Management of Patient Behaviour towards Oral Health

Dental professionals have an ideal opportunity to help patients improve their oral health with good oral hygiene habits.

Understanding behavior change in patients can help dental professionals be more successful in encouraging patient compliance to adopt antimicrobial rinsing by targeting interventions to the individual patient’s values, stage of readiness to change, and skill set.

What are some patient’s barriers to change?

• Patients may not view chronic gingivitis/periodontitis as threatening

• Patients feel oral health care instructions are time consuming and difficult to follow

• Patients may suffer from dental treatment anxiety

• Lack of economic resources may be a factor

What are some dental professionals' barriers to encourage change?

• Some professionals have the habit of only recommending traditional oral hygiene measures (brushing, flossing) when there are incremental benefits of adding an alternative oral hygiene measure (e.g. antimicrobial mouthrinse)

• Lack of confidence in using motivational techniques

• Lowered expectations that patients will listen to their advice and make a change

• Lack of time for oral hygiene instruction

The transtheoretical stages of change model is useful in this case with suggested intervention:

What are some practical tips for behaviour change with patients?

1. Become comfortable asking questions and listening

• Ask about current health practices

• Determine the patient’s motive for wanting to change and use that as the point of discussion

Example: What do you do on a daily basis to take care of your mouth?

2. Assess patient willingness to change

• If not ready, provide interventions over multiple visits

• If ready, supervise practice and provide a plan. Explain that lapses do happen.

Example: Would you be willing to try using an antimicrobial mouthrinse twice daily?

3. Anticipate obstacles

• Stressful life experiences can disrupt formation of positive habits

• Encourage patient to incorporate external memory triggers to maintain or resume positive oral health habits during stressful periods

Example: It can be hard sometimes to remember new healthy habits when we’re busy, sick, traveling, or stressed out. What are some ways that help you remember to do things when life is stressful? What are some obstacles that may keep you from using an antimicrobial mouthrinse twice daily?

4. Follow up with the patient

• Specific follow-up and praise demonstrate care for the patient and is appreciated

Example: Were you able to find a product you really liked? Could you easily access the product? Was it hard to be consistent? What was your biggest challenge? Even though you weren’t able to use the rinse every day twice daily, I’m glad that you were able to use it before bed most nights. You have made a great start! Do you think you can use it more often?