Evaluating Effects of Motivational Interviewing by Dental Hygienists on Improvement in Tooth brushing and Flossing Adherence: A Review

Abstract

Motivational interviewing (MI) is a patient-centered counseling approach that has gained increasing attention in dental practice for promoting oral health behaviors. This review aimed to synthesize the current evidence on the effectiveness of MI delivered by dental hygienists in improving patients' adherence to toothbrushing and flossing recommendations. A comprehensive literature search was conducted in PubMed, Scopus, and CINAHL databases for studies published between 2000 and 2023. The search terms included "motivational interviewing," "dental hygienists," "toothbrushing," "flossing," and "oral hygiene." The methodological quality of the included studies was assessed using the Cochrane Risk of Bias Tool for randomized controlled trials (RCTs) and the Newcastle-Ottawa Scale for observational studies. A total of 12 studies (8 RCTs and 4 observational studies) met the inclusion criteria. The findings suggest that MI delivered by dental hygienists can lead to significant improvements in patients' toothbrushing and flossing frequency, as well as clinical outcomes such as plaque and gingival indices, compared to traditional oral hygiene education or no intervention. However, the long-term sustainability of these effects remains unclear, and there is heterogeneity in the MI interventions and outcome measures used across studies. Future research should focus on standardizing MI training and delivery protocols for dental hygienists, evaluating the cost-effectiveness of MI in different dental settings, and investigating strategies for maintaining behavior change over time.