Improving periodontal outcomes: merging clinical and behavioral science. This article consists of two parts; this summary will focus on the second part, concerning patient motivation and adherence.

 

The authors discuss the lack of compliance to oral care recommendations and possible ways to deal with it, based on available literature.

Daily oral home care is essential for successful periodontal treatment. However, adherence to recommendations is shown to be low. 30-60% of health information is forgotten after one hour and 50% of health recommendations are not followed. The traditional way of telling the patient what to do does not seem to fulfill what is needed to reach a high level of compliance. What can the clinician do?

The approach discussed in this article is to merge social and health science to achieve a behaviour change. A method which has proven effective is motivational interviewing (MI). It is based on four communication skills: open-ended questions, affirmations, reflections and summary. The approach puts the patient as an individual in the centre, and the outcome of the conversation can be an enhanced understanding, desire, and ability to change one’s own oral care behaviour and goals.

MI has shown positive results in contributing to reduced plaque scores and gingival inflammation. The authors conclude that more research is needed in this field, but also stress the importance of education in MI to improve adherence with oral self-care in patients, to make it sustainable and reduce the need for reinforcement to a minimum.