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Objectives: The field of Behavioural Medicine offers strategies that can minimize the need for more intensive medical treatments and can improve outcomes of these treatments and adherence to medication prescriptions or postsurgical recommendations. Thus, this paper provides scientific evidence and examples of behavioural and motivational strategies for improving adherence to oral health recommendations. Methods: Increasing evidence from randomized controlled trials suggests that improving self‐regulation, autonomous motivation and social environmental supports for adherence are critical for improving a wide range of behaviours including oral health behaviours. Theory‐based interventions including Social Cognitive Theory (behavioural strategies) and Self‐determination theory (motivational strategies) are described and examples of their effectiveness are provided specific to oral health outcomes. Results: Social Cognitive Theory provides a framework for building skills and self‐efficacy (self‐confidence, competence, mastery and self‐regulation) through developing action plans that target goal setting, monitoring and positive feedback within the context of providing support. Behavioural strategies, including self‐monitoring, goal setting and skill building, are all important elements for promoting long‐term lifestyle changes by targeting increases in self‐efficacy and mastery (self‐confidence and self‐regulation skills). Motivational interviewing and positive communication strategies are also discussed specific to improving oral health outcomes. Conclusions: In sum, behavioural medicine provides an opportunity and framework for supporting patients/individuals to achieve changes in target health behaviours, including oral health recommendations. [ABSTRACT FROM AUTHOR]

Background: Recent advances in the psychological understanding of health‐related behaviour have focused on producing a comprehensive framework to model such behaviour. The Capability‐Opportunity‐Motivation‐Behaviour (COM‐B) and its associated Theoretical Domains Framework (TDF) allow researchers to classify psychological and behavioural constructs in a consistent and transferable manner across studies. Aim: To identify oral and dental health‐related studies that have used the TDF and/or COM‐B as frameworks to guide research and examine the ways in which these concepts have been practically used in such research. Method: Narrative review of published literature. To be included, the paper had to (1) state that the TDF or COM‐B had been used and to have targeted at least one construct identified in either framework, (2) include primary empirical data, (3) focus on a behaviour directly related to oral or dental‐related health (eg brushing, applying fluoride varnish, flossing) and/or attitudes, intentions and beliefs related to the behaviour. Studies could include any research design, and participants of any age or gender and include patients, parents or dental health professionals. Findings: Nine studies were identified that had drawn on the COM‐B and/or TDF as the framework for their research. Seven of the studies were based on the TDF only, with one employing both the COM‐B and Health Belief Model, and one using the TDF with COM‐B. The nine studies covered a broad range of oral health‐related behaviours including child tooth brushing, fluoride varnish application and non‐ or micro‐invasive management of proximal caries lesions. The populations in the studies included dentists, dental teams and parents of children. All studies adopted only a subset of the constructs within the TDF, often without justification. Conclusions: It is encouraging that oral health researchers are adopting standardized psychological frameworks to develop their research and oral health interventions. Future work should build on the small number of studies identified in this review and consider using standardized tools to do so. [ABSTRACT FROM AUTHOR]

Objective: To explore how caries was reported in studies that employed the International Caries Detection and Assessment System (ICDAS). Methods: A systematic database search up to August 2017 was carried out using PubMed, Ovid MEDLINE, Cochrane library and ISI Web of Science electronic databases. Only studies that used the ICDAS for dental caries examinations were included. Studies were excluded if the examination was done only for the validation or the calibration of the ICDAS and/or if the examination was not done for the whole dentition. Measures used to report caries were considered. Results: A total of 126 papers met the inclusion criteria. Forty‐four different synthesis measures were used to report caries. Most of the studies used a combination of multiple measures to report patient's caries level. These reporting measures cluster into four main groups: the number of individual ICDAS scores (ie, total counts of every score); the number of decayed surfaces/teeth (ie, total counts of combined caries scores for surfaces or teeth); measures of caries experience (ie, total counts of combined caries scores, filled and/or missing surfaces or teeth); and measures of central tendency and dispersion. The number of decayed surfaces and individual ICDAS scores were the most commonly used measures. Three studies used mean ICDAS score (ie, total ICDAS scores divided by the number of teeth), two used mean ICDAS score of carious teeth (ie, total ICDAS scores divided by the number of carious teeth) and two used the maximum ICDAS score (ie, highest ICDAS score recorded). The total ICDAS score was used only once. Many studies synthesized from the ICDAS the number of decayed, missing and filled teeth/surfaces (dmft/DMFT, dmfs/DMFS) as a measure of caries experience. Conclusions: There are variations among studies in the utilization of the system to summarize caries. Most studies presented caries data using the categorical characteristics of the ICDAS. [ABSTRACT FROM AUTHOR]

