Oral Hygiene and Sugar Consumption Habits: Changes Over Time

Objectives: This study evaluates 6-month changes and their maintenance after 12 months in oral hygiene and sucrose consumption habits among children after implementing Cognitive-Behavioral Therapy (CBT) principles.
Methods: The study included 38 twin pairs from the CARDEC Twins cohort, selected from children born at Hospital das Clínicas, São Paulo, Brazil (2007–2019). Participants received individualized guidance on oral hygiene and sucrose reduction based on CBT principles, delivered by trained professionals. Goals were collaboratively set among professionals, children and families and tracked via standardized calendars. The primary outcome for each habit monitoring was the habit change after 6 months. As a secondary outcome, we considered habit improvement and maintenance after 12 months. To assess the outcomes, we used a pre-tested checklist at baseline, 6, and 12 months. Logistic regression analyses were use to test the relationship between prior changes and the habits maintenance and the also the association with twins independent variables.
Results: At 6 months, habits of sucrose consumption were improved in 45% of participants. At 12 months, 32% of children maintained these habits and 26% demonstrated additional improvements. These outcomes were not influenced by baseline behavior (p=0.77) or initial 6-month change (p=0.40). Oral hygiene habits were initially more robustly improved (71%), followed by 20%-rate of 12-month maintenance and 40% improvement on such practices and did not influence by prior behavior (0.70) or initial changes (0.14). No associations were observed between outcomes and twins characteristic (p > 0.05). Both habits changes over time showed moderate concordance within twin pairs (48–58%).
Conclusions: CBT-based guidance promotes immediate and sustained children’s habit changes in oral hygiene and sucrose consumption. Oral hygiene improvements were more pronounced, likely due to skill reinforcement and calendar tracking. Twin concordance in outcomes suggests shared environmental influences