Oral hygiene interventions must be better tailored to the target groups

Prevention is the basis for oral hygiene care, that’s globally agreed. However, programmes and interventions by health organizations are less successful than anticipated. Although they contribute to reducing the number of people with mouth-related diseases, they do not reach all the target groups. Interventions must therefore be better tailored to the target groups you want to influence, states Yvonne Buunk-Werkhoven. She will be awarded a PhD by the University of Groningen on 1 April 2010.
 
When people have problems with their teeth, their psychological wellbeing also suffers. When people have a well-cared-for and aesthetically attractive set of teeth they feel good. Despite this, people only become aware of the importance of good oral hygiene once they start to have trouble with their teeth. 

Motivate properly

Buunk-Werkhoven: ‘Virtually everybody cleans their teeth and considers good care important, but that does not necessarily mean that everyone does it properly. Many people still have to learn how to clean their teeth properly. You could compare it to giving up smoking, everyone knows it’s bad, but you keep doing it anyway. Everyone knows it’s a good idea to clean your teeth, but to really motivate people it’s important to provide them with information that appeals to them.’

Tailored interventions

In her thesis Buunk-Werkhoven describes several intervention studies, in Spain and Uruguay for example, concentrating on improving personal oral hygiene behaviour. The effects of a positive motivational message turn out to depend on the country, the level of education and the importance that people attach to good health. So tailor the intervention to what people think is important, is Buunk-Werkhoven’s view. 

Positive motivational message

It turns out that with the adult Dutch population, a positive attitude, social pressure, a feeling of being able to implement the required behaviour and knowledge about oral care are the most important predictors of oral hygiene behaviour. Buunk-Werkhoven: ‘A positive motivational message works best with this target group.’

Promoting behaviour control

In the army, another group included by Buunk-Werkhoven in her research, it’s important to focus on promoting observed behaviour control so that they can implement adequate oral hygiene. With the military, only a positive attitude and the feeling of being able to implement the desired behaviour count. ‘Dental fitness is very important within the forces, even though the focus is mainly on cure rather than prevention. When someone is sent abroad, their teeth have to be in tip-top condition. If you want to develop a good intervention programme for the military it’s particularly important to promote a positive attitude towards oral hygiene.’ 

Cultural control

Buunk-Werkhoven also conducted research outside the Netherlands so as to include cultural differences. ‘Culture often determines what is considered important. Although someone in Nepal won’t enjoy losing one or two teeth, it doesn’t play a major role in his or her life. In the Dutch Antilles and in Uruguay, social pressure plays an important role alongside a positive attitude. Hierarchy is very important there, whereas in Nepal it’s the feeling of being able to implement the desired behaviour that is important. The average age at which people in Nepal first visit the dentist is 36, and toothbrushes are not available everywhere by any means. That means that the information provision there has to follow a different approach than in a Western country like the Netherlands.’ 

Curriculum vitae

Yvonne Buunk-Werkhoven (Gieten, 1967) worked as an oral hygienist and lecturer for the Centre for Dentistry and Dental Hygiene of the UMCG and from 2003 to 2009 was seconded to the Forensic Psychiatric Centre Dr. S. van Mesdag in Groningen. At the same time she followed a degree in social psychology at the University of Groningen. Her supervisors are Prof. A. Dijkstra and Dr C.P. van der Schans. Her thesis is entitled World White Teeth: Determinants and promotion of oral hygiene behavior in diverse contexts. Buunk-Werkhoven is currently a lecturer on the Applied Psychology degree programme at Hanze University of Applied Sciences Groningen. She is an editorial board member of the NTvM and as a potential committee member is very involved in the Dutch Society for Oral Hygienists (NVM). A conference on this subject will be held on 16 April in Hoorn, chaired by Buunk-Werkhoven.