Dental Tribune UK Edition, October 25-3, 2010, No.26 Vol.4

October 25-31, 201030 Oral Health Feature United Kingdom Edition E ncouraging patients to change their behaviour and improve their oral hygiene is challenging but essen- tial. ‘To understand how to moti- vate change in patients, the oral healthcare practitioner needs to be aware of the distinction be- tween compliance and adher- ence,’ according to the American education experts Joyce Turcotte and Rebecca Lang. In an article in the journal Contemporary Oral Hygiene, they explain that the word ‘compli- ance’ suggests patients obey the clinician’s instructions. In con- trast, the term ‘adherence’ char- acterises patients as autonomous, independent and intelligent, tak- ing more active and voluntary roles in their dental treatment. ‘The distinction is who is di- recting the change. Compliance is authority-driven and adherence is patient-driven. When a patient behaves in a compliant manner, he or she is following the hygien- ist’s rules. This may not be val- ued, understood or committed to by the patients. However, adher- ence is a commitment made to particular behaviours congruent with a selected lifestyle,’ say Tur- cotte and Lang. That lifestyle will probably include achieving the freshest possible breath. Since most people have a bad breath problem at some time and in nine out of 10 cases the cause originates from within the mouth presenting fresh breath as a de- sirable, and even necessary, ele- ment of a successful oral hygiene programme can greatly influence the demand to see the hygienist. The Facts • The BDA estimates that approxi- mately 30 per cent of the popu- lation suffer from chronic bad breath at any one time. • A survey conducted by Periprod- ucts Ltd indicated that nearly 70 per cent of those questioned had experienced bad breath on some- one else. • Approximately 90 per cent of physiological malodour originat- ing from sites within the oral cav- ity can be attributed to Volatile Sulphur Compounds (VSC). • The gingival tissue is a principal location of VSC. • 80 per cent of bad breath ema- nates from the back of the tongue • VSC present themselves as odour-causing molecules made up of small sulphur atoms. • The aim of bad breath preven- tion is to eliminate the VSC as much as possible. • A healthy mouth constantly pro- ducesVSCatverylowlevelsthere- fore it is important to maintain a good standard of oral hygiene. •Tongue cleansing is an impor- tant element of a successful oral hygiene programme to achieve a high level of oral freshness. • Recommend oral care products specifically designed to eliminate odour-causing Volatile Sulphur Compounds (VSC) associated with oral malodour, such as the RetarDEX™ Alcohol Free oral health care range with fluoride and the OOLITT™ excel tongue cleanser. Co-discovering with the pa- tient the areas in the mouth that have the potential to harbour bac- teria associated with tooth decay, gum disease and bad breath will help patients to accept that they need regular visits to the dentist and hygienist. Explaining this to patients before starting their examina- tions places you in a position of impartial observer and allows the patient to participate in the self-discovery process that is nec- essary for them to become an ac- tive contributor in their own care. An equally successful way of en- couraging co operation is to ask a simple question; ‘Are you ever concerned about the freshness of your breath?’ The answer to this question can create an excellent dialogue opener and allows for further investigation and a com- mitted patient. Who wouldn’t want Fresh Breath? DT Encouraging change is essential