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Psychology of behaviour change is key to effective oral health promotion

Lookup NU author(s): Dr Richard HolmesORCiD



This is the authors' accepted manuscript of a review published in its final definitive form in 2016. For re-use rights please refer to the publishers terms and conditions.


Commentary: Oral health promotion (OHP) aims to improve and protect oral health whilst reducing inequalities through a focus upon the underlying determinants of oral health. This review by Kay et al. (2016) was funded and commissioned by the UK National Institute of Health and Care Excellence for the purpose of informing public health guidance. The scope of the review was relatively narrow in that it only considered the effectiveness of OHP in dental practice settings. A total of 44 studies, published from 1994 onwards and in English, were included in the review. The research question was clearly stated: 'Is oral health promotion within dental practice effective and how can its effects be optimized?'. The studies were assessed in detail for their quality. Unfortunately, the quality of evidence was described as 'very disparate' and the quality of reporting 'highly variable'. Many studies used relatively short follow-up periods and/or patient-reported outcomes rather than objective clinical or observed behavioural measures. The authors were unable to undertake a meta-analysis as a result of heterogeneity of the interventions and outcome measures used in the primary studies. A firm conclusion about a 'best' OHP approach to use with patients in dental practice settings was not possible, however evidence statements were made. Oral hygiene and gingival/periodontal health may be significantly improved through OHP interventions developed using behavioural and psychological models. OHP delivered verbally by dental professionals was insufficient (without the use fluoride) to impact upon caries levels. Developing a 'therapeutic alliance' between dental professional and patient is key to the success of OHP in dental practice settings. Greater emphasis on teaching oral health professionals about health psychology and behaviour change would make OHP in dental practice settings more effective.

Publication metadata

Author(s): Holmes RD

Publication type: Review

Publication status: Published

Journal: Evidence-Based Dentistry

Year: 2016

Volume: 17

Pages: 70-71

Online publication date: 21/10/2016

Acceptance date: 14/08/2016

ISSN (print): 1462-0049

ISSN (electronic): 1476-5446


DOI: 10.1038/sj.ebd.6401180