March 2015

Changing Behaviours

It can be very difficult to change our behaviours - once we have established routines it can be hard to make changes and stick to them for a sustained period of time. This is clear when you consider that an estimated 85% of people who made New Year's Resolutions in January, have already broken them.

As a dental professional, half the battle we face is encouraging patient compliance. Modern clinical techniques, dental instruments and cutting-edge technologies enable an outstanding level of quality in all treatments we provide, so that we can achieve optimum functionality and aesthetics in everything we do. These results can only be retained, however, if patients understand the importance of continued oral care and

Patient education plays a huge role in raising awareness of the on-going care necessary, but traditional approaches are largely ineffective and suboptimal adherence to good oral health routines remains a significant barrier to the control of oral diseases. We are, after all, attempting to change a patient's behaviours, and the need for new interventions that address personal motivations has become clear.

It's all in the mind...

Various psychological models have therefore been developed to help us improve patients' fundamental behaviours - while not all extensively tested for their effect in oral health, they have been highly successful for alcohol and substance abuse, smoking cessation and HIV/AIDS prevention. Each theory draws on psychological ideas of self-efficiency, motivation, counselling and the resulting behaviour change, but it should be noted that different models might suit different patients better. For example, the same approach might not be effective for adults and adolescents.[ii]

One of the most widely used theories is the Transtheoretical Model (TTM), which has actually been proven reliable and valid for use in changing oral self-care. It works to establish a patient's current situation and assess their readiness to change by looking at the perceived pros and cons of making the change. Focusing on four key areas - stages of change, processes of change, decisional balance and self-efficacy - the TTM model recognises that many people will relapse on their dental health regime, giving a more realistic programme to follow.

So how does this help us?

With models such as the TTM, we can better assess and understand a patient's readiness and willingness to change. Using this, we can then tailor our oral health advice to suit the individual and help enhance their compliance to effective dental health routines. On-going support and encouragement is also essential, as is recognition and praise when a goal is achieved. The national Change4Life campaign is a great example of how to retain people's interest in their own health - it uses various activities to encourage exercise and healthy eating, making it fun and removing the previous psychological barriers. We can do something similar in dentistry using models such as the TTM, which will help us to show patients that the pros always outweigh the cons.