Motivational interviewing for caries prevention in adolescents

Abstract

Objectives: This randomized controlled trial aimed to investigate the effectiveness of motivational interviewing (MI) in improving adolescents' oral health behaviors and preventing their dental caries. Methods: Fifteen secondary schools were enrolled and randomly allocated to three intervention groups: (I) prevailing health education (PE); (II) MI; (III) MI coupled with interactive caries risk assessment (RA) tool. A total of 512 adolescents (12-13 years of age) with unfavorable oral health behavior ('toothbrushing less often than twice a day' AND/OR 'snacking three times or more a day') were recruited; 161, 163 and 188 in Group I-III respectively. At baseline and after 24 months, information on their sociodemographic background, oral health self-efficacy and behaviors, and oral hygiene and tooth status were collected through questionnaires and oral examinations. Generalized Linear Mixed Model was constructed with 'intervention group' as fixed factor and 'school' as random factor. Results: 460 (89.8%) participants were followed up after 24 months. Comparisons with Group I showed that (i) restriction of frequent snacking was more likely in Group II [OR (95% CI): 3.91 (1.48-10.33)] and Group III [OR (95% CI): 6.33 (2.46-16.27)], whereas participants in Group III were more likely to adopt the twice daily brushing behavior [OR (95% CI) of 4.80 (1.79-12.85)]; (ii) no significant difference in plaque score reduction was found among three groups (p>0.05); (iii) Group II and III had lower increment in cavitated carious lesions (△DICDASII 3-6MFT) [β (95% CIs): -0.19 (-0.37, -0.01) and -0.20 (-0.38, -0.02) respectively], whereas increment of total carious lesions (△DICDASII 1-6MFT) was lower in Group III [β (95% CI): -0.63 (-1.24, -0.02)]. Direct comparisons between Group II and III showed no significant differences in behavioral and clinical outcomes. Conclusions: MI outperforms PE in improving adolescents' oral health behaviors and preventing dental caries. Incorporation of RA does not significantly enhance the effectiveness of MI.