Brief Motivational Interviewing in Dental Practice
One of the toughest and most frustrating obstacles dental professionals face is patient compliance. Patient compliance has been shown to be one of the most important factors in managing and preventing dental disease. Long-established practices to modify patient behavior has focused on clinicians exerting their influence over patients. Historically, this has not been as successful as we would like. In an article published May 2019 in the Dentistry Journal explores another option, motivational interviewing, for modifying patient’s behavior.1
Motivational interviewing is defined as “a collection person-centered form of guiding to elicit and strengthen motivation for change”. Motivational interviewing has been used for years for a variety of health behavior. Multiple systematic reviews have been conducted, to assess the efficacy and effectiveness of motivational interviewing. One such study included 30 controlled trials including drug use, alcohol, HIV risk, diet, and exercise. The results showed motivational interviewing had a moderate effect when compared to control groups in the areas of diet and exercise, with sustained efficacy up to 4 years after treatment.
A systematic review that focused on the efficacy of motivational interviewing and improving oral health behaviors found no effect on children, however, it did have a positive effect on parents’ behaviors. Another systematic review compared the efficacy of motivational interviewing and conventional approaches. This review found motivational interviewing outperformed conventional approaches in five of the seven studies included.
There are four aspects of motivational interviewing that need to be applied for success. They are defined in the article as follows:
- Partnership: working together with equal input from patient and clinician, respecting patient autonomy.
- Acceptance: understanding the patient’s perspective and not being judgmental; ensuring that we focus on their positive health behaviors and support them with their self-efficacy to change unhealthy behaviors.
- Compassion: supporting patients who may be struggling with behavior change, showing real compassion and empathy towards them.
- Evocation: is an attempt to explore what is important to the patient and how they would like to change.
Ways to achieve these aspects include using open-ended questions, offering affirmations, reflective listening, and summarizing the patient’s goals and needs as they have expressed them. Keeping in mind motivation to change can and will fluctuate, using motivational interviewing can help determine where the patient falls on the spectrum of motivation to change. Motivational interviewing provides an evidence-based strategy for successful behavior change.
The authors conclude by stating “Motivational Interviewing is an effective behavior change method, which can be utilized in the dental practice setting. It can be used as a brief intervention to motivate patients to improve their oral hygiene behaviors as well as providing a framework for delivering diet, smoking cessation, and alcohol advice.”
Do you currently utilize motivational interviewing when practicing? If you do, have you seen improved success in behavior modification? If not, would it be something you would be interested in trying to improve behavior modification? Do you feel well equipped to use motivational interviewing? Should this technique be taught in dental and dental hygiene schools?
- Gillam DG, Yusuf H. Brief Motivational Interviewing in Dental Practice. Dent J (Basel). 2019;7(2):51. Published 2019 May 1. doi:10.3390/dj7020051