Motivational interviewing for improving children’s oral health

Objectives: This randomized controlled trial incorporates motivational interviewing (MI) and interactive caries risk assessment (RA) into prevailing health education (HE) and investigates the effectiveness of HE, HE+MI, and HE+MI+RA in changing children’s oral health behaviors.
Methods: This study targeted children aged 3-4 years with unfavorable oral health behaviors (infrequent toothbrushing and/or frequent snacking). A total of 692 parent-child dyads were recruited and randomly allocated to three groups. Parents in three groups received interventions of HE (n=231), HE+MI (n=231), or HE+MI+RA (n=230), respectively. At baseline and after six months, parents completed a questionnaire on children’s oral health behaviours, parental oral health perceptions, and parental efficacy for protecting children’s oral health.
Results: The sociodemographic background and oral health related behaviours of children were comparable among three groups at baseline (all p>0.05). After six months, 689 (99.6%) children were followed up. Significantly higher proportion of parents reported improved efficacy in controlling children's snacking in the HE+MI group (65.6%) and the HE+MI+RA group (64.6%), as compared with the HE group (49.5%) (p=0.041). The improvement in parental efficacy in children’s toothbrushing was also greater after HE+MI (60.6%) and HE+MI+RA (60.0%) than after HE (44.7%) (p=0.026). Frequent snacking was no more practised by 50.7%, 67.9%, and 67.5% of the children, whereas 47.1%, 60.0%, and 59.4% of the children increased their toothbrushing frequency in the HE, HE+MI,and HE+MI+RA groups,respectively.The improvements in both behaviors were greater in the HE+MI and HE+MI+RA groups than in the HE group (p=0.042 and 0.023, respectively). Additional improvements in parents'oral health knowledge were found after HE+MI+RA (p<0.05).
Conclusions: HE+MI and HE+MI+RA are more effective than HE alone in improving parental efficacy and children’s oral health related behaviours. (Supported by General Research Fund #106120135; Research Grant Council of Hong Kong)