Gum disease patients ignore dentist advice

May 15 2005

The best efforts of dentists don't always mean people will look after their teeth, British researchers have found.

A study by a team at the University of Newcastle upon Tyne discovered that only up to one-third of gum disease patients, who received advice on how long to brush their teeth, followed it to the letter.

Yet the same people perceived their brushing habits to be better than they were - a finding which has major implications for dentists wishing to change their patients' behaviour.

Gum disease can eventually lead to multiple tooth loss, but in many cases damage can be stabilised or reversed if treatment is combined with a good home toothcare regime. For the study, patients were given advice on a regime - which in particular said they should brush their teeth twice a day for two minutes each time.

Each of the 17 study participants used an electronic 'data logger' powered toothbrush that recorded brushing time. The brush had a light on the handle that flashed when two minutes had elapsed. They were also asked to fill in diaries detailing their brushing habits. The experiment recorded brushing times for two periods of four weeks.

When researchers analysed the data, the data logger toothbrushes showed approximately one-third of people followed the advice whereas the diaries suggested that more than half of patients thought they had been compliant.

The results of the study are published in the British Dental Journal.

Lead researcher, Dr Giles McCracken, a lecturer with Newcastle University's School of Dental Sciences, said: "Research has shown that brushing for two minutes is the optimum time for most people to remove the plaque from your teeth. If you brush for less time, you aren't removing enough, and if you brush for longer the benefits may not be much greater.

"The fact that many participants in our experiment said they had followed the dentist's advice when our records proved they had not, has implications for the profession, especially in our increasingly litigious society."

"Patients must understand their health is mainly their responsibility, and if they are not going to comply with the advice of health providers like dentists who have their best interests at heart, they must accept the consequences."

The Newcastle researchers are carrying out further research into how advice is given in the dental chair, and whether this can be specially adapted for each individual receiving treatment.

Co-researcher, Prof Peter Heasman, said: "I think that many dentists and dental hygienists are fully aware that their patients do not always follow their professional advice. Nevertheless, we were surprised to find so many of our patients who were unable to follow instructions accurately, even in the short term."