Motivational Interviewing in Preventing Dental Caries in Preschool Children

Abstract

Objectives: Prevailing health education (HE) is ineffective to change health behaviour sustainably. This randomized controlled trial integrated motivational interviewing (MI) and interactive caries risk assessment (RA) into HE and compared the effectiveness of HE, HE+MI, and HE+MI+RA in changing oral health behaviours and preventing early childhood caries.

Methods: This study targeted children aged 3-4 years with unfavorable oral health behaviors (infrequent toothbrushing and/or frequent snacking). A total of 692 parent-child dyads were recruited and randomly assigned to three groups. Parents in three groups received interventions of HE (n=231), HE+MI (n=231), and HE+MI+RA (n=230), respectively. At baseline and after 12 months, parents completed a questionnaire on children’s oral health behaviours and parental efficacy for protecting children’s oral health and children underwent an oral examination by a blinded examiner.

Results: The sociodemographic background and oral health behaviours of children were comparable among three groups at baseline (all p>0.05). After 12 months, 655 (94.7%) children were followed up. Significantly more positive changes in parental efficacy for protecting children’s oral health and in children’s oral health behaviours were observed in the HE+MI and HE+MI+RA groups than in the HE group (all p<0.05). The mean(SD)number of new carious teeth (Δdmft) in the HE, HE+MI, and HE+MI+RA groups were 1.2 (1.9), 0.6 (1.4), and 0.6 (1.1), respectively, with significant difference between HE group and the other two groups (both p<0.001). Compared with the HE group, the HE+MI and HE+MI+RA groups exhibited significantly lower chance for new caries (both p<0.001); the OR (95% CI) were 0.45 (0.30-0.66) and 0.53 (0.36-0.77) respectively.

Conclusions: Motivational interviewing is more effective than prevailing health education in improving parental efficacy and children’s oral health behaviours and preventing caries of preschool children. (Supported by General Research Fund #106120135; Research Grant Council of Hong Kong)