Universidad de Concepción, Concepción, Chile.
Norwegian Institute of Public Health, Oslo, Norway.
Community Dent Oral Epidemiol. 2024 Feb;52(1):84-92. doi: 10.1111/cdoe.12904. Epub 2023 Sep 5.
This systematic review with meta-analysis was performed to assess whether motivational interviewing (MI) effectively prevents oral morbidities in adults.
Studies considered were randomized controlled trials, cluster-randomized controlled trials and community-based randomized trials assessing interventions based on MI or indicating that a counselling technique based on the principles developed by Miller and Rollnick was used. Controls were any type of oral health education or negative controls. Participants were 18-60 years old. The main outcome was any oral morbidity. From 602 studies identified in MEDLINE, Scopus, Web of Science and LILACS databases, seven studies were included in the synthesis.
Studies included only evaluated periodontal outcomes, no studies were found for other oral morbidities. Patients' mean age was 43.7 years, and the follow-up time after MI or MI-based intervention varied between 1 month and 1 year. The total study population was 272 people with moderate-to-severe periodontitis; other groups analysed were pregnant women (n = 112) and patients with mental disorders and alcohol problems (n = 60). Meta-analysis for the plaque index (four studies, n = 267), bleeding on probing (two studies, n = 177) and gingival index (two studies, n = 166) were carried out. The summary effects for the random-effects model were estimated respectively as -3.59 percentage points (CI: [-11.44; 4.25] for plaque index, -6.41 percentage points (CI: [-12.18, -0.65]) for bleeding on probing and -0.70 (CI: [-1.87; 0.48]) for gingival index, marginally favouring the MI group. The reduced number of studies, the non-disclosure of some aspects of the data and the heterogeneity among them undermine the precision of the estimates.
The current evidence available is limited to periodontal outcomes, and it is not possible to determine whether MI effectively prevents oral morbidities in adults.
本系统评价和荟萃分析旨在评估动机性访谈(MI)是否能有效预防成年人的口腔疾病。
研究对象为随机对照试验、整群随机对照试验和社区随机试验,评估基于 MI 的干预措施或表明使用基于 Miller 和 Rollnick 原则开发的咨询技术的干预措施。对照组为任何类型的口腔健康教育或阴性对照。参与者年龄为 18-60 岁。主要结局为任何口腔疾病。从 MEDLINE、Scopus、Web of Science 和 LILACS 数据库中检索到的 602 项研究中,有 7 项研究纳入了综合分析。
研究仅评估了牙周病结局,未发现其他口腔疾病的研究。患者的平均年龄为 43.7 岁,MI 或基于 MI 的干预措施后的随访时间为 1 个月至 1 年。总研究人群为 272 名中重度牙周炎患者;其他分析的组别有孕妇(n=112)和精神障碍及酒精问题患者(n=60)。对菌斑指数(四项研究,n=267)、探诊出血(两项研究,n=177)和牙龈指数(两项研究,n=166)进行了荟萃分析。随机效应模型的汇总效应估计值分别为 -3.59 个百分点(CI:[-11.44;4.25],菌斑指数)、-6.41 个百分点(CI:[-12.18,-0.65],探诊出血)和 -0.70(CI:[-1.87;0.48],牙龈指数),倾向于 MI 组。研究数量减少、部分数据未公开以及数据之间存在异质性,降低了估计的准确性。
现有证据仅限于牙周病结局,无法确定 MI 是否能有效预防成年人的口腔疾病。