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Objectives: To describe and evaluate an individually tailored treatment programme based on a behavioural medicine approach to oral hygiene self-care for patients with chronic periodontitis. Methods: Two experimental single-case studies with multiple-baseline design across different self-administered oral hygiene behaviours were conducted. Cognitive Behavioural techniques were used to organize the strategies for the intervention and the approach to counselling was inspired by and structured in accordance with Motivational Interviewing. The central features in the programme were the individual analysis of knowledge and oral hygiene habits, individually set goals for oral hygiene behaviour, practice of manual dexterity for oral hygiene aids, continuous self-monitoring of the behaviour and prevention of relapse. Results: Both participants reached the predecided criteria for clinical significance in reducing plaque and bleeding on probing. Reductions of periodontal probing depth were achieved as well. The positive results remained stable throughout the 2-year study period. Conclusion: The successful application of this educational model suggests that it could be used as a method for tailoring interventions targeted to oral hygiene for patients with periodontal conditions. The programme will now be tested in a larger randomized controlled trial.

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

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.

When oral health interventions for behavior change are evaluated psychological outcomes ought to be included. The study evaluate the effects of two different oral hygiene interventions on attitudes, subjective norms and self-efficacy, and examined the predictive value of these individual factors for interdental cleaning (IC), plaque control (PlI) and bleeding on probing 12-months after non-surgical periodontal treatment Participants (n=113) were randomly allocated to an experimental or a control group. The experimental intervention was an individually tailored treatment based on participants’ cognitions and beliefs, behavioral goals, and oral health status. In the experimental group, the intention to perform IC daily increased. High self-efficacy (SE) scores at baseline predicted daily IC and PlI scores ≤ 20%, 12-month after treatment. Individuals with low SE had a higher probability of attaining a successful level of oral hygiene if treated with experimental intervention rather than standard treatment.