Combating dental caries with behaviour change techniques
LONDON, UK: A recent study has identified a cost-effective, low-intensity intervention technique that could prevent dental caries in thousands of children across the UK. Informed by motivational interviewing and behaviour change techniques, the method provides an alternative to clinical prevention strategies and will help dental nurses improve oral health in children at high risk of developing dental caries.
According to Queen Mary University of London, nearly a quarter of 5-year-olds in the UK experience dental caries. Caries is the primary reason that children are admitted to hospital, and an estimated 33,779 children aged 9 or under had their teeth extracted between 2017 and 2018. Each extraction costs the National Health Service around £1,000.
In a study that involved over 200 families of 5- to 7-year-olds who had had their primary teeth extracted, researchers developed a verbal intervention strategy and trained dental nurses to have a therapeutic conversation with parents of children coming to have their children’s teeth removed. They used the Dental RECUR Brief Negotiated Interview for Oral Health (DR-BNI) method, which is based on motivational interviewing and behaviour change techniques, and found that a single therapeutic conversation can reduce the risk of developing recurrent caries by 29%.
All families involved in the study could choose between the DR-BNI or a control intervention that included a conversation between the parents and the nurse regarding the child’s future tooth eruption. The families that chose to use the DR-BNI method were asked to list certain goals they felt they could achieve, such as swapping sweet drinks for unsweetened ones or brushing their children’s teeth at bedtime. The control intervention group was advised to visit the dentist as usual.
“This trial is important because we found that if we change how we talk to parents about prevention, their children will go on to develop many fewer cavities,” said lead author Dr Cynthia Pine, professor of dental public health at the university. “The key is helping parents to choose one or two behaviours they feel they can change for their child, rather than us telling parents what to do—that makes the difference.”
Additional research has recently reported that one in ten primary school leavers in the UK are not sufficiently equipped to independently brush their teeth. Commenting on the study, Dr Nigel Carter, OBE, chief executive of the Oral Health Foundation, said: “Parents and teachers have an important role to play in educating children from an early age on the importance of maintaining good oral health, but they need support. Scotland and Wales have had great success in educating youngsters through a designated oral health programme, but we are yet to see a similar initiative in England.”
“The government must prioritise oral health education across the country and ensure children have the tools and information they need to look after their mouths as they grow and develop,” Carter concluded.
The study, titled “Dental RECUR randomized trial to prevent caries recurrence in children”, was published in the February 2020 issue of the Journal of Dental Research.