***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES This pragmatic r and omized trial evaluated the effectiveness of a tailored educational intervention on oral health behaviors and new untreated carious lesions in low-income African-American children in Detroit , Michigan . METHODS Participating families were recruited in a longitudinal study of the determinants of dental caries in 1021 r and omly selected children ( 0 - 5 years ) and their caregivers . The families were examined at baseline in 2002 - 2004 ( Wave I ) , 2004 - 2005 ( Wave II ) and 2007 ( Wave III ) . Prior to Wave II , the families were r and omized into two educational groups . An interviewer trained in applying motivational interviewing principles ( MI ) review ed the dental examination findings with caregivers assigned to the intervention group ( MI + DVD ) and engaged the caregiver in a dialogue on the importance of and potential actions for improving the child 's oral health . The interviewer and caregiver watched a special 15-minute DVD developed specifically for this project based on data collected at Wave I and focused on how the caregivers can ' keep their children free from tooth decay ' . After the MI session , the caregivers developed their own preventive goals . Some families in this group chose not to develop goals and were offered the project-developed goals . The goals , if defined , were printed on glossy paper that included the child 's photograph . Families in the second group ( DVD-only ) were met by an interviewer , shown the DVD , and provided with the project 's recommended goals . Both groups of families received a copy of the DVD . Families in the MI + DVD group received booster calls within 6 months of the intervention . Both caregivers and the children were interviewed and examined after approximately 2 years ( Wave III : 2007 ) . RESULTS After 6-month of follow-up , caregivers receiving MI + DVD were more likely to report checking the child for ' precavities ' and making sure the child brushes at bedtime . Evaluation of the final outcomes approximately 2 years later found that caregivers receiving the MI + DVD were still more likely to report making sure the child brushed at bedtime , yet were no more likely to make sure the child brushed twice per day . Despite differences in one of the reported behaviors , children whose caregivers received the motivational intervention did not have fewer new untreated lesions at the final evaluation . CONCLUSIONS This study found that a single motivational interviewing intervention may change some reported oral health behaviors , it failed to reduce the number of new untreated carious lesions This cluster-r and omized pragmatic ( effectiveness ) trial tested maternal counseling based on Motivational Interviewing ( MI ) as an approach to control caries in indigenous children . Nine Cree communities in Quebec , Canada were r and omly allocated to test or control . MI-style counseling was delivered in test communities to mothers during pregnancy and at well-baby visits . Data on outcomes were collected when children were 30 months old . Two hundred seventy-two mothers were recruited from the 5 test and 4 control communities . Baseline characteristics were comparable but not equivalent for both groups . At trial ’s end , 241 children had follow-up . The primary analysis outcome was enamel caries with substance loss ( d2 ) ; no statistically significant treatment effect was detected . Prevalence of treated and untreated caries at the d2 level was 76 % in controls vs. 65 % in test ( p = 0.17 ) . Exploratory analyses suggested a substantial preventive effect for untreated decay at or beyond the level of the dentin , d3 ( prevalences : 60 % controls vs. 35 % test ) , and a particularly large treatment effect when mothers had 4 or more MI-style sessions . Overall , these results provide preliminary evidence that , for these young , indigenous children , an MI-style intervention has an impact on severity of caries ( clinical trial registration IS RCT N41467632 ) The purpose of the present study was to investigate the frequency of smoking cessation and the use of proximal tooth cleaning routines after a nonsurgical periodontal treatment phase in a Specialist clinic of Periodontology and to evaluate if these behaviour changes had any influence on the periodontal healing results . The investigation was conducted as a retrospective longitudinal study on a r and omly selected population of 100 patients referred for periodontal treatment . The variables were registered from the dental records and the radiographs . Forty-six individuals declared that they were smokers at baseline and one individual of those quitted smoking during the nonsurgical treatment period . The percentage of individuals who performed proximal tooth cleaning daily  was significantly increased from 56 % to 72 % during the treatment period . The patients practising proximal tooth cleaning daily had significantly lower Plaque index before as well as after the nonsurgical periodontal treatment phase compared to those without the routine . The subjects who did not perform tooth cleaning daily before the treatment and who did not introduce this routine had significantly deeper periodontal pockets compared to those who performed inter-dental cleaning daily before treatment or who had adopted the routine during the treatment phase . However , there were no significant differences according to number of deepened periodontal pockets after nonsurgical treatment irrespective of proximal cleaning routines . In the future , motivational interviewing may be a more effective method to achieve a behaviour change if an extended education of dental hygienists within this area will be implemented AIM To develop and test the methodology of an intervention to reduce avoidance of dental care among adolescents , and to measure the respondents ' beliefs regarding the intervention ( credibility and cognitions ) . METHODS Based on a group comparison design a sample of 18 year olds ( n=50 ) with dental non-attendance behaviour was r and omly selected to three experimental and one control group . Subjects were surveyed with one baseline question naire and one post-intervention question naire , to evaluate their beliefs regarding the program . Two different instruments were tested : 1 ) cards representing different statements related to previous dental experiences , possible reasons for attending ( pros ) and not attending ( cons ) dental appointments , and preferences for future treatment . Cards were selected based on individual priority ; 2 ) a brief , structured telephone interview based on Motivational Interviewing . The instruments were tested separately ( groups I and II ) and in combination ( group III ) . Subjects in the control group ( group IV ) were given conventional health education . RESULTS Subjects in the experimental groups had significantly higher credibility scores to the statement " How much easier do you perceive dental treatment to be for you , based on this program " , compared with the control group ( p<0.05 ) . They had also more positive beliefs to the statement " I think the interviewer liked to talk to me " ( p<0.05 ) than controls . CONCLUSION A question naire sent to non-attending adolescents followed by a brief telephone call based on Motivational Interviewing appears to be a credible intervention for adolescents avoiding dental care OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity AIM Because patient adherence to oral hygiene is essential for periodontal treatment success , the aim of the study was to assess whether a motivational interview addressing the five dimensions of Leventhal 's theory performed better than conventional basic instruction on improving compliance with plaque control among patients with periodontitis . MATERIAL S AND METHODS A r and omized controlled clinical trial design was used in which a group of patients underwent a motivational interview in addition to classical consultation . A control group received only the st and ard consultation . The O'Leary Plaque Index was used to judge the oral hygiene at baseline and at 1 month follow-up . Patient satisfaction with the dental visit was scored using a specific question naire . RESULTS At baseline , the mean full mouth plaque score varied between 55 % ( experimental group ) and 58 % ( control group ) . Patients in the experimental group had a higher oral hygiene improvement ( 21 ± 20 % versus 4 ± 5 % , p < 0.001 ) 1 month post-treatment . The motivational interview result ed in greater satisfaction scores compared with those of patients in the control group : 10.55 ± 1.53 versus 8.82 ± 2.40 , p = 0.014 . CONCLUSIONS This new concept of motivational interview is a promising approach and can be useful for counselling-related periodontal disorders PURPOSE The purpose s of this r and omized controlled trial were to : ( 1 ) test motivational interviewing ( MI ) to prevent early childhood caries ; and ( 2 ) use Poisson regression for data analysis . METHODS A total of 240 South Asian children 6 to 18 months old were enrolled and r and omly assigned to either the MI or control condition .  Children had a dental exam , and their mothers completed pretested instruments at baseline and 1 and 2 years postintervention . Other covariates that might explain outcomes over and above treatment differences were modeled using Poisson regression . Hazard ratios were produced . RESULTS Analyses included all participants whenever possible . Poisson regression supported a protective effect of MI ( hazard ratio [HR]=0.54 (95%CI=035 - 0.84)-that is , the M/ group had about a 46 % lower rate of dmfs at 2 years than did control children . Similar treatment effect estimates were obtained from models that included , as alternative outcomes , ds , dms , and dmfs , including " white spot lesions . " Exploratory analyses revealed that rates of dmfs were higher in children whose mothers had : ( 1 ) prechewed their food ; ( 2 ) been raised in a rural environment ; and ( 3 ) a higher family income ( P<.05 ) . CONCLUSIONS A motivational interviewing-style intervention shows promise to promote preventive behaviors in mothers of young children at high risk for caries BACKGROUND The purpose of this study was to compare the effect of a motivational interviewing ( MI ) counseling visit with traditional health education for mothers of young children at high risk of developing dental caries . METHODS The authors enrolled 240 infants aged 6 to 18 months and their mothers in the study and r and omly assigned them to  MI or traditional health education ( control ) groups . Mothers in the control group received a pamphlet and watched a videotape . Those in the MI group received the pamphlet and watched the videotape , as well as received an MI counseling session and six follow-up telephone calls during the first year . There were no interventions in year 2 . RESULTS After two years , children in the MI group exhibited significantly less new caries ( decayed or filled surfaces ) than those in the control group ( that is , a protective effect of MI ) ( odds ratio = 0.35 , 95 percent confidence interval = 0.15 to 0.83 ) . CONCLUSIONS MI is a promising approach that warrants further attention in a variety of dental context s. CLINICAL IMPLICATION S The results of this study show that MI has a protective effect with regard to the development of early childhood caries . One reason for this clinical effect is greater compliance with recommended fluoride varnish treatment regimens in families who received MI counseling compared with families who received traditional education More knowledge is needed regarding what works to prevent oral health problems and reduce disparities in oral health . Motivational interviewing ( MI ) has demonstrated utility for improving health behavior , including among those with severe mental illness . This study tests whether MI enhances the efficacy of an oral health education intervention in individuals with severe mental illness . Sixty individuals were r and omly assigned to MI plus oral health education or oral health education alone .  Plaque scores , oral health knowledge , and self-regulation were assessed at baseline and at 4 and 8 weeks . Repeated- measures ANOVA showed improvement ( p < 0.05 ) in plaque , autonomous regulation , and oral health knowledge across time for both groups ; however , individuals receiving MI improved significantly more when compared with those receiving oral health education 
    Output:
    
Better quality of evidence was provided by studies that investigated dental caries , which also had the largest population sample s. The evidence of the effect of MI  on improving oral health outcomes is conflicting .
We found inconclusive effectiveness for most oral health outcomes .