A single session of motivational interviewing as an additive means to improve adherence in periodontal infection control: a randomized controlled trial.

AIM: To evaluate the effect of a single session of motivational interviewing (MI) on self-performed periodontal infection control. MATERIAL AND METHODS: A randomized, examiner masked, controlled clinical trial of 6-month duration was performed involving 44 patients with chronic periodontitis, referred for periodontal treatment. At baseline, all subjects were examined concerning marginal gingival bleeding (MBI) and plaque (PI). Test subjects received a single MI-session before initiation of the periodontal treatment. Otherwise, all patients followed the same treatment protocol for conventional educational intervention and non-surgical periodontal therapy. Efficacy variables for evaluation of self-performed periodontal infection control were MBI (primary variable) and PI. RESULTS: The MI intervention resulted in a negligible decrease (3-4%) in MBI and PI that was not significantly different from the changes observed in the control group without any intervention. Neither was any additive effect of the initial MI-session found on the standard of oral hygiene subsequent to conventional treatment. A desirable MBI score of ≤20% at the end of treatment was associated with being a female patient, whereas high plaque scores at baseline counteracted a corresponding desirable final PI of ≤20%. CONCLUSION: A single freestanding MI session as a prelude to conventional periodontal treatment had no significant effect on the individuals' standard of self-performed periodontal infection control in a short-term perspective.

Patients' attitudes towards oral health and experiences of periodontal treatment: a qualitative interview study.

PURPOSE: The aim of the present qualitative study was to analyse patients' attitudes towards oral health and experiences of periodontal treatment. MATERIALS AND METHODS: Patients who were referred to a specialist clinic in periodontics were subjected to open-ended interviews before (Abrahamsson et al, 2008), as well as after, the phase of cause-related periodontal therapy. An interview guide was used with themes of interest. The time interval between the interviews was about 6 months. Because the study focused on psychosocial interactions, the qualitative method used for the analysis was Grounded Theory (Glaser and Strauss, 1967). Data collection and analysis were simultaneous processes that focus on psychosocial processes, existing problems and how these problems were dealt with. The interviews were tape-recorded and transcribed verbatim, and consequently analysed in a hierarchical coding process until saturation was met (n = 16). RESULTS: In the analysis, a core category was identified: 'Understanding the seriousness of the disease condition'. This core concept was related to four additional categories and dimensions: 'The need to be treated respectfully', 'To gain insight', 'Frustration about the financial cost for treatment' and 'Feelings of control over the situation'. Taken together, the core category and its related subcategories described a psychosocial process that was related to periodontal treatment. CONCLUSIONS: The results elucidated the patients' vulnerability and the importance of patient communication in the treatment for chronic periodontitis in order for the patient to feel in control of the situation.

Dental beliefs: evaluation of the Swedish version of the revised Dental Beliefs Survey in different patient groups and in a non-clinical student sample.

The aim of this study was to evaluate and to test the psychometric properties of a Swedish version of the revised Dental Beliefs Survey (DBS-R) in different patient groups and in a non-clinical sample of students. It was hypothesized that negative dental beliefs, assessed using the DBS-R, would discriminate between fearful and non-fearful study groups. The questionnaire was distributed together with the Dental Anxiety Scale (DAS). The sample included 550 adults who responded to the questionnaires (206 students, 177 general dental patients, 105 periodontal patients and 62 patients at a waiting list for dental-fear treatment). The internal drop-out rate was low. The results confirmed that the DBS-R discriminates well between fearful patients and the other study groups. The DBS-R had a high internal consistency in all the study groups. Furthermore, the DBS-R correlated significantly with age (higher values in younger age groups) and the DAS. Regression analyses showed that the DBS-R subdimensions of 'communication' and 'control'/or 'trust', respectively, were significant predictors for dental fear. The results suggest that the DBS-R is a reliable and valid instrument for use in different Swedish patient- and non-clinical population groups in order to assess attitudes to dentists. However, the underlying factor structure of the DBS-R needs to be further explored and established.