[Adherence to oral hygiene and dental self-care].
Nearly every person will be in need of dental treatment in his lifetime, whether purely for health causes or alternately for esthetic issues. Yet the main reasons of seeking dental treatment are in fact Caries, Gingivitis and Periodontitis. In spite of the fact that these pathologies occur due to the accumulation of Plaque around the oral cavity and teeth, they are fairly easy to prevent. Using simple techniques such as oral rinsing, flossing and brushing of the teeth, are normally sufficient for obtaining good oral health. If this is actually the case, than how is it that we are witnessing a massive spread of dental problems? How come there are so many incidents of people suffering from dental problems if the preventative care is that easy to manage? The answer lies in the concept of Adherence, referring to the cooperation of an individual with the demands of his treatment regime and the dental staff. The idea of promoting health adherence aims mainly for using medication, attending the periodic inspections and examination, and making lifestyle changes such as preventive care illustrated above. This article exemplifies how one of the current trends in Medical Psychology discipline is to enhance adherence by establishing a secure therapeutic alliance which is based upon a positive relationship between the patient and his doctor, increasing patient's confidence and sense of self-efficacy, and recruiting family members and friends to the patient's process of change. A distinctive emphasis is put on expanding the patient's knowledge about his condition, and raising awareness to the linkage between his medical (to be more specific-dental) problem and its symptoms to the implications. The most modish and putative intervention nowadays is Patient Centered, where the guiding principles used are urging the patient to be responsible for implying the treatment regime, taking active participation, and make decisions regarding his current and future status. This article illustrates, through a comprehensive literature review of theories, models and researches, the contemporary methods for promoting adherence to oral hygiene, dental Self-Care and treatment. Using the combination of a survey from a select sample of specialists in the field of Dentistry, and the conclusions inferred from studies reviewed, I was able to determine how investment in the Bio-Psycho-Social approach would improve patient satisfaction from their doctors and outcomes of the treatment, shorten the duration of treatment, consume only little resources, improve dental health of patients and prevent repetitive visits to the dentists clinics. At the same time, despite the fact that dentistry practitioners acknowledge the importance of patient's adherence and take active measures such as talks, praises, guidance and providing information, most of them don't seem to comprehend interfusion of family members or friends as an integral part of the treatment. Moreover, their overall feeling is of incompetence when regarding dealing with un-adherent patients. Therefore, maybe there is room for providing dentists and staff with seminars, conventions etc. about the latest novelties on the subject. In conclusion, enhancing dental patient's adherence to health behavior is a domain mainly under the responsibility of the dentist, but also of his staff. As elaborated in the article, the measures for doing so are: 1. Information- the dentist should guide patients about the different methods for maintaining oral hygiene, explain how proper adherence benefits positive treatment outcome, and provide a broad and informative picture of the patient's specific problem. 2. Positive rapport - the need for establishing a good relationship between the doctor and his patients is crucial for attaining effective and satisfactory treatment outcomes. No doubt that this matter depends upon the personality and character of both the doctor and the patient, but using positive verbal reinforcements, symbolic incentives (such as free toothpaste samples), support throughout the treatment, sharing the rationale behind professional decisions with the patient, and proving several treatment options to choose from, are all methods for recruiting patients to the treatment process and the implementation of health behavior change. 3. Using reminders - the dentist can suggest different ideas for preventing slips and withdrawals in the patient's behavior, mainly through dental calendars or periodic phone calls to prompt patient's persistence in their actions. In addition, it is possible of course to use family and friends as a supportive auxiliary power.
Academic College of Tel Aviv-Yafo, School of Behavioral Sciences, Medical Psychology, M A Program.
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Poplinger
D006293:Health Promotion; D006801:Humans; D009909:Oral Health / Q000592:standards*; D009910:Oral Hygiene / Q000592:standards*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D012648:Self Care