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Effectively communicate behavioral change to patients with periodontal disease

Date: February 2021

Author: Natalie Bradley Dip SCD MFDS RCSEd

There is a high prevalence of periodontal disease globally. Managing and treating periodontal disease requires patient cooperation and behavior changes for home care and habits. This is often a challenge, especially if substantial behavior changes are needed in order to improve oral health. The following section focuses on how to have successful conversations with our patients regarding behavioral change as part of the management of periodontal disease.

How can we motivate patients to change?

Motivating patients to change is not easy! It has been shown that initiating conversations by linking a person’s current health concern with their health behavior can lead to resistance to the advice health care professionals are trying to deliver. There are some strategies that are generally better received, for example:

Capitalise on patient initiated discussions. For example, if a patient has mentioned earlier in the conversation that they had thought of investing in an electric toothbrush, you can bring that into the discussion and inform them of the benefits of using an electric toothbrush and recommend one, providing instructions on how to use it for oral hygiene at home.

Use questions and answers. Encourage your patients to answer questions and in your answers talk about how to improve their behaviors. For example, if they ask what the causes of periodontal disease are, you can discuss their oral hygiene regime and other habits such as smoking.

Motivational Interviewing is increasingly being applied in medical and dental fields as a method to encourage behavior change. This uses a patient-centered approach to help the patient recognize why they should, and how they can, change their behavior.

Patient discussion on periodontal disease that is specific to the person and discusses the associations and links between periodontal health and general health.

Encouraging positive behavior throughout the patient journey, for example if they improve their oral hygiene between visits to positively recognize this with the patient.

Reinforcement of advice at each patient visit.

If techniques like above are used, for adult patients with pre-existing periodontal disease, understanding of the seriousness of periodontal disease and the benefits of behavioral change has been found to result in improved adherence to oral hygiene instructions.

What should we avoid?

It is really important to avoid starting on the wrong foot when having these conversations with patients, such as linking current health concerns to personal behavior which can lead to rejection of the change you are suggesting.

What behavior changes are needed?

Advice should include effective plaque control measures, including the prescription or recommendation of home-use oral care products will help patients. For individuals with gingivitis, oral hygiene advice leading to improvements in oral hygiene are needed and treatment may also be required. In addition to using antibacterial toothpaste such as Colgate Total, brushing and interdental cleaning advice and recommendations will help patients. In addition, an antimicrobial rinse can help to reduce gingivitis, and in the case of patients with gingivitis, a 0.12% chlorhexidine gluconate alcohol-free rinse such as Colgate® PerioGard® Oral Rinse used in the treatment of gingivitis and that helps to promote healing.

In order to correctly change patients’ behaviors, they need to receive appropriate advice and knowledge! This should be tailored advice, specific to the patient with goals set together so that the patient can see their progress and continue to be motivated to change their behavior.