The Transtheoretical Model of Change Applied to Oral Hygiene Behaviors in Adolescents Wearing Fixed Appliances

Background: A great challenge for orthodontics is that patients could achieve a good level of oral hygiene in order to prevent oral health problems. There is evidence that patient-centered approaches may have better outcomes than traditional advice giving when a lifestyle change is involved. The aim of this study was to evaluate the association between the transtheoretical model stages of change and the level of oral hygiene in orthodontic patients. Material and Methods: A total of 106 orthodontic patients, aged 12-25 years, wearing fixed appliances in both arches, were recruited from the Orthodontic Department of Universitat de Barcelona. All patients received a session of conventional education in oral hygiene, were evaluated using plaque and gingival indexes and were categorized according to the transtheoretical model of Prochaska and Diclemente, a model to determine health-related behaviors based on people readiness to change habits. Results: Almost two thirds of patients reported being at less advanced stages of change (63%), being the most frequent stage the preparation one (40%). Patients showed a mean plaque index of 1.05 (0.45) and a mean gingival index of 0.75 (0.38). A decrease in both indexes was found as the phase of stage of change progressed. Conclusion: Participants being at more advanced stages of change had better oral hygiene as compared with the ones at the contemplation and preparation stages.