Sir, we read the article entitled Motivational interviewing in general dental practice: A review of the evidence by E. J. Kay, D. Vascott, A. Hocking, and H. Nield (Br Dent J 2016;221: 785–791), which presents a systematised review of the evidence in relation to motivational interviewing (MI) in dental practice. This approach to changing oral health behaviours and habits is an emerging and significant theme. Considering their proposed objective, the authors concluded that the MI technique has the potential to benefit patients with poor oral hygiene and suggested that MI training for oral healthcare professionals can be added to the established set of practices. However, we observed that only two of the eight articles included are intervention studies that use the MI-based approach specifically to treat patients with periodontal disease.1,2 Of the remaining studies, one addresses the cost-effectiveness of the intervention3 without analysing clinical results as the main outcome. Another study4 claimed to apply an MI-based approach, but according to the methods described it does not fall under the assumptions and techniques described by Miller and Rollnick.5

Three articles did not use MI-based approaches,6,7,8 and one is a qualitative study9 that only describes the approach used by dental hygienists. Lastly, one study is not cited in the references, making it impossible to determine whether the intervention involved MI or not.

The evidence found by the authors does not support the conclusions, neither regarding better oral health among patients, since the studies included did not synthesise sufficient and adequate evidence for this conclusion, nor professional training, given that none of the articles assessed this aspect for oral health teams. Moreover, we believe that MI is not centred solely on providing additional skills and techniques for clinical practice, as proposed by the authors. MI involves changing professional attitudes and conduct to establish a dialogue about change, promoting self-efficacy and helping patients change their unhealthy oral health behaviours. It is important for readers to understand that MI is a specific approach, with assumptions and techniques described by Miller and Rollnick, and should not be confused with other behavioural approaches.10 There is more robust evidence available to understand the current scenario in relation to MI use and its effects on oral health.11 As such, we reiterate the fragility of the findings of the published review and suggest that future reviews on the subject follow eligibility criteria for study inclusion in order to obtain more reliable conclusions about MI in general dental practice.