How to Guide Patients Suffering From Periodontitis Towards Behavioural Change: A Systematic Review

OBJECTIVE: After reviewing the various interventions to evaluate their impact on guiding patients towards plaque control, their effects on periodontitis stabilisation, and the behavioural changes reported by patients. METHODS: This PROSPERO-registered systematic review followed PRISMA guidelines. Randomised controlled trials in adults with periodontitis assessing interventions to improve motivation for plaque control were included. Primary outcome was plaque index; secondary outcomes were other periodontal parameters and patient-reported behaviours. Study selection in different databases, data extraction, and risk-of-bias assessment were performed independently by two reviewers. RESULTS: Eight trials were included, with four different motivational interventions. Motivational Interviewing showed positive trends but no significant differences versus control (motivation-method described in the latest recommendations). Behavioural Interventions demonstrated plaque index and probing depth improvements, along with stronger tooth-brushing adherence. Patients included in Individually Tailored Oral Health Educational Programmes showed significantly greater plaque index improvement and maintenance of interdental cleaning versus controls. The Self-Care Commitment Model enhanced plaque control and self-care behaviours, though between-group differences were limited. These last three interventions were multi-sessional. The level of evidence was generally low-to-moderate. CONCLUSIONS: Multi-session motivational interventions seemed to have a positive effect for guiding patients towards behavioural changes. Larger and longer-term studies are needed to confirm these findings. TRIAL REGISTRATION: PROSPERO registration number: CRD42024551991.