Motivational Interviewing and Subgingival Instrumentation Outcomes in Periodontitis

Condition(s) studied

Investigational drug(s) / intervention(s)

Motivational Interviewing: A single individual motivational interviewing session will be delivered to each patient at baseline and 1 month

Oral hygiene instructions: Oral hygiene instructions will be provided to each patient at baseline and at 1 month.

Study summary

Motivational Interviewing (MI) represents a patient centered counselling approach designed to facilitate behaviour change by guiding patients through the exploration and resolution of ambivalence toward positive health actions. Adapting OARS microskills (open ended questions fostering dialogue, affirmations building self-efficacy, reflective listening mirroring emotions, summarization making commitments) intertwined with the RULE framework (resisting the righting reflex, understanding personal motivations, empathic listening, empowering autonomy) helps cultivate patient's intrinsic motivation for sustained oral hygiene adherence. It effectively resolves ambivalence toward plaque control behaviours essential for periodontitis management. Grounded in MI's core spirit of equal partnership, evocation of inner values, acceptance and compassionate support, this approach fosters long term adherence to treatment. This is in contrast to oral hygiene instructions that typically employ a directive advice giving method, where clinicians provide patients with prescriptive guidance on maintaining optimal oral hygiene practices. Periodontitis staging, as defined by the 2017 World Workshop classification, delineates disease severity (Stages I-III), complexity of management, and extent of involvement, while grading (A-C) offers a prognostic indicator of the risk for future progression based on factors such as rate of advancement and responsiveness to therapy. Integrating motivational interviewing (MI) with periodontitis staging and grading creates a structured framework from diagnosis to patient centered action, enhancing adherence to stage specific treatment plans. This study seeks to investigate the influence of MI on Clinical outcomes, Patient motivation, Patient related outcomes and Patient's Self-efficacy in oral hygiene following subgingival instrumentation among patients stratified by periodontitis stage. By doing so, it aims to explore the potential of behavior change interventions to yield not only clinical improvements but also broader health benefits in the management of periodontitis.

Eligibility

Primary outcome measure(s)

• The Dental Treatment Motivation Scale (DTMS) — Baseline, 3 month, 6 month
  The Dental Treatment Motivation Scale (DTMS)19 questionnaire will be used to measure each participant's level of motivation. . The scale has a total of 15 items, which assess intrinsic (seven questions) and extrinsic motivation (eight questions). Answers provided on a scale are from 1 to 5, where 1 = "strongly disagree" and 5 = "strongly agree." Patients will complete the questionnaire at the 3, 6 month follow-up appointment after periodontal treatment. Higher score indicates higher level of patient motivation towards dental treatment.
• Patient related outcome Measure — Baseline, 3 month, 6 month
  The Oral Health Impact Profile-14 (OHIP-14) questionnaire will be used to measure each participant's Oral Health related quality of life (OHRQoL). It evaluates 14 questions under seven domains: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. Each item is scored on a 5-point Likert scale (1=never to 5=very often) with total scores ranging from 0-56 (higher scores indicate worse Oral health quality of life).
• Evaluation of Patient's Self Efficacy — Baseline, 3 month, 6 month
  The Oral Hygiene Related Self Efficacy Scale (OHSE) questionnaire will be used for assessing self-efficacy. It includes 19 items rated on 4 point Likert scale from (1) Completely confident not to (4) Completely confident. Higher scores indicate stronger belief in one's ability to maintain oral health, correlating with better hygiene practices and treatment outcomes.

Trial sites (1)

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