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

Amanda M Leske; Claire Mustchin; Sandy Clarke-Errey; Julie Satur; Nabina Bhujel; Sadna Rajan

doi:10.1038/s41415-022-4341-4

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

Br Dent J. 2022 Jun 8. doi: 10.1038/s41415-022-4341-4. Online ahead of print.

Authors

Amanda M Leske¹, Claire Mustchin², Sandy Clarke-Errey³, Julie Satur², Nabina Bhujel⁴, Sadna Rajan⁵

Affiliations

¹ Paediatric Dentistry, Melbourne Dental School, The University of Melbourne, Australia.
² Oral Health Therapy, Melbourne Dental School, The University of Melbourne, Australia.
³ Statistical Consulting Centre, School of Mathematics and Statistics, The University of Melbourne, Australia.
⁴ Paediatric Dentistry, Guy´s and St Thomas´ NHS Foundation Trust, UK.
⁵ Paediatric Dentistry, Melbourne Dental School, The University of Melbourne, Australia; King´s College London, London, UK. sadna.rajan@kcl.ac.uk.

PMID: 35676460
DOI: 10.1038/s41415-022-4341-4

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 (Δd_ICDAS1-6mfs + D_ICDAS1-6MFS) 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.