Table 1 The TIPPS intervention
The TIPPS interaction is patient-centred, lasts for several minutes, with more time being taken for patients with greater need. The intervention format, the language used, and clinical communication are dependent upon the patients’ health literacy and understanding. The emphasis is on tailoring the intervention to the patient’s needs using appropriate demonstrations of plaque removal using models or watching the patient and providing advice. There are 5 TIPPS phases which are tailored to the needs of the patient at baseline and at subsequent follow-up visits. The different phases are | |
1 | Talk is the opening phase of TIPPS. Talk includes a discussion of the causes of periodontal disease and the importance of oral hygiene in its prevention. Integral to this phase is the use of visual aids to describe periodontal disease and the imparting of knowledge such as brushing teeth with fluoride toothpaste twice a day for 2 min, using of a small-headed toothbrush, and using interdental cleaning once a day. |
2 | Instruct is the second phase in which the patient is shown how to clean their teeth effectively, using the toothbrush, fluoride toothpaste, dental floss, and interdental cleaning brushes. |
3 | Practise allows the patient to clean their teeth in front of the clinician who provides and requests feedback from the patient, with concerns raised, addressed. |
4 | Plan adopts a patient-centred approach as the clinician negotiates and, with the patient, develops an action plan for effective plaque removal. This plan is reviewed and modified as the patient moves from preparation, through action to maintenance of their oral hygiene behaviours. |
5 | Support is the final phase of TIPPS, and it allows the clinician to support the patient during the early phase of behaviour change and consolidation of toothbrushing and interdental clean as daily routines. |