41598-018-29163-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 06/12/2018] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to evaluate the associations between cigarette use and five salivary oxidative stress biomarkers, copper-zinc superoxide dismutase (Cu/Zn SOD), manganese superoxide dismutase (MnSOD), catalase, thioredoxin-1 (TRX1), and peroxiredoxin-2 (PRX2), to assess the effectiveness of non-surgical periodontal therapy. MATERIALS AND METHODS This is an observational study,167 patients diagnosed with periodontitis were recruited. Both saliva samples and clinical measurements (plaque index (PI), bleeding on probing (BOP), and pocket depth (PD)) were taken at baseline and after completing non-surgical periodontal therapy. The Levels of salivary biomarkers were determined using a MILLIPLEX® MAP Human Oxidative Stress Magnetic Bead Panel kit. The overall reductions in PI and BOP were 31.56% and 42.16%, respectively. BOP reduction after treatment in female or male non-smokers was significantly higher than in male former smokers (p < 0.05). After completing non-surgical periodontal therapy, Cu/ZnSOD, MnSOD, catalase, and Prx2 significantly decreased. There was a significant interaction between smoking status and ΔCu/ZnSOD on PI and a significant interaction between smoking status and ΔCatalase on BOP. CONCLUSIONS Cigarette smoking interferes with redox homeostasis in the body, alters antioxidants levels, and influences the periodontal disease activity.
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Affiliation(s)
- Chia-Huang Chang
- College of Public Health and Nutrition, Taipei Medical University, Taipei, 110, Taiwan
| | - Ming-Lun Han
- Department of Internal Medicine, Min-Sheng General Hospital, Taoyuan, 330, Taiwan
| | - Nai-Chia Teng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11s0, Taiwan
| | - Chang-Yu Lee
- Division of Periodontics, Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, 110, Taiwan
| | - Wan-Ting Huang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11s0, Taiwan
| | - Che-Tong Lin
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11s0, Taiwan
| | - Yung-Kai Huang
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, 110, Taiwan.
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Stenman J, Wennström JL, Abrahamsson KH. A brief motivational interviewing as an adjunct to periodontal therapy-A potential tool to reduce relapse in oral hygiene behaviours. A three-year study. Int J Dent Hyg 2017; 16:298-304. [DOI: 10.1111/idh.12308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2017] [Indexed: 12/17/2022]
Affiliation(s)
- J Stenman
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - JL Wennström
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - KH Abrahamsson
- Department of Periodontology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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Hoben M, Kent A, Kobagi N, Huynh KT, Clarke A, Yoon MN. Effective strategies to motivate nursing home residents in oral care and to prevent or reduce responsive behaviors to oral care: A systematic review. PLoS One 2017; 12:e0178913. [PMID: 28609476 PMCID: PMC5469468 DOI: 10.1371/journal.pone.0178913] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/09/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Poor oral health has been a persistent problem in nursing home residents for decades, with severe consequences for residents and the health care system. Two major barriers to providing appropriate oral care are residents' responsive behaviors to oral care and residents' lack of ability or motivation to perform oral care on their own. OBJECTIVES To evaluate the effectiveness of strategies that nursing home care providers can apply to either prevent/overcome residents' responsive behaviors to oral care, or enable/motivate residents to perform their own oral care. MATERIALS AND METHODS We searched the databases Medline, EMBASE, Evidence Based Reviews-Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science for intervention studies assessing the effectiveness of eligible strategies. Two reviewers independently (a) screened titles, abstracts and retrieved full-texts; (b) searched key journal contents, key author publications, and reference lists of all included studies; and (c) assessed methodological quality of included studies. Discrepancies at any stage were resolved by consensus. We conducted a narrative synthesis of study results. RESULTS We included three one-group pre-test, post-test studies, and one cross-sectional study. Methodological quality was low (n = 3) and low moderate (n = 1). Two studies assessed strategies to enable/motivate nursing home residents to perform their own oral care, and to studies assessed strategies to prevent or overcome responsive behaviors to oral care. All studies reported improvements of at least some of the outcomes measured, but interpretation is limited due to methodological problems. CONCLUSIONS Potentially promising strategies are available that nursing home care providers can apply to prevent/overcome residents' responsive behaviors to oral care or to enable/motivate residents to perform their own oral care. However, studies assessing these strategies have a high risk for bias. To overcome oral health problems in nursing homes, care providers will need practical strategies whose effectiveness was assessed in robust studies.
