Psychological approaches to behaviour for improving plaque control.

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.