Skip to main content

Motivational Predictors of Change in Oral Health: An Experimental Test of Self-Determination Theory

An Erratum to this article was published on 12 May 2007

An Erratum to this article was published on 12 May 2007

Abstract

We tested the hypothesis that a psychosocial dental intervention formulated in terms of self-determination theory would increase patients’ perceived competence and autonomous motivation for dental care and would decrease their plaque and gingivitis over a seven month period, compared to standard dental treatment. We also tested a process model in which the intervention was expected to increase perceived dental competence and autonomous motivation, that they would be positively associated with oral health behaviors (i.e., brushing and flossing), which was expected to decrease plaque and, in turn, decrease gingivitis. We also examined whether: changes in perceived competence and autonomous motivation would mediate the effect of the intervention on dental-health behaviors; dental-health behaviors would mediate the links from changes in perceived competence and autonomous motivation to change in plaque; and change in plaque would mediate the relation of dental health behaviors to change in gingivitis. Finally, we examined the fit of the overall model with structural equation modelling. Results supported all predictions.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

Notes

  1. A full 5-page version of the intervention is available from the authors on request.

  2. For all measures skewness and kurtosis values were between −2 and 2, and reliabilities above .60, and they were judged to be acceptable according to criteria normally set (Muthen & Kaplan, 1985).

References

  • Anderson, J. C., & Gerbing, D. W. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103, 311–423.

    Article  Google Scholar 

  • Axelsson, P. (1981). Concept and practice of plaque-control. Pediatric Dentistry, 3(Special Issue), 101–112.

    Google Scholar 

  • Axelsson, P. (1994). Mechanical plaque control. In N. P. Lang & T. Karring (Eds.), Proceedings of the 1st European Workshop on Periodontology (pp. 219–243). London: Quintessence Publishing Co., Ltd.

  • Baard, P. P., Deci, E. L., Ryan, R. M. (2004). Intrinsic need satisfaction: A motivational basis of performance and well-being in two work settings. Journal of Applied Social Psychology, 34, 2045–2068.

    Article  Google Scholar 

  • Bagøien, T. E., & Halvari, H. (2005). Autonomous motivation, involvement in physical activity, and perceived sport competence: Structural and mediator models. Perceptual and Motor Skills, 100, 3–21.

    PubMed  Article  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator–-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    PubMed  Article  Google Scholar 

  • Bhaskar, S. N. (1977). Synopsis of oral pathology. St. Louis, Missouri: The C. V. Mosby Company.

    Google Scholar 

  • Bollen, K. (1989). Structural equations with latent variables. New York: Wiley.

    Google Scholar 

  • Cock, D., & Halvari, H. (1999). Relations among achievement motives, autonomy, performance in mathematics, and satisfaction of pupils in elementary school. Psychological Reports, 84, 983–997.

    Google Scholar 

  • deCharms, R. (1968). Personal causation: The internal affective determinants of behavior. New York: Academic Press.

    Google Scholar 

  • Deci, E. L., Eghrari, H., Patrick, B. C., & Leone, D. R. (1994). Facilitating internalization: The self-determination theory perspective. Journal of Personality, 62, 119–142.

    PubMed  Article  Google Scholar 

  • Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York: Plenum Press.

    Google Scholar 

  • Deci, E. L., & Ryan, R. M. (2000). The “what” and “why” of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11, 227–268.

    Article  Google Scholar 

  • Engel, G. E. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–136.

    PubMed  Article  Google Scholar 

  • Harris, N. O. (1999). Introduction to primary preventive dentistry. In N. O. Harris & F. Garcia-Godoy (Eds.), Primary preventive dentistry (pp. 1–18). Stamford, CT: Appleton & Lange.

    Google Scholar 

  • Horwitz, R. I., & Horwitz, S. M. (1993). Adherence to treatment and health outcomes. Archives of Internal Medicine, 153, 1863–1868.

