title: The provision of oral hygiene instructions and patient motivation in a dental care system without dental hygienists.
abstract: BACKGROUND
  Oral hygiene instructions (OHI) and patient motivation (PM), often provided by dental hygienists, are essential attributes to establishing good oral health in patients. The purpose of this study was to investigate the provision of OHI and PM by dental professionals in a dental care system without dental hygienists.
  
  
  METHODS
  A questionnaire, including 22 items (demographics, OHI and PM), was presented to 1037 dental professionals (=21.6% Flemish population). Descriptive statistics were used to analyse the provision of OHI and PM. Additionally, the Fisher-Freeman-Halton exact test was used to investigate the influence of qualification (general practitioner/specialist), work experience (< or ≥ 25 years), workload (< or ≥ 30 h), location of practice (rural/urban) and chair-side assistance (with/without).
  
  
  RESULTS
  Response rate was 75%. Participants reported a single strategy for preventive care and felt their efforts were not in harmony with the results. Lack of time, remuneration and patient interest were reported as complicating factors and participants agreed on allowing assistants to provide preventive care. Significant variance was found based on qualification (12/17 items), work experience (7/17 items), workload (1/17 items), location of practice (2/17 items) and chair-side assistance (15/17 items).
  
  
  CONCLUSIONS
  In a context without dental hygienists, OHI and PM appeared non-compliant with current international guidelines. Although dental professionals were concerned with preventive dentistry, they reported barriers including lack of time, remuneration and patient compliance. Almost all participants expressed the need for delegation of in-mouth OHI, suggesting a need for dental hygienists.
authors.affiliation: Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.|Praktijk voor Parodontologie, Hasselt, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Thevissen
authors.affiliation: Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.|Department of Prosthodontics, School of Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: De Bruyn
authors.affiliation: Department of Periodontology and Oral Implantology, Dental School, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Koole
mesh_terms: D000328:Adult; D003756:Dental Hygienists; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009910:Oral Hygiene; D010349:Patient Compliance; D010353:Patient Education as Topic; D012648:Self Care; D011795:Surveys and Questionnaires
keywords: dentistry; oral hygiene instruction; patient motivation