Global Dental Hygienists Survey on Oral-Systemic Link Knowledge and Practices
The IFDH conducted a survey in April-May 2021 to explore dental hygienists' understanding and practices regarding the connection between oral health and overall health. With 706 respondents from 23 countries, key findings include the distribution of respondents based on years of experience, work settings, educational qualifications, awareness of links between oral health and various conditions like cardiovascular diseases, diabetes, mouth cancer, and pregnancy outcomes. This survey aims to identify opportunities for future educational programs.
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IFDH Oral-Systemic Link Knowledge and Practices Survey April-May 2021
Oral-Systemic Link Survey Background Survey #4 in a series supported by Procter & Gamble Objective: To better understand global dental hygienists knowledge and practices regarding the relationship between oral health and overall health (i.e., oral-systemic link) Information used to identify opportunities for future educational programs Survey flow: IFDH 34 national associations individual members
706 respondents from 23 countries Top countries United Kingdom 40% Canada 14% South Africa 7% Finland 7% Korea 5% Portugal 4% Israel 4% United States 3% Norway 3% Countries with < 2% : Ireland, Belgium, Australia, Sweden, Malta, Singapore, Latvia, Switzerland, Italy, Netherlands, Austria, Denmark, New Zealand, United Arab Emirates
More than 25 years 40% Years of experience 16 to 25 years 22% 5 to 15 years 24% Skewed towards more years in practice Less than 5 years 14% 0% 10% 20% 30% 40% 50%
Other, please specify 5% Community / Public Health 11% Work Setting Hospital Clinic 5% Majority in private practice, general dentistry Educational Setting 6% Corporate Practice 6% Private Practice, Specialist 11% Private Practice, General Dentistry 56% 0% 10% 20% 30% 40% 50% 60%
Doctoral Degree 3% Education Master's Degree 11% Bachelor's Degree 26% 70% have a Diploma or Bachelor s Degree Associate Degree 3% Advanced Diploma 8% Diploma 44% Certificate of Competence 5% 0% 10% 20% 30% 40% 50%
Are you aware of a link between oral health and the conditions below? Are you aware of a link between oral health and the conditions below? Established link. Possible link. More studies are needed. There is no link. I'm not sure. Majority of respondents report an established link with oral health and: 0% 20% 40% 60% 80% 100% Cardiovascular diseases 90% Diabetes 92% Diabetes 92% Cardiovascular disease 90% Mouth cancer 75% Pregnancy outcomes 72% Pregnancy outcomes 72% Mouth cancer 75%
Are you aware of a link between oral health and the conditions below? Are you aware of a link between oral health and the conditions below? Established link. Possible link. More studies are needed. There is no link. I'm not sure. Less than half of respondents report an established link with oral health and: 0% 20% 40% 60% 80% 100% Alzheimer s disease (cognitive function) 42% 42% 5% 11% Rheumatoid arthritis 41% 34% 5% 20% Alzheimer s disease 42% Rheumatoid arthritis 41% COVID-19 22% Kidney disease 19% Colon cancer 12% Kidney disease 19% 33% 11% 37% COVID-19 22% 53% 10% 15% Colon cancer 12% 36% 12% 39%
How often do you perform the following activities as part of routine How often do you perform the following activities as part of routine appointments? appointments? Always/Often Sometimes Rarely/Never Common practices during routine appointments: - Review medical history - Counsel patients about link between oral health and overall health Review patients' medical history 97% 1% 2% Counsel patients with specific conditions (e.g., diabetes) about the link between their oral health and overall health including common risk factors 87% 9% 4% Counsel all patients, regardless of health status, about the link between their oral health and overall health 74% 20% 6% Take patients' blood pressure Uncommon practices: - Take blood pressure - Test blood sugar level 13% 9% 78% Test patients blood sugar level 4% 6% 91% 0% 20% 40% 60% 80% 100%
Please indicate how much you agree or disagree with each statement below. Please indicate how much you agree or disagree with each statement below. Respondents strongly agree that: Strongly agree Neither agree or disagree Strongly disagree Somewhat agree Somewhat disagree 0% 20% 40% 60% 80% 100% - Relationship exists between dental plaque, bacteria, gingival bleeding/inflammation, and overall health - Improved plaque control will reduce risk of systemic conditions Improving plaque control will reduce the Improving plaque control will reduce ... risk of several systemic whole body health conditions. 78% Dental plaque dysbiosis contributes to systemic burden and increases your risk 62% Dental plaque dysbiosis contributes t... of systemic disease. Bacteria from your mouth enter your Bacteria from your mouth enter your b... body and increase your risk of certain systemic diseases. 81% Gingival bleeding and inflammation are 70% Gingival bleeding and inflammation ar... key factors in the relationship between oral health and overall health. Effective daily home oral hygiene is - There is a need for more medical-dental interprofessional integration Effective daily home oral hygiene is ... important to reduce the risk of systemic conditions, similar to regular exercise or smoking cessation. There needs to be more integration between dental and medical professionals regarding the relationship between oral health and overall health. 87% 83% There needs to be more integration be...