    PubMed  Article  Google Scholar 

  • Hu, L., & Bentler, P. M. (1995). Evaluating model fit. In R. H. Hoyle (Ed.), Structural equation modeling: concepts, issues, and applications (pp. 76–99). Thousand Oaks, CA: Sage.

    Google Scholar 

  • Jacobs-Schoen, M. (1986). The effect of a cognitive behavioural counceling intervention on preventive dental hygiene. Unpublished Doctoral Dissertation. University of California, CA: Los Angeles.

  • Jöreskog, K. G. (1993). Testing structural equation models. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 294–316). London: Sage.

  • Jöreskog, K. G., & Sörbom, D. (1982). Recent developments in structural equation modeling. Journal of Marketing Research, 19, 404–416.

    Article  Google Scholar 

  • Karasek, R. (1979). Job demands, job decision latitude and mental strain: Implications for job redesign. Administrative Science Quarterly, 24, 285–308.

    Article  Google Scholar 

  • Karasek, R., & Thorell, T. (1990). Healthy work: Stress, productivity and the reconstruction of working life. New York: Basic Books.

    Google Scholar 

  • Koch, G. (1988). Importance of early determination of caries risk. International Dental Journal, 38, 203–210.

    PubMed  Google Scholar 

  • Löe, H. (1967). The Gingival Index, the Plaque Index and the Retention Index Systems. The Journal of Periodontology, 38, 610–616.

    Google Scholar 

  • Löe, H., & Silness, J. (1963). Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scandinavia, 21, 533–551.

    Google Scholar 

  • Muthen, B., & Kaplan, D. (1985). A comparison of some methodologies for the factor analysis of non-normal Likert variables. British Journal of Mathematical and Statistical Psychology, 38, 171–189.

    Google Scholar 

  • Newman, H. N., & Listgarten, M. A. (1999). The development of dental plaque: FROM preeruptive primary cuticle to acquired pellicle to dental plaque to calculus formation. In N. O. Harris & F. Garcia-Godoy (Eds.), Primary preventive dentistry (pp. 19–39). Stamford, Connecticut: Appleton & Lange.

  • Nix, G. A., Ryan, R. M., Manly, J. B., & Deci, E. L. (1999). Revitalization through self-regulation: The effects of autonomous and controlled motivation on happiness and vitality. Journal of Experimental Social Psychology, 35, 266–284.

    Article  Google Scholar 

  • North, F., Syme, S. L., Feeney, A., Head, J., Shipley, M., & Marmot, M. (1993). Explaining socioeconomic differences in sickness absence: the Whitehall II study. British Medical Journal, 306, 361–366.

    PubMed  Article  Google Scholar 

  • Ryan, R. M., & Connell, J. P. (1989). Perceived locus of causality and internalisation: examining reasons for acting in two domains. Journal of Personality and Social Psychology, 57, 749–761.

    PubMed  Article  Google Scholar 

  • Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55, 68–78.

    PubMed  Article  Google Scholar 

  • Ryan, R. M., Plant, R. W., & O’Malley, S. (1995). Initial motivations for alcohol treatment: Relations with patient characteristics, treatment involvement and dropout. Addictive Behaviors, 20, 279–297.

    PubMed  Article  Google Scholar 

  • Segars, A. H. (1994). Scale development in information systems research: A paradigm incorporating unidimensionality and its assessment. In J. DeGross, S. L. Huff, & M. C. Munro (Eds.), Proceedings of the 15th International Conference on Information Systems (pp. 1–12). Canada: Vancouver.

  • Silness, J., & Löe, H. (1964). Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scandinavia, 22, 112–135.

    Google Scholar 

  • Strandkleiv, O. I. (1999). Subjektivt velvære, indre motivasjon, målorientering, kompetanseoppfatning og klasseromsklima. Unpublished Master's thesis, Universitetet, Oslo.

