Oral hygiene behaviours and readiness to change using the TransTheoretical Model (TTM)

The aim of this pilot study was to investigate the Transtheoretical Model (TTM) in relation to measures of readiness to change oral hygiene behaviours.

Participants (N = 105) were recruited from a dental hygiene patient waiting list. A self-administered questionnaire was designed; it included four measures related to inter-dental cleaning used for TTM staging, confidence and frequency measures of future interdental cleaning and toothbrushing, together with items seeking demographic details. Data collection occurred before a dental hygiene appointment where oral health advice was offered, and then at three and six months afterwards, in order to measure readiness to change post-intervention.

All three questionnaires were returned by 91.4% of participants. The confidence measures for maintaining toothbrushing twice per day and for interdental cleaning were associated with TTM staging at baseline (respective correlation coefficients of 0.200; P = 0.042 and 0.584; P < 0.001). Participants were likely to be in a higher TTM stage at 3 months after attendance at the dental hygiene clinic and then decline to a lower TTM stage by 6 months (baseline to 3 months and 6 months: Wilcoxon signed rank tests of p= 0.024 and p = 0.627). Of the 31 participants (33%) who improved their TTM staging between baseline and 3 months, 11 (35%) fell back to a lower category between 3 months and 6 months, 14 (45%) maintained their improvement, and 6 (19%) improved further.

Understanding a person's readiness to change could improve the way in which oral hygiene interventions and advice are given in the clinical setting. The TTM staging measurement tool used here provides insight into people's readiness to change their oral hygiene behaviours, and its use would aid practitioners in the delivery of oral health messages. The initial improvement in TTM stage and subsequent regression was consistent with the TTM's relapse phenomenon and reinforces the concept that on-going support is crucial to maintaining behaviour change.