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Evaluation of an individually tailored oral health educational programme on periodontal health
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Högskolan, Dalarna.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Socialstyrelsen, Stockholm.
2010 (English)In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 37, no 10, 912-919 p.Article in journal (Refereed) Published
Abstract [en]

Aim: To evaluate an individually tailored oral health educational programme (ITOHEP) on periodontal health compared with a standard oral health educational programme. A further aim was to evaluate whether both interventions had a clinically significant effect on non-surgical periodontal treatment at 12-month follow-up. Material and Method: A randomized, evaluator-blinded, controlled trial with 113 subjects (60 females and 53 males) randomly allocated into two different active treatments was used. ITOHEP was based on cognitive behavioural principles and motivational interviewing. The control condition was standard oral hygiene education (ST). The effect on bleeding on probing (BoP), periodontal pocket depth, "pocket closure" i.e. percentage of periodontal pocket >4 mm before treatment that were <5 mm after treatment, oral hygiene [plaque indices (PlI)], and participants' global rating of oral health was evaluated. Preset criteria for PlI, BoP, and "pocket closure" were used to describe clinically significant non-surgical periodontal treatment success. Results: The ITOHEP group had lower BoP scores 12-month post-treatment (95% confidence interval: 5-15, p<0.001) than the ST group. No difference between the two groups was observed for "pocket closure" and reduction of periodontal pocket depth. More individuals in the ITOHEP group reached a level of treatment success. Lower PlI scores at baseline and ITOHEP intervention gave higher odds of treatment success. Conclusions: ITOHEP intervention in combination with scaling is preferable to the ST programme in non-surgical periodontal treatment.

Place, publisher, year, edition, pages
2010. Vol. 37, no 10, 912-919 p.
Keyword [en]
Randomized controlled trial; Oral hygiene behaviour; Periodontitis; Cognitive behavioural strategies; clinical significance
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-111554DOI: 10.1111/j.1600-051X.2010.01590.xISI: 000281636300007OAI: oai:DiVA.org:uu-111554DiVA: diva2:281596
Projects
Behavioural medicine perspectives for change and prediction of oral hygiene behaviour
Available from: 2009-12-16 Created: 2009-12-16 Last updated: 2010-12-03Bibliographically approved
In thesis
1. Behavioural Medicine Perspectives for Change and Prediction of Oral Hygiene Behaviour: Development and Evaluation of an Individually Tailored Oral Health Educational Program
Open this publication in new window or tab >>Behavioural Medicine Perspectives for Change and Prediction of Oral Hygiene Behaviour: Development and Evaluation of an Individually Tailored Oral Health Educational Program
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis is about a behavioural medicine approach in periodontal treatment and oral hygiene self-care. The aim of this thesis was to develop, describe, and evaluate an individually tailored oral health educational program on oral hygiene behaviour and non-surgical periodontal treatment success, and to determine factors of importance for predicting oral hygiene behaviour.

Two separate studies, both conducted at a specialist clinic for periodontics in a Swedish county council are described. In the first study, the program was developed and described in two experimental single-case studies with multiple baseline designs (Paper I). The second study was a randomised controlled single-blinded trial [n = 113, mean age 51.2, 53% female] in which, the effectiveness of the program was compared with standard treatment on oral hygiene habits, plaque control, and gingivitis (Paper II), periodontal status (Paper III), and attitudes, subjective norms, and self-efficacy (Paper IV). The tailored oral health educational program included a motivational interviewing method and cognitive behavioural techniques, and the individual tailoring for each participant was based on participants’ thoughts and cognitions, intermediate and long-term goals, and oral health status.

Participants in the individually tailored program reported higher frequency of daily interdental cleaning and were more confident about maintaining the attained level of behaviour change, had better oral hygiene, and healthier gingival tissue, particularly interproximally. There was a great reduction in periodontal pocket depth and bleeding on probing scores (BoP) for participants in both programs with a greater reduction in BoP scores in the tailored-treatment group. A lower dental plaque score at treatment start increased the predicted probability of attaining treatment success, and self-efficacy towards interdental cleaning predicted oral hygiene behaviour.

These studies demonstrate an individually tailored oral health education program is preferable to standard program as an oral hygiene behaviour change interventions in non-surgical periodontal treatment.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 76 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 510
Keyword
Behavioural medicine, oral health education, Periodontitis, tailored treatment, self-efficacy.
National Category
Dentistry
Identifiers
urn:nbn:se:uu:diva-111546 (URN)978-91-554-7690-8 (ISBN)
Public defence
2010-02-12, Universitetshuset, Sal IX, Övre Slottsgatan 2, Uppsala, 10:00 (Swedish)
Opponent
Supervisors
Projects
Behavioural medicine perspectives for change and prediction of oral hygiene behaviour
Available from: 2010-01-22 Created: 2009-12-16 Last updated: 2010-01-22Bibliographically approved

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