Too lazy to brush and floss? Research team will motivate you with online counseling

BUFFALO, N.Y. — Brush your teeth twice per day and floss regularly are habits most people know of, but despite the pleas of dentists nationwide, few follow through on this advice.

Now, dentists are considering a new approach to improve oral health practices among the public: motivational interviewing.

University at Buffalo researchers have received a new $438,000 grant to develop the first online intervention based on motivational interviewing to help dental patients improve oral health behaviors, including frequent brushing and flossing, and slow risk behaviors that negatively affect oral health, such as tobacco and alcohol use.

The two-year grant is funded by the National Institute of Dental and Craniofacial Research in the National Institutes of Health. The investigation is led by Sebastian Ciancio, DDS, SUNY Distinguished Service Professor in the UB School of Dental Medicine; and Kurt Dermen, PhD, senior research scientist in the Jacobs School of Medicine and Biomedical Sciences at UB.

“Books, demonstrations, discussions – none of it is working. Dentists are always trying to motivate people to brush and floss properly, yet half of the U.S. population has some form of gingivitis,” says Ciancio, also director of the UB Center for Dental Studies.

Dermen adds, “Creating an effective online program based on motivational interviewing will make it possible to achieve large-scale improvements in oral health at a relatively low cost.”

Motivational interviewing is a collaborative, goal-oriented counseling style that promotes behavior change by helping patients resolve doubt and indecision. Rather than give direction, the counselor guides patients to identify their own reasons and plans for change.

The researchers turned to this approach due to its effectiveness in treating alcohol and substance abuse. In a previous study, the investigators tested the ability of motivational interviewing to improve brushing and flossing habits in dental patients who suffered from alcohol abuse. The project’s success led to the development of an intervention training manual for dental professionals.

Because dental practices are limited in the amount of time they can spend counseling patients, the new study will modify the training manual into an online intervention that can be easily delivered to patients.

Researchers will conduct focus group interviews with 32 dentists and hygienists and 32 dental patients to guide development of the program. Various iterations of the online intervention will be tested with small sets of patients.

The final version of the intervention will be tested with 24 UB Dental patients, the School of Dental Medicine teaching clinic that provides affordable care to thousands of Western New Yorkers. Patients will report their perceptions of the program’s ability to engage and motivate changes in behavior.

Future research will test the program’s effectiveness and its utility with other populations at risk for oral disease, such as patients diagnosed with HIV or diabetes.

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Additional investigators include Christopher Barrick, PhD, senior research scientist in the Jacobs School of Medicine and Biomedical Sciences; and Jennifer Livingston, PhD, associate professor in the UB School of Nursing.