Abstract
Erratic or non-adherence to supportive periodontal therapy (SPT) is a common issue following active periodontal therapy. Qualitative research exploring reasons for adherence and non-adherence to SPT from the patient’s perspective remains limited. This mixed-methods study aimed to inform and elaborate on factors influencing patients’ adherence to supportive maintenance care.
Thirteen participants who had received periodontal treatment within the Otago School of Dentistry Postgraduate Periodontics department were interviewed regarding their experiences with SPT. Quantitative data regarding their current periodontal status were recorded prior to the interview and used to provide context to the qualitative data. NVivo® (version 14) software was used for inductive thematic analysis of the transcribed semi-structured interviews.
The semi-structured interviews explored the participants’ experiences before and after receiving periodontal therapy, the perceived benefits of SPT, challenges they faced during SPT, and the participants’ perceptions of their own and the oral health professional’s responsibilities during SPT. In this study, ‘oral health professionals’ refers to dental hygienists, general dentists, undergraduate or postgraduate dental students, and dentist specialists.
Four themes were generated from the interview data: ‘Prior communication’, ‘Adapting to a new lifestyle’, ‘Drivers for seeking care’, and ‘The patient/practitioner relationship’. A majority of participants reported a lack of information prior to receiving periodontal therapy in the Postgraduate Periodontics department despite regularly seeing an oral health professional for dental care. Following active periodontal therapy, most participants reported they were aware of the need for lifelong supportive periodontal therapy and acknowledged their personal responsibility to maintain adequate plaque control and return for recall appointments on a regular basis. Adherent participants tended to demonstrate a more proactive approach to periodontal care by pre-booking recall appointments, prioritising oral hygiene routines, and requesting constructive feedback from their oral health professional regarding their periodontal condition and quality of plaque control. Participants often attributed their erratic adherence to SPT to extenuating circumstances such as severe stress, poor mental health, and work schedules. All participants reported an empathetic approach from oral health professionals to be conducive in promoting adherence to SPT. When comparing the qualitative and quantitative data for individual participants, contradictions were noted between some participant’s self-reported levels of adherence and presenting periodontal condition. These contradictions granted insight into the complexities of adherence in a periodontal context.
The findings of this research suggest that the relationship between the patient and practitioner is a major influential factor for promoting adherence to SPT. Unempathetic and inflexible treatment approaches during SPT may negatively influence adherence to SPT. The findings of this study may help oral health professionals to better understand the challenges patients face with adhering to SPT and improve the way in which periodontal health-related information is tailored and delivered to patients.