***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective In the United Kingdom in 2006 , 5,325 persons were diagnosed with oral cancer ; and in 2007 it caused around 1,850 deaths . The purpose of this study was to assess the patient awareness , in a dental access centre , of a poster and leaflet campaign providing information about smoking and excess alcohol consumption as risk factors in the development of oral cancer , and to explore dental patients ' beliefs and perceptions about these risk factors . Methods Posters and leaflets providing information about risk factors for oral cancer were displayed in the patient waiting areas of a dental access centre . Data were collected prospect ively in relation to the smoking and drinking habits of patients attending the centre . This information was used to categorise patients into one of four groups ranging from low to high consumption . During triage , patients were asked if they had read any of the information about oral cancer that was on display , and patients in the high risk groups were asked to participate in a semi-structured interview that would explore their knowledge about risk factors and their views on the delivery of healthcare messages in relation to oral cancer . Results Data on risk status and exposure to the poster and leaflet campaign  were collected for 1,161 patients attending during the study period . More than 50 % of these patients were smokers , with 36 % in the high or very high tobacco and alcohol use groups . Approximately 40 % of patients within each consumption group had read any of the information available . Nine patients agreed to be interviewed and overall knowledge about risk factors for oral cancer , even after reading the information was poor . Conclusion Dental access centres attract a significant number of patients with lifestyle habits that make them vulnerable to oral cancer , and as such are well placed to deliver oral health messages to this high risk group . However , the delivery of information through a simple poster and leaflet campaign is likely to have limited impact BACKGROUND New perspectives are needed for oral health programmes ( OHPs ) . The aim was to evaluate the preventive effect of a risk-based OHP in comparison with a traditional programme . DESIGN An age cohort of 794 Finnish children , 446 in the intervention group and 348 in the control group , was followed from 18 months to 5 years of age . The children were screened for mutans streptococci ( MS ) in the dental biofilm . The main outcome measure was the proportion of children with dental caries ( decayed , missing , or filled primary teeth > 0 ) at the age of 5 years . The intervention , targeted to MS-positive subjects in the intervention group only , was based on repeated health education to the caretakers and xylitol lozenges for the child . Dental hygienists carried out the programme . RESULTS OHP was effective in white-collar families [ numbers needed to treat ( NNT ) = 3 , 95 % CI 2 - 11 ] . Factors significantly associated with caries at 5 years were MS colonization at 18 months , occupation of caretaker , but also gender when incipient carious lesions were included in the index . CONCLUSION Early risk-based OHP , targeted to the families of MS-positive children , can reduce the risk for caries in white-collar families . For blue-collar families , different kinds of methods in caries prevention and support are needed This experimental study determined if a " report card-like " oral health action plan was effective in improving oral health behaviors in a sample of 69 patients , ages 1 to 6 years . Participants were divided r and omly into control and intervention groups . Data collected included dmft , plaque score , Streptococcus mutans levels and oral health behaviors . Participants in the intervention group received an oral health action plan that included : 1 . child 's current caries-risk status ; 2 . identification issues of concern ; and 3 . one " goal " to improve on for the next visit . All participants returned after two months for follow-up examination and data collection Aim To test the effectiveness of dental health educators in general dental practice . Objective To evaluate the effectiveness and cost of primary care trusts seconding dental health educators free of charge to suitable general dental practice s to provide dental health counselling to mothers of regularly attending pre-school children at risk to caries . Method Two-cell , parallel group , cluster r and omised , controlled clinical trial of two years ' duration . Clinical setting : 30 general dental practice s in North-West Engl and . Participants : 269 mothers of 334 pre-school children . Interventions : Those in the test group were given visits to a dental health educator over a 2-year period to counsel mothers of at-risk , pre-school children . The rest were held as a control . Main outcome measures : Caries prevalence of the children and dental health knowledge , attitudes and toothbrushing skills of the parents . The full costs of the exercise were kept throughout . The