Behavioral change in a primary care provider can reduce a child’s risk of caries, yet changing behavior is difficult.  Education of a parent or care provider is the first and necessary step toward behavioral change, but by itself it is not sufficient.  There are many theoretical models that demonstrate why changing behavior is difficult.  One barrier to change is the communication style, effectiveness, and cultural awareness of the health care provider with the patient. 

In the past few years a technique, motivational interviewing (MI) has been studied to enhance communication and subsequently behavioral change in medicine and dentistry.  With this approach the health care provider uses an empathic, collaborative style to elicit and build on the patient’s own reasons for change.  The core of MI is that intrinsic motivation is strengthened by discussing how change is consistent with the patient’s own values and goals.  Patients also are given the autonomy to make their own decisions about change, which has been shown to increase commitment to change.  Studies showing behavioral change of mothers by MI techniques shows promise in reducing dental caries in their offspring.