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Affiliation(s)
- Matthias Hoben
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Angelle Kent
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Nadia Kobagi
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Kha Tu Huynh
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Alix Clarke
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Minn N. Yoon
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Abstract
Data sourcesThe Cochrane Oral Health Groups Trial Register, Medline, Embase and PsycINFO.Study selectionRandomised controlled trials (RCTs), controlled clinical trials (CCTs), cohort studies or case-control studies were considered. Only studies in patients aged 18 or older with pre-existing periodontal disease and clearly stating a psychological model or theory had been used were included. Studies exploring smoking cessation were not included.Data extraction and synthesisAll data were collected by a single author using pre-decided parameters. The reviewers used the Cochrane criteria to assess risk of bias in clinical trials and the Newcastle Ottawa Scale for observational studies. Marked heterogeneity from the wide variety of psychological approaches used in the studies prevented meta-analysis.ResultsFifteen papers relating to 14 different studies were included from an initial 722 articles identified. This included three cohort studies, ten RCTs and a before/after study. A total of 1,106 patients were included across the studies. Of the 19 psychological models included in the initial search, seven were shown to have some form of impact on oral hygiene motivation, demonstrated by observed behavioural and clinical outcomes.ConclusionsThe authors concluded that, in adult patients with pre-existing periodontal disease, understanding of the seriousness of periodontal disease and the benefits of behavioural change resulted in improved adherence to oral hygiene instructions. They concluded that goal-setting, self-monitoring and indeed planning can be useful in improving oral health-related behaviours.
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Affiliation(s)
- Brett Duane
- Dublin Dental University Hospital, Dublin, Eire
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Kopp SL, Ramseier CA, Ratka-Krüger P, Woelber JP. Motivational Interviewing As an Adjunct to Periodontal Therapy-A Systematic Review. Front Psychol 2017; 8:279. [PMID: 28293208 PMCID: PMC5329060 DOI: 10.3389/fpsyg.2017.00279] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/14/2017] [Indexed: 12/11/2022] Open
Abstract
Aim: Periodontal therapy is highly dependent on a patient's long-term adherence with regard to oral hygiene, diet, and regular check-ups at the dentist. Motivational Interviewing (MI) is a client-centered, directive method for encouraging a patients' behavioral health change. The aim of this systematic review was to reveal the effects of MI as an adjunct to periodontal therapy. Methods: Three databases (PubMed, Cochrane Library, and Web of Science) were reviewed for randomized controlled clinical trials. Articles were included when using MI as an adjunct to periodontal therapy and presenting clinical periodontal and oral hygiene related parameters. Two authors independently coded the relevant articles. Results: The search yielded 496 articles. After analysis and exclusion, a total of five papers could be included. The quality of the articles ranged between 72–88%. The two independent raters showed a high inter-rater reliability (Cohens-Kappa = 0.89). In two studies MI showed a significant positive effect on bleeding on probing and plaque values. One study showed improvement of self-efficacy in interdental cleaning. Two studies showed no influence of MI on periodontal parameters of the patients. Conclusion: The use of MI as an adjunct to periodontal therapy might have a positive influence on clinical periodontal parameters (plaque values, gingival, and periodontal inflammation) and psychological factors related to oral hygiene (self-efficacy). Due to the low body of evidence further studies are needed. Future studies should include fidelity measures of the applied MI, a high number of counselors, several MI sessions, and long-term study follow-up to show potential effects.
