Dental Teams Struggle With Behaviour Change Conversations: Focus Group Findings

Objectives: Patients’ self-care behaviours are important risk/protective factors in developing oral diseases, so supporting behaviour change is an important component of preventive dentistry and everyday contemporary practice. Delivering Better Oral Health guidance recommends behaviours which prevent and manage disease and that, with recent developments in behavioural science, certain approaches to giving advice are more likely to be effective. However, we do not know how dental teams currently approach supporting individuals to change health behaviours, and what the implementation gap may be.

Aim: to investigate how dental teams understand behaviour change conversations, the challenges they experience, and the type of support they feel they need.
Methods: Five focus groups with 23 participants working in England (10 dentists, 3 dental practice managers, 4 dental therapists/hygienists, 6 dental nurses) were recruited via professional associations, social media and local dental networks. These were taped, transcribed and analysed thematically.
Results: Dental teams describe their attempts to support behaviour change as challenging. Younger professionals can have difficulty with the conversational elements to build rapport and express empathy, especially with patients who are older or parents. The majority were focused on ‘giving out’ information, warnings, and free merchandise in an effort to ‘engage’ patients. Participants were aware that their advice was often likely to be unfruitful but was delivered as fulfilling their duty of informing of risk, especially as conscious of possible later accusation of professional misconduct. Awareness as to how to put assessing readiness to change into practice and knowing ‘when to stop hammering away’, was a challenge. Participants felt they were short of non-commercial, simple, visual imagery to support conversations, with time and space further challenges
Conclusions: Dental teams require support in having effective behaviour change conversations. These findings will be used to inform producing resources based on approaches recommended by behavioural science experts.