Health education improves knowledge of oral health, however, it has proven not to be sufficient in positively influencing oral health behaviors. Recent research shows that motivational interviewing, a person-centered counseling strategy, is more effective in promoting positive change in oral health behaviors and preventing tooth decay.
Dental caries (tooth decay) is an oral disease that affects people worldwide, including a significant proportion (an estimated 60-90%) of school age children. It is a preventable disease that requires individuals to embrace healthy self-care behaviors such as healthy diet and personal hygiene. Health education has been used to provide general knowledge about oral health in order to reduce the burden of the disease in communities, however, in adolescents, such education has not been able to produce a sustained change in oral health behavior.
In a recent study published in the Journal of Adolescent Health, researchers compared the effectiveness of motivational interviewing with prevailing health education for changing the oral health behaviors of adolescents. The study enrolled a total of 512 children aged 12 and 13 with unfavorable oral health behaviors (tooth brushing less than twice a day and/or snacking at least three times a day). The children were randomly assigned to either a prevailing education (PE) group (n = 161), motivational interviewing (MI) group (n = 163) or motivational interviewing with interactive dental caries risk assessment (MI + RA) group (n = 188). Students in the PE group together with the whole school received 30 minutes of oral health education at baseline. Students in the MI group received a 15-30 minutes one-on-one face-to-face session while those in the MI+RA group had an interactive risk assessment included at different stages of the MI. Both MI groups received follow up phone calls at 2 weeks, one month, 2 months, 4 months and 6 months. Data was collected at baseline, 6 months and 12 months.
The study found that participants in both MI groups showed improvements (as evidenced by increase in frequency of tooth brushing and reduction in snacking) in their oral health behaviors leading to reduction in dental caries compared to those in the PE group. Follow up confirmed that improvements were sustained for up to 12 months. The RA component further benefited improvement of the oral hygiene status, but did not significantly impact other study outcomes.
This study shows that MI is a more efficient method for promoting positive changes in the oral health behaviors of adolescents. Although it provides evidence for inclusion of MI in oral health promotional programs, there is need for long term follow-up studies as well as an evaluation of the cost effectiveness of this intervention.
Written By: Asonga T. Folefoc