Evidence map›Paper›PMID 40684208›Full record

Trial reportBMC oral health2025

Effectiveness of HAPA-based oral hygiene instruction in patients over 65 years of age: a randomized controlled trial.

Linn Baumann, Verena Klusmann, Charlène Bamberg, Stefan Rüttermann, Susanne Gerhardt-Szép

Abstract readRandomized Controlled TrialComparative Study
In one paragraph

Trial report in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Linn BaumannDepartment of Operative Dentistry, Carolinum Dental University-Institute gGmbH, J.W. Goethe University, Frankfurt/Main, Germany. baumann@med.uni-frankfurt.de.
Verena KlusmannDepartment of Health, Medical and Life Sciences, Health Promotion and Prevention, Furtwangen University, Furtwangen, Germany.
Charlène BambergDepartment of Operative Dentistry, Carolinum Dental University-Institute gGmbH, J.W. Goethe University, Frankfurt/Main, Germany.
Stefan RüttermannDepartment of Operative Dentistry, Carolinum Dental University-Institute gGmbH, J.W. Goethe University, Frankfurt/Main, Germany.
Susanne Gerhardt-SzépDepartment of Operative Dentistry, Carolinum Dental University-Institute gGmbH, J.W. Goethe University, Frankfurt/Main, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe aim of the study was to provide oral hygiene instructions tailored to behavioral stages based on the Health Action Process Approach (HAPA) and to assess their impact on oral health compared with standardized instructions in patients aged 65 and older.

methodsA total of 67 university clinic patients were randomly assigned to an intervention (n = 33) and a control group (n = 34) and 62 patients, aged 65 to 87 years (M = 71.3, SD = 5.3), participated in both the baseline and the follow-up visit. To assess oral hygiene, the parameters Gingival Bleeding Index (GBI) and Plaque Control Record (PCR) were recorded at baseline and 12 weeks after instruction. In the intervention group, a questionnaire was used at the beginning of both visits to survey oral hygiene behavior and motivation to change behavior. For both groups, the first visit included a survey on oral hygiene parameters followed by either HAPA-based or standard instruction with demonstration of oral hygiene aids.

resultsAnalyses of covariance with baseline control revealed no difference in GBI between the intervention and control group at the 12-week follow-up. Both the intervention group, t(29) = 3.91, p <.001, d = 0.71, as well as the control group, t(31) = 3.67, p <.001, d = 0.65, demonstrated significant improvement in GBI. In contrast, only the intervention group showed a significant improvement in PCR at reevaluation, t(29) = 2.29, p =.03, d = 0.42. Additionally, the intervention group reported a significant increase in motivation and the frequency of interdental care, t(29), 6.67, p <.001, d = 1.22.

conclusionThis study provides first evidence on the HAPA model being effectively applicable in the context of dental prophylaxis among university clinic patients older than the age of 65. A positive effect on patients’ behavior and oral hygiene could be demonstrated. While general instruction proved effective in reducing gingival bleeding, the theory-based HAPA intervention offered specific advantages in motivation, interdental care, and plaque buildup.

trial registrationGerman Study Register of Clinical Studies (DRKS, ID DRKS00030040, German Clinical Trials Register, Date of registration 22.03.2023).

Indexed as

Health BehaviorHealth Education, DentalOral HygienePatient Education as TopicTranstheoretical ModelAdherence InterventionsAgedAged, 80 and overDental PlaqueDental Plaque IndexFemaleFollow-Up StudiesHumansMaleMotivationPeriodontal IndexDentistryHealth behavior theoryOral healthPatient education

Identifiers

PMID40684208
PMCPMC12276706

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.