Dental avoidance in adolescents is associated with higher rates of caries and may continue for years if untreated. Avoidance is postulated to be the result of dental fear and negative perceptions of dental attendance, and may begin in adolescence as youth are increasingly able to influence dental attendance, compared with children. Motivational Interviewing (MI), a counseling technique particularly useful for individuals who are ambivalent about making a behavior change, has been found to be efficacious in a number of health areas, including alcohol and nicotine cessation, dietary change, exercise change, contraceptive use, safer sex practices, and others. In dentistry, to date the following effects of MI have been described: MI components successfully discriminate between those who practice desirable oral health behaviors and those who do not;MI counseling for young mothers is successful in reducing early childhood caries;dental students who learn MI counseling demonstrate differences in subsequent patient interviews;and dentally-avoidant find the MI approach to be relevant and useful. These preliminary results, together with those from research in related health areas, indicate that MI may be efficacious in ameliorating dental avoidance in adolescents. Computerized and web-based applications save dental personnel time and money, may be accessed where there is no readily-available dental or mental health professional, and have high appeal to adolescents. One complete web-based MI intervention has been developed to date, for excessive alcohol use, and has been found to significantly decrease alcohol consumption.
The specific aims of this project are to develop MI components for adolescent dental avoidance, test the efficacy of the MI intervention with dentally-avoidant adolescents, and create a software package which will permit individuals to access the complete MI package via computer or the web.
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