Motivational interviewing for improving adolescents' oral health behaviors

Abstract

OBJECTIVES: This randomized controlled trial aimed to compare the effectiveness of three intervention schemes, namely prevailing health education (HE), motivational interviewing (MI), and MI coupled with interactive caries risk assessment (RA) in improving adolescents’ oral health self-efficacy and behaviors. METHODS: Fifteen participating secondary schools were randomly assigned to three groups: (I) HE, (II) MI, and (III) MI+RA. Adolescents aged 12-13 years were recruited if they had unfavorable oral health behavior (inadequate toothbrushing and/or frequent snacking). Group I received oral health talk and pamphlets. Each participant in Group II joined a MI session with a dental hygienist. In Group III, interactive RA was incorporated to facilitate MI. At baseline and after 6 months, participants completed a questionnaire; their oral hygiene status was recorded using Silness-Loe plaque index (PI). RESULTS: A total of 512 participants were recruited, including 161, 163 and 188 in Group I-III, respectively. After 6 months, 492 (96.1%) were followed up. The improvements of participants’ self-efficacy in controlling snacking and toothbrushing were greater in Group II and III than in Group I (p<0.05). More participants in Group II and III stopped their unfavorable snacking behaviors (≥3 times a day), as compared with Group I (p<0.001); the ORs (95% CIs) were 2.20 (1.09-4.46) and 5.83 (2.43-13.98) for Group II and III respectively. The same trend was found in positive change in their toothbrusing behavior (i.e. starting toothbrushing twice a day); the ORs (95% CIs) were 2.20 (1.15-4.20) and 3.92 (2.12-7.26) for Group II and III, respectively. There were significant differences in PI reduction across three groups (p<0.05); the mean (SD) were 0.08 (0.48), 0.10 (0.30), and 0.27 (0.40) for Group I-III, respectively. CONCLUSIONS: Motivational interviewing was more effective than prevailing health education in improving adolescents’ oral health self-efficacy and behaviors.