Comparing protection-motivation theory-based intervention with routine public dental health care

Tooth brushing with fluoride toothpaste has a major effect on the reduction in dental caries. However, among young children, tooth brushing requires skill and motivation from caregivers and is not widely practised. To find a more effective way to train caregivers, Protection-Motivation Theory (PMT)-based educational programmes were compared with the basic one with regard to the incremental caries rate in children, caregiver's motivation and caregiver's awareness.

In a quasi-experimental study, 9- to18-month-old children and their caregivers (N = 102) were allocated to PMT or control groups. The PMT group received PMT-based oral health education programme while the control group received public hospital's current one. Children's caries status and motivation and awareness among caregivers were measured. Mann-Whitney U test was used to find out the difference between control and test groups.

After 12 months, the PMT group showed lower dmft, dmfs and incremental caries rate compared with control. Chi-square test showed the control group was at more risk of developing additional dental caries (RR 2.23, 95% C.I.: 1.41-3.54, p < 0.001), and when early carious lesions were included (RR 2.40, 95% C.I.: 1.56-3.69, p < 0.001). In terms of motivation and awareness among caregivers, the PMT group rated their perception of disease severity and belief in self-efficacy significantly higher than the control group.

PMT-based education programmes encourage suitable motivation and awareness that changes oral healthcare behaviour of caregivers, relating to decreased incremental caries rate in infants and toddlers comparing with regular health education methods.