Using motivational interviewing to reduce parental risk related behaviors for early childhood caries: a pilot study

Abstract

Background: Decades of epidemiological studies have documented high rates of early childhood caries (ECC) among American Indian and Alaska Native (AIAN) children. The aim of this pilot study was to investigate if a motivational interviewing (MI) intervention improved oral self-care behaviors of AIAN caregivers of infants, and determine if the MI intervention promoted positive changes in caregivers' ECC risk-related behaviors. Methods: Caregivers of infants presenting for well-child visits in a medical clinic were randomized to treatment and control groups. At the first visit, a caries risk test (CRT) for cariogenic bacteria was completed for both groups. The Parental Care of Child's Teeth (PCCT) was administered at the second visit and used to assess ECC risk-related behaviors. Over the course of four well-child visits, caregivers in the treatment group participated in a MI discussion focusing on behavior changes and desired outcomes for their personal oral health and their child's. The duration of the intervention was 1 year. The control group was given oral health information traditionally provided at well-child visits. At the fourth well-child visit, the CRT and PCCT questionnaire were administered again. Results: The mean bacterial load for mutans streptococcus (MS) was similar at both visits. A slight reduction in the mean bacterial levels of lactobacilli was observed in both the test and control groups after the last visit, although not at a level of statistical significance. The treatment group showed minimal improvement in child feeding practices and nighttime bottle habits. Conclusions: Motivational Interviewing had little effect on oral self-care behaviors as measured by bacterial load, nor did MI reduce parental risk related behavior for early childhood caries.

Dental hygienists’ use of motivational interviewing and perceptions of effectiveness in changing patient behaviors

“…had similar findings as dentists reported, “there was only so much they could do if patients don't follow their recommendations.” 32 Behavior change is complex and the literature across health disciplines points to a limited understanding of how health professionals and their patients can achieve optimal behavior change 15 . A lack of positive behavior change is evident within MI literature, as many studies reported seeing no change in behavioral or clinical outcomes as a result of MI interventions 19,25–27 . Additionally, this finding may be attributed to nearly 10% of the respondents practicing in a non‐profit or a FQHC setting where social determinants of health impact behavior change 15,27,33 .…”

“…A lack of positive behavior change is evident within MI literature, as many studies reported seeing no change in behavioral or clinical outcomes as a result of MI interventions 19,25–27 . Additionally, this finding may be attributed to nearly 10% of the respondents practicing in a non‐profit or a FQHC setting where social determinants of health impact behavior change 15,27,33 . Blue et al.…”

“…Blue et al. found MI did not reduce parental risk‐related behaviors for early childhood caries in an AI population and discussed the limited ability to test upstream variables, such as social disadvantages, risk exposure, and social inequities—all factors that play a causal role in poor health outcomes 27 …”

“…found no significant differences in plaque reduction between participants in the MI group versus the traditional health education group 19 . Additionally, studies have investigated the effectiveness of MI on decreasing the incidence of dental caries, but findings remain inconclusive 20–27 . Given these mixed results, additional high‐quality studies are needed to affirm the use of MI in improving oral health.…”

Brief Motivational Interviewing Counseling to Improve Oral Hygiene Behavior Among Adolescent

“…Previous studies reported that MI interventions in dental health were mostly carried out on parents, caregivers, preschool children, patients with periodontal disease. 33,34,35,36,37 The lack of MI intervention research in adolescents. This study proves that MI is effectively implemented for adolescents.…”