Managing oral hygiene as a risk factor for periodontal disease: a systematic review of psychological approaches to behaviour change for improved plaque control in periodontal management

Background: Plaque control in patients with periodontal disease is critically dependent upon self-care through specific oral hygiene-related behaviours.

Objectives: To determine the relationship between adherence to oral hygiene instructions in adult periodontal patients and psychological constructs. To determine the effect of interventions based on psychological constructs on oral health-related behaviour in adult periodontal patients.

Data sources: The Cochrane Oral Health Group's Trials Register, MEDLINE, EMBASE and PsycINFO.

Study appraisal and synthesis methods: Studies were grouped according to the study design, and appraised using an appropriate methodology, either the Newcastle-Ottawa assessment for observational studies, or the Cochrane criteria for trials.

Results: Fifteen reports of studies were identified.

Limitations: There was a low risk of bias identified for the observational studies. Older trials suffered from high risk of bias, but more recent trials had low risk of bias. However, the specification of the psychological intervention was generally poor.

Conclusions and implications of key findings: The use of goal setting, self-monitoring and planning are effective interventions for improving oral hygiene-related behaviour in patients with periodontal disease. Understanding the benefits of behaviour change and the seriousness of periodontal disease are important predictors of the likelihood of behaviour change.