statistical analysis controlled for the clustering of children within practice s. Results After 2 years , 271 ( 81 % ) children and 248 ( 92 % ) mothers remained in the study . There was an 18 % difference in mean dmft between the groups in favour of the test group children but this was not statistically significant . At the end of the study there was an 18 % difference in mean dmft between the groups in favour of the test group children but this was not statistically significant . No difference in plaque levels was found . The mothers in the test group were more knowledgeable , had better attitudes towards the dental health of their offspring and better toothbrushing skills than those in the control . Each 2-hour session to counsel ten parents cost £ 40 . Conclusion Primary care trusts should carefully consider the cost value of seconding dental health educators to counsel parents of regularly attending , at-risk , pre-school children when considering such an option AIM To evaluate the effectiveness of an individually tailored oral health educational programme for oral hygiene self-care in patients with chronic periodontitis compared with the st and ard treatment . MATERIAL AND METHOD A r and omized , evaluator-blinded , controlled trial with two different active treatments were used with 113 subjects ( 60 females and 53 males ) r and omly allocated to an experimental or a control group . The individually tailored oral health educational programme was based on cognitive behavioural principles and the individual tailoring for each participant was based on participants ' thoughts , intermediate , and long-term goals , and oral health status . The effect of the programmes on gingivitis [ gingival index ( GI ) ] , oral hygiene [ plaque indices ( PlI ) and self-report ] , and participants ' global rating of treatment was evaluated 3 and 12 months after oral health education and non-surgical treatment . RESULTS Between baseline and the 12-month follow-up , the experimental group improved both GI and PlI more than the control group . The mean gain-score difference was 0.27 for global GI [ 99.2 % confidence interval ( CI ) : 0.16 - 0.39 , p<0.001 ] and 0.40 for proximal GI ( 99.2 % CI : 0.27 - 0.53 , p<0.001 ) . The mean gain-score difference was 0.16 for global PlI ( 99.2 % CI : 0.03 - 0.30 , p=0.001 ) , and 0.26 for proximal PlI ( 99.2 % CI : 0.10 - 0.43 , p<0.001 ) . The subjects in the experimental group reported a higher frequency of daily inter-dental cleaning and were more certain that they could maintain the attained level of behaviour change . CONCLUSION The individually tailored oral health educational programme was efficacious in improving long-term adherence to oral hygiene in periodontal treatment . The largest difference was for interproximal surfaces BACKGROUND The purpose of this study was to compare the effect of a motivational interviewing ( MI ) counseling visit with traditional health education for mothers of young children at high risk of developing dental caries . METHODS The authors enrolled 240 infants aged 6 to 18 months and their mothers in the study and r and omly assigned them to  MI or traditional health education ( control ) groups . Mothers in the control group received a pamphlet and watched a videotape . Those in the MI group received the pamphlet and watched the videotape , as well as received an MI counseling session and six follow-up telephone calls during the first year . There were no interventions in year 2 . RESULTS After two years , children in the MI group exhibited significantly less new caries ( decayed or filled surfaces ) than those in the control group ( that is , a protective effect of MI ) ( odds ratio = 0.35 , 95 percent confidence interval = 0.15 to 0.83 ) . CONCLUSIONS MI is a promising approach that warrants further attention in a variety of dental context s. CLINICAL IMPLICATION S The results of this study show that MI has a protective effect with regard to the development of early childhood caries . One reason for this clinical effect is greater compliance with recommended fluoride varnish treatment regimens in families who received MI counseling compared with families who received traditional education OBJECTIVES To investigate whether primary care patients who cl aim to smoke tobacco gain greater benefit of a patient information leaflet ( PIL ) on oral cancer than nonsmokers . METHODS Two studies were conducted . Study 1 examined the research question initially , and Study 2 acted as a replication and inclusion of additional secondary outcome measures . The leaflet was design ed and tested in an earlier study . Knowledge of oral cancer was assessed by a previously vali date d 36-dichotomous-item scale . A single-item question ascertained self-reported smoking status ( kappa = 0.94 ) . Study 1 participants were drawn from 14 practice s ( 6 medical , 8 dental ) . A r and omised control group design was adopted . The experimental group received the leaflet on attendance to the practice and then completed the question naire . The control group received the question naire only .  