Colgate: Oral health – It’s all in the mind!

In this series of articles, the EFP is asking its partners how they see the need for changing behaviours in dental prevention and healthcare and what they themselves are doing about it.

In this interview we talk to George Kitsaras, resident psychologist at Colgate Palmolive, but works at the University of Manchester, Irina Chivu, Colgate Palmolive’s lead of scientific affairs for the European region, and Stephanie Jakumeit, who works with Irina and is responsible specifically for gum health.

It may seem simple just to brush your teeth, however George Kitsaras says it is a mental thing as much as a physical one.“It’s a very all consuming behaviour that manifests how behavioural sciences work… you have to think about that behaviour, do it, and do it properly, and once you do it, not to mess it up with your actions after.”  For example, brush your teeth then have a slice of cake!  Moreover, you have to try and remember all this for the rest of your life!  

He adds:  “Behaviour is all about consistency, creating habits for life and those habits have to be based on science and advice.”

Advice is not a one size fits all though.  In other words, to change the behaviour of an individual, advice must be tailored to them.  Children will need different advice to adults for example so that it is relevant to them.

As George Kitsaras explains, the COM model is used.  This stands for Capability, Opportunity and Motivation.  He says that “any behaviour is influenced by one’s capability to do that behaviour, then is there opportunity to do that behaviour, and then motivation is the crucial part.”  You need to make people want to brush their teeth, not just know they have to do it.  The University of Manchester has worked with Colgate Palmolive using this research model to change behaviour and educate the public, including fun ways of educating children with Bright Start Bright Futures.

“The understanding we gain through that research goes directly into how we design the communication for people” says Irina Chivu-Gurip.  She adds: “COMB is the model that we apply which is like giving the recipe on how we need to help people to change their behaviour, but before that it all starts by getting insights into what is the motivation is for children, or the elderly; what do they think and what is their values, what drives them?”   This is a very people centric approach.

For example talk to teenagers about the importance of oral health so they’ll still have their teeth in 30 years time, and they “won’t give a damn about that” says Irina. However “explain oral health in terms of how your peers perceive you and making sure you have fresh breath and they care because it is relevant to them.”

The same applies to lots of different groups, be it ethnic, age or gender.

What about looking at a given population`s general behaviour and tailoring products to that behaviour, for example looking at eating habits, sugary diet, alcohol etc?

George Kitsaras believes: “When we think about oral hygiene and oral health it would be a mistake to focus only on brushing teeth and using mouthwash.  It is what we do throughout the day that matters.  If you brush your teeth then have lots sugar with your coffee throughout the day, it would undo the good work you put on brushing your teeth.”

A big study run over seven years by the University of Manchester in Cumbria in England showed just this problem.  Fluoride had been added to the mains water in the area, so people thought that that gave them freedom to do whatever they wanted for the rest of the day, including eating unlimited sugar!  So behaviour is psychological!

Teeth get all the attention.  We always say we are going to brush our teeth, we never talk about brushing gums.  Gums don’t seem to be psychologically important to people, but they should be! This is where Stephanie Jakumeit says things must change!

“People need to understand that for healthy teeth you need healthy gums!”  She goes on:“there is room to improve, especially as we know that people may have bleeding, they see it as normal.  Gingivitis, other problems like swelling and redness they don’t care about it, they don’t realise.”

“There is a lot to do to educate people to take care and to make sure they go to the dentist and check what is going on.”

Education, understanding people and psychology is key as is the affordability of dentists, maximising and making the best use of a dentist visit and educating the dentists themselves.

Bringing all that together is what is needed.  “We do have a full time PHD student, who is herself a dental therapist working on that, funded by Colgate” says George Kitsaras.  “Her PHD is all about understanding professional behaviours, understanding what matters to patients and finding solutions that maximise the dentist’s time and efficiency.”

So the right product range that appeals to different people, the right teaching materials that resonate, and marrying dentists` time to patient need, along with knowing what makes folk tick seems to be the answer.

That should help stop people ending up a gum tree!