Why is mechanical cleaning not always sufficient to control plaque?

In a recent interview with Professors Nicola West and Tim Newton, they spoke about how dental professionals can build on the support they already provide to their patients, to try to achieve improved plaque control.

Nicola: According to van der Weijden and Slot (2015), under half of the plaque is removed if you ask someone to clean their teeth. If you ask them to clean again, it tends not to be not much better.

We are creatures of habit and clean in the same way each time.

Tim: Although evidence can always tell us what will work on average or in general, it’s about how you tailor that evidence for the person in front of you. That’s particularly true for behaviour change.

What we tend to think about is principles that are very effective in helping to change someone’s behaviour. But when it comes to the individual, you have to think about where they are, what they might be able to achieve, what they can fit in, and how you take those principles and tie them to that individual case.

Nicola: I agree. It’s important to recognise that different people have different susceptibilities. And to know how to take those into consideration when creating a plan if we’re going to manage individual patients successfully.

Can you offer an example of how that might work?

Tim: So, we’re all developing new habits all the time. And mobile phones are a great example of that. It’s a habit we’ve developed very, very rapidly, because it gives us something that we value very directly.

But the key to habit formation is repetition and cues. So it’s the fact that you do it every day.

And that goes back to what I was saying about trying to get people to self-monitor. If you self-monitor, you’re reminding yourself to do it every day and seeing how well you do.

The other thing is having clues or cues that tell us that it’s time to do something.

So, for example, tooth brushing is often the first thing you do when you get up. If we can tie the behaviour we want into a cue, it just reminds us to do it.

There’s a lovely study that I often quote. Put your running shoes by the front door makes you run more, because you see your shoes (Lally and Gardner, 2013).

Leaving your mouthwash out in the bathroom or having your mouthwash in the bag that you always take to work will remind you that you have to use it.


To read the interview in full visit here: www.dentistry.co.uk/2020/12/02/managing-oral-hygiene-healthy-habits.

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