Does Motivational Interviewing Work on Decreasing ECC In Lower Income Areas?

© Evgeniy Kalinovskiy / Adobe Stock

Native Americans and Alaskan Natives have a high risk for early childhood caries (ECC). The pilot study Using Motivational Interviewing To Reduce Parental Risk-Related Behaviors For Early Childhood Caries: A Pilot Study by Christine M. Blue, Michelle C. Arnett, et al. investigates whether motivational interviewing intervention involving the parents and the children together will be effective toward improved oral self-care behaviors of infants and young children. The entire goal is to increase dental hygiene education in the parents who implement the dental care routine and in the children who must adopt the procedures for themselves in the near future.

Motivational Interviewing

Caregivers of infants who attended a well-child visit at a dental clinic were given a Caries Risk Test (CRT) on their first visit. Cariogenic bacteria levels were tested and documented. A PCCT test, or a Parental Care Of Child’s Teeth test, was administered to the parents during the second visit to the clinic to assess any risky behaviors known to cause caries being passed down from the parent to the child.

At a total of four visits, the children’s teeth were examined for ECC, and guardians were given a short class based on a discussion of healthy hygiene behaviors and target behaviors they want to teach their children. The CRT and PCCT test was given again in the fourth meeting. The four visits to the clinic happened over the length of a year. A control group visited the dentist for the same amount of time and was given normal advice and suggestions during the visits, as is the norm. They received no extra attention other than what is standard.

Early Childhood Caries

A child has early childhood caries if they have filled, decayed, or missing primary teeth before the age of six. ECC is a disease caused by pathogenic bacteria. Poor oral hygiene behaviors and a lack of fluoride help the bacteria thrive and spread. The disease can even spread from parent to child through everyday behaviors, such as kisses, sharing of food and drinks, or pacifier contamination. Caregivers have a direct influence on the health routines of their children.

Early childhood caries is the most prominent in Native American populations and the Alaskan Native populations. Actually, these children suffer much more dental issues than any other race in the United States. Motivational Interviewing (MI) has proven a positive behavior modification tool when it comes to reversing damaging behaviors with the goal of guiding the patient to internalize positive behaviors. Comfortable communication is essential for the success of these strategies.

Did Motivational Interviewing Work?

Twenty-four test subjects completed the process, and ‘mothers’ were overwhelmingly the main caregivers of each child. All participants are considered to be from low-income backgrounds and were at risk for ECC. Initial bacteria levels were relatively the same in each group and unusually high. A slight reduction was observed in the bacteria levels in the children’s mouths during the fourth visit, and children reported minimal extra efforts toward their hygiene. The levels were so small that they had no statistical significance. Both the control group and the tested group had similar levels, which suggest that motivational interviewing is not very effective when it comes to increasing a person’s level of oral hygiene. The researchers also learned that the guardian’s levels of bacteria reflected that of the children, so MI was not effective with participants on both ends of the age spectrum. Other motivational practices and strategies should be created based on what this official MI failed to do.

Now Listen to the Today’s RDH Dental Hygiene Podcast Below: