Improving Patient's Compliance with Periodontitis Treatement by a Behavioral Approach

The role of patient's supragingival plaque control seems to be crucial in the prevention of periodontal diseases and in the prognosis of periodontal treatment. Unfortunately, a lack of patient's compliance is often seen in the field of periodontology. Thus, there is a particular interest in patient's behavioral understanding and modification by using behavioral tools. This may lead to an increase of adherence to periodontal treatment. Objectives: The aim of this study is to investigate whether a behavioral intervention based on the autoregulation theory can improve periodontitis patient's compliance with proper dental care at a 3-month follow-up. Methods:42 patients matched for gender (19 men, 23 women, mean age=44 years)and education, were randomly assigned to a control or two experimental treatment conditions. In the control group patients were asked to fill-in a questionnaire assessing the representation of periodontitis.Then they received a regular treatment based on oral hygiene instructions.In the first experimental group, an adittional analysis of the questionnaire was given. Finally, in the second experimental group (autoregulation group), patients were adittionaly requested to keep daily records of their oral cleaning precedures. Plaque indices (PIs) were measured prior to treatment and at a 3-month follow-up. Results:Prior analyses (anova 3(groupes) x 2(time measurements)showed a non significant reduction of PI in the second experimental group.As individual differences appreared to be important at baseline, a relative reduction index ((plaque after-plaque before)/plaque before) was created. In a new analysis, a significant (p<.04) reduction of plaque in the autoregulation group was observed compared to the other two groups. Conclusions: The results of this study are particularly interesting. They show a significant improvement in patient's compliance using a behavioral approach based on the autoregulation theory in a 3-month follow-up. Future investigations with larger samples and longer follow-ups are suggested.