How to Guide Patients Suffering From Periodontitis Towards Behavioural Change: A Systematic Review

After reviewing the various interventions to evaluate their impact on guiding patients towards plaque control, their effects on periodontitis stabilisation, and the behavioural changes reported by patients.

This PROSPERO-registered systematic review followed PRISMA guidelines. Randomised controlled trials in adults with periodontitis assessing interventions to improve motivation for plaque control were included. Primary outcome was plaque index; secondary outcomes were other periodontal parameters and patient-reported behaviours. Study selection in different databases, data extraction, and risk-of-bias assessment were performed independently by two reviewers.

Eight trials were included, with four different motivational interventions. Motivational Interviewing showed positive trends but no significant differences versus control (motivation-method described in the latest recommendations). Behavioural Interventions demonstrated plaque index and probing depth improvements, along with stronger tooth-brushing adherence. Patients included in Individually Tailored Oral Health Educational Programmes showed significantly greater plaque index improvement and maintenance of interdental cleaning versus controls. The Self-Care Commitment Model enhanced plaque control and self-care behaviours, though between-group differences were limited. These last three interventions were multi-sessional. The level of evidence was generally low-to-moderate.

Multi-session motivational interventions seemed to have a positive effect for guiding patients towards behavioural changes. Larger and longer-term studies are needed to confirm these findings.

PROSPERO registration number: CRD42024551991.