Complete data were collected from 739 respondents . The design of Study 2 was identical ; 786 new respondents from 16 practice s ( 7 medical , 9 dental ) were collected . RESULTS Both studies confirmed that smokers knew less about oral cancer than nonsmokers ( P < 0.05 ) when access to the leaflet had been denied . On receipt of the leaflet , there was no distinction in oral cancer knowledge between the smoking status categories of respondents . Evidence of reassurance about screening from leaflet exposure was supported by the second study . CONCLUSION This programmed research has demonstrated an effect of a brief PIL to offset the decrement in oral cancer knowledge observed in primary care patients who use tobacco in comparison to their nonsmoking counterparts . The leaflet reduced anxiety about oral health screening in smokers Considerable re sources are expended in dealing with dental disease easily prevented with better oral hygiene . The study hypothesis was that an evidence -based intervention , framed with psychological theory , would improve patients ’ oral hygiene behavior . The impact of trial methodology on trial outcomes was also explored by the conducting of two independent trials , one r and omized by patient and one by dentist . The study included 87 dental practice s and 778 patients ( Patient RCT = 37 dentists/300 patients ; Cluster RCT = 50 dentists/478 patients ) . Controlled for baseline differences , pooled results showed that patients who experienced the intervention had better behavioral ( timing , duration , method ) , cognitive ( confidence , planning ) , and clinical ( plaque , gingival bleeding ) outcomes . However , clinical outcomes were significantly better only in the Cluster RCT , suggesting that the impact of trial design on results needs to be further explored AIM To evaluate an individually tailored oral health educational programme ( ITOHEP ) on periodontal health compared with a st and ard oral health educational programme . A further aim was to evaluate whether both interventions had a clinical ly significant effect on non-surgical periodontal treatment at 12-month follow-up . MATERIAL AND METHOD A r and omized , evaluator-blinded , controlled trial with 113 subjects ( 60 females and 53 males ) r and omly allocated into two different active treatments was used . ITOHEP was based on cognitive behavioural principles and motivational interviewing . The control condition was st and ard oral hygiene education ( ST ) . The effect on bleeding on probing ( BoP ) , periodontal pocket depth , " pocket closure " i.e. percentage of periodontal pocket > 4 mm before treatment that were < 5 mm after treatment , oral hygiene [ plaque indices ( PlI ) ] , and participants ' global rating of oral health was evaluated . Preset criteria for PlI , BoP , and " pocket closure " were used to describe clinical ly significant non-surgical periodontal treatment success . RESULTS The ITOHEP group had lower BoP scores 12-month post-treatment ( 95 % confidence interval : 5 - 15 , p<0.001 ) than the ST group . No difference between the two groups was observed for " pocket closure " and reduction of periodontal pocket depth . More individuals in the ITOHEP group reached a level of treatment success . Lower PlI scores at baseline and ITOHEP intervention gave higher odds of treatment success . CONCLUSIONS ITOHEP intervention in combination with scaling is preferable to the ST programme in non-surgical periodontal treatment Study aim was to determine the influence of a patient information leaflet ( PIL ) on mouth cancer to improve knowledge , reduce distress and increase intention to accept a mouth screen over a 2-month period . The design was a r and omised controlled trial . Two dental practice s in the northwest of Engl and participated . St and ardised multi-item scales of the three outcome measures were employed . The PIL was given to a r and omised intervention group of patients in waiting room . Single sheet question naire was completed by both groups of patients at baseline in waiting room ( immediately following leaflet administration in intervention arm of study ) . Repeat question naire completion at 8 weeks by all patients through postal system . Mann-Whitney U-tests comparing outcome variables between patients with and without access to the leaflet at baseline 
    Output:
    
Results showed that oral health promotion based on behavioural and psychological models was effective for improving oral health .
Verbal advice affected knowledge and reported behaviour , written advice promoted oral health knowledge .
There was moderate evidence that the attributes of the ' sender ' of an oral health promotion message influenced its effectiveness .
Many barriers and facilitators were shown to influence the effectiveness of OHP in dental practice .
The results of this review suggest that the psychology of behaviour change is the key to oral health promotion and greater emphasis on teaching oral health professionals about health psychology would make oral health promotion in the dental surgery more effective