Child dental caries is a serious problem in rural areas and is associated with avoidance.
The aim of this research is to evaluate the effectiveness of a Motivational Interviewing (MI) intervention in reducing the avoidance of rural adolescents. A preliminary study using a retrospective case-control design was implemented to identify risk factors that discriminate between avoidant and non-avoidant adolescents from rural families. The results pointed to a set of interrelated factors: parental behaviors and beliefs appear to impact adolescent behaviors and beliefs. Negative beliefs, fear, feelings of lack of control and denial of benefits of treatment were identified as related to avoidance. The subjects in this study will be 200 students aged 12-18 who will be screened from 3680 children from 6 participating schools in Lewis County, Washington. Subjects will have DMFT>=3 and one or more tooth with World Health Organization (WHO, 1979) code 3 (dentin caries to a level of fracturing of surrounding enamel undermined by carious dentin) or code 4 (deep cavity with probable pulp involvement. A randomized clinical trial with an experimental and control condition will be employed. Two groups will be studied. An integrated MI counseling intervention that takes individual resistance into account will be compared to a control condition, traditional health education. The time spent in each condition will be the same. The primary endpoint for this study is completion of a dental visit within a six-month period after the intervention.
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