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Oral health behavioral and social intervention research concepts and methods.

Oral health affects many aspects of a person’s functioning and overall health and well-being, including speaking, eating, and maintaining one’s appearance, self-esteem, physical comfort, activity level, and quality of life (1). Behavioral and social factors significantly impact oral health. Nutrition, feeding, and oral hygiene practices, pain management, treatment adherence, dental anxiety, oral health knowledge and literacy, parenting, corporate advertising, and access to healthcare and dental insurance, as well as other socioeconomic factors, are some of the many behavioral and social oral health-related issues. Primary, secondary and tertiary prevention behavioral and social interventions are needed to target these issues, reduce the incidence of oral health problems, and improve the rates at which people recover from them. 
 
Behavioral interventions are those that educate or instruct individuals about good oral health and disease management practices or how to handle psychological and social challenges that impact their oral health behavior. Examples include: a) prenatal education and assessment of expectant parents to decrease primary caregivers’ mutans streptococci levels and risk of transmission to infants (2); b) motivational interviewing with mothers to prevent early childhood caries (3–5) or with adolescents to reduce dental avoidance behavior (6); c) the 5A’s (ask, advice, assess, assist, arrange) in routine dental care to increase tobacco quit rates (7); and d) dental office-based weight control interventions for children and adolescents to reduce dental caries and prevent obesity-related systemic diseases (e.g., diabetes) that negatively impact oral health (8). 
 
Social interventions are those that target groups of people, organizations, or communities to improve oral care. Examples include: a) school-based interventions to promote preadolescents’ gingival health (9); b) social marketing campaigns to increase awareness of and screening for oral cancer in African Americans (10,11); c) providing dental homes for pregnant women on Medicaid to improve their access and utilization of dental care (12); and d) training dentists to detect methamphetamine users with dental comorbidities and refer these patients to substance abuse treatment programs (13). Developing and testing behavioral and social interventions to promote oral health and effectively treat diseases and disorders represent important parts of the NIDCR strategic plan (14).