Using Social Marketing to Influence Behavior Change and Improve Oral Health

Background:  Oral diseases are largely preventable, yet dental care is the number one unmet health need in many communities throughout the country.  The Mighty Mouth campaign, developed by Washington Dental Service Foundation with help from Marketing for Change, is a social marketing campaign in Washington state to motivate people to do more to prevent oral disease.  This case study of The Mighty Mouth campaign will highlight the formative research, strategy, implementation, evaluation and refinements. Two years of campaign experience and tactics and tools will be shared including videos, earned and social media.

Program background:  Findings from formative research, including 14 focus groups and a baseline survey of 1,200 Washington residents, shaped the campaign.  The research showed that people value oral health, but on a rung lower than overall health. Behaviors to prevent disease appeared to be influenced by knowledge gaps, cost and emotional barriers.  The Mighty Mouth Campaign was developed to add new credibility and immediate rewards (better breath, fitness) for good oral health behaviors (flossing, brushing, healthy snacking and regular oral health checkups).  The campaign reaches adults aged 25 to 75 through paid and earned media, events, partnerships, floss giveaways, social media and retail point-of-service initiatives. Oral health messages are delivered through third-party validators such as physicians, nurses and pharmacists who are trusted sources of health information – not just oral health advocates. Upbeat testimonials and humor, rather than scare tactics, are used to position oral health as something everyone wants, needs and deserves.  A key element are partnerships with organizations that have significant reach (e.g. hospitals, drugstores, YMCA) to drive home the message that oral health is essential to health, beauty and fitness. 

Evaluation Methods and Results: Fifteen months after launch, a follow-up phone survey was conducted (n=1200) to identify changes since the baseline.  At follow-up, 62% of respondents recalled at least one element of the campaign through aided recall.  Four of five measures used to gauge oral health value strengthened.  There was also a slight increase in the number of times respondents said they brushed each day. Research shows that many attitudinal measures have topped out in Washington and 80 percent of people reported they brushed 2 times or more ‘yesterday’.  However, there is still room to improve flossing and regular checkups.

Conclusions: Learnings from the first two years are being used to guide Phase 2 of the campaign including targeting segmented audiences with tailored messages and expanding use of digital media.  Engaging physicians and other influencers (TV personalities and sports celebrities) will continue as an important strategy to influence norms.  The evaluation reinforced the need to connect oral health with issues the public already cares about including fitness, beauty and saving money.

Implications for research and/or practice:  Most people say oral health is important to overall health, but there is inconsistency between what people believe and their behavior.  Education is necessary, but not sufficient, to improve oral health behaviors.  Social marketing featuring innovative approaches, surprising messages and unexpected messengers will help influence behaviors leading to better health and lower healthcare costs.