Systematic cognitive behavioral approach for oral hygiene instruction: A short-term study

Naoki Kakudate, Manabu Morita, Makoto Sugai, Masamitsu Kawanami

Research output: Contribution to journalArticlepeer-review

50 Citations (Scopus)


Objective: Determine whether a six-step behavioral cognitive method is more effective than traditional oral hygiene instruction. Methods: Thirty-eight patients with chronic periodontitis were randomly assigned to two groups. The control group was given traditional oral hygiene instruction for 20 min. The intervention group received counseling by Farquhar's six-step method for 10 min after traditional oral hygiene instruction. In both groups, oral hygiene instruction was given once a week, and performed three times in total for 3 weeks. Clinical characteristics, deposition of dental plaque, frequency and duration of brushing, frequency of interdental cleaning and scores based on scale of "self-efficacy for brushing of the teeth" were compared in both groups. Results: There were no differences between the two groups in clinical, demographic, behavioral and self-efficacy characteristics at the baseline examination. However after the third visit, the intervention group had a significantly higher self-efficacy, lower plaque index, longer brushing duration and higher frequency of inter-dental cleaning than those of the control group. Multiple regression analysis showed significant association of toothbrushing duration with self-efficacy for brushing of the teeth (p < 0.001). Conclusion: The six-step method might be more effective for enhancing self-efficacy and behavioral change of oral hygiene than traditional oral hygiene instruction alone. Practice implications: Dentists and dental hygienists can use the six-step method for effective oral hygiene instruction.

Original languageEnglish
Pages (from-to)191-196
Number of pages6
JournalPatient Education and Counseling
Issue number2
Publication statusPublished - Feb 2009
Externally publishedYes


  • Behavioral change
  • Oral hygiene instruction
  • Patient education
  • Periodontitis
  • Self-efficacy
  • Six-step method

ASJC Scopus subject areas

  • Medicine(all)


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