Young adults with a high incidence of caries can quickly change their oral health behaviors

Young adults with extensive caries often have a high propensity for oral health risk. At the same time, with the right support and treatment, they can change their unhealthy behavior. A dissertation at the University of Gothenburg describes the challenges of helping patients in this vulnerable category.

In Sweden, oral health has improved significantly over the past few decades. Most people’s oral health is already good; but this favorable condition is uneven and unevenly distributed. Some groups bear a significantly heavier burden of disease related to socioeconomic and other factors than the majority.

Jenny Hagman, whose daily job is as a dental practitioner in hospital orofacial medicine within the Swedish Public Dental Care Services in Gothenburg, defended the present thesis on the topic of odontological psychology and public health at the Sahlgrenska Academy, University of Gothenburg. In her thesis, she describes the vulnerability of the young age group (18–25 years).

Many of them move away from home, find work and become responsible for their own finances and health. At the same time, they start paying for health care – when it comes to dental care, from the year of their 24th birthday. Infrequent dental visits, a high-sugar diet, and smoking make for a bad but not uncommon combination among young people with tooth decay.

Immediate positive effect

Hagman’s thesis is based on a study in the Västra Götaland region of 135 young adults with a high incidence of caries. All of them received standardized oral health information in community dentistry as part of the study, and half were randomly assigned to also receive treatment from a psychologist.

A related form of therapy is known as acceptance and commitment therapy (ACT). Treatment consisted of identifying the value of good oral health for patients and teaching them mental skills such as acceptance. These are skills that can help them establish new, more beneficial oral health habits.

In the group receiving ACT, an immediate impact on health behaviors was evident: their brushing improved and their use of floss, toothpicks, and fluoride increased. The behavior of the control group also changed, but less so.

A follow-up study showed that those receiving ACT treatment had the most improvement in oral health, although the amount of plaque and gingivitis was not significantly different between the two groups. The results also show a dividing line between women and men: supplementation with ACT treatment appears to be more effective for women’s oral health.

Discussion of new methods

Dental services have traditionally attempted to influence patients’ oral health behaviors by providing information on the causes and progression of oral disease and by advising patients on what they need to change to maintain or improve their oral health.

Over the past few decades, the efficacy of this approach has been questioned and other methods have been sought to address these issues. Hagman’s thesis is well suited to the discussion.

The results show the potential for direct behavior change and improved oral health in a group of young adults with major caries problems. Their willingness to undergo psychological treatment aimed at influencing their behavior is also a boon in itself.

These findings indicate that there is a need to develop effective methods and techniques to promote oral health and that theory-based methods aimed at modifying people’s behavior can potentially improve self-care and oral health.”

Jenny Hagman

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