Periodontal disease is very common and successful treatment and management requires patient compliance with recommended oral hygiene procedures and regular follow-up. Motivational interviewing is a communication approach for supporting behaviour change which uses a collaborative counselling style to strengthen a patients motivation and commitment to change. It has been used in a number of fields including, weight reduction, smoking cessation, alcohol consumption and oral health.
The aim of this review was to assess the effects of motivational interviewing (MI) as an adjunct to periodontal therapy.
Methods
Searches were conducted in the Medline, Cochrane Library and Web of Science, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) databases.
Randomised controlled trials (RCTs) including the use of MI as an adjunct to periodontal treatment and reporting both inflammatory and plaque indices were included. Risk of bias was assessed in relation to both the MI intervention, periodontal therapy and general bias and an overall percentage score calculated.
Results
- 5 papers were included.
- All 5 papers did well in the risk of bias assessment (range 72 to 88%)
- Sample sizes varied from 44-113 patients
- Follow up periods ranged from 6 week-12 months.
- 2 studies MI showed a significant positive effect on bleeding on probing and plaque values.
- 1 study showed improvement of self-efficacy in interdental cleaning.
- 2 studies showed no influence of MI on periodontal parameters of the patients.
Conclusions
The authors concluded: –
the use of Motivational Interviewing as an adjunct to periodontal therapy might have a positive influence on clinical periodontal parameters and psychological factors related to oral hygiene. Due to the low body of evidence further long-term studies are needed.
Comments
This review has focused only on the use of motivational interviewing to improve the outcomes of periodontal treatment in contrast to previous reviews (see other references) which have considered a range of behavioural approaches to improve compliance. The authors have also chosen to exclude studies that did not use both a plaque index (PI) and one inflammatory index (e.g., gingival index, bleeding on probing index) which could have limited. While 5 papers have been included it would appear that one of the studies is reported in two papers so only 4 separate studies were available.
The included studies lack details of the type of MI provided and were delivered by a range of personnel and in some studies were combined with other behavioural interventions. THe author also suggest that studies should have conducted a ‘sham exposure’ which would have improved the quality of the studies. In all this and other review of the use on MI in oral heath interventions suggest that this approach could have benefits but that further high quality studies are needed.
Links
Primary paper
Kopp SL, Ramseier CA, Ratka-Krüger P, Woelber JP. Motivational Interviewing As an Adjunct to Periodontal Therapy-A Systematic Review. Front Psychol. 2017 Feb 28;8:279. doi: 10.3389/fpsyg.2017.00279. eCollection 2017. Review. PubMed PMID:28293208; PubMed Central PMCID: PMC5329060.
Other references
Original review protocol on PROSPERO
Dental Elf – 18th Feb 2016
Dental Elf – 27th Apr 2015
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