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Updated: Jun 11, 2026

Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
A modified cognitive behavioural model as a method to improve adherence to oral hygiene instructions--a pilot study
M Fjellström1, M Yakob, B Söder
1Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
Objective:
The purpose of this project was to create a modified CBT model to determine the impact on increased adherence to oral hygiene instructions. In a pilot study test, this model was compared with traditional instructions.
Method:
Tools developed and tested in this pilot study were a self-reporting questionnaire, a visual information consisting of pictures and a diary to document according to a modified CBT method. Four participants were divided into two groups, control group and CBT group. At the first visit, all participants answered a self-reporting questionnaire. The clinical examination consisted of measuring the PI, GI and GBI. The same information and instructions were given. All received toothbrushes, dental floss and professional tooth cleaning. The CBT group was instructed to document their feelings and thoughts in a diary. After 3 weeks, the participants answered the same questionnaire, and the same clinical measurements were conducted at the re-examination. The CBT group brought their diaries for evaluation.
Result:
At the end of the study, there was a difference in PI, GI and GBI between the groups. The levels of PI, GI and GBI had decreased more in the CBT group than in the control group. The questionnaire also showed that the CBT group had increased their knowledge and awareness about oral health.
Conclusion:
This pilot study shows that using a modified model of CBT, by keeping a diary, resulted in increased adherence to oral hygiene and knowledge about gingivitis, compared with traditional instructions.
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