Please indicate how much you agree or disagree with each statement below. Please indicate how much you agree or disagree with each statement below. Strongly agree Neither agree or disagree Strongly disagree Somewhat agree Somewhat disagree 0% 20% 40% 60% 80% 100% Most respondents strongly or somewhat agree that patients understand there s a link between plaque/periodontal disease and overall health. My patients understand that plaque control is important beyond oral health. 34% 42% 11% 9% 3% My patients proactively ask me about the connection between oral health and overall health. However, most patients are not proactively asking about it. 7% 26% 21% 29% 17% My patients understand that periodontal disease can influence their overall health. 37% 40% 9% 10% 4%
Please indicate how much you agree or disagree with each statement below. Please indicate how much you agree or disagree with each statement below. Strongly agree Neither agree or disagree Strongly disagree Somewhat agree Somewhat disagree There are opportunities to: 0% 20% 40% 60% 80% 100% - provide dental hygienists with more information on the oral- systemic link to educate patients I have all the information I need to explain the relationship between oral health and overall health to my patients. 21% 43% 16% 18% 3% - increase time dental hygienists have to counsel patients about it I don t have enough time to counsel patients about the relationship between oral health and overall health. 9% 38% 12% 20% 22% - provide more direction about how to put oral-systemic link news into practice There is a lot of news about the relationship between oral health and overall health, but there isn t clear direction about how to put it into practice. 25% 44% 13% 13% 6%
Which sources, if any, do you rely on for information about the relationship between oral health and overall health? (Check all that apply) Peer-reviewed journals (e.g., Journal of Dental Hygiene, International Journal of Dental Hygiene, 83% Top resources for information about oral-systemic link: CE/webinars 80% Professional magazines (e.g., RDH, Access, Dimensions, Oh Canada!) 63% - Peer-reviewed journals 83% - CE courses and webinars 80% - Professional magazines 63% - Colleagues 58% Information from my colleagues/peers 58% Research conferences 51% Textbooks / What I learned in school 49% Study clubs 27% Social media / Facebook groups 22% Manufacturer s professional sales rep information 18% News media (television, radio, magazine) 17% Other, please specify 3% 0% 20% 40% 60% 80% 100%
Whom do you think patients consider as their PRIMARY source of information regarding the relationship between oral health and overall health? Other, please specify 4% 60% of respondents said patients view Oral Health Professionals as primary source for oral-systemic link information Not sure 11% Medical specialist 7% Primary medical doctor 18% Oral health professionals 60% 0% 10% 20% 30% 40% 50% 60% 70%
How important are each of the following oral health practices to reduce a patient s risk for systemic diseases (e.g., cardiovascular disease, diabetes)? Extremely important Very important Somewhat important Not very important Oral health practices receiving highest extremely important rating for reducing risk for systemic diseases: 0% 20% 40% 60% 80% 100% Reducing gingival bleeding 81% Reducing gingival bleeding Regular dental prophylaxis 55% Regular dental prophylaxis Managing periodontal disease Managing periodontal disease 90% - Remove plaque regularly via toothbrushing 91% - Managing periodontal disease 90% - Interdental cleaning 82% - Reducing gingival bleeding 81% Controlling plaque regrowth with an a... Controlling plaque regrowth with an antimicrobial rinse 16% 25% Controlling plaque regrowth with an a... Controlling plaque regrowth with an antimicrobial paste 82% Interdental cleaning Interdental cleaning Removing plaque regularly via 91% Removing plaque regularly via toothbr... toothbrushing
What information is most important to you? Both 90% Disease-specific materials based on patients needs (i.e. diabetes) Dental hygienists want general and disease- specific information about oral-systemic link 5% General information (i.e. relationship of periodontal disease to systemic disease. 4% Other, please specify 1% Neither 1% 0% 20% 40% 60% 80% 100%
In what format would you prefer to receive patient education materials on the relationship between oral health and overall health? (Check all that apply) 0% 20% 40% 60% 80% Most desired format for information on oral-systemic link: -Printable material/pamphlets (71%) -Online videos (54%) -Chairside laminates (51%) Printable material / pamphlets 71% Online videos 54% Chairside laminates 51% Social media content for my practice website 36% In-office posters 34% None, I don t want materials on this topic. 2% Other 1%
Other IFDH Survey Results Click the links below to learn more about other IFDH surveys: 2021 Electric toothbrush survey 2020 Covid Survey 2019 Toothpaste Survey The IFDH thanks Procter & Gamble for supporting these surveys.
