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Health Behavior Change in the Dental Practice




Health Behavior Change in the Dental Practice

Christoph Ramseier (Editor), Jean E. Suvan (Editor)

ISBN: 978-0-813-82106-1 September 2010 Wiley-Blackwell 196 Pages

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Health Behavior Change in the Dental Practice presents an overview of health behavior change, focusing on the spirit of motivational interviewing. Targeting the clinical application of the principles, the book applies lessons learned from the field of general and behavioral medicine to the dental practice. By presenting a series of clinical examples and accompanying dialogue, the book guides the reader in using motivational interviewing techniques as tools for oral hygiene education, tobacco use cessation, and dietary counseling. Health Behavior Change in the Dental Practice supports the trend towards risk management in oral health care, offering practical guidance to promote health behavior change in patients.


List of Contributors

1. Introduction to Health Behavior Change for the Dental Practice

Health Care in the Twenty-first Century

The Opportunity in the Dental Setting

Adop tion and Integration of Health Behavior Change

The Role and Responsibility of the Dental Professional

Collaborative Care Toward Whole Health


2. The Challenge of Behavior Change


Behavior Change: Some Key Concepts

The Patient’s Perspective

The Clinician’s Perspective

Understanding Health Behavior Change

Social Cognitive Theory and Self-Efficacy Theory

The Health Belief Model

Theory of Planned Behavior

The Transtheoretical Model of Behavior Change

Self-Determination Theory



3. Communication and Health Behavior Change Counselling


The Relationship between the Clinician and the Patient

Styles of Communication




Key Skills for Communicating about Health Behavior Change

Question 1: Is the patient happy to talk with you about behavior change?

Question 2: How are you asking questions?

Question 3: How do you provide support?

Question 4: How do you convey understanding?

Question 5: How do you get information across?

Question 6: How do you bring it all together?




4. Motivational Interviewing (MI) and Its Basic Tools


What Is Motivational Interviewing?

Research Evidence for MI

What Triggers Behavior Change?

Motivation and the Clinician-Patient Relationship

Definition of MI

“Spirit” of MI

Major Principles

Express Empathy

Develop Discrepancy

Roll with Resistance

Support Self-Efficacy

OARS: Basic Tools for Building Motivation to Change

Use Open-Ended Questions

Affirm Patients

Use Reflective Listening

Use Summaries

Elicit Change Talk

Evocative Questions

Decisional Balance or Pros and Cons Matrix

The Importance Ruler

Elaborating, Querying Extremes, and Looking Back and Forward

Exploring Goals and Values

Responding to Change Talk

Responding to Resistance

Enhancing Confidence

Strengthening Commitment

Negotiating a Plan for Change



5. Brief Interventions in Promoting Health Behavior Change


Using a Patient-Centered Approach

Righting Reflex

Goals of Brief Interventions

Assessing Motives

Health History Form

Open-Ended Questions

Readiness Scales

Raising Awareness

Giving Information versus Raising Awareness

Conveying Understanding

Supporting Change

Encouraging Patient Problem Solving

Offering a Set of Strategies

Planning for the Change

Use of the Telephone for Brief Interventions

Use of Computers for Brief Interventions

Giving Brief Advice

When Brief Interventions Are Not Appropriate

Bringing It All Together



6. Implementation of Health Behavior Change Principles in Dental Practice


Content of Change (the Objectives)

Context of Change (the Environment)

Process of Change (the Implementation Plan)

Micro-Environment: The Dental Visit

Easier than You Think

Patient Activation Fabric for the Dental Visit (Implementation Model)

“Your Patient Is Here,”

Single Behavior Patient Scenario

Multiple Behavior Patient Scenario

Macro-Environment: The Practice Setting

Importance of Support

Overcoming Potential Obstacles to Practice Implementation

Practical Guidance for Beginners (or Non-Beginners)



7. Health Behavior Change Education


History of Medical and Dental Education

In Medicine

In Dentistry

In Dental Hygiene

Currents Trends in Dental Care and Education

The Need for Change in Dental Education

Public Health Goals and Responsibilities

New Educational Initiatives and Methods

Theoretical Education

Pathology and Epidemiology of Diseases

Behavior as a Determinant of Health and Disease

Practical Education


Continuing Education


Assessment of Health Behavior Change Education







  • Applies motivational interviewing techniques directly to dentistry
  • Provides a workable strategy for health behavior change in the dental practice
  • Focuses on improving clinician-patient communication skills for the best treatment outcomes
  • Draws on examples from everyday practice
  • Provides a thorough review of supporting literature