title: Dental hygienists' knowledge, attitudes and practice behaviors regarding caries risk assessment and management.
abstract: OBJECTIVE
  Lifelong control of disease processes associated with dental caries should be an essential part of the process of care for practicing dental hygienists. The purpose of this study was to identify the knowledge, attitudes and practice behaviors among dental hygienists regarding caries risk assessment (CRA) and management.
  
  
  METHODS
  Utilizing the American Dental Hygienists' Association (ADHA) Survey/Research Center database of all registered dental hygienists in the U.S., 2,500 actively licensed dental hygienists were randomly selected and sent a web-based survey via SurveyMonkey™. The survey included items about practice characteristics and questions regarding knowledge, attitudes and practice behaviors regarding CRA and management. Second and third emails were sent to non-respondents. A 4-point Likert type scale (1=never, 2=sometimes, 3=frequently and 4=always) was used to rate the occurrence of caries management recommendations used in the practice setting. Frequencies and percentiles were used to evaluate demographic, knowledge and attitude information.
  
  
  RESULTS
  The response rate was 9% (n=219) - 87% were ADHA members. Participants reported a high level of comfort (89%) in performing CRA, yet only 23% used an established CRA/management instrument. Over-the-counter fluoride dentifrices (70.1%), individualized oral hygiene instructions (86%) and individualized recare intervals (73.7%) were most often used as caries management recommendations, while low-dose fluoride rinses (45%) and prescription strength sodium fluoride gel or paste (42%) were used less frequently. Dental hygienists scored high on knowledge of CRA with the exception of white spot lesions as a risk factor (42%) and efficacy of chlorhexidine in caries management (61%).
  
  
  CONCLUSIONS
  There is a need to improve practicing dental hygienists' knowledge and involvement in the active management of caries. Focused training in the use of established CRA/management tools should be designed to improve their knowledge and influence practice behaviors.
authors.forename: Elena M
authors.initials: EM
authors.lastname: Francisco
authors.forename: Tara L
authors.initials: TL
authors.lastname: Johnson
authors.forename: Jacqueline J
authors.initials: JJ
authors.lastname: Freudenthal
authors.forename: Galen
authors.initials: G
authors.lastname: Louis
mesh_terms: D001291:Attitude of Health Personnel; D003731:Dental Caries; D003756:Dental Hygienists / Q000193:education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D018570:Risk Assessment
keywords: caries incidence; caries management; caries risk assessment; dental hygienists' knowledge attitudes and practices; white spot lesion