Effectiveness of motivational interviewing in preventing early childhood caries

Abstract

Objectives: Dental caries is highly prevalent and is preventable if healthy behaviors can be adopted. Prevailing health education (PE) often fails to elicit sustained changes in health behaviors. This randomized controlled trial incorporated motivational interviewing (MI) and an interactive caries risk assessment (RA) tool and compared the effectiveness of PE, PE+MI, and PE+MI+RA in improving oral health behaviors and preventing early childhood caries. Methods: A total of 692 children aged 3-4 years with unfavorable oral health behaviors (frequent snacking and/or insufficient toothbrushing) were enrolled and randomly assigned to three groups: (I) PE (n=231), (II) PE+MI (n=231), and (III) PE+MI+RA (n=230). Parents in the three groups received respective interventions. At baseline and after 24 months, clinical examinations were conducted to assess the dental caries and oral hygiene status of the children. In addition, parents completed a questionnaire on parental efficacy and children’s oral health behaviors. Results: 632 (91.3%) parent-child dyads were followed up at 24 months. Improvements in parental efficacy and children’s oral health behaviors (snacking and toothbrushing) were significantly greater in Group II and Group III than in Group I (all p<0.05). Caries increment (△dmft) in Group II (1.26±2.06) and Group III (1.24±1.89) was significantly lower than in Group I (1.94±2.53) (both p<0.05). Multivariate analysis showed significantly lower likelihood of developing new caries in Group II and Group III, as compared with Group I [OR (95% CI): 0.434 (0.298-0.633) and 0.490 (0.337-0.713) for Group II and Group III, respectively; both p<0.001]. There were no significant differences between Group II and Group III across all outcome measures (all p>0.05). Conclusions: Incorporation of MI enhances the effectiveness of PE in improving parental efficacy and children’s oral health behaviors, and in preventing early childhood caries. Combination of RA does not further improve the effectiveness of MI in protecting children’s oral health.