Habitual formation in teeth brushing and flossing in order to establish healthy oral hygiene
OA Version
Citation
Abstract
Oral health is essential to understand as every individual has suffered from some oral disease. Oral diseases can affect any individual at any age, whether their conditions are preventative, severe, or irreversible. Therefore, understanding the impact of oral health is crucial due to the widespread prevalence of dental caries and periodontal diseases, which are significant public health concerns globally. These conditions affect oral well-being and have systemic implications, contributing to health disparities.
Health behaviors significantly impact oral health, particularly tooth brushing and interdental cleansing. Increasing tooth brushing frequency to twice daily with fluoridated toothpaste decreases caries incidence by 50%. Regular tooth brushing, twice or more daily, correlates with a favorable oral microbiome and reduces dental plaque. In contrast, irregular brushing increases the risk of dental caries and disrupts oral microbiome composition. Frequent tooth brushing and flossing are associated with reduced risks of cardiovascular disease, gingiva bleeding, and inflammatory markers such as C reactive protein and fibrinogen. Individuals brushing twice daily have a lower risk of gingiva bleeding than those brushing once or less daily. Poor tooth brushing habits increase the risk of cardiovascular diseases by 70% and have an increased number of inflammatory markers. Furthermore, increased tooth brushing frequency correlates with lower risks of oral diseases, malignancies, diabetes mellitus, and dyslipidemia.
This is due to the systemic-oral connection stating that oral diseases can affect an individual's health. Conversely, systemic health can affect the oral health of an individual. This is extensively seen in the relationship between periodontal disease and cardiovascular diseases, as both have a direct connection with one another. Promoting foundational oral hygiene practices like tooth brushing and flossing is essential for preventing and potentially reversing these issues.
However, successful integration requires a nuanced understanding of habit formation. Recognizing the psychological components involved, such as motivation, routine establishment, consistency, and effort, is essential. Research indicates that habits are formed through cues, routines, and rewards, forming the habit loop, which is essential in developing habits. Individuals can effectively build and sustain oral health habits by comprehending these elements. Integrating toothbrushing and flossing into daily routines becomes more achievable when guided with evidence-based habit formation strategies such as understanding the shift and transition between goal-directed and habitual behaviors. Behaviors are categorized as goal-directed or habitual, depending on the conscious decision-making and planning level involved. Goal-directed behavior requires high-level decision-making and planning, while habitual behavior is automatic and unconscious. Two strategies, model-based and model-free, are intertwined with habit formation, with the former involving goal setting, evaluation of outcomes, and cognitive processes, and the latter focusing solely on rewards.
The habit loop, involving cue, routine, and reward, is crucial in habit formation. Repetition and consistency are vital to instilling habits and transitioning behaviors from intentional to reflexive and automatic. The basal ganglia, particularly the dorsal striatum, plays a central role in habit formation, shifting from goal-directed to habitual behavior over time. The dorsomedial region is essential in decision-making and learning, while the dorsolateral region is associated with automatic and habitual behavior. The transition between goal-directed and habitual behavior is seen in the caudate nucleus and the putamen, increasing neuronal activity when a behavior is being performed.
Furthermore, it is essential to learn the differences in health habits between children and adults as both involve different factors and require different approaches to maintaining positive oral health and establishing habits. The process of habit formation differs between children and adults due to developmental stages and cognitive abilities, emphasizing the role of parents in instilling positive oral health habits in children and the need for adults to evaluate and adopt positive habits throughout their lives. Parental guidance requires motivation, praise, and self-regulatory skills to adapt to changes and difficulties that may arise while trying to establish routines in children.
Establishing education on oral health and habit theory empowers individuals to take proactive steps in maintaining optimal health, addressing health challenges associated with oral health conditions, and promoting overall well-being.