Health behaviour change in a dental setting

This meta-analysis claims to be the first evaluating mindfulness-based interventions in primary care.

With a number of common risk factors, tobacco use, harmful use of alcohol, unhealthy diets and physical inactivity causing around 50% of deaths worldwide as well having adverse oral health consequence. Oral Health professionals can play an important role in supporting patients adopt positive health behaviours. The aim of this review was to assess the efficacy of health behaviour change interventions/counselling provided in the dental setting in adults.

Methods

Searches were conducted in Medline, Embase, LILACS and the Cochrane Library with no year or language restrictions. This was supplemented by hand searching of last 3 years of the Journal of Clinical Periodontology, and Journal of Periodontology. Study designs were limited to Systematic Reviews, Randomized Controlled Trials (RCTs), and Controlled Clinical Trials (CCTs). Two reviewers independently selected studies. Data abstraction was performed collaboratively by two reviewers and study quality assessed using the AMSTAR tool.

Results

7 systematic reviews were included.
For interventions provided by dental professionals in dental settings
- Tobacco use prevention – no studies
- Smokeless tobacco use cessation – 2 systematic reviews reporting a positive impact
- Smoking cessation – 5 systematic reviews – evidence of strong effectiveness in a dental setting
- Dietary interventions – 4 systematic reviews – moderate evidence for improving fruit and vegetable consumption but limited for sugar consumption.
- Alcohol withdrawal – 3 systematic reviews – moderate evidence for beneficial effect on reducing alcohol consumption.
- Increase in physical activity – One systematic review – limited evidence of positive change.

Conclusions

The authors concluded:

While aiming to improve periodontal treatment outcomes and the maintenance of periodontal health current evidence suggests that tobacco use brief interventions conducted in the dental practice setting were effective thus underlining the rational for behavioural support.

Comments

This review used abroad search strategy and has identified 7 systematic reviews that assess counselling provided by dental professionals for a range of harmful behaviours. The strongest evidence is for smoking cessation and dietary interventions , which is possibly not surprising as it is these areas that have received most attention to date as they may be seen as having the most direct links with oral disease. Although the impact of alcohol on the oral environment is recognised, there appears to be a greater reluctance for dental professionals to address this area as was once the case with smoking. With significant proportion of ‘healthy adults’ attending dental practices regularly, there is the opportunity for increasing health promotion opportunities presented by dental visits and helping improve our patients general as well as oral health.