Motivational Factors for the Non- Compliant Patient.

Abstract

Objective: To evaluate the oral hygiene attitudes of non-compliant patients and find motivating strategies to improve their adherence to oral hygiene recommendations. Assessment: A 33 year old male Caucasian patient presented to our clinic with the chief complaint of “I need to get my teeth cleaned.” He had not been to the dentist in 17 years. His medical history was positive for HIV/AIDS. The patient stated that he has smoked a half of a pack of cigarettes daily for the last 20 years and that he drinks socially. The patient stated that he brushes once a day with a manual toothbrush and rarely flosses. His gingival description was generalized mild plaque induced marginal, papillary gingivitis as evidenced by pale pink, bulbous, spongy gingiva with slight BOP. Localized moderate to severe plaque induced gingivitis on lingual mandibular tissue as evidenced by red, rolled, inflamed papilla with easy BOP on the mandible. His periodontal description was generalized 4-6 mm CAL most likely due to inflammation from pseudo-pocketing. Generalized healthy bone levels as evidenced radiographically by 1-2 mm measurements from the CEJ to crest of alveolar bone. DH Care Plan: Prophylaxis, extensive OHI that includes finding motivating factors for this patient to maintain effective plaque control at home. Evaluation: When evaluating this patient’s success in treatment, we found he was not compliant 5 out of the 10 appointments that we had agreed to schedule. His behavior and attitude remained unchanged despite the efforts used to motivate the patient. His attitude reflected his desire for a quick resolution to improve his oral health, rather than making the commitment and effort to alter his lifestyle. Conclusion: Finding the right motivating strategies for your patient will determine how successful their treatment outcomes will be in achieving optimal oral health.