Component 2: Identifying Putative Risk Behaviors
The next level of inquiry may overlap with or blend “back and
forth” with component 1; it involves:
1. Identifying the major risk behaviors (activities being done
or not being done) for the patient’s current oral condition,
i.e., what patient behaviors likely contribute to the clinical
presentation?
2. Assessing and determining which specific factors—and
thus which behaviors—most likely contribute to the patient’s
current oral condition? Can the provider verify their
assumptions—by “back-tracing” the risk factor to one or
several specific behaviors? For example, with patients who
have poor plaque control, providers may need “more data:”
(a) Has the patient not seen the dentist in the past
5 years?
(b) Do they only brush in the morning and not at night
before going to bed?
(c) How effective is their tooth brushing technique?
(d) Has the provider actually seen the patient brush their
teeth in real time?
(e) Does the patient floss or use inter-dental cleaning
aids? How effective are the patient’s oral hygiene
techniques? Can the identified behaviors that contribute
risk for oral disease be prioritized (in terms
of immediate risk for developing disease or furthering
disease progression)—keeping in mind the larger
picture of the patient’s overall health?
(f) What is the most important behavior that, if altered,
would have the most significant impact on, for example,
reducing the risk for dental caries or periodontal
disease?
(g) Can the provider link together and communicate the
oral health-risk behavior to the patient’s future risk
for developing an adverse systemic health outcome?
(h) What part of an identified (putative) risk behavior
(Someting being done or not done ) can be altered
to most help the patient improve his or her oral health
over time?
3. Does the patient have (as an example) dry mouth?
(a) If yes, how severe is it?
(b) What does the patient do to presently address it?
(c) Does the patient know how dry mouth (coupled with
refined sugar intake) can contribute to tooth decay
[65]?
(d) How does the provider explain this risk to the patient
in a way that is meaningful to the patient?
(e) Can the provider encourage and/or empower the patient
to be actively involved in this coaching process
[70••]? Can the provider help motivate the patient to