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Cochrane Database of Systematic Reviews

Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases

Overview of attention for article published in Cochrane database of systematic reviews, February 2016
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75 Mendeley
Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases
Published in
Cochrane database of systematic reviews, February 2016
DOI 10.1002/14651858.cd005097.pub3
Pubmed ID

Lucy O'Malley, Pauline Adair, Debbie L Bonetti, Philip M Preshaw, Pia-Merete Jervøe-Storm


Adherence to oral hygiene is an important aspect of the treatment of periodontal disease. Traditional educational interventions have been shown to be of little value in achieving long term behaviour change. The aim of this review was to determine the impact of interventions aimed to increase adherence to oral hygiene instructions in adult periodontal patients based on psychological models and theoretical frameworks. This review considered the following outcomes:Observational measures of oral health related behaviourSelf reported oral health related behaviours, beliefs and attitudes towards oral health related behaviourClinical markers of periodontal disease. The Cochrane Oral Health Group's Trials Register (2005), CENTRAL (The Cochrane Library 2004, Issue 4), MEDLINE (from 1966 to December 2004), EMBASE (from 1980 to December 2004), PsycINFO (from 1966 to December 2004), Ingenta (from 1998 to December 2004) and CINAHL (from 1966 to December 2004). Reference lists from relevant articles were searched and the authors of eligible trials were contacted to identify trials and obtain additional information. No language restriction was applied. Randomised controlled trials testing the effectiveness of interventions based on psychological models compared with educational, attention or no active intervention controls to improve adherence to oral hygiene in adults with either gingivitis or periodontitis. Titles and abstracts of studies that were potentially relevant to the review were independently screened by two review authors. Those that were clearly ineligible were rejected. For the remaining studies, the full paper was reviewed by two review authors and where necessary further information was sought from the author to verify eligibility. Included studies were assessed on their quality using standard criteria. The review identified four studies (including 344 participants) in which a psychological model or theory had been explicitly used as the basis for the design of the intervention. The overall quality of trials was low. Due to the heterogeneity between studies, both in terms of outcome measures and psychological models adopted, a meta-analysis was not possible. The four studies adopted four different theoretical frameworks, though there was some overlap in that three of the studies incorporated elements of Operant and Classical Conditioning. Psychological interventions resulted in improved plaque scores in comparison to no intervention groups, and in one study in comparison to an attention control group. One study found decreased gingival bleeding in the active intervention group but no change in pocket depth or attachment loss after 4 months. Psychological interventions were associated with improved self reported brushing and flossing in both studies which assessed these behaviours. Only one study explored the impact of psychological interventions on beliefs and attitudes, the psychological intervention, in comparison to educational and no intervention controls, showed improved self efficacy beliefs in relation to flossing, but no effect on dental knowledge or self efficacy beliefs in relation to tooth brushing. There is tentative evidence from low quality studies that psychological approaches to behaviour management can improve oral hygiene related behaviours. However, the overall quality of the included trials was low. Furthermore, the design of the interventions was weak and limited, ignoring key aspects of the theories. Thus, there is a need for greater methodological rigour in the design of trials in this area.

Mendeley readers

The data shown below were compiled from readership statistics for 75 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Unknown 74 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 16 21%
Student > Bachelor 9 12%
Student > Ph. D. Student 8 11%
Researcher 6 8%
Student > Doctoral Student 6 8%
Other 18 24%
Unknown 12 16%
Readers by discipline Count As %
Medicine and Dentistry 41 55%
Psychology 7 9%
Nursing and Health Professions 5 7%
Agricultural and Biological Sciences 2 3%
Social Sciences 2 3%
Other 5 7%
Unknown 13 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 February 2016.
All research outputs
of 22,849,304 outputs
Outputs from Cochrane database of systematic reviews
of 12,323 outputs
Outputs of similar age
of 400,529 outputs
Outputs of similar age from Cochrane database of systematic reviews
of 245 outputs
Altmetric has tracked 22,849,304 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 12,323 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 30.4. This one is in the 36th percentile – i.e., 36% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 400,529 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 75% of its contemporaries.
We're also able to compare this research output to 245 others from the same source and published within six weeks on either side of this one. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.