Effectiveness of psychological intervention in improving adolescents’ oral health: A systematic review and meta-analysis

Abstract

ObjectivesThis systematic review aimed to evaluate the effectiveness of psychological interventions in improving oral health behaviors and status among adolescents. SourcesA comprehensive search was conducted in the following six electronic databases, PubMed, Ovid Medline, Ovid Embase, Cochrane Library, APA PsycINFO (ProQuest) and Web of Science. Study selectionThe PICO format was used to select eligible studies. Population was adolescents 12 to 18 years old. Intervention was psychological interventions based on psychological theories or models. Comparison was conventional oral health education or negative control. Outcomes were oral health-related behaviors, oral health status, oral health-related quality of life (OHRQoL), self-efficacy and psychological cognitive factors. The risk of bias tool used was RoB 2. DataSixteen papers on 14 studies met the inclusion criteria. The studies were conducted in school or clinic settings. Regarding risk of bias, most studies had some concerns and the others had a high risk. The psychological interventions improved adolescent's oral hygiene and periodontal status in the short-term (up to 6 months), with the overall SMD = -0.97 (-1.45, -0.49) in plaque level and SMD = -1.18 (-2.32, -0.04) in periodontal status. No significant difference in plaque level was found in the long-term (12 to 24 months), with the overall SMD = -0.31 (-0.64, 0.02). There was improvement in OHRQoL in the short-term, with the overall SMD = 1.04 (0.34, 1.73). Additionally, significant differences were found regarding self-efficacy, oral health-related behaviors (tooth brushing and dental flossing) and psychological cognitive factors between the intervention group and control group (all p < 0.05) in the short-term. Due to the heterogeneity of the studies, meta-analysis could not be conducted in the above three outcome measurements. ConclusionsLow certainty of evidence shows that psychological intervention is effective in improving adolescents’ oral hygiene in short-term. In addition, very low certainty of evidence was found in improving periodontal status, self-efficacy, oral health-related behaviors, psychological cognitive factors, and OHRQoL in short-term. Clinical significanceBy targeting the psychological process and cognitive factors of oral health-related behaviors among adolescents, psychological interventions have the potential to improve oral health behaviours and promote oral health among adolescents. Implementing evidence-based psychological interventions in dental practice can lead to more comprehensive and effective dental care for adolescents.