Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
J Dent Res. 2019 Dec;98(13):1418-1424. doi: 10.1177/0022034519873842.
The importance and value of behavioral sciences in dentistry have long been recognized, and their contribution to dental education, research, clinical practice, and oral health policy has been significant over the past half century. Over time behavioral sciences have expanded our understanding of oral health beyond "disease" to a broader biopsychosocial concept of oral health. This in turn has led dentistry away from a focus of "treatment" to oral health "care," notably in the new millennium. Key oral health behaviors have been identified for more than half a century: the importance of diet, oral hygiene, dental services, and other factors. Various behavioral models and theories have been proposed, particularly since the 1970s, providing useful frameworks with sound psychological basis to help understand the paths of oral health behaviors. These models draw on theories of self-efficacy, motivation, counseling, and "behavior change." Since the 1980s, there has been a greater understanding that these behaviors often share a common pathway with the etiology of other diseases (common risk factors). Furthermore, the relationship between individual factors and the broader environmental factors has been increasingly emphasized since the 1990s, leading to a united call for action in addressing oral health inequalities. Within the past decade, there are useful examples of models, frameworks, and techniques of behavior change with respect to oral health, involving planning, prompting, encouraging, goal setting, and/or motivating. In particular, there is a growing interest and use of motivational interviewing. Likewise, behavioral therapies, such as cognitive behavioral therapy, are increasingly being employed in dental practice in the management of dental anxiety, pain, and psychosomatic dental and oral problems, with promising results. Recommendations are outlined for future directions for behavioral sciences in the promotion of oral health.
行为科学在牙科中的重要性和价值早已得到认可，在过去的半个世纪中，它们对牙科教育、研究、临床实践和口腔健康政策的贡献是巨大的。随着时间的推移，行为科学扩展了我们对口腔健康的理解，超越了“疾病”，形成了更广泛的身心社会概念。这反过来又使牙科从关注“治疗”转向了口腔健康“护理”，尤其是在新千年。半个多世纪以来，我们已经确定了一些关键的口腔健康行为：饮食、口腔卫生、牙科服务和其他因素的重要性。自 20 世纪 70 年代以来，提出了各种行为模型和理论，为理解口腔健康行为的途径提供了有用的框架和合理的心理基础。这些模型借鉴了自我效能、动机、咨询和“行为改变”理论。自 20 世纪 80 年代以来，人们越来越认识到，这些行为通常与其他疾病（共同危险因素）的病因有共同的途径。此外，自 20 世纪 90 年代以来，人们越来越强调个体因素与更广泛的环境因素之间的关系，这导致人们呼吁采取行动解决口腔健康不平等问题。在过去十年中，就口腔健康而言，有一些关于行为改变的模型、框架和技术的有用示例，涉及规划、提示、鼓励、设定目标和/或激励。特别是，动机性访谈的应用越来越多。同样，认知行为疗法等行为疗法也越来越多地被应用于牙科实践中，以管理牙科焦虑、疼痛和身心牙科及口腔问题，取得了可喜的效果。本文就行为科学在促进口腔健康方面的未来发展方向提出了建议。
