Applying Behavior Change Exercise
John Doe is a 56-year-old male who believes that his teeth are not very important. Although he does show up to regular care appointments, he does not take self-care at home seriously. He refuses to even discuss flossing as he has such a strong hate towards it. He is missing many teeth and has 6-8mm pocket depth generalized with generalized bone loss. John also smokes 1-2 packs of cigarettes a day. He continually likes to snack and prefers diet coke over water, resulting in many demineralized areas.
Describe the motivation and/or behavior change theory assessment factors and communication between the dental hygienist and client in order to initiate further behavior change counseling. Include motivational interviewing principles in the communication approach.
The behaviour change theory indicates that oral health issues are often behavioural lifestyle issues. As the HCP, I would have to convince and motivate the importance of health to John who doesn't believe his oral care is important.I would give him knowledgeable evidence and motivation . I would relate my knowledge to his lack of self care to make him realize that he will continue to lose teeth if he does not change his ways. For John, we could talk about habits and try to incorporate small things to help improve his diet, his self care and his smoking. To continue to be successful with his behaviour change, we need participation from both John and HCP. There are 6 constructs that influence the clients decision in taking action in their care. These are: susceptibility, severity, benefits, barriers, cues to action and self efficacy. These can help motivate a client to become active with their care as it makes them aware of their behaviour making them willing to change.
Describe at least 2 or 3 further behavior change strategies individualized for the client during planning and/or implementation steps. Include motivational interviewing principles in the communication approach.
Reinforcements could motive John to care more about his oral hygiene. Since he is 56 years old something like a stickering system wouldn’t be very motivational. So a better approach would be understanding his needs and trying to meet them. As it is very clear John really likes his pop he can be rewarded by having a pop after he performs proper oral hygiene. Giving John a full understanding of proper oral health and how drinking his pop in a different way and taking oral hygiene into his own hands could benefit him. Another behaviour change could be using the strategies of change to attempt to motivate John to stop smoking. If he is smoking 1-2 packs a day that could definitely be reduced. Asking him questions such as do you have any plans on quitting smoking in the next 6 months? If the answer is no then encouraging him to attempt to take action to reduce the amount of cigarettes would be beneficial. This could change the next appointment’s answer to yes I want to quit. It is extremely important that the HCP gives John all the information he needs in order to make the right decisions. Pamphlets on tobacco use and counselling could be offered to motivate John to stop smoking, which would overall benefit his oral health.
Describe possible goals or follow-up plans for the client and/or the hygienist.
Since John Doe is not compliant with the average standards set out in the oral hygiene education we must adapt. In order to do so Oral Education must be given in a different way. If he is refusing to floss or brush at home a toothpick could be suggested. Obviously this isn't the most ideal form of oral health however it will still break some of the plaque biofilm. He could also be encouraged to come into the dental office more often to allow us to mechanically break the biofilm. A goal could be attempting to change the diet to watering down the coke or finding something to protect the teeth. A goal that can easily be monitored would be the changes in the periodontal pockets, if they decrease at all by increasing the amount of care at home. Another follow-up plan could be monitoring the soft spots and suggesting fluoride treatment to remineralize the soft areas. The severity of the current state must be addressed very clearly to emphasize the importance to John and what would happen if nothing changes.