Oral Health Intervention Using Behavioral Change Techniques for Mild Dementia: A Mixed Method Study

TL;DR

This study explores how behavioral change techniques can help people with mild dementia improve their oral health through care partner-assisted coaching.

Contribution

The study introduces a novel application of behavioral change techniques in oral health care for individuals with mild dementia.

Findings

Goal setting, problem-solving, and action planning were the most used behavioral change techniques.

Most dyads showed improved gingival health after the intervention.

BCT-based interventions show potential for enhancing oral hygiene self-care in mild dementia.

Abstract

Maintaining oral health in individuals with mild dementia (PLwMD) is challenging due to cognitive impairments that hinder independent adherence to oral hygiene routines. To encourage PLwMDs’ engagement in oral hygiene self-care behaviors, implementing behavioral change techniques (BCTs) are essential. Despite the effectiveness of BCT-based interventions in various health contexts, their application in PLwMD has been underexplored. To address this gap, this study evaluated the effect of a care partner-assisted intervention designed to improve oral health outcomes through structured coaching sessions incorporating BCTs. Seventeen care partners–PLwMD dyads participated in four monthly coaching sessions led by an interventionist and a dental hygienist. A mixed-methods approach was employed, including 1) deductive content analysis of coaching session transcripts to identify BCT applications and 2) quantification of BCT occurrences based on code frequency. Additionally, gingival index changes from baseline to the 3-month follow-up were used to categorize dyads as ’no change (n = 3)’, ‘worsened (n = 2)’, and ‘improved (n = 12)’. Preliminary results showed that the most prevalent BCT codes were goal setting, problem-solving, and action planning, etc. This suggests that greater use of BCTs drives positive behavior change, reinforcing better oral hygiene practices and improving oral health outcomes. The finding also highlights the potential of BCT-based interventions to enhance self-care behaviors for oral health in PLwMD. Further exploration is warranted to optimize care partner training and intervention strategies to maximize and sustain improvements in oral health outcomes for PLwMD.