Predicting dental attendance from dental hygienists' autonomy support and patients' autonomous motivation: A randomised clinical trial.

OBJECTIVE: To test the hypothesis that a Self-Determination Theory (SDT) intervention designed to promote oral health care competence in an autonomy-supportive way would predict change in caries competence relative to standard care. Further, to test the SDT process path-model hypotheses with: (1) the intervention and individual differences in relative autonomous locus of causality (RALOC) predicting increases in caries competence, which in turn would positively predict dental attendance; (2) RALOC negatively predicting dental anxiety, which would negatively predict dental attendance; (3) RALOC and caries disease referred to the dentist after an autonomy-supportive clinical exam directly positively predicting dental attendance; and (4) the intervention moderating the link between RALOC and dental attendance. DESIGN: A randomised two-group experiment was conducted at a dental clinic with 138 patients (M(age) = 23.31 yr., SD = 3.5), with pre- and post-measures in a period of 5.5 months. RESULTS: The experimental model was supported. The SDT path model fit the data well and supported the hypotheses explaining 63% of the variance in dental attendance. CONCLUSIONS: Patients personality (RALOC) and hygienists promoting oral health care competence in an autonomy-supportive way, performance of autonomy-supportive clinical exams and reductions of anxiety for dental treatment have important practical implications for patients' dental attendance.