Motivational Interviewing to Improve Oral Hygiene in Adolescent Orthodontic Patients (MI-Ortho)

The University of Alabama at Birmingham

Status: Active, not recruiting

Conditions: Oral Hygiene Reinforcement During Fixed Orthodontic Treatment; Oral Hygiene Education Methods; Dental Plaque Index; Motivational Interview, OHI; DMFT Index; Gingivitis

Treatments: Behavioral: Standard Oral Health Education; Behavioral: Motivational Interviewing-Based Counseling

Study type: Interventional

Funder types: Other

Identifiers

NCT07164989

300014350

UAB (Other Grant/Funding Number)

Details and patient eligibility

About

This study is being conducted to explore how motivational interviewing (MI), A patient-centered counseling method, can help improve oral health awareness and practices in adolescents undergoing orthodontic treatment. Adolescents often struggle to maintain good oral hygiene during orthodontic care, which can lead to complications such as gum disease, tooth decay, and poor treatment outcomes.

Participants in this study will receive brief, structured conversations focused on encouraging them to set goals and take responsibility for their oral health. These interviews are designed to be non-judgmental and supportive, helping the participants explore their own motivations for keeping their teeth and gums healthy during braces treatment.

The study will take place at a pediatric dentistry clinic and will involve adolescents aged approximately 14 to 19 who are receiving orthodontic care. The goal is to assess whether this type of communication improves their oral hygiene behaviors and outcomes compared to standard oral health education. Findings from this research may help pediatric dentists and orthodontists improve how they engage adolescent patients in taking care of their oral health.

Full description

This study aims to assess the effectiveness of motivational interviewing (MI) in promoting oral health behaviors and awareness among adolescent orthodontic patients in a pediatric dentistry setting. Adolescents often face unique challenges in maintaining good oral hygiene during orthodontic treatment due to age-related factors such as motivation, compliance, and shifting priorities. As a result, they are at increased risk for plaque accumulation, gingival inflammation, and white spot lesions.

Motivational interviewing is a well-established, evidence-based counseling approach that focuses on enhancing an individual's intrinsic motivation to change by exploring and resolving ambivalence. It has shown promise in areas such as smoking cessation, weight management, and medication adherence, but its application in oral health-especially among adolescents-remains underutilized.

This randomized controlled trial will enroll adolescent patients between the ages of 14 and 19 who are currently undergoing fixed orthodontic treatment. Participants will be randomly assigned to either the intervention group (receiving MI-based counseling sessions at routine orthodontic appointments) or the control group (receiving standard oral health education). The MI sessions will be brief (approximately 15-20 minutes), conducted by trained pediatric dental professionals, using a structured MI script and checklist based on established MI protocols.

The study will evaluate oral health behaviors through self-reported questionnaires and objective clinical measures, including plaque index, gingival index, and oral hygiene compliance as recorded in follow-up appointments. Secondary outcomes will include participant satisfaction, perceived autonomy in health decisions, and parental involvement in oral care.

Ethical safeguards include patient consent, parental consent, and measures to protect participant confidentiality. Given the low-risk, behavioral nature of the intervention, the study does not require a Data Monitoring Committee. All data will be monitored by the Principal Investigator and reviewed periodically by the study team to ensure fidelity and safety.

The findings from this study are expected to provide valuable insights into how motivational interviewing can be implemented effectively in clinical dental settings to improve adolescent engagement and long-term oral health outcomes.

Enrollment: 50 estimated patients

Sex: All

Ages: 14 to 19 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Adolescents aged 14-19 years
• Currently undergoing fixed orthodontic treatment with active appliances in the mouth
• Available for three study encounters over a 6-month period
• Able to read, understand, and communicate in English without the use of a translator
• Able to provide consent, and whose parent/guardian also agrees to provide consent

Exclusion criteria

• Patients with systemic diseases or conditions that may impact oral health
• Patients who are expected to complete orthodontic treatment or have appliances removed within 6 months
• Individuals requiring interpreter services for participation
• Individuals unable or unwilling to provide consent (or whose guardians cannot provide consent)
• Currently enrolled in another behavioral or oral health intervention study.
• Any condition deemed by the investigators to make the participant ineligible for safe and effective participation.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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50 participants in 2 patient groups

Motivational Interviewing Group

Experimental group

Description:

Motivational Interviewing (MI) will be conducted as the primary behavioral intervention in the study group. MI is a collaborative, patient-centered communication technique designed to enhance a patient's intrinsic motivation to adopt healthier behaviors. It involves five core processes: engaging, focusing, evoking, planning, and reviewing. These sessions aim to help patients identify their own goals and motivations related to oral hygiene and to foster a sense of autonomy and accountability. In this study, MI sessions will be delivered by a single trained dental professional who has previous formal training and experience conducting MI as part of earlier research. To maintain quality and consistency, a structured MI script and checklist based on established MI protocols will be used for each session. Sessions will take place at three different time points throughout the study period.

Treatment:

Behavioral: Motivational Interviewing-Based Counseling

Standard Oral Health Education Group

Experimental group

Description:

Participants in this group will receive the conventional oral hygiene education typically provided in orthodontic clinics. This includes verbal instructions and printed educational materials on topics such as toothbrushing technique, flossing with braces, and the importance of maintaining oral hygiene during orthodontic treatment. Education will be delivered by pediatric dental staff during scheduled orthodontic appointments at the same time points as the intervention group (baseline, 1-month, and 6-month visits). No motivational interviewing techniques will be used. This approach reflects routine care and serves as the comparator for evaluating the added value of MI.

Treatment:

Behavioral: Standard Oral Health Education