Motivational Interviewing in Dentistry: Systematic Review of Randomized Controlled Trials

Abstract

Objective: The control and management of many oral health conditions highly depends on one’s daily self-care practice and compliance to preventive and curative measures. Conventional (health) education (CE), focusing on disseminating information and giving normative advice, is insufficient to achieve sustained behavioral changes. A counseling approach, motivational interviewing (MI), is potentially useful in changing oral health behaviors. This systematic review aimed to synthesize the evidence on the effectiveness of MI, in comparison with CE, in improving oral health. Method: Four databases (PubMed-Medline, Web of Science, Cochrane Library and PsycINFO) were searched to identify randomized controlled trials which evaluated the effectiveness of MI, in comparison with CE, in changing oral health behaviors and improving oral health of dental patients and the public. The scientific quality of the studies was rated and their key findings were qualitatively synthesized.

Result: The search yielded 221 potentially relevant papers, among which 20 papers (on 16 studies) met the eligibility criteria. The quality of the studies varied from 10 to 18, out of a highest possible score of 21. Concerning periodontal health, superior effect of MI on oral hygiene was found in five trials and was absent in two trials. Two trials targeting smoking cessation in adolescents failed to generate positive effect. MI outperformed CE in improving at least one outcome in 4 studies on preventing early childhood caries, 1 study on adherence to dental appointment and 2 studies on abstinence of illicit drugs and alcohol use to prevent the reoccurrence of facial injury.

Conclusion: Reviewed randomized controlled trials showed varied success of MI in improving oral health. The potential of MI in dental healthcare, especially on improving periodontal health, remains controversial. Further studies with methodological rigor are needed for a better understanding of the roles of MI in dental practice.