Good oral health can be achieved and maintained by compliance with preventive and curative measures and effective self-care. However, adherence to positive behaviours such as toothbrushing, interdental cleaning, smoking cessation and good dietary habits can be variable.  Traditional approaches of patient education revolve around disseminating information and normative advice.  Increasingly the use of motivational interviewing (MI) is suggested as an approach for adoption in dentistry.  MI has been described as patient-centered counselling for encouraging behaviour change by helping patients explore and resolve ambivalence.   The aim of this review was to compare the effectiveness of motivational interviewing (MI) with conventional (health) education (CE) in improving oral health

The PubMed-Medline, Web of Science, Cochrane Library and PsycINFO databases were searched. Randomised controlled trials where MI was explicitly used as an active element of at least one of the interventions were included and a comparison was made between MI and CE.   Only English language studies were included.  A qualitative synthesis was conducted owing to wide heterogeneity of the studies in target behaviors and conditions, timing of outcome assessment, and observed outcomes.

• 16 studies were included in the review
• Of 7 studies on improving periodontal health by reinforcing oral hygiene measures, MI outperformed CE in 5 studies with greater improvement in at least one outcome measure. In the other 2 studies, no significant difference was found.
• MI outperformed CE in improving at least one outcome in 4 studies on preventing early childhood caries,
• In 2 trials targeting smoking cessation in adolescents MI failed to generate positive effect.
• MI outperformed CE in 1 study on adherence to dental appointment and 2 studies on abstinence of illicit drugs and alcohol use to prevent the re-occurrence of facial injury.

The authors concluded

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 rigour are needed for a better understanding of the roles of MI in dental practice.

Comment

A earlier review by Yevlahova and Satur  in 2009 which looked at models for individual oral health promotion  found that MI approaches were the most effective for altering health behaviours in a clinical setting  and suggested that there was potential to develop the MI approach within the oral health field.  This review again suggests that this approach may be more effective however the quality and variety of the currently available studies in the dental arena makes definitive conclusions difficult at present.

Links

Gao X, Man Lo EC, Ching Ching Kot S, Wai Chan KC. Motivational Interviewing in Improving Oral Health: A Systematic Review of Randomized Controlled Trials. J Periodontol. 2013 Jun 27. [Epub ahead of print] PubMed PMID: 23805818.

Yevlahova D, Satur J. Models for individual oral health promotion and their effectiveness: a systematic review. Aust Dent J. 2009 Sep;54(3):190-7. doi: 10.1111/j.1834-7819.2009.01118.x. Review. PubMed PMID: 19709105.