Aims Whilst there is a considerable body of literature examining the pharmacology of conscious sedation, the social tasks required to successfully provide conscious sedation have not been reported. This paper discusses data regarding the interpersonal work integral to effective conscious sedation provision, from a larger qualitative study exploring how patients and clinicians engage with secondary care conscious sedation provided within the UK. Method Semi-structured interviews were conducted with 13 conscious sedation providers and nine patients within UK-based secondary care sedation settings. Digital audio-recordings were transcribed verbatim and subsequently analysed using a constant comparative method within NVivo Data Analysis Software. Results Four main themes of interpersonal work were reported by participants: displaying care, containing emotions, demonstrating competence and maximizing the effect. Conclusion This study shows that performing conscious sedation requires more than technical delivery, and involves the projection of attributes in a literal 'performance.' The importance of managing outward emotional appearance reflects previous dental research. The need to manage outward appearance, and the emotional impact this has, is of relevance to all clinicians. [ABSTRACT FROM AUTHOR]

Objectives To test the extent to which parents' judgements about their children's oral health behaviour conform to the principles of a specific theory of cognitive decision making - Range-frequency Theory. Methods Experimental study with an opportunity sample of 121 parents of young children (3-6 years old) living in areas of relative deprivation in South Wales. Parents were allocated to four different experimental groups, and each completed a pen-and-paper exercise, which involved being presented with (and rating) how often other parents brushed their children's teeth. The brushing frequencies presented varied between the groups, directly test the rank and range principle of Range-frequency Theory. Results Parents' ratings of other toothbrushing frequencies were predicted by the range and rank principle of Range-frequency Theory. A comparison between Group 1 and Group 2 showed that parents' ratings of similar brushing frequencies were affected by their relative rank among other brushing frequencies presented. A comparison between Group 3 and Group 4 showed that parents in a group who were presented with a very high brushing frequency (21 times a week) rated all other brushing frequencies as relatively less healthy than the comparison group. Conclusions The principles of Range-frequency Theory predicted parents' judgement about children's oral health behaviour - specifically toothbrushing frequency. These findings provide a theoretical framework on which to develop future oral health education and interventions aimed at promoting twice-daily toothbrushing to parents of young children. [ABSTRACT FROM AUTHOR]

This paper describes the development of a scale designed to measure the extent to which severe dental anxiety or phobia affects patients' social well- being outside of the dental setting. Items initially selected on the basis of clinical experience were administered to two groups: 78 patients seeking help for severe anxiety and 88 patients attending the general clinic of a dental hospital. Items on the scale discriminated between these two groups and also between patients who were reluctant to attend even when experiencing symptoms and those who attend more regularly. Although the scale correlated moderately well with Coral's Dental Anxiety Scale, factor analysis indicated that its items assess the effects of severe anxiety on the two domains of psychological reactions and social inhibition as they occur as indirect effects of dental care. The scale could be included in assessments designed to measure the social and psychological effects of severe dental anxiety. [ABSTRACT FROM AUTHOR]

In the present article we analyze a series of studies designed to detect the caries preventive effect of Duraphat by means of meta-analysis. Meta-analysis is a collection of statistical methods designed to investigate and to summarize a series of investigations. It may be a valuable tool to complement traditional narrative reviews. During the last years meta-analysis has attracted increasing interest in sociology, psychology and medicine. In order to find previous studies concerned with the clinical effects of Duraphat we applied a systematic literature search. Papers were included independent of results when they fulfilled a checklist of well defined methodological selection criteria. In order to aggregate the results of the Duraphat- studies we used different complementary statistical approaches: Firstly, the so-called file drawer problem is considered. This may help to get a better insight into the problem of underreporting non-significant results or publication bias. It was found to be very unlikely that underreporting of non-significant results could reverse the conclusion into an overall null-result. After that, the inhomogeneity between studies is investigated. The overall variation of caries reduction R is separated into two components: A between study component of variance and a variance pertaining to the individual studies (random effects model). It was found that the overall variation is dominated by the between studies variation and not by the sampling variation. Due to the pronounced variation between studies the confidence interval of the overall effect size IR =0.38) is quite large (95%-Cl: 0.19-0.57). The heterogeneity of our studies naturally suggested exploring possible sources thereof by investigating the dependence of caries reduction on variables characterizing the studies. It was found that caries reduction is negatively correlated with study duration. This finding provided a study-duration-adjusted effect of caries reduction. [ABSTRACT FROM AUTHOR]

Most studies of the relationship between dental anxiety and oral health status have used subjective rather than clinical indicators of oral health. In this paper we examine differences between older adults who are and are not dentally anxious using a broad range of clinical measures. The data show that dentally anxious individuals were more likely to be edentulous, and among the dentate, had more missing and fewer filled teeth. As a result , dentally anxious dentate subjects were more likely to need prosthodontic treatment. They were also more likely to need immediate treatment for the relief of pain and infection and periodontal care. There was evidence to suggest differences in patterns of dental treatment between those who were and were not dentally anxious and some evidence consistent with the hypothesis that aging influences the relationship between dental anxiety and oral health status. [ABSTRACT FROM AUTHOR]