Oral hygiene routine formation: the effects of habit stacking, regularity, and reward

Habit-based interventions hold promise for promoting dental health by establishing enduring dental hygiene routines. In the present study, we will investigate the importance of linking the target behavior to an antecedent cue, based on the idea that this is crucial for stimulus-response (S-R) habit learning. Furthermore, we investigate whether habit formation is affected by (temporal) regularity, pleasure and perceived health benefits. This work builds forth on previous research by Judah and colleagues (2013, 2018). After a brief tooth picking intervention, 100 healthy, young volunteers (18-35 years) will form a tooth picking routine during 6 consecutive weeks. Half of the participants are instructed to tooth pick after brushing (habit stacking group), and half before (control group). Participants subsequently self-report tooth picking behaviour and behavioral automaticity weekly (T1-T6). We also obtain a more objective measure of adherence through recording lid openings of the electronic containers that hold the tooth picks. We expect greater automatization of the target routine of tooth picking in the stacking group relative to the control group. We also expect that regularity and immediate reward (i.e., pleasure) promote automatization.