Motivational Interviewing in improving oral hygiene behaviora review of literature with possible application in Periodontics H. Esther Nalini1, Punithavathy. R2
Abstract: Success in periodontal therapy is highly dependent upon the ability and willingness of the patient to maintain a good oral hygiene. There is a great need to increase the patient's adherence to oral hygiene instructions, which requires changes in the patient's behavior particularly to improve the long-term treatment success in periodontal patients. Improving patients adherence to instructions require changes in patients behavior regarding the use of oral hygiene techniques, avoidance of deleterious habits and modification of diet in patients with Diabetes mellitus. Inflammatory periodontal diseases require patients to make permanent lifestyle changes because of their chronic nature. This review article is to discuss on the possible effectiveness and application of motivational interviewing in individual tailoring of periodontal treatment with individual goals and problems which is definitely more effective for reaching periodontal health goals than a targeting approach. Key words: oral hygiene, periodontal therapy, motivational interviewing.
Reader, Dept of Periodontics,
Senior Lecturer, Dept of Pedodontics, K.S. R Institute of Dental Science and Research. Tiruchengode, Tamilnadu, India.
Address for correspondence: Dr. H. Esther Nalini, M.D.S., 2/9, Gayathri Towers, Narayanasamy street, n.g.g.o colony, Erode- 638009 E- mail: firstname.lastname@example.org.
Introduction: A high standard of oral hygiene, healthy dietary habits, avoidance of tobacco use are major factors required for attaining and maintaining health 1 in individuals with periodontal disease. Cognitive behavioral interventions have been found to be more effective than only information and oral hygiene instructions2. A cognitive process that appears important in achieving explicit goals is the perceived discrepancy between what the person actually does and what he actually seeks to do. This is utilized in motivational interviewing, where an essential strategy is to create discrepancies between what a client expresses regarding a specific health behavior and 3 the actual behavior displayed . When exploring an individual's motivation for change in oral hygiene behavior, this technique can be useful as a tool in the management of periodontal patients. Motivational interviewing can be used at an individual level to target and modify inappropriate behavior and be implemented into the periodontal treatment plan tailored according to the patients needs. The importance of behavior change counseling in periodontal care Periodontal health is supported by appropriate behaviors such as regularly performed plaque control, avoidance of tobacco, and
consumption of a healthy diet. Inadequate oral hygiene, tobacco use and uncontrolled diet in type 2 diabetes mellitus are shown to have a destructive impact on periodontal tissues. There is growing evidence that the patients individual behavior is seen to be influential or even critical for the success of periodontal therapy, since the results of periodontal therapy appear to be limited in patients who especially lack appropriate behavior. In a recent review by Ramsier et al it was shown that second to plaque control smoking cessation was the most important measure for the management of chronic 4 periodontitis . Jonsson et al have found that an individually tailored oral health programme was efficacious in improving long term adherence to oral hygiene in periodontal treatment5. Therefore it appears essential in clinical concepts of periodontal care to include assessment of patient behavior and apply effective behavior change counseling methods. Motivational Interviewing 6 William Richard Miller , the originator of motivational interviewing, developed the method in response to his observations regarding the treatment of patients with alcohol...