  • Thylstrup, A., Brunn, C., & Holman, L. (1994). In vivo caries models–mechanisms for caries initiation and arrestment. Advances in Dental Research, 8, 144–157.

    PubMed  Google Scholar 

  • von der Fehr, E. R., Löe, H., & Theilade, E. (1970). Experimental caries in man. Caries Research, 4, 131–136.

    PubMed  Article  Google Scholar 

  • Williams, G. C., Cox, E. M., Kouides, R., & Deci, E. L. (1999). Presenting the facts about smoking to adolescents: The effects of an autonomy supportive style. Archives of Pediatrics and Adolescent Medicine, 153, 959–964.

    PubMed  Google Scholar 

  • Williams, G. C., & Deci, E. D. (1996). Internalization of biopsychosocial values by medical Students: A test of self-determination theory. Journal of Personality and Social Psychology, 70, 767–779.

    PubMed  Article  Google Scholar 

  • Williams, G. C., Freedman, Z. R., & Deci, E. L. (1998). Supporting autonomy to motivate glucose control in patients with diabetes. Diabetes Care, 21, 1644–1651.

    PubMed  Article  Google Scholar 

  • Williams, G. C., Gagné, M., Ryan, R. M., & Deci, E. L. (2002). Supporting autonomy to motivate smoking cessation: A test of self-determination theory. Health Psychology, 21, 40–50.

    PubMed  Article  Google Scholar 

  • Williams, G. C., Grow, V. M., Freedman, Z., Ryan, R. M., & Deci, E. L. (1996). Motivational predictors of weight loss and weight-loss maintenance. Journal of Personality and Social Psychology, 70, 115–126.

    PubMed  Article  Google Scholar 

  • Williams, G. C., McGregor, H. A. Sharp, D., Levesque, C., Kouides, R. W., Ryan, R. M., & Deci, E. L. (2006). Testing a self-determination theory intervention for motivating tobacco cessation: Supporting autonomy and competence in a clinical trial. Health Psychology, 25, 91–101.

    PubMed  Article  Google Scholar 

  • Williams, G. C., McGregor, H. A., Zeldman, A., Freedman, Z. R., & Deci, E. L. (2004). Testing a self-determination theory process model for promoting glycemic control through diabetes self-management. Health Psychology, 23, 58–66.

    PubMed  Article  Google Scholar 

  • Williams, G. C., Rodin, G. C., Ryan, R. M., Grolnick, W. S., & Deci, E. L. (1998). Autonomous regulation and long-term medication adherence in adult outpatients. Health Psychology, 17, 269– 276.

    PubMed  Article  Google Scholar 

  • Willmann, D. E., & Chaves, E. S. (1999). The role of dental plaque in the etiology and progress of inflammatory periodontal disease. In N. O. Harris & F. Garcia-Godoy (Eds.), Primary Preventive Dentistry (pp. 63–76). Stamford, Connecticut: Appleton & Lange.

  • Wolfe, G., Stewart, J., & Hartz, G. (1991). Relationship of dental coping beliefs and oral hygiene. Community Dental and Oral Epidemiology, 19, 111–114.

    Article  Google Scholar 

  • Wolfe, G. R., Stewart, J. M., Meader, L. A., & Hartz, G. W. (1996). Use of dental coping beliefs scale to measure cognitive changes following oral hygiene interventions. Community Dental and Oral Epidemiology, 24, 37–41.

    Article  Google Scholar 

Download references

Acknowledgements

We express thanks to Edward L. Deci for reading this manuscript and providing helpful suggestions for revisions.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anne E. Münster Halvari.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s11031-007-9056-y

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Halvari, A.E.M., Halvari, H. Motivational Predictors of Change in Oral Health: An Experimental Test of Self-Determination Theory. Motiv Emot 30, 294 (2006). https://doi.org/10.1007/s11031-006-9035-8

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11031-006-9035-8

Keywords

  • Autonomous motivation
  • Autonomy support
  • Oral care
  • Oral health