The use of motivational interviewing is increasing in dentistry and the recent SIGN guideline (Dental Elf  18^th March 2014)  recommended that  oral health promotion interventions should be based on recognised health behaviour theory and models such as motivational interviewing. The aim of this review was to analyze the effectiveness of motivational interviewing in changing oral health behaviors and preventing dental clinical problems.

Searches were conducted in PubMed, LILACS, SciELO, PsycINFO, Cochrane Database of Systematic Reviews and Google Scholar without date limits or language restrictions. Two reviewers carried out study selection and quality assessment independently. A scoring instrument was used for the quality assessment.

• 10 studies were included.
• 6 were conducted in adults and 4 with parents of young children.
• Interventions varied in duration (15 to 90 minutes) and number of sessions (1-7)
• 5 studies used trained counselor with extensive MI experience.
• Five interventions assessed the impact of MI on oral health behaviours and 9 on clinical outcomes (three on dental caries, six on dental plaque, four on gingivitis and three on periodontal pockets).
• Four studies reported positive effects of MI on oral health outcomes whereas another four showed null effect.

The authors concluded

We found inconclusive effectiveness for most oral health outcomes. We need more and better designed and reported interventions to fully assess the impact of MI on oral health and understand the appropriate dosage for the counselling interventions.

Comments

We have previously highlighted a review of MI by Gao et al (Dental Elf 4^th July 2013) . That review searched a similar range of databases including 16 studies in all. Eight of the same studies are included within this review so both reviews include studies that the other reviewers have excluded. However, both reviews come to similar conclusions in that the available evidence suggests that the MI approach may be more effective although this current review is less definitive. The limited number of available studies and the variation in approaches to MI that have been used in dental studies means that definitive conclusions will require better designed studies.

Links

Cascaes AM, Bielemann RM, Clark VL, Barros AJ. Effectiveness of motivational interviewing at improving oral health: a systematic review. Rev Saude Publica. 2014 Feb;48(1):142-153. PubMed PMID: 24789647.

Dental Elf 4^th July 2013 – Review suggests that motivational interviewing may have potential for improving oral health

Dental Elf  18^th March 2014- Dental Interventions to prevent caries in children – SIGN Guideline 138