Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management

Caoimhin Mac Giolla Phadraig, Olive Healy, Aisyah Ahmad Fisal, Carilynne Yarascavitch, Maria van Harten, June Nunn, Tim Newton, Peter Sturmey, Koula Asimakopoulou, Blánaid Daly, Marie Therese Hosey, Pedro Vitali Kammer, Alison Dougall, Andrew Geddis-Regan, Archana Pradhan, Arlette Suzy Setiawan, Bryan Kerr, Clive S Friedman, Bryant W Cornelius, Christopher StirlingSiti Zaleha Hamzah, Derek Decloux, Gustavo Molina, Gunilla Klingberg, Hani Ayup, Heather Buchanan, Helena Anjou, Isabel Maura, Ilidia Reyes Bernal Fernandez, Jacobo Limeres Posse, Jennifer Hare, Jessica Francis, Johanna Norderyd, Maryani Mohamed Rohani, Neeta Prabhu, Paul F Ashley, Paula Faria Marques, Shalini Chopra, Sharat Chandra Pani, Susanne Krämer

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Objectives: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour. 
Methods: Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action.
Results: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied.
Discussion: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.
Original languageEnglish
Pages (from-to)550-571
Number of pages22
JournalCommunity Dentistry and Oral Epidemiology
Volume52
Issue number4
Early online date22 Mar 2024
DOIs
Publication statusPublished - 1 Aug 2024

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