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Motivational interviewing versus conventional caries prevention strategies in high-caries-risk children and families: a non-randomised trial

British Dental Journal (2022)Cite this article

Abstract

Background This study compared the effectiveness of motivational interviewing (MI) and conventional caries prevention (CCP) for primary (caries increment) and secondary outcomes (caries intensity, gingival health, caregiver-reported oral health-related knowledge, behaviours and attitudes) over 12 months.

Methods High-caries-risk children and caregivers received CCP or MI with comprehensive dental care. Fidelity was monitored using MI treatment integrity code 4.2.1. Caries increment, intensity and gingival health were measured at baseline, six and twelve months. Readiness Assessment of Parents Concerning Infant Dental Decay questionnaires recorded oral health-related knowledge, behaviours and attitudes.

Results In total, 86 caregiver-child dyads (CCP = 51; MI = 35) were recruited. The mean difference (95% confidence interval [CI]) in caries increment (ΔdICDAS1-6mfs + DICDAS1-6MFS) was significantly higher with MI compared to CCP at six (MI 2.3 [1.2, 3.5] vs CCP 0.6 [0.1, 1.0]; p <0.001) and twelve (MI 4.3 [2.5, 6.0] vs CCP 1.2 [0.6, 1.8]; p <0.001) months. Multivariate analysis with CCP as reference group, odds ratio (95% CI) for new/progressed caries (Δdecayed, missing and filled surface score [permanent] + decayed, missing and filled surface score [primary] >0) at six and twelve months were 18.2 (4.0, 81.7); p <0.001 and 12.6 (3.3, 47.8); p <0.001, respectively. The MI group reported positive behaviours and attitudes.

Conclusions CCP was more effective in reducing caries increment when behaviour change technique was incorporated into the preventative strategies as per current paediatric dentistry guidelines.

Key points

  • CCP was more effective than MI for prevention of caries development and progression.

  • Preventive strategies with behaviour change techniques incorporated were effective in reducing caries.

  • Clinicians are recommended to use combination behavioural methods for high-caries-risk children.

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Acknowledgements

The authors wish to acknowledge the contributions of Victoria Perchyonok and Luisa Lorenzo to the delivery of MI.

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Authors and Affiliations

  1. Paediatric Dentistry, Melbourne Dental School, The University of Melbourne, Australia

    Amanda M. Leske

  2. Oral Health Therapy, Melbourne Dental School, The University of Melbourne, Australia

    Claire Mustchin & Julie Satur

  3. Statistical Consulting Centre, School of Mathematics and Statistics, The University of Melbourne, Australia

    Sandy Clarke-Errey

  4. Paediatric Dentistry, Guy´s and St Thomas´ NHS Foundation Trust, UK

    Nabina Bhujel

  5. Paediatric Dentistry, Melbourne Dental School, The University of Melbourne, Australia; King´s College London, London, UK

    Sadna Rajan

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Contributions

Amanda M. Leske, Sadna Rajan and Nabina Bhujel designed and developed the idea. Amanda L. Leske, Claire Mustchin, Julie Satur, Nabina Bhujel and Sadna Rajan finalised the research protocol. Amanda M. Leske collected data. Amanda M. Leske and Sandy Clarke-Errey analysed data. Amanda M. Leske prepared the first draft. Amanda M. Leske, Sadna Rajan, Nabina Bhujel and Sandy Clarke-Errey revised and edited subsequent drafts. Amanda M. Leske, Sandy Clarke-Errey, Claire Mustchin, Julie Satur, Nabina Bhujel and Sadna Rajan approved the final draft.

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Correspondence to Sadna Rajan.

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Leske, A., Mustchin, C., Clarke-Errey, S. et al. Motivational interviewing versus conventional caries prevention strategies in high-caries-risk children and families: a non-randomised trial. Br Dent J (2022). https://doi.org/10.1038/s41415-022-4341-4

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