Motivational Interviewing and Subgingival Instrumentation Outcomes in Periodontitis

Motivational Interviewing (MI) represents a patient centered counselling approach designed to facilitate behaviour change by guiding patients through the exploration and resolution of ambivalence toward positive health actions. Adapting OARS microskills (open ended questions fostering dialogue, affirmations building self-efficacy, reflective listening mirroring emotions, summarization making commitments) intertwined with the RULE framework (resisting the righting reflex, understanding personal motivations, empathic listening, empowering autonomy) helps cultivate patient's intrinsic motivation for sustained oral hygiene adherence. It effectively resolves ambivalence toward plaque control behaviours essential for periodontitis management. Grounded in MI's core spirit of equal partnership, evocation of inner values, acceptance and compassionate support, this approach fosters long term adherence to treatment. This is in contrast to oral hygiene instructions that typically employ a directive advice giving method, where clinicians provide patients with prescriptive guidance on maintaining optimal oral hygiene practices. Periodontitis staging, as defined by the 2017 World Workshop classification, delineates disease severity (Stages I-III), complexity of management, and extent of involvement, while grading (A-C) offers a prognostic indicator of the risk for future progression based on factors such as rate of advancement and responsiveness to therapy. Integrating motivational interviewing (MI) with periodontitis staging and grading creates a structured framework from diagnosis to patient centered action, enhancing adherence to stage specific treatment plans. This study seeks to investigate the influence of MI on Clinical outcomes, Patient motivation, Patient related outcomes and Patient's Self-efficacy in oral hygiene following subgingival instrumentation among patients stratified by periodontitis stage. By doing so, it aims to explore the potential of behavior change interventions to yield not only clinical improvements but also broader health benefits in the management of periodontitis.