Young people with wide cavities often have a higher risk of oral health. At the same time, with the right support and treatment, they can change their unhealthy behaviors. A dissertation from the University of Gothenburg describes the challenges in helping patients in this vulnerable group.
In Sweden, oral health has improved significantly over the past decades. Most people’s oral health is now good, but this favorable condition is unevenly and unfairly distributed. Some groups bear a much greater burden of disease, related to socioeconomic and other factors, than the majority.
Jenny Hagmann, who works as a dentist at the Clinic for Oral and Maxillofacial Medicine within the General Dental Service in Gothenburg, defended her current thesis in the field of Dental Psychology and Public Health at the Sahlgrenska Academy, University of Gothenburg. In her dissertation, she describes the vulnerability of the young adult population (18-25 years old).
Many of them leave the family home, find a job, and become responsible for their own finances and health. At the same time, they begin to pay for health care – for dental care, starting from the year of their 24th birthday. Frequent dental visits, a diet high in sugar, and smoking are a poor combination but not uncommon for young people to experience cavities.
Immediate positive effect
Hagemann’s thesis is based on a study conducted in the Västra Götaland region of 135 young adults with a high incidence of dental caries. As part of the study, they all received standardized information about oral health as part of general dental care, and half were randomly assigned to also receive treatment from a psychiatrist.
The form of therapy involved is known as Acceptance and Commitment Therapy (ACT). The treatment involved establishing the value of patients’ good oral health and training them in mental skills, such as acceptance. These are skills that can help them establish new healthy oral hygiene habits.
In the group receiving the ACT, the immediate effect on healthy behaviors was clear: Their toothbrushing improved, and their use of dental floss, toothpicks and fluoride increased. The behavior of the control group also changed, but to a lesser extent.
A follow-up study showed that those who received ACT treatment improved their oral health the most, although the amount of plaque and gingivitis did not differ significantly between the two groups. The results also suggest a line between women and men: It appears that supplementing with ACT treatment was more effective for women’s oral health.
Discuss new methods
Dental services have traditionally attempted to influence patients’ oral health behavior by providing information about the causes and progression of oral disease, and advising patients on what needs to change, if they want to maintain or improve oral health.
In recent decades, the effectiveness of this approach has been called into question, and other approaches have been sought to address these problems. Hagemann’s thesis is relevant to this debate.
The results demonstrate the potential for direct behavior modification and oral health improvement in a group of young adults with significant caries problems. Their willingness to undergo psychological treatment designed to influence their behavior is also an advantage in itself.
These results show that there is a need to develop effective methods and techniques to promote oral health, and that theory-based methods aimed at modifying people’s behavior have the potential to improve self-care and oral health. »