Abstract
Objectives: To determine the effectiveness of a motivational interviewing-based educational program in reducing the number and intensity of new caries and bacterial dental plaque levels at 6 months post randomization. Study Design: A randomized and single blind clinical trial in 100 schoolchildren between 6-10 years of age presenting the highest risk score of caries according to the Caries Management by Risk Assessment (CAMBRA) criteria was performed. These patients were randomized to two groups: control (in which the mothers initially received an oral prevention informative session) and experimental (in which the mothers received the initial informative session, followed by individual motivational interviewing sessions during a period of 6 months). The International Caries Detection and Assessment System (ICDAS) scores and bacterial plaque were evaluated at baseline, at 6 and 12 months. Results: After 12 months, children in the experimental group had 2.12 ± 0.8 new caries versus 3.5 ± 0.9 in the control group (t=7.39; p<0.001). Caries in the experimental group was seen to be limited to the enamel, with a median intensity of 2 (range 0-3) versus 3 (0-6) in the control group (U=1594; p<0.0001). Bacterial plaque determined by the O’Leary index decreased in both groups; however, it decreased more in the experimental than in the control group (34.3 vs. 20.6; t=-3.12, p= 0.002) respectively. Conclusions: Motivational interviewing is better than traditional educational programs in preventing caries and decreasing bacterial plaque. Key words:Health educational, motivational interviewing, caries risk.
Highlights
Dental caries is highly prevalent throughout the world, and affects between 60-90% of the school population [1,2]
Four subjects were excluded during follow-up in the study: three in the control group [they did not accept final evaluation] and one in the experimental group [parents showed less than 80% adherence to motivational sessions and did not participate in the final evaluation]
No difference was found in the number of caries between groups; experimental group showed lower plaque control than the control group at baseline (Table 1)
Summary
Dental caries is highly prevalent throughout the world, and affects between 60-90% of the school population [1,2]. Educational methods for the promotion of health have been evaluated [8,9,10], mostly in the form of traditional or unidirectional programs based on informative sessions imparted by health professionals, leaflets, or public media campaigns [9] This type of approach has not been effective in modifying habits or in reducing the prevalence of caries [8,10], since the knowledge gained is only effective over the short term and is unable to modify behaviors [7]. Motivational interviewing [MI] is a psychopedagogic tool developed in recent decades with the primary objective of providing patients with intrinsic motivation to achieve and retain behavioral changes [11] It has been successfully used in establishing preventive behaviors related to diseases such as diabetes or HIV infection / AIDS [12,13]. This study compares parental information plus motivational sessions versus only parental information in reducing the number and intensity of new caries and bacterial dental plaque levels in children from a rural population
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