Oral Health Behavior Management in Patients with Periodontitis: A COM-B-Guided Qualitative Study

This study aimed to explore barriers and support needs related to oral health behaviors among patients with periodontitis guided by the Capability-Opportunity-Motivation-Behavior (COM-B) model in a Chinese clinical context.

Semi-structured qualitative interviews were conducted with 17 patients diagnosed with stage II-IV periodontitis who attended the Department of Stomatology at a tertiary hospital in Chengde, China, between December 2025 and January 2026. Participants were recruited using purposive sampling. Interviews were conducted in person, and data were analyzed using qualitative content analysis guided by the COM-B model. Themes and sub-themes were identified through an iterative and collaborative coding process conducted by two trained researchers.

Three main themes and eleven sub-themes were identified, reflecting barriers and support needs related to oral health behaviors. Within the capability domain, barriers included insufficient disease knowledge and information literacy, inadequate skills in using oral hygiene tools, and physical limitations. Within the opportunity domain, barriers included constraints related to objective resources and life circumstances and unsupportive social norms, while participants expressed support needs for professional and social support. Within the motivation domain, barriers included negative behavioral experiences, concerns about social judgment, and lack of self-efficacy, whereas perceived benefits and disease awareness and the desire to preserve oral health supported sustained oral health behaviors.

Patients with periodontitis experience interconnected barriers and support needs across capability, opportunity, and motivation domains. These qualitative findings provide evidence to inform the development of tailored oral health behavior interventions.