The effect of risk communication on periodontal treatment outcomes: A randomized controlled trial

BACKGROUND: This study determines the effects of a routine assessment (Treatment as Usual, TAU) versus a risk communication intervention (Risk) versus a Goal-Setting, Planning and Self-Monitoring (GPS) intervention on periodontal disease patients' clinical and psychological outcomes. METHODS: In a three-arm randomized controlled trial (RCT; registration: ISRCTN59696243) adults (N = 97) judged to have moderate oral hygiene attended a primary dental care setting for a standard consultation. Intervention participants received an individualized calculation of their periodontal disease risk using only the Previser Risk Calculator (Risk group) or supplemented with a GPS-behavioral intervention (GPS group). Clinical, behavioral and psychological measures were obtained at baseline, 4 and 12 weeks later. RESULTS: Percent plaque reduced significantly (P < 0.05) in intervention groups but not in TAU group. Percent of sites bleeding-on-probing reduced in all groups, but the effect was more pronounced in the intervention groups. Interdental cleaning frequency improved only in the intervention groups (P < 0.05). Brushing frequency and probing depths showed little variation across time/groups. Disease risk and most thoughts about periodontal disease changed across time (P < 0.05). CONCLUSIONS: A simple behavioral intervention using individualized periodontal disease risk communication, with or without GPS, reduced plaque and bleeding and increased interdental cleaning over 12 weeks. This is the first study in the field to show that risk communication and behavioral techniques such as Goal-Setting, Planning and Self-Monitoring can improve periodontal outcomes.