ObjectivesWe conducted a trial to assess the treatment fidelity of an individual‐based oral health education intervention utilising motivational interviewing (MI) techniques and its efficacy when compared to a group‐based traditional oral health education intervention (TOHE) and a standard of care group (SC) in a sample from Philadelphia during a 12‐month follow‐up.BackgroundThere is lack of information on how different types of oral health educational interventions affect older adults on non‐clinical outcomes including changes in oral health‐related quality of life (OHRQoL), oral health self‐efficacy (SE) and oral health knowledge (OHK).Materials and methodsOne hundred and eighty patients were randomly allocated to TOHE, MI and SC groups. Treatment fidelity was measured in 16 non‐study patients. The MI intervention was administered by a public health dental hygienist (PHDH). All interviews were audio‐recorded and coded by an expert using the Motivational Interviewing Treatment Integrity (MITI) Code. Multivariable longitudinal regression analyses accounting for baseline demographics and correlated errors due to repeated measures via generalised estimating equation were conducted following an intention to treat approach.ResultsOver the 1‐year follow‐up, SE and OHRQoL scores significantly improved amongst the MI group whereas both outcomes worsened amongst the SC group. During the same period, SE and OHRQoL did not change in the TOHE group.ConclusionFindings from the study support the fidelity of this intervention and the improvement of all non‐clinical outcomes after 12 months amongst the MI group.
The factors that were controlled or measured and analyzed in these studies were: gender, smoking status, age and chronic gingivitis level. The results add support to the hypothesis that male subjects show less variation, however there is limited evidence linking the female menstrual cycles to variations in gingivitis status. Further research in this area is required before definitive conclusions can be made. Selecting a subject population in order to decrease variation must be undertaken with caution. A subject population selected for particular attributes can be extremely valuable when assessing the anti-gingivitis potential of new agents, but this population would be as biased if used for large efficacy clinical trials. The data obtained will not necessarily be able to be generalized, that is, applicable to the whole population. However there is sufficient evidence to justify balancing for (or excluding) smokers from subject populations in experimental gingivitis studies.
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