Brief oral health promotion intervention among parents of young children to reduce early childhood dental decay

Background: Severe untreated dental decay affects a child’s growth, body weight, quality of life as well as cognitive development, and the effects extend beyond the child to the family, the community and the health care system. Early health behavioural factors, including dietary practices and eating patterns, can play a major role in the initiation and development of oral diseases, particularly dental caries. The parent/caregiver, usually the mother, has a critical role in the adoption of protective health care behaviours and parental feeding practices strongly influence children’s eating behaviours. This study will test if an early oral health promotion intervention through the use of brief motivational interviewing (MI) and anticipatory guidance (AG) approaches can reduce the incidence of early childhood dental decay and obesity. Methods: The study will be a randomised controlled study with parents and their new-born child/ren who are seen at 6–12 weeks of age by a child/community health nurse. Consenting parents will complete a questionnaire on oral health knowledge, behaviours, self-efficacy, oral health fatalism, parenting stress, prenatal and peri-natal health and socio-demographic factors at study commencement and at 12 and 36 months. Each child–parent pair will be allocated to an intervention or a standard care group, using a computer-generated random blocks. The standard group will be managed through the standard early oral health screening program; “lift the lip”. The intervention group will be provided with tailored oral health counselling by oral health consultants trained in MI and AG. Participating children will be examined at 24, and 36 months for the occurrence of dental decay and have their height and weight recorded. Dietary information obtained from a food frequency chart will be used to determine food and dietary patterns. Data analysis will use intention to treat and per protocol analysis and will use tests of independent proportions and means. Multivariate statistical tests will also be used to take account of socio-economic and demographic factors in addition to parental knowledge, behaviour, self-efficacy, and parent/child stress. Discussion: The study will test the effects of an oral health promotion intervention to affect oral health and general health and have the potential to demonstrate the "common risk factor" approach to health promotion.Peter Arrow, Joseph Raheb and Margaret Mille

An evaluation of workshop training in motivational interviewing for oral health counsellors

The aim of the study was to describe the findings of workshop training of clinical and non–clinical oral health personnel in a motivational interviewing (MI) approach to oral health counselling. A two–day workshop was conducted to provide training in MI as part of the training for a randomised controlled trial. The training involved a series of short presentations covering the principles, practice and the ‘spirit’ of the MI approach, structured practice exercises and role–play demonstrations. Participants (n=10) undertook structured practice exercises in the use of open–ended questions, non–verbal listening and reflective skills, summaries and affirmations in MI. Trainees then undertook simulated parent practice exercises using role–play with performance feedback and MI with parents of preschool children in a dental care setting. The workshop was evaluated using a knowledge–based questionnaire, trainer evaluation and a Helpful Response Questionnaire. Data were analysed using the paired t–test and the Wilcoxon Signed Rank test. Mean MI knowledge (from 4.3±1.5 to 6.4±1.4,p < 0.01) and Helpful Response Questionnaire scores (from 6.9 to 11.3, p < 0.01) significantly improved. The two–day workshop improved knowledge in MI and empathy among participants