Does motivational interviewing contribute to caries prevention in children from lower income families?

Abstract

Aim To investigate the differential preventive effect of motivational interviewing on early childhood caries according to socioeconomic variables in a primary healthcare setting.

Trial design Randomised, double-blind trial with two parallel groups, based in a community setting.

Study population Selected from an invited subgroup of children born in 2013 and 2014 in the northern area of the city of Porto Alegre, Rio Grande do Sul, Brazil

Interventions Primary caregivers of the patients were randomised to receive information about breastfeeding, child nutrition and oral hygiene during an initial dental appointment in the patient's first year of life either by conventional delivery techniques or by motivational interviewing.

Outcomes Analysis of dmfs index from clinical examination

Results Nine-hundred and fifteen patients were randomised to the two arms and 414 children were included in the study, with 501 lost to follow up. One-hundred and eighty-six received conventional health education, and 228 received motivational interviewing. The caries rate per 100 surface year was 1.29 for the conventional education group, and 0.46 for the motivational interviewing group. The effect of motivational interviewing was statistically significant in the lower-income category with prevention of 57% of carious lesions. There was no such statistically significant difference in the higher income subjects.

Conclusions The outcome showed reduced caries experience by children where their primary caregiver has received preventative advice via a motivational interviewing technique when compared to conventional education methods. This study suggests that motivational interviewing is more effective in more disadvantaged groups.