Behaviour change

Behaviour Change

• Behaviour change is relevant to oral and general health.
• Evidence-based guidelines for oral health-related behaviours should be understood.
• The COM-B model (Capability, Opportunity, Motivation – Behaviour) explains behaviour influences.
• Patient-centred conversations support oral health behaviour change in dental hygiene and therapy practice.

GDC Learning Outcomes

• Lists of GDC Learning Outcome codes are provided (1.1.1, 1.1.11, 1.7.1, 1.10.1, 1.10.2, 1.10.3, 1.11.1, 2.3, 3.1, 3.2, 4.1, 6.1, 6.2, 6.3).

Intended Learning Outcomes

• Students will describe behaviour change and its relevance to oral and general health.
• Students will familiarise themselves with evidence-based guidelines for oral health behaviours.
• Students will identify factors influencing behaviour using the COM-B model.
• Students will discuss how patient-centred conversations support oral health behaviour change.

Assessment

• Formative: Active engagement in sessions and peer feedback.
• Summative: E-assessment and OSCE.
• Future: Effective behaviour change improves patient health outcomes.

Links to Prior Learning

• History Taking: Dental, social, diet.
• Delivering Better Oral Health Toolkit: Evidence-based guidance for behaviour change.
• Communication: Verbal, non-verbal, clinical conversations.

Outline for the Session

• Theory: Definitions, context, evidence for oral health behaviours.
• Influences on Behaviour: Psychological theory (COM-B).
• Behaviour Change: In action, linked to communication.
• Practical: Case studies in teams.
• Definitions: - Behaviour: What is done in response to internal or external factors. - Health Behaviour: What impacts the health, positively or negatively.
  • Behaviour Change: Actions taken to change existing behaviours.

Why is this important?

• Behaviours influence health and well-being, including oral health.
• Oral health professionals should support patients to adopt positive health behaviours.

Evidence-based Guidance

• National Institute for Health and Care Excellence (NICE) provides guidance.
• NICE provides guidance on oral health promotion in general dental practice (NG30).
• Behaviour change strategies are discussed, targeting individual approaches to general health.

Oral health-related behaviours quiz

• A quiz on oral health-related behaviours was administered using mentimeter.
• The quiz aimed to test understanding of related behaviours and relevant guidance.

Oral Health in the UK

• 75% of the population report cleaning their teeth twice daily.
• 66% of the population has visible plaque.
• A significant proportion (9 in 10 ) require support for oral health.
• Data on dental attendance and excellent oral health are provided by age group, using ADHS 2009 data.

Toothbrushing advice

• Use a powered or manual toothbrush, adapting to patient needs.
• Benefits include reducing dental caries and periodontal disease risk.
• Proper and consistent brushing is essential.

Dietary guidance

• Based on the DBOH Toolkit, recommendations include reducing sugar intake.
• Also, eat a balanced diet with plenty of fruits and vegetables.
• The NHS advises daily free sugar recommendations (30g/day for 11+ years old).

Dietary intake of free sugars

• Data on dietary intake of free sugars by age group and gender (NDNS 2016/17).

Fluoride Exposure

• Fluoride toothpaste (1450 ppm, lower concentrations for younger children) usage is high (76%).
• Spitting but not rinsing is advised for fluoride application.

Smoking advice

• Recommendations discourage smoking and encourage cessation.
• Around 14% of the UK population smokes (aged 18+).

Alcohol advice

• Limit alcohol intake to 14 units a week.

Attendance

• Recommendations for dental attendance are based on risk using NICE guidance.
• Intervals between oral health reviews are discussed.

BSP UK Clinical Practice Guidelines

• Guidelines for the treatment of periodontal diseases are provided.
• Focus areas include diagnosis, periodontal health/gingivitis/periodontitis, explaining disease and risk factors/ treatment, importance of Oral Hygiene.

Impact of oral health-related behaviours

• The relationship between oral health, systemic health, and behaviours are presented visually.

What influences our behaviour?

• The factors that influence behaviour are highlighted using a diagram.

Own experiences of influences on behaviour

• This section discusses influences on behaviour through examples, visual representations, and diagrams.

The wider determinants of health

• Social, economic, and environmental factors influence health behaviour.
• This section presents various factors impacting health.

Motivation

• Factors motivating specific actions are explored.
• Intrinsic and extrinsic motivation types are discussed.

Habits

• Creating habits for improved oral hygiene is an aim.
• It takes 66 days for a habit to develop, emphasizing this concept for patients.

COM-B Model

•  For effective behaviour change, interventions should be aligned with evidence-based theories.
•  The framework is central for explaining complex behaviours.
•  The COM-B Model (Capability, Opportunity, Motivation) underpinning behaviours in health.

COM-B Model - example application

• COM-B model is applied to the example of eating chocolate.
• Demonstrates practical application of this model.

COM-B Model applied to oral health

• Describes how the COM-B model applies to tooth-brushing.

Psychology of clinical practice – Case scenario 1 – Bella

• A case example (Bella) shows how the COM-B model is applied in clinical practice.
• Bella’s case illustrates a scenario in which the COM-B Model can be implemented in a dental practice.

COM-B Model applied to Case Scenario 1 – Bella

• This section analyses the case of Bella, a patient at the dental clinic, using the COM-B Model. A detailed analysis of Bella's scenario is provided. The factors influencing her oral health habit-forming were addressed using this model.