Behavior modification for orthodontic patients: an exploratory approach to patient education

The purpose of this project was to explore the usefulness of a behavior modification approach in changing oral hygiene habits of orthodontic patients. Two orthodontists identified patients in their practice who exhibited excessive plaque formation and inflammation and referred them to a health educator/dental hygienist. The health education program was subsequently presented to fifty-three patients, 8 to 18 years of age. Three counseling sessions with parental participation were scheduled approximately 2 weeks apart. The program consisted of a model for counseling, a rising and retiring survey to identify home routines, a list of "possible reinforcers" geared toward preteen interests, a monitoring card to record toothbrushing behavior, and a contract signed by both parent and child. Behavioral change in oral hygiene habits was measured through general assessment of toothbrushing technique, plaque accumulation, and soft-tissue appearance. Change in frequency of brushing was measured by patient self-monitoring. Patient and parental comments, as well as educator reactions, were considered in the over-all evaluation of the project.