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Affiliation(s)
- Svenja L Kopp
- Department of Operative Dentistry and Periodontology. University Freiburg Medical Center Freiburg im Breisgau, Germany
| | - Christoph A Ramseier
- Department of Periodontology and Fixed Prosthodontics, University of Bern, School of Dental Medicine Bern, Switzerland
| | - Petra Ratka-Krüger
- Department of Operative Dentistry and Periodontology. University Freiburg Medical Center Freiburg im Breisgau, Germany
| | - Johan P Woelber
- Department of Operative Dentistry and Periodontology. University Freiburg Medical Center Freiburg im Breisgau, Germany
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Newton JT, Asimakopoulou K. Managing oral hygiene as a risk factor for periodontal disease: a systematic review of psychological approaches to behaviour change for improved plaque control in periodontal management. J Clin Periodontol 2016; 42 Suppl 16:S36-46. [PMID: 25639708 DOI: 10.1111/jcpe.12356] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Plaque control in patients with periodontal disease is critically dependent upon self-care through specific oral hygiene-related behaviours. OBJECTIVES To determine the relationship between adherence to oral hygiene instructions in adult periodontal patients and psychological constructs. To determine the effect of interventions based on psychological constructs on oral health-related behaviour in adult periodontal patients. DATA SOURCES The Cochrane Oral Health Group's Trials Register, MEDLINE, EMBASE and PsycINFO. STUDY APPRAISAL AND SYNTHESIS METHODS Studies were grouped according to the study design, and appraised using an appropriate methodology, either the Newcastle-Ottawa assessment for observational studies, or the Cochrane criteria for trials. RESULTS Fifteen reports of studies were identified. LIMITATIONS There was a low risk of bias identified for the observational studies. Older trials suffered from high risk of bias, but more recent trials had low risk of bias. However, the specification of the psychological intervention was generally poor. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS The use of goal setting, self-monitoring and planning are effective interventions for improving oral hygiene-related behaviour in patients with periodontal disease. Understanding the benefits of behaviour change and the seriousness of periodontal disease are important predictors of the likelihood of behaviour change.
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Wilder RS, Bray KS. Improving periodontal outcomes: merging clinical and behavioral science. Periodontol 2000 2016; 71:65-81. [DOI: 10.1111/prd.12125] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 02/03/2023]
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Woelber JP, Spann-Aloge N, Hanna G, Fabry G, Frick K, Brueck R, Jähne A, Vach K, Ratka-Krüger P. Training of Dental Professionals in Motivational Interviewing can Heighten Interdental Cleaning Self-Efficacy in Periodontal Patients. Front Psychol 2016; 7:254. [PMID: 26941698 PMCID: PMC4764709 DOI: 10.3389/fpsyg.2016.00254] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 02/09/2016] [Indexed: 11/16/2022] Open
Abstract
Background: The success of periodontal therapy depends on the adherence of patients to professional recommendations. The aim of this study was to investigate the influence of a workshop in motivational interviewing (MI) on non-surgical periodontal treatment performed by dental students. Materials and Methods: In the experimental group patients with periodontitis were treated by students trained in MI, while in the control group patients were treated by students who had not been trained in MI. Clinical oral parameters were assessed by a blinded periodontist in addition to the evaluation of psychological questionnaires given before and after the non-surgical periodontal treatment (6 months). Conversations between patients and students were recorded and rated with the Motivational Treatment Integrity Code (MITI-d) by a blinded psychologist. Results: There were 73 patients in the MI group and 99 patients in the control group. The MI group showed significantly higher scores in the MITI-d analysis. Regression analysis showed that there were no significant differences between groups with regard to plaque level, gingival bleeding, pocket depth reduction or bleeding upon probing. However, patients in the MI-group showed significantly higher interdental cleaning self-efficacy than patients in the control group (MI = 19.57 ± 4.7; control = 17.38 ± 6.01; p = 0.016). Conclusion: Teaching MI to dental students resulted in a significant improvement in the self-efficacy of interdental cleaning in patients compared to a control group of non-trained students, but no improvement in other aspects of non-surgical periodontal therapy. The study also showed that an 8-h workshop with supervision significantly improved the MI-compliant conversations of dental students without requiring more conversation time.
