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动机性访谈预防幼儿龋病的效果:系统评价和荟萃分析。

Motivational interviewing for preventing early childhood caries: A systematic review and meta-analysis.

机构信息

Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.

Graduate Program in Assessment Technology for the National Health System (SUS), Grupo Hospitalar Conceição (GHC), Porto Alegre, Brazil.

出版信息

Community Dent Oral Epidemiol. 2021 Feb;49(1):10-16. doi: 10.1111/cdoe.12578. Epub 2020 Sep 30.

Abstract

OBJECTIVES

This systematic review with meta-analysis was performed to assess whether motivational interviewing (MI) is effective in the prevention of early childhood caries (ECC) and to examine potential sources of heterogeneity.

METHODS

Interventions based on motivational interviewing were considered eligible. The main outcome was new caries lesions (some studies included white-spot lesions in total count), and secondary outcomes included caregivers' oral health knowledge, home-care behaviours, plaque index, gingival index and fluoride varnish applications. Controls were any type of oral health education or negative controls without any specific intervention.

RESULTS

From a total of 1498 studies identified in the databases search, 1078 were assessed for eligibility by reading titles and abstracts, after removal of duplicates. Full-text screening was performed in 61 articles, with 18 reporting on 14 different studies included in the qualitative synthesis and 8 in the quantitative synthesis (four studies included new white-spot lesions in total count). Subgroup analysis was performed by the control group dmft/dmfs and the test for subgroup differences suggests that there is a subgroup effect (P = .06), so population caries experience modifies the effect of MI-based intervention. In populations with high caries experience, the MI-based approach proved preventing an average of 3.15 (95% CI: -6.14, -0.17) dmfs in young children. In samples with low caries experience, differences were smaller, since the caries levels were already lower (-0.31; 95% CI: -0.63, 0.00).

CONCLUSION

Motivational interviewing has the potential to modify knowledge and behaviours and reduce ECC with a more significant impact on children with high caries experience.

摘要

目的

本系统评价和荟萃分析旨在评估动机性访谈(MI)是否能有效预防幼儿龋(ECC),并探讨潜在的异质性来源。

方法

基于动机性访谈的干预措施被认为是合格的。主要结果是新的龋损(一些研究包括总计数中的白垩斑),次要结果包括照顾者的口腔健康知识、家庭护理行为、菌斑指数、牙龈指数和氟化物涂料应用。对照组为任何类型的口腔健康教育或无特定干预的阴性对照组。

结果

从数据库搜索中总共确定了 1498 项研究,通过阅读标题和摘要,排除重复项后,对 1078 项进行了合格性评估。对 61 篇文章进行了全文筛选,其中 18 篇报道了 14 项不同研究的结果,纳入定性综合分析,8 项纳入定量综合分析(四项研究包括总计数中的新白垩斑)。通过对照组 dmft/dmfs 进行亚组分析,并对亚组差异进行检验,提示存在亚组效应(P=.06),因此人群龋病经验改变了基于 MI 的干预效果。在龋病经验高的人群中,基于 MI 的方法被证明可以预防幼儿平均 3.15(95%CI:-6.14,-0.17)个 dmfs 的龋病。在龋病经验低的样本中,差异较小,因为龋病水平已经较低(-0.31;95%CI:-0.63,0.00)。

结论

动机性访谈有可能改变知识和行为,降低 ECC 的发生率,对龋病经验高的儿童的影响更为显著。

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