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Affiliation(s)
- Johan P Woelber
- Department of Operative Dentistry and Periodontology, University Medical Center Freiburg Freiburg, Germany
| | - Narin Spann-Aloge
- Department of Operative Dentistry and Periodontology, University Medical Center Freiburg Freiburg, Germany
| | - Gilgamesh Hanna
- Department of Operative Dentistry and Periodontology, University Medical Center Freiburg Freiburg, Germany
| | - Goetz Fabry
- Department of Medical Psychology, University Medical Center Freiburg Freiburg, Germany
| | | | - Rigo Brueck
- Private Psychological Practice, San Diego CA, USA
| | - Andreas Jähne
- Rhein-Jura Klinik, Clinic for Psychotherapy Bad Säckingen, Germany
| | - Kirstin Vach
- Department of Medical Biometry and Statistics, University Medical Center Freiburg Freiburg, Germany
| | - Petra Ratka-Krüger
- Department of Operative Dentistry and Periodontology, University Medical Center Freiburg Freiburg, Germany
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Werner H, Hakeberg M, Dahlström L, Eriksson M, Sjögren P, Strandell A, Svanberg T, Svensson L, Wide Boman U. Psychological Interventions for Poor Oral Health. J Dent Res 2016; 95:506-14. [DOI: 10.1177/0022034516628506] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this systematic review and meta-analysis was to study the effectiveness of psychological interventions in adults and adolescents with poor oral health. The review follows the PRISMA guidelines for systematic reviews. The PICO format (population, intervention, comparison, and outcome) was used to define eligible studies. The populations were adults or adolescents (≥13 y of age and independent of others) with poor oral health (defined as dental caries, periodontal disease, and/or peri-implantitis). The interventions were psychological and/or behavioral models and theories, in comparison with traditional oral health education/information. The primary outcomes were dental caries, periodontitis, gingivitis, and peri-implantitis. Secondary outcomes were dental plaque, oral health–related behavior, health-related quality of life, health beliefs and attitudes, self-perceived oral health, and complications/risks. The systematic literature search identified 846 articles in December 2013 and 378 articles in July 2015. In total, 11 articles on 9 randomized controlled trials were found to meet the inclusion criteria. These reported on adults with periodontal disease, and several used motivational interviewing (MI) as their mode of intervention. The CONSORT guidelines and the GRADE approach were used for study appraisal and rating of evidence. The meta-analysis showed no statistically significant differences in gingivitis or plaque presence. In addition, a meta-analysis on MI compared with education/information found no statistically significant differences in gingivitis presence. Only 1 meta-analysis—on psychological interventions versus education/information regarding the plaque index—showed a small but statistically significant difference. There were also statistically significant differences reported in favor of psychological interventions in oral health behavior and self-efficacy in toothbrushing. However, the clinical relevance of these differences is difficult to estimate. The certainty of evidence was low. Future research needs to address several methodological issues and not only study adults with periodontal disease but also adolescents and patients with dental caries and peri-implantitis.
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Affiliation(s)
- H. Werner
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M. Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - L. Dahlström
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - M. Eriksson
- Medical Library, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - P. Sjögren
- Health Technology Assessment–centre, Region Västra Götaland, Gothenburg, Sweden
| | - A. Strandell
- Health Technology Assessment–centre, Region Västra Götaland, Gothenburg, Sweden
| | - T. Svanberg
- Medical Library, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - L. Svensson
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - U. Wide Boman
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Pietrabissa G, Ceccarini M, Borrello M, Manzoni GM, Titon A, Nibbio F, Montano M, Bertone G, Gondoni L, Castelnuovo G. Enhancing behavioral change with motivational interviewing: a case study in a Cardiac Rehabilitation Unit. Front Psychol 2015; 6:298. [PMID: 25852614 PMCID: PMC4364083 DOI: 10.3389/fpsyg.2015.00298] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 03/02/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Psychological interventions in cardiac rehabilitation programs appear relevant in as much they significantly contribute to achieve the goals of rehabilitation, to reduce the risk of relapses and to improve patients' adherence to therapy. To this aim, motivational interviewing (MI) has shown promising results in improving motivation to change and individuals' confidence in their ability to do so. OBJECTIVE The purpose of this article is to integrate theory with practice by describing a three-session case scenario. It illustrates how MI's skills and strategies can be used to enhance heart-healthy habits. MI may be synergistic with other treatment approaches and it is used here in conjunction with brief strategic therapy. CONCLUSION By the use of MI principles and techniques, the patient reported an increase in his motivation and ability to change, developing a post discharge plan that incorporates self-care behaviors. CLINICAL IMPLICATIONS MI may be effective in motivating and facilitating health behavior change among obese patients suffering from heart failure.
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Affiliation(s)
- Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
- Department of Psychology, Catholic University of Milan, MilanItaly
| | - Martina Ceccarini
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
- Faculty of Psychology, University of Bergamo, BergamoItaly
| | - Maria Borrello
- Faculty of Psychology, University of Bergamo, BergamoItaly
| | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
- Department of Psychology, Catholic University of Milan, MilanItaly
| | - Annamaria Titon
- Cardiac Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
| | - Ferruccio Nibbio
- Cardiac Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
| | - Mariella Montano
- Cardiac Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
| | - Gianandrea Bertone
- Cardiac Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
| | - Luca Gondoni
- Cardiac Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Saint Joseph Hospital, VerbaniaItaly
- Department of Psychology, Catholic University of Milan, MilanItaly
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Woelber JP, Bienas H, Fabry G, Silbernagel W, Giesler M, Tennert C, Stampf S, Ratka-Krüger P, Hellwig E. Oral hygiene-related self-efficacy as a predictor of oral hygiene behaviour: a prospective cohort study. J Clin Periodontol 2015; 42:142-9. [PMID: 25472523 DOI: 10.1111/jcpe.12348] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2014] [Indexed: 11/26/2022]
Abstract
AIM The aim of this study was to assess whether oral hygiene-related self-efficacy is correlated with current oral hygiene and might influence the outcome of oral hygiene instruction. MATERIALS AND METHODS Hundred and twenty-six patients filled out questionnaires about oral hygiene-related self-efficacy, general self-efficacy, oral hygiene-related knowledge and demographic variables. Plaque and gingival inflammation were measured and an individual oral hygiene plan was conducted. After 6 months, oral hygiene indices were assessed again. RESULTS Women had significantly higher scores in oral hygiene-related self-efficacy than men (women mean 60.40 ± 9.41; men mean 56.04 ± 11.55; p = 0.039) and oral hygiene-related self-efficacy was significantly correlated with general self-efficacy independent from the age of the patients (r = 0.3114, p = 0.0004). Higher scores in oral hygiene-related self-efficacy were significantly correlated with lower scores of gingival bleeding for non-smoking patients (r = -0.301, p = 0.0066), usage of a professional tooth cleaning within these 6 months (p = 0.0406), reappearance to the follow-up appointment (p = 0.0303), and higher goals in inter-dental cleaning plans (p = 0.0189). CONCLUSION Oral hygiene-related self-efficacy is an influencing factor in the oral hygiene behaviour and has the potential to predict patients' oral hygiene outcomes.
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Affiliation(s)
- Johan P Woelber
- Department of Operative Dentistry and Periodontology, University Freiburg Medical Center, Freiburg im Breisgau, Germany
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Cascaes AM, Bielemann RM, Clark VL, Barros AJD. Effectiveness of motivational interviewing at improving oral health: a systematic review. Rev Saude Publica 2014; 48:142-53. [PMID: 24789647 PMCID: PMC4206116 DOI: 10.1590/s0034-8910.2014048004616] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 09/22/2013] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To analyze the effectiveness of motivational interviewing (MI) at improving
oral health behaviors (oral hygiene habits, sugar consumption, dental
services utilization or use of fluoride) and dental clinical outcomes
(dental plaque, dental caries and periodontal status). METHODS A systematic search of PubMed, LILACS, SciELO, PsyINFO, Cochrane and Google
Scholar bibliographic databases was conducted looking for intervention
studies that investigated MI as the main approach to improving the oral
health outcomes investigated. RESULTS Of the 78 articles found, ten met the inclusion criteria, all based on
randomized controlled trials. Most studies (n = 8) assessed multiple
outcomes. Five interventions assessed the impact of MI on oral health
behaviors and nine on clinical outcomes (three on dental caries, six on
dental plaque, four on gingivitis and three on periodontal pockets). Better
quality of evidence was provided by studies that investigated dental caries,
which also had the largest population samples. The evidence of the effect of
MI on improving oral health outcomes is conflicting. Four studies reported
positive effects of MI on oral health outcomes whereas another four showed
null effect. In two interventions, the actual difference between groups was
not reported or able to be recalculated. CONCLUSIONS We found inconclusive effectiveness for most oral health outcomes. We need
more and better designed and reported interventions to fully assess the
impact of MI on oral health and understand the appropriate dosage for the
counseling interventions.
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Gao X, Lo ECM, Kot SCC, Chan KCW. Motivational Interviewing in Improving Oral Health: A Systematic Review of Randomized Controlled Trials. J Periodontol 2014; 85:426-37. [DOI: 10.1902/jop.